Retiring to paradise? : reassessing liminality through leisure migration to Spain

Over the last forty years, we have witnessed the birth of a new phenomenon in the Western world, that of 'the dream retirement. ' This study examines a group of (mainly) Northern European older people who move to Spain in search of the culmination of their life-project. Following years of working to the clock they move away from the 'rat-race' to find warmth, good health, company, friendship and enjoyment. Yet [...] the experience is often judged negatively by outsiders. The Costa is portrayed as a slightly unreal world, a liminal zone beyond the 'normal' realm of work. This thesis, an ethnographic exploration of life for older migrants in Spain takes seriously this 'unreal' world. It explores the negotiation of the designated 'free-time' at the end of the working life. The creation of retirement at a determined legal cut-off point has forced a separation between working identities and identities in the life beyond, which previously had (if at all) a ragged boundary between them. In short, it is a modern-day rite of passage. Now, as retirement approaches, new questions come to the fore. Where should we retire? How do we negotiate that culturally created 'time off' at the end of the working years? Do we find satisfaction, companionship, hope and fulfilment of dreams? Perhaps more mundanely,what do we actually do with that time?This thesis is an ethnographic study devoted to exploring the lives and worlds of older people who, in answering the above questions, chose to migrate to Spain from Northern Europe. Its focus is the new brand of 'woopies' (well off older persons) seeking the 'rewards' of leisure following a lifetime of working. They enter an interstitial space devoted to the pursuit of adult play. The thesis interrogates the reality of such rewards, looking at the tensions inherent in the 'freedom' sought within utopian spaces such as Spain. I reveal how the imagined freedoms necessitate some form of regulation, and I employ a re-examination of anthropological models of ritual to do so

National early warning scores in care homes: do policy imperatives reflect a genuine need?

Background the National Early Warning Score (NEWS) is a tool based on vital signs that aims to standardise detection of, and response to, clinical deterioration in adults. NEWS has been adopted in hospitals but not adapted for other settings. This study aimed to explore the feasibility of measuring the NEWS in care homes and describe the distribution of NEWS readings amongst care home residents. Methods descriptive analysis of all NEWS readings recorded in a 30-month period (2016–19) across 46 care homes in one Clinical Commissioning Group in England. Comparisons were made between measurements taken as a routine reading and those prompted by concern about acute illness. Results a total of 19,604 NEWS were recorded from 2,424 older adults (≥65 years; mean age 85). Median NEWS was 2. Two thirds (66%) of residents had a low NEWS (≤2), and 28% had a score of 0. Of the total NEWS readings, 6,277 (32%) were known to be routine readings and 2,256 (12%) were measured because of staff concerns. Median NEWS was 1 for routine and 2 for concern recordings. Overall, only 12% of NEWS were high (≥5), but a higher proportion were elevated when there were concerns about acute illness (18%), compared with routine recordings (7%). Conclusions use of NEWS in care homes appears to be feasible. The majority of NEWS were not elevated, and the distribution of scores is consistent with other out-of-hospital settings. Further work is required to know if NEWS is triggering the most appropriate response and improving care home resident outcomes. Keywords care homes, track and trigger systems, National Early Warning Score, older people Topic internship and residencyprecipitating factorsvital signselderlymedical residenciesnational early warning score (news

Incorporation of Novel Elements in Bioactive Glass Compositions to Enhance Implant Performance

Increasing popularities of bioactive-glasses and their potential medical applications have led to countless studies into improving their material characteristics and overall performance. Some scientists hope to create new bioactive-glass compositions, while others seek to merely modify existing ones such as the novel 45S5 bioactive-glass composition; created by Dr. Larry Hench. These modifications aim to address potential complications that may arise at a site following implantation such as bacterial infections. In other cases, the incorporation of a selected element or compound may aim to improve the implant functioning by increasing cell proliferation. Although possibilities are plentiful, researchers avoid compromising the typical bioactive glass characteristics when doping with elements such as silver, or gold to achieve additional properties. This chapter elaborates on the incorporation of popular elements by doping bioactive-glass compositions to introduce desired properties based on the implant application

Linear and nonlinear analysis of normal and CAD-affected heart rate signals

Coronary Artery Disease (CAD) is one of the dangerous cardiac disease, often may lead to sudden cardiac death. It is difficult to diagnose CAD by manual inspection of electrocardiogram (ECG) signals. To automate this detection task, in this study, we extracted the Heart Rate (HR) from the ECG signals and used them as base signal for further analysis. We then analyzed the HR signals of both normal and CAD subjects using (i) time domain, (ii) frequency domain and (iii) nonlinear techniques. The following are the nonlinear methods that were used in this work: Poincare plots, Recurrence Quantification Analysis (RQA) parameters, Shannon entropy, Approximate Entropy (ApEn), Sample Entropy (SampEn), Higher Order Spectra (HOS) methods, Detrended Fluctuation Analysis (DFA), Empirical Mode Decomposition (EMD), Cumulants, and Correlation Dimension. As a result of the analysis, we present unique recurrence, Poincare and HOS plots for normal and CAD subjects. We have also observed significant variations in the range of these features with respect to normal and CAD classes, and have presented the same in this paper. We found that the RQA parameters were higher for CAD subjects indicating more rhythm. Since the activity of CAD subjects is less, similar signal patterns repeat more frequently compared to the normal subjects. The entropy based parameters, ApEn and SampEn, are lower for CAD subjects indicating lower entropy (less activity due to impairment) for CAD. Almost all HOS parameters showed higher values for the CAD group, indicating the presence of higher frequency content in the CAD signals. Thus, our study provides a deep insight into how such nonlinear features could be exploited to effectively and reliably detect the presence of CAD

Deploying Web-based Visual Exploration Tools on the Grid

We discuss a web-based portal for the exploration, encapsulation, and dissemination of visualization results over the Grid. This portal integrates three components: an interface client for structured visualization exploration, a visualization web application to manage the generation and capture of the visualization results, and a centralized portal application server to access and manage grid resources. Our approach uses standard web technologies to make the system accessible with minimal user setup. We demonstrate the usefulness of the developed system using an example for Adaptive Mesh Refinement (AMR) data visualization

Identification of calpain cleavage sites in the G1 cyclin-dependent kinase inhibitor p19INK4d

Calpains are a large family of Ca2+-dependent cysteine proteases that are ubiquitously distributed across most cell types and vertebrate species. Calpains play a role in cell differentiation, apoptosis, cytoskeletal remodeling, signal transduction and the cell cycle. The cell cycle proteins cyclin D1 and p21KIP1, for example, have been shown to be affected by calpains. However, the rules that govern calpain cleavage specificity are poorly understood. We report here studies on the pattern of μ-calpain proteolysis of the p19INK4d protein, a cyclin-dependent kinase 4/6 inhibitor that negatively regulates the mammalian cell cycle. Our data show new characteristics of calpain action: μ-calpain cleaves p19INK4d immediately after the first and second ankyrin repeats that are structurally less stable compared to the other repeats. This is in contrast to features observed so far in the specificity of calpains for their substrates. These results imply that calpain may be involved in the cell cycle by regulating the cell cycle regulatory protein turnover through CDK inhibitors and cyclin

High Prevalence of Pre-Existing Liver Abnormalities Identified Via Autopsies in COVID-19: Identification of a New Silent Risk Factor?

A high prevalence of hepatic pathology (in 17 of 19 cases) was reported in post-mortem (PM) examinations of COVID-19 patients, undertaken between March 2020 and February 2021 by a single autopsy pathologist in two English Coronial jurisdictions. The patients in our cohort demonstrated high levels of recognised COVID-19 risk factors, including hypertension (8/16, 50%), type 2 diabetes mellitus (8/16, 50%) and evidence of arteriopathy 6/16 (38%). Hepatic abnormalities included steatosis (12/19; 63%), moderate to severe venous congestion (5/19; 26%) and cirrhosis (4/19; 21%). A subsequent literature review indicated a significantly increased prevalence of steatosis (49%), venous congestion (34%) and cirrhosis (9.3%) in COVID-19 PM cases, compared with a pre-pandemic PM cohort (33%, 16%, and 2.6%, respectively), likely reflecting an increased mortality risk in SARS-CoV-2 infection for patients with pre-existing liver disease. To corroborate this observation, we retrospectively analysed the admission liver function test (LFT) results of 276 consecutive, anonymised COVID-19 hospital patients in our centre, for whom outcome data were available. Of these patients, 236 (85.5%) had significantly reduced albumin levels at the time of admission to hospital, which was likely indicative of pre-existing chronic liver or renal disease. There was a strong correlation between patient outcome (length of hospital admission or death) and abnormal albumin at the time of hospital admission (p = 0.000012). We discuss potential mechanisms by which our observations of hepatic dysfunction are linked to a risk of COVID-19 mortality, speculating on the importance of recently identified anti-interferon antibodies

Effect of Advertising on product growth of Techno Phone in Enugu State, Nigeria

The purpose of this seminar work is focuses on effect of advertising on product growth of techno phone in Enugu State, Nigeria. Specifically the study aimed to pursue the following objectives: to determine whether advertising increase  sales of  techno phone, to ascertain the effect of advertising on profit of techno phone, to determine the nature of the relationship between advertising and  market share  of techno phone. The study has a population /sample size of (25)   using connivance sampling method at 5% error to tolerance and 95% level of confidence. Instruments used for data collection were primary questionnaires and interview. The total number of 25 copies of the questionnaire were distributed at a spot and collected . Survey research design was adopted for the study. Three hypotheses were tested using Pearson product moment correlation coefficient and simple linear regression  tool. The findings indicate that advertising significantly increase  sales  volume of  techno phone ( r  = 0.616;  F= 14.065; t  = 3. 750; p< 0.05).  Advertising significantly affect profit of techno phone (r = 0.651; F= 16.888 ; t  = 4.110; p< 0.05). There is a positive relationship between advertising and  market share  of techno phone  (r =.802, P<.05). The study concluded that effectiveness of advertising reach the target indexes of sales volume, market share, awareness and consumer preferences, i.e. achievement of all planned goals and objectives. The study recommends that organization should embark advertisement constantly, because it will help in educating their customers on how used their product and at same time increase the profit volume of the organizatio

Management of Multisystem Inflammatory Syndrome in Children (MIS-C) in resource limited settings: The Kenyan Experience

Background: Since the onset of the recent COVID-19 pandemic, there have been growing concerns regarding multisystem inflammatory syndrome in children (MIS-C). This study aims to describe the clinico-epidemiological profile and challenges in management of MIS-C in low-middle income countries by highlighting the Kenyan experience. Methods: A retrospective study at the Aga Khan University Hospital Nairobi, Avenue Hospital Kisumu and Kapsabet County Referral Hospital was undertaken to identify cases of MIS-C. A detailed chart review using the World Health Organization (WHO) data collection tool was adapted to incorporate information on socio-demographic details and treatment regimens. Findings: Twenty children with MIS-C were identified across the three facilities between August 1st 2020 and August 31st 2021. Seventy percent of the children were male (14 of 20). COVID-19 PCR testing was done for five children and only one was positive. The commonest clinical symptoms were fever (90%), tachycardia (80%), prolonged capillary refill (80%), oral mucosal changes (65%) and peripheral cutaneous inflammation (50%). Four children required admission into the critical care unit for ventilation support and inotropic support. Cardiac evaluation was available for six patients four of whom had myocardial dysfunction, three had valvulitis and one had pericarditis. Immunoglobulin therapy was availed to two children and systemic steroids provided for three children. There were no documented mortalities. Interpretation: We describe the first case series of MIS-C in East and Central Africa. Majority of suspected cases of MIS-C did not have access to timely COVID-19 testing and other appropriate evaluations which highlights the iniquity in access to diagnostics and treatment

Implementation of the National Early Warning Score in UK care homes:a qualitative evaluation

BACKGROUND: The National Early Warning Score (NEWS) is a tool for identifying and responding to acute illness. When used in care homes, staff measure residents' vital signs and record them on a tablet computer, which calculates a NEWS to share with health services. This article outlines an evaluation of NEWS implementation in care homes across one clinical commissioning group area in northern England. AIM: To identify challenges to implementation of NEWS in care homes. DESIGN AND SETTING: Qualitative analysis of interviews conducted with 15 staff members from six care homes, five health professionals, and one clinical commissioning group employee. METHOD: Interviews were intended to capture people's attitudes and experiences of using the intervention. Following an inductive thematic analysis, data were considered deductively against normalisation process theory constructs to identify the challenges and successes of implementing NEWS in care homes. RESULTS: Care home staff and other stakeholders acknowledged that NEWS could enhance the response to acute illness, improve communication with the NHS, and increase the confidence of care home staff. However, the implementation did not account for the complexity of either the intervention or the care home setting. Challenges to engagement included competing priorities, insufficient training, and shortcomings in communication. CONCLUSION: This evaluation highlights the need to involve care home staff and the primary care services that support them when developing and implementing interventions in care homes. The appropriateness and value of NEWS in non-acute settings requires ongoing monitoring