Coping styles within the family system in the chronic phase following acquired brain injury: its relation to families’ and patients’ functioning

OBJECTIVE: To investigate how the functioning of family members and the coping styles they use are related to the psychosocial functioning both of the family members and of the person who has sustained a brain injury. DESIGN: Cross-sectional study. SUBJECTS: Primary caregivers (n = 61) and other family members (n = 15) of 61 patients with brain injury. METHODS: Primary caregivers completed the Utrecht Coping List, the Life Satisfaction Questionnaire 9, and the Caregiver Strain Index. All family members completed the Family Assessment Device. Data for the patients were collected retrospectively. RESULTS: Primary caregivers who had a preference for passive coping styles reported that they experienced a lower level of family functioning, a lower quality of life, and a higher strain. Neither the coping styles nor the psychosocial outcomes of the primary caregivers were significantly associated with patients' self-reported quality of life. Furthermore, there was no correlation between the level of family functioning and a patient's quality of life. CONCLUSION: Coping styles of caregivers are important determinants for their own psychosocial functioning, but not for patients' psychosocial functioning, although causality cannot be inferred. To enhance caregivers' psychosocial functioning, rehabilitation should focus on changing their coping styles into ones that are less passive. Furthermore, distinct or additional interventions may be needed to change the patient's coping style

A novel hypothesis for an alkaline phosphatase ‘rescue’ mechanism in the hepatic acute phase immune response

AbstractThe liver isoform of the enzyme alkaline phosphatase (AP) has been used classically as a serum biomarker for hepatic disease states such as hepatitis, steatosis, cirrhosis, drug-induced liver injury, and hepatocellular carcinoma. Recent studies have demonstrated a more general anti-inflammatory role for AP, as it is capable of dephosphorylating potentially deleterious molecules such as nucleotide phosphates, the pathogenic endotoxin lipopolysaccharide (LPS), and the contact clotting pathway activator polyphosphate (polyP), thereby reducing inflammation and coagulopathy systemically. Yet the mechanism underlying the observed increase in liver AP levels in circulation during inflammatory insults is largely unknown. This paper hypothesizes an immunological role for AP in the liver and the potential of this system for damping generalized inflammation along with a wide range of ancillary pathologies. Based on the provided framework, a mechanism is proposed in which AP undergoes transcytosis in hepatocytes from the canalicular membrane to the sinusoidal membrane during inflammation and the enzyme's expression is upregulated as a result. Through a tightly controlled, nucleotide-stimulated negative feedback process, AP is transported in this model as an immune complex with immunoglobulin G by the asialoglycoprotein receptor through the cell and secreted into the serum, likely using the receptor's State 1 pathway. The subsequent dephosphorylation of inflammatory stimuli by AP and uptake of the circulating immune complex by endothelial cells and macrophages may lead to decreased inflammation and coagulopathy while providing an early upstream signal for the induction of a number of anti-inflammatory gene products, including AP itself

Simplified instantaneous non-local quantum computation with applications to position-based cryptography

Instantaneous measurements of non-local observables between space-like separated regions can be performed without violating causality. This feat relies on the use of entanglement. Here we propose novel protocols for this task and the related problem of multipartite quantum computation with local operations and a single round of classical communication. Compared to previously known techniques, our protocols reduce the entanglement consumption by an exponential amount. We also prove a linear lower bound on the amount of entanglement required for the implementation of a certain non-local measurement. These results relate to position-based cryptography: an amount of entanglement scaling exponentially in the number of communicated qubits is sufficient to render any such scheme insecure. Furthermore, we show that certain schemes are secure under the assumption that the adversary has less entanglement than a given linear bound and is restricted to classical communication.Comment: 18 pages, 2 figures. V2: clarified results of the crypto section, improved readabilit

Dementia and guardianship: challenges in social work practice in a health care setting

This thesis critically examines social work practice in complex and disputed situations where an alternative legal decision-maker is perceived as necessary for a person with dementia. Australia has unique adult guardianship legislation and social workers are actively engaged in the process in a variety of ways, such as weighing the benefits against the possible harm and lodging applications. Yet within the profession this is an area where there is very little research. The purpose of this study is therefore to enable social workers to better understand the dynamics involved in adult guardianship proceedings for a person with dementia and provide knowledge that can be used for more effective practice. The theoretical approach is to use perspectives from social constructionism, with the links which can be made to modernism and postmodernism being taken into account. Five research case studies were investigated drawing from the caseload of social workers in an aged care service at a large metropolitan hospital in Australia. A thematic network analysis of the findings showed that the research case studies are constantly evolving, where different players participate by bringing their own perspectives, and in this process alliances are formed which reflect underlying dynamics of power. There are many diverse and contested issues, such as varied understandings of dementia and capacity and differing constructions of the notions of risk, protection and responsibility. The implications for social work practice are that in a contemporary health and welfare context social work is well placed to make an important contribution through its traditional roles of negotiation, interpretation and mediation between those who have discursive rights and those who do not

Private and Secure Public-Key Distance Bounding: Application to NFC Payment

Distance-Bounding is used to defeat relay attacks. For wireless payment systems, the payment terminal is not always online. So, the protocol must rely on a public key for the prover (payer). We propose a generic transformation of a (weakly secure) symmetric distance bounding protocol which has no post-verification into wide-strong-private and secure public-key distance bounding

Slow relaxation in the two dimensional electron plasma under the strong magnetic field

We study slow relaxation processes in the point vortex model for the two-dimensional pure electron plasma under the strong magnetic field. By numerical simulations, it is shown that, from an initial state, the system undergoes the fast relaxation to a quasi-stationary state, and then goes through the slow relaxation to reach a final state. From analysis of simulation data, we find (i) the time scale of the slow relaxation increases linearly to the number of electrons if it is measured by the unit of the bulk rotation time, (ii) during the slow relaxation process, each electron undergoes an superdiffusive motion, and (iii) the superdiffusive motion can be regarded as the Levy flight, whose step size distribution is of the power law. The time scale that each electron diffuses over the system size turns out to be much shorter than that of the slow relaxation, which suggests that the correlation among the superdiffusive trajectories is important in the slow relaxation process.Comment: 11pages, 19 figures. Submitted to J. Phys. Soc. Jp

Mucopolysaccharidosis type VI phenotypes-genotypes and antibody response to galsulfase

Background: Mucopolysaccharidosis type VI (Maroteaux-Lamy syndrome; MPS VI) is an autosomal recessive lysosomal storage disorder in which deficiency of N-acetylgalactosamine 4-sulfatase (arylsulfatase B; ARSB) leads to the storage of glycosaminoglycans (GAGs) in connective tissue. The genotype-phenotype correlation has been addressed in several publications but the picture is not complete. Since 2007, enzyme-replacement therapy (ERT) has been available for patients with MPS VI in the Netherlands. The purpose of our study was to learn more about the genotype-phenotype correlations in MPS VI and the antibody response to ERT with galsulfase (recombinant human arylsulfatase B). Methods. We identified ARSB mutations in 12 patients and used site-directed mutagenesis to study their effect. Antibody levels to galsulfase were measured using ELISA and a semi-quantitative immunoprecipitation method. We assessed the in vitro inhibitory effect of antibodies on galsulfase uptake and their effect on clinical outcome. Results: Five patients had a rapidly progressive phenotype and seven a slowly progressive phenotype. In total 9 pathogenic mutations were identified including 4 novel mutations (N301K, V332G, A237D, and c.1142 + 2 T > C) together composing 8 pathogenic genotypes. Most mutations appeared not to affect the synthesis of ARSB (66 kD precursor), but to hamper its maturation (43 kD ARSB). Disease severity was correlated with urinary GAG excretion. All patients developed antibodies to galsulfase within 26 weeks of treatment. It was demonstrated that these antibodies can inhibit the uptake of galsulfase in vitro. Conclusions: The clinical phenotypes and the observed defects in the biosynthesis of ARSB show that some of the mutations that we identified are clearly more severe than others. Patients receiving galsulfase as enzyme-replacement therapy can develop antibodies towards the therapeutic protein. Though most titers are modest, they can exceed a level at which they potentially affect the clinical outcome of enzyme-replacement therapy

Optimal Proximity Proofs Revisited

Distance bounding protocols become important since wireless technologies become more and more common. Therefore, the security of the distance bounding protocol should be carefully analyzed. However, most of the protocols are not secure or their security is proven informally. Recently, Boureanu and Vaudenay defined the common structure which is commonly followed by most of the distance bounding protocols: answers to challenges are accepted if they are correct and on time. They further analyzed the optimal security that we can achieve in this structure and proposed DBopt which reaches the optimal security bounds. In this paper, we define three new structures: when the prover registers the time of a challenge, when the verifier randomizes the sending time of the challenge, and the combined structure. Then, we show the optimal security bounds against distance fraud and mafia fraud which are lower than the bounds showed by Boureanu and Vaudenay for the common structure. Finally, we adapt the DBopt protocol according to our new structures and we get three new distance bounding protocols. All of them are proven formally. In the end, we compare the performance of the new protocols with DBopt and we see that we have a better efficiency. For instance, we can reduce the number of rounds in DB2 (one of the instances of DBopt) from $123$ to $5$ with the same security

Challenges of Misbehavior Detection in Industrial Wireless Networks

In recent years, wireless technologies are increasingly adopted in many application domains that were either unconnected before or exclusively used cable networks. This paradigm shift towards - often ad-hoc - wireless communication has led to significant benefits in terms of flexibility and mobility. Alongside with these benefits, however, arise new attack vectors, which cannot be mitigated by traditional security measures. Hence, mechanisms that are orthogonal to cryptographic security techniques are necessary in order to detect adversaries. In traditional networks, such mechanisms are subsumed under the term "intrusion detection system" and many proposals have been implemented for different application domains. More recently, the term "misbehavior detection" has been coined to encompass detection mechanisms especially for attacks in wireless networks. In this paper, we use industrial wireless networks as an exemplary application domain to discuss new directions and future challenges in detecting insider attacks. To that end, we review existing work on intrusion detection in mobile ad-hoc networks. We focus on physical-layer-based detection mechanisms as these are a particularly interesting research direction that had not been reasonable before widespread use of wireless technology.Peer Reviewe