An evaluation of the Department of Health’s Health and Social Care Volunteering Fund

The Health and Social Care Volunteering Fund (HSCVF) is an innovative programme that was established in 2009 by the Department of Health (DH) to build organisational and community capacity for volunteering through a national and local grant scheme. The HSCVF has offered both funds and tailored support to health and social care projects delivered by Voluntary, Community and Social Enterprise (VCSE) organisations. The HSCVF is managed by a partnership led by Ecorys and with expertise from leading national voluntary sector organisations: Attend, Community Service Volunteers (CSV) and Primetimers. To date the HSCVF has funded a total of 157 local and national projects, of which 114 are currently live. This report presents findings from an evaluation of the HSCVF with a specific focus on the 2010/2011 national and local projects, conducted by a team from the Institute for Health & Wellbeing at Leeds Metropolitan University. It presents evidence on the extent to which, how and in what ways the HSCVF programme has built organisational and community capacity across the national and local HSCVF projects, as well as on the health and social outcomes that resulted

Volume-Based Care among Young Women Diagnosed with Uterine Cancer

Purpose. To characterize volume-based care of uterine cancer among women aged ≤50 years. Methods. The Maryland Health Service Cost Review Commission database was accessed for uterine cancer surgical cases from 1994 to 2005. Cross-tabulations and logistic regression models were used to evaluate for significant associations among volume-based care and other variables comparing women ≤50 years with those aged >50 years. Results. Women ≤50 years comprised 13.6% of the cases. Women ≤50 years were less likely to be managed by high-volume surgeons (31.6% versus 35.1%, P = 0.02). For women ≤50 years, there was a trend toward management at low-volume hospitals (52.0% versus 54.0%, P = 0.22). No deaths were reported among the group of women ≤50 years treated by high-volume providers or at high-volume centers. Women ≤50 years managed by high-volume surgeons had longer length of stay (P < 0.001) and higher adjusted cost of hospital-related care (P < 0.00). Women ≤50 years managed at high-volume centers had higher adjusted cost of hospital-related care (P = 0.01). Conclusion. Primary surgical care of young women with uterine cancer is often performed by low-volume providers

Cardiocirculatory intraoperative assessment during single-shot caudal anaesthesia in children: comparison between levobupivacaine and ropivacaine

BACKGROUND: Caudal block with levobupivacaine or ropivacaine is the most commonly used regional anaesthesia in children. METHODS: The aim of study was to compare the cardiocirculatory profile induced in two matched groups of young patients, submitted to caudal anaesthesia with levobupivacaine or ropivacaine for an elective subumbilical surgery. Sixty children were enrolled: thirty received levopubivacaine 0.25% and thirty ropivacaine 0.2%. Intraoperative heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) were monitored at following times: Ta0 (after anaesthesia induction), Tal (after caudal anaesthesia), Ta2 (five minutes later), Ta3 (ten minutes later), Ts1 (at surgical incision), Ts2, Ts3, Ts4, Ts5 (every 10 minutes during surgery), Taw (at the awakening). RESULTS: In both groups the cardiocirculatory trend remained within normal ranges at all times considered, demonstrating the safety of the method with both drugs. Both groups showed a similar trend at the different monitoring times: low decrease in HR, SBP and DBP after caudal block, slight increase in parameters after skin incision, slight decrease during surgery, increase at awakening. Regarding SBP and DBP, the levobupivacaine group children generally showed higher levels compared to the ropivacaine group, especially for DBP. CONCLUSIONS: Paediatric caudal anaesthesia is an effective method with an very infrequent complication rate. Possible hypotheses for differing haemodynamic behaviour could include a stronger vasoconstriction reflex of innervated areas during caudal anaesthesia with levobupivacaine and a lower levobupivacaine induced block of the sympathetic fibers, related to different pharmacokinetic profile of low concentrations of the local anaesthetics used in paediatric epidural space

Feedback between high-pressure genesis of abiotic methane and strain localization in subducted carbonate rocks

AbstractFluid-rock interactions exert key control over rock rheology and strain localization. Redox may significantly affect the reaction pathways and, thereby, the mechanical properties of the rock. This effect may become critical in volatile-rich, redox sensitive rocks such as carbonate-rich lithologies, the breakdown of which can significantly modify the net volume change of fluid-mediated reactions. Subduction focus the largest recycling of crustal carbonates and the most intense seismic activity on Earth. Nevertheless, the feedbacks between deep carbon mobilization and deformation remain poorly investigated. We present quantitative microstructural results from natural samples and thermodynamic modeling indicating that percolation of reducing fluids exerts strong control on the mobilization of carbon and on strain localization in subducted carbonate rocks. Fluid-mediated carbonate reduction progressed from discrete domains unaffected by ductile deformation into localized shear zones deforming via diffusion creep, dissolution-precipitation creep and grain boundary sliding. Grain-size reduction and creep cavitation along localized shear zones enhanced fluid-carbonate interactions and fluid channelization. These results indicate that reduction of carbonate rocks can exert an important positive feedback on strain localization and fluid channelization, with potential implications on seismic activity and transport of deep hydrocarbon-bearing fluids.</jats:p

Protracted shearing at mid‐crustal conditions during large‐scale thrusting in the Scandinavian Caledonides

During continental collision, large tracts of crust are mobilised along major shear zones. The metamorphic conditions at which these zones operate, the duration of thrusting, and the deformation processes that facilitated hundreds of km of tectonic transport are still unclear. In the Scandinavian Caledonides, the Lower Seve Nappe displays a main mylonitic foliation with thickness of ~1 km. This foliation is overprinted by a brittle‐to‐ductile deformation pattern localized in C and C’‐type shear bands proximal to the tectonic contact with the underlying Särv Nappe. Thermobarometry of amphibolites and micaschists suggest a first high‐pressure stage at 400‐500°C and 1‐1.3 GPa recorded in mineral relics. The main mylonitic foliation developed under epidote amphibolite facies conditions along the retrograde path from 600°C and 1 GPa to 500°C and 0.5 GPa. Age dating of synkinematic titanite grains in the amphibolites indicates that this mylonitic fabric formed at around 417 ± 9 Ma, but older ages spanning 460‐430 Ma could represent earlier stages of mylonitization. The shear bands developed at lower metamorphic conditions of 300‐400°C and ~0.3 GPa. In the micaschists, the recrystallized grain size of quartz decreases towards the shear bands. Monomineralic quartz layers are eventually dismembered to form polyphase aggregates deforming by dominant grain size sensitive creep accompanied by slip in muscovite and chlorite. Plagioclase zoning truncations suggest that the shear bands originated by fracturing followed by ductile deformation. The results suggest protracted and long‐lasting shearing under amphibolite to greenschist facies conditions during the juxtaposition, stacking and exhumation of the Lower Seve Nappe

‘Small Project, Big Difference’: capacity building through a national volunteering fund : An Evaluation of The Department of Health’s Health and Social Care Volunteering Fund

This article reports the findings of a mixed methods evaluation study on the impact of a national fund to support volunteering as a mechanism to achieve health and social goals, within the Department of Health’s Volunteering Fund Programme (HSCVF). This paper adds understanding of the mechanisms through which government organisations can build VSCE organisational capacity to support volunteers. Firstly, the programme increased capacity via resource mobilisation to enhance volunteer recruitment, secondly it strengthened voluntary, community and social enterprise (VCSE) organisations through linkages and finally the programme supported development and learning. The HSCVF impacted upon both volunteering projects and host organisations to produce a range of positive outcomes that were particularly marked in smaller organisations: ‘small project, big difference’. Successful community capacity building can result from programmes such as HSCVF, with this paper contributing to the evidence base by detailing the processes through which this occurred

Identification and characterization of a spontaneous ovarian carcinoma in Lewis rats

<p>Abstract</p> <p>Background</p> <p>Ovarian carcinoma is the fourth most common cause of death from cancer in women. Limited progress has been made toward improving the survival rate of patients with this disease in part because of the lack of a good animal model. We present here a model of spontaneous ovarian carcinoma arising in a normal Lewis rat.</p> <p>Methods</p> <p>A spontaneously occurring tumor of the left ovary was found in a normal Lewis rat during necropsy, which was sectioned for histological examination and placed into single cell suspension. Tumor cells were passaged <it>in vivo </it>by intraperitoneal injection into immunocompetent Lewis rats, and <it>in vitro </it>culture resulted in generation of a cell line. Tumor cells were examined by flow cytometry for expression of estrogen receptor α, progesterone receptor, androgen receptor, her-2/neu, epithelial cell adhesion molecule, and CA125. β-catenin expression and cellular localization was assessed by immunocytochemistry. RNA was harvested for gene expression profiling and studying the expression of cytokines.</p> <p>Results</p> <p>The tumor, designated FNAR, could be serially transplanted into Lewis rats and propagated as a cell line <it>in vitro</it>, maintaining the properties of the original tumor. The FNAR cells displayed striking morphologic similarities to human ovarian carcinoma, resembling the endometrioid carcinoma subtype of surface epithelial neoplasms. The cells expressed estrogen receptor α, progesterone receptor, androgen receptor, her-2/neu, epithelial cell adhesion molecule, CA125, and nuclear β-catenin. A gene expression profile showed upregulation of a number of genes that are also upregulated in human ovarian carcinoma.</p> <p>Conclusion</p> <p>This reliable model of ovarian carcinoma should be helpful in better understanding the biology of the disease as well as the development of novel treatment strategies.</p

Alterations in Mucin Expression in Ovarian Mucinous Tumors: Immunohistochemical Analysis of MUC2, MUC5AC, MUC6, and CD10 Expression

The aim of this study was to evaluate the immunohistochemical expression of MUC2, MUC5AC, MUC6, and CD10 in ovarian mucinous adenoma (MA), mucinous borderline tumor (MB), and mucinous adenocarcinoma (MC), and to analyze the relationship between prognosis and these expressions. The expression of MUC2, MUC5AC, MUC6, and CD10 was evaluated by immunohistochemical analysis in 29 cases of MA, 29 cases of MB, and 26 cases of MC and scored based on the percentage of positive cells. Moreover, the ovarian mucinous tumors were classified into 4 phenotypes based on the staining patterns: intestinal, gastrointestinal, gastric, and unclassified patterns. The gastrointestinal pattern and the expression of MUC2 and CD10 increased from MA to MC. Conversely, the gastric pattern and MUC5AC expression decreased from MA to MC. Low MUC2 expression in MC was correlated with a better long-term survival rate. MUC2 expression in MC may be a useful predictor of the clinical outcome. The expression patterns of MUC2, MUC5AC, MUC6, and CD10 indicated that intestinal metaplasia may arise from the gastric-like epithelium in MA and that a close association exists between carcinogenesis and intestinal metaplasia in major ovarian mucinous tumors

Hydrological droughts in the 21st century, hotspots and uncertainties from a global multimodel ensemble experiment

Increasing concentrations of greenhouse gases in the atmosphere are expected to modify the global water cycle with significant consequences for terrestrial hydrology. We assess the impact of climate change on hydrological droughts in a multimodel experiment including seven global impact models (GIMs) driven by biascorrected climate from five global climate models under four representative concentration pathways (RCPs). Drought severity is defined as the fraction of land under drought conditions. Results show a likely increase in the global severity of hydrological drought at the end of the 21st century, with systematically greater increases for RCPs describing stronger radiative forcings. Under RCP8.5, droughts exceeding 40% of analyzed land area are projected by nearly half of the simulations. This increase in drought severity has a strong signal-to-noise ratio at the global scale, and Southern Europe, the Middle East, the Southeast United States, Chile, and South West Australia are identified as possible hotspots for future water security issues. The uncertainty due to GIMs is greater than that from global climate models, particularly if including a GIM that accounts for the dynamic response of plants to CO2 and climate, as this model simulates little or no increase in drought frequency. Our study demonstrates that different representations of terrestrial water-cycle processes in GIMs are responsible for a much larger uncertainty in the response of hydrological drought to climate change than previously thought. When assessing the impact of climate change on hydrology, it is therefore critical to consider a diverse range of GIMs to better capture the uncertainty