The Westminster Confession: unfinished business

In an extended study, Dr Macdonald gives an historical account of the changing status of the Westminster Confession of Faith in the Scottish Reformed churches. He focuses in particular on the debate within the Church of Scotland about what place a seventeenth-century statement of faith should have in a modern church, and whether the Westminster Confession should continue to be considered the Kirk’s ‘principal subordinate standard’ or simply a ‘historic statement of the faith of the Reformed Church’. In examining the issues and the work that went into formulating potential ways forward on this, Dr Macdonald shares useful insights as to the purpose and value of confessions and statements of faith. He concludes by suggesting that the status of the Westminster Confession is an issue the Church of Scotland would do well to return to.Publisher PD

The Westminster Confession: Unfinished business

In an extended study, Dr Macdonald gives an historical account of the changing status of the Westminster Confession of Faith in the Scottish Reformed churches. He focuses in particular on the debate within the Church of Scotland about what place a seventeenth-century statement of faith should have in a modern church, and whether the Westminster Confession should continue to be considered the Kirk’s ‘principal subordinate standard’ or simply a ‘historic statement of the faith of the Reformed Church’. In examining the issues and the work that went into formulating potential ways forward on this, Dr Macdonald shares useful insights as to the purpose and value of confessions and statements of faith. He concludes by suggesting that the status of the Westminster Confession is an issue the Church of Scotland would do well to return to.Note: This paper was originally published in Theology in Scotland vol. 23, no. 2 (2016)&nbsp

Understanding our present – anticipating our future

After a brief history by way of background, Finlay Macdonald invites us to view current issues in the Church of Scotland in the context of, and in continuity with, issues from its past. He argues that structures and institutions manifest a continuity of principle or tradition which is evidenced in the recurrence of certain key issues, the church-state relation for example. He also offers a finely-crafted discussion on issues of contemporary significance for the Church and the relation of these to the still discernible principles which underlie them

Heart failure in young adults is associated with high mortality: a contemporary population-level analysis

Background: Data on young patients with heart failure (HF) are sparse. We examined the characteristics, healthcare utilization and survival of younger versus older patients with HF. Methods: Analysis of linked administrative databases in Alberta, Canada. 34,548 patients with first hospitalization for HF as principal diagnosis were identified from 2002 to 2014. Patients were stratified into four age groups: 20-44, 45-54, 55-64, and ≥65 years. Results: Of the 34548 patients, 496 (1.4%), 1319 (3.8%), 3359 (9.7%) and 29374 (85%) patients were aged 20-44, 45-54, 55-64 and ≥65 years, respectively. Incidence of HF hospitalization decreased over time among patients ≥65 years, and increased among men aged 20 – 64 years. In the year following the index HF hospitalization, younger compared to older patients were less likely to present to the emergency department (ED) (e.g. 67.2% of those aged 20-44 years vs. 74.8% of those aged ≥65 years) or be hospitalized: for any reason (48.5% vs. 61.2%), cardiovascular causes (28.6% vs. 34.4%), or HF (14.8% vs. 23.6%). Mortality rates were lower in younger patients aged 20-44 years, but still substantial: 3.9%, 12.4%, and 27.7% at 30 days, 1 year, and 5 years respectively. Conclusions: Although young patients, especially those <45 years of age, accounted for a small proportion of the total population, adverse events were frequent, with half of the younger patients being readmitted, two thirds presenting to an ED, and over 10% dying within a year

Impedance spectroscopy of epitaxial multiferroic thin films

Temperature dependent impedance spectroscopy enables the many contributions to the dielectric and resistive properties of condensed matter to be deconvoluted and characterized separately. We have achieved this for multiferroic epitaxial thin films of BiFeO3 (BFO) and BiMnO3 (BMO), key examples of materials with strong magneto-electric coupling. We demonstrate that the true film capacitance of the epitaxial layers is similar to that of the electrode interface, making analysis of capacitance as a function of film thickness necessary to achieve deconvolution. We modeled non-Debye impedance response using Gaussian distributions of relaxation times and reveal that conventional resistivity measurements on multiferroic layers may be dominated by interface effects. Thermally activated charge transport models yielded activation energies of 0.60 eV +- 0.05 eV (BFO) and 0.25 eV +- 0.03 eV (BMO), which is consistent with conduction dominated by oxygen vacancies (BFO) and electron hopping (BMO). The intrinsic film dielectric constants were determined to be 320 +- 75 (BFO) and 450 +- 100 (BMO)

Regulation of the host immune system by helminth parasites

Helminth parasite infections are associated with a battery of immunomodulatory mechanisms, which impact all facets of the host immune response to ensure their persistence within the host. This broad-spectrum modulation of host immunity has intended and unintended consequences, both advantageous and disadvantageous. Thus the host may benefit from suppression of collateral damage during parasite infection, and from reduced allergic, autoimmune and inflammatory reactions. However, helminth infection can also be detrimental in reducing vaccine responses, increasing susceptibility to co-infection, and potentially reducing tumor immunosurveillance. In this review we will summarize the panoply of immunomodulatory mechanisms used by helminths, their potential utility in human disease, and prospective areas of future research

PDK1 regulation of mTOR and hypoxia-inducible factor 1 integrate metabolism and migration of CD8+ T cells.

mTORC1 (mammalian target of rapamycin complex 1) controls transcriptional programs that determine CD8+ cytolytic T cell (CTL) fate. In some cell systems, mTORC1 couples phosphatidylinositol-3 kinase (PI3K) and Akt to the control of glucose uptake and glycolysis. However, PI3K-Akt-independent mechanisms control glucose metabolism in CD8+ T cells, and the role of mTORC1 has not been explored. The present study now demonstrates that mTORC1 activity in CD8+ T cells is not dependent on PI3K or Akt but is critical to sustain glucose uptake and glycolysis in CD8+ T cells. We also show that PI3K- and Akt-independent pathways mediated by mTORC1 regulate the expression of HIF1 (hypoxia-inducible factor 1) transcription factor complex. This mTORC1-HIF1 pathway is required to sustain glucose metabolism and glycolysis in effector CTLs and strikingly functions to couple mTORC1 to a diverse transcriptional program that controls expression of glucose transporters, multiple rate-limiting glycolytic enzymes, cytolytic effector molecules, and essential chemokine and adhesion receptors that regulate T cell trafficking. These data reveal a fundamental mechanism linking nutrient and oxygen sensing to transcriptional control of CD8+ T cell differentiation

A Pilot study of the Sharing Risk Information Tool (ShaRIT) for Families with Hereditary Breast and Ovarian Cancer Syndrome

<p>Abstract</p> <p>Background</p> <p>Individuals who carry deleterious BRCA mutations face significantly elevated risks of breast, ovarian, and other cancers. These individuals are also responsible for informing relatives of their increased risk for carrying the family BRCA mutation. Few interventions have been developed to facilitate this family communication process.</p> <p>Methods</p> <p>We developed the Sharing Risk Information Tool (ShaRIT), a personalized educational intervention, to support BRCA carriers as they discuss BRCA positive results and their implications with relatives. We conducted a pilot study of 19 BRCA carriers identified through the University of California San Francisco Cancer Risk Program. Our study had two aims: 1) to assess the feasibility and acceptability of ShaRIT, and 2) describe characteristics associated with increased family communication and BRCA testing. Participants in our study were divided into two groups: those who had not received ShaRIT as part of their genetic counseling protocol (control group, n = 10) and those who received ShaRIT (n = 9).</p> <p>Results</p> <p>All 9 women who received ShaRIT reported that it was a useful resource. Characteristics associated with increased sharing and testing included: female gender, degree of relationship, and frequency of communication. Increased pedigree knowledge showed a trend toward higher rates of sharing.</p> <p>Conclusions</p> <p>Both participants and genetic counselors considered ShaRIT a well-received, comprehensive tool for disseminating individual risk information and clinical care guidelines to Hereditary Breast and Ovarian Cancer Syndrome families. Because of this, ShaRIT has been incorporated as standard of care at our institution. In the future we hope to evaluate the effects of ShaRIT on family communication and family testing in larger populations of BRCA positive families.</p

Cancer worry among Norwegian male BRCA1/2 mutation carriers

This qualitative study explored the experiences of Norwegian men after being identified as BRCA 1/2 mutation-positive. Only limited knowledge is available on this topic; therefore, the aim of this study was to gain a deeper insight from the men’s own perspectives. Data were collected from in-depth interviews with 15 men and seven of their partners. The participants described fear of cancer development, and two main narrative patterns were identified: fear for their own health, including fear of developing cancer, and negative feelings about responsibility for others’ health. The men expressed fear of developing cancer themselves and described a need for genetic risk information. They were also deeply concerned about how the mutation might affect their children and other relatives. There is a need for guidelines concerning genetic risk information and follow-up programs for male BRCA 1/2 mutation carriers. This study adds valuable contextual insights into their experiences of living with fear of cancer