The role and influence of "Champions" in a community-based lifestyle risk modification programme

This article describes the training and implementation of the Waist Disposal Challenge in service clubs in Western Australia in 2009–2010. Ninety-three Champions from 52 clubs were trained to deliver educational presentations to 1100 peers and facilitate a BMI competition among 764 peers. Champions reported significant improvements in their knowledge and confidence to motivate their peers to make changes to their diet and physical activity with 82% of participants completing the BMI competition and on average 58% experiencing and sustaining a BMI reduction for 12 months. It is evident that the Champions had influenced the uptake and success of the intervention

Product Service System Innovation in the Smart City

Product service systems (PSS) may usefully form part of the mix of innovations necessary to move society toward more sustainable futures. However, despite such potential, PSS implementation is highly uneven and limited. Drawing on an alternate socio-technical perspective of innovation, this paper provides fresh insights, on among other things the role of context in PSS innovation, to address this issue. Case study research is presented focusing on a use orientated PSS in an urban environment: the Copenhagen city bike scheme. The paper shows that PSS innovation is a situated complex process, shaped by actors and knowledge from other locales. It argues that further research is needed to investigate how actors interests shape PSS innovation. It recommends that institutional spaces should be provided in governance landscapes associated with urban environments to enable legitimate PSS concepts to co-evolve in light of locally articulated sustainability principles and priorities

Effects of elasticity and pressure-sensitive yielding on plane-stress crack-tip fields

The asymptotic plane-stress mode I crack-tip fields under small-scale yielding for pressure-sensitive materials are investigated. The yield criterion for these materials is described by a linear combination of the effective stress and the hydrostatic stress. Plastic dilatancy is introduced by normality flow rule. A closed-form general asymptotic solution for singular centered fan sectors is given as a function of [mu], which is a pressure sensitivity parameter introduced in the yield condition. When elastic-perfectly plastic behavior is considered, the finite element results show the existence of elastic sectors bordering the stress-free crack faces. The near-tip stresses of the finite element results agree well with those of the corresponding asymptotic analysis. The angular spans of the elastic and plastic sectors vary with the value of [mu]. The parameter [mu] also has significant effects on the sizes and shapes of the plastic zones. The contribution of hydrostatic stress in the yield criterion for this class of pressure-sensitive materials extends the boundary of the plastic zone much farther in front of the crack-tip than that for incompressible Mises materials.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30958/1/0000630.pd

Key features of palliative care service delivery to Indigenous peoples in Australia, New Zealand, Canada and the United States: A comprehensive review

Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern. Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples’ preferences, needs, opportunities and barriers to palliative care. Methods: A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards and related to palliative care service delivery for Indigenous populations; papers could use quantitative or qualitative approaches. Common themes were identified using thematic synthesis. Studies were evaluated using Daly’s hierarchy of evidence-for-practice in qualitative research. Results: Of 522 articles screened, 39 were eligible for inclusion. Despite diversity in Indigenous peoples’ experiences across countries, some commonalities were noted in the preferences for palliative care of Indigenous people: to die close to or at home; involvement of family; and the integration of cultural practices. Barriers identified included inaccessibility, affordability, lack of awareness of services, perceptions of palliative care, and inappropriate services. Identified models attempted to address these gaps by adopting the following strategies: community engagement and ownership; flexibility in approach; continuing education and training; a whole-of-service approach; and local partnerships among multiple agencies. Better engagement with Indigenous clients, an increase in number of palliative care patients, improved outcomes, and understanding about palliative care by patients and their families were identified as positive achievements. Conclusions: The results provide a comprehensive overview of identified effective practices with regards to palliative care delivered to Indigenous populations to guide future program developments in this field. Further research is required to explore the palliative care needs and experiences of Indigenous people living in urban areas

Autophagy Regulates the Liver Clock and Glucose Metabolism by Degrading CRY1

The circadian clock coordinates behavioral and circadian cues with availability and utilization of nutrients. Proteasomal degradation of clock repressors, such as cryptochrome (CRY) 1, maintains periodicity. Whether macroautophagy, a quality control pathway, degrades circadian proteins remains unknown. Here we show that circadian proteins BMAL1, CLOCK, REV-ERB alpha, and CRY1 are lysosomal targets, and that macroautophagy affects the circadian clock by selectively degrading CRY1. Autophagic degradation of CRY1, an inhibitor of gluconeogenesis, occurs in a diurnal window when rodents rely on gluconeogenesis, suggesting that CRY1 degradation is timeimprinted to maintenance of blood glucose. High-fat feeding accelerates autophagic CRY1 degradation and contributes to obesity-associated hyperglycemia. CRY1 contains several light chain 3 (LC3)-interacting region (LIR) motifs, which facilitate the interaction of cargo proteins with the autophagosome marker LC3. Using mutational analyses, we identified two distinct LIRs on CRY1 that exert circadian glycemic control by regulating CRY1 degradation, revealing LIRs as potential targets for controlling hyperglycemia.Peer reviewe

Is dignity therapy feasible to enhance the end of life experience for people with motor neurone disease and their family carers?

Background: Development of interventions that address psychosocial and existential distress in people with motor neurone disease (MND) or that alleviate caregiver burden in MND family carers have often been suggested in the research literature. Dignity therapy, which was developed to reduce psychosocial and existential distress at the end of life, has been shown to benefit people dying of cancer and their families. These results may not be transferable to people with MND. The objectives of this study are to assess the feasibility, acceptability and potential effectiveness of dignity therapy to enhance the end of life experience for people with motor neurone disease and their family carers. Methods/design: This is a cross-sectional study utilizing a single treatment group and a pre/post test design. The study population will comprise fifty people diagnosed with MND and their nominated family carers. Primarily quantitative outcomes will be gathered through measures assessed at baseline and at approximately one week after the intervention. Outcomes for participants include hopefulness, spirituality and dignity. Outcomes for family carers include perceived caregiver burden, hopefulness and anxiety/depression. Feedback and satisfaction with the intervention will be gathered through a questionnaire. Discussion: This detailed research will explore if dignity therapy has the potential to enhance the end of life experience for people with MND and their family carers, and fill a gap for professionals who are called on to address the spiritual, existential and psychosocial needs of their MND patients and families

The support needs of terminally ill people living alone at home: a narrative review

Context: The number of terminally ill people who live alone at home and without a caregiver is growing and exerting pressure on the stretched resources of home-based palliative care services. Objectives: We aimed to highlight the unmet support needs of terminally ill people who live alone at home and have no primary caregiver and identify specific models of care that have been used to address these gaps. Methods: We conducted a narrative review of empirical research published in peer-reviewed journals in English using a systematic approach, searching databases 2002–2013. This review identified 547 abstracts as being potentially relevant. Of these, 95 were retrieved and assessed, with 37 studies finally reviewed. Results: Majority of the studies highlighted the reduced likelihood of this group to be cared for and die at home and the experiences of more psychosocial distress and more hospital admissions than people with a primary caregiver. Few studies reported on the development of models of care but showed that the challenges faced by this group may be mitigated by interventions tailored to meet their specific needs. Conclusion: This is the first review to highlight the growing challenges facing community palliative care services in supporting the increasing number of people living alone who require care. There is a need for more studies to examine the effectiveness of informal support networks and suitable models of care and to provide directions that will inform service planning for this growing and challenging group

El proyecto genómico del hongo Ophiostoma

The Canadian Ophiostoma Genome Project, which was initiated in 2001, is a collaborative effort between research teams in four different universities. Its general objective is to conduct a large-scale identification and analysis of genes controlling important aspects of the life cycle of Ophiostomatoid fungi. To this end, several expressed sequence tag (EST) libraries were obtained for the Dutch elm disease pathogen Ophiostoma novo-ulmi and the sapstainer O. piceae, following partial, single-pass automated sequencing of complementary DNA clones. The largest EST library, prepared from yeast like cells of O. novo-ulmi grown at 24 °C, contains over 3,400 readable sequences and serves as a general reference library for Ophiostomatoid fungi. Smaller, specific EST libraries were constructed from mycelia of O. novo-ulmi grown at suboptimal temperatures, from perithecia formed in laboratory crosses, as well as from O. piceae grown on different carbon sources. Ongoing bioinformatic searches in public databases have so far identified over 750 Ophiostoma unique ESTs which show significant homology with other fungal genes of known function, although a high proportion of Ophiostoma ESTs are either orphans (no match to any known gene) or show homology to genes of unknown function. In addition to EST analysis, differential expression of selected genes and structural genomics are also being studied.El programa canadiense sobre el genoma de Ophiostoma, iniciado en 2001, es una colaboración entre equipos de investigación de cuatro universidades diferentes. Su objetivo general es el desarrollo de la identificación y análisis a gran escala de los genes que controlan algunos aspectos importantes del ciclo vital de los hongos de Ophiostoma. Con este fin, se ha obtenido diversas bibliotecas de marcadores de secuencias expresadas (bibliotecas EST) para la el patógeno de la grafiosis Ophiostoma novo-ulmi y para el hongo de tinción vascular O. piceae, seguido de una secuenciación automática parcial de un único paso de clones complementarios de ADN. La mayor biblioteca EST, preparada a partir de conidios de O. novo-ulmi cultivadas a 24 ºC, contiene más de 3.400 secuencias legíbles, y sirve como biblioteca de referencia para los hongos de Ophiostoma. Se han desarrollado bibliotecas específicas menores a partir de micelios de O. novo-ulmi cultivados a temperaturas sub-óptimas, a partir de los peritecios formados en cruces realizados en laboratorio, así como a partir de O. piceae cultivado en distintas fuentes de carbón. Las búsquedas bioinformáticas en bases de datos públicas han permitido identificar hasta ahora más de 750 EST exclusivos de Ophiostoma, lo que muestra una significativa homología con otros genes fúngicos de función conocida, aunque una alta proporción de los EST de Ophiostoma son o bien huérfanos (no relacionados con ningún gen conocido), o bien muestran homología con genes cuya función es desconocida. Además del análisis EST, la expresión diferencial de genes seleccionados y la estructura genómica están siendo también estudiadas