Living beyond the unanticipated sudden death of a partner : A phenomenological study

This research project used a Husserlian phenomenologlcal approach to explore grief and Its Impact upon men and women who have experienced the sudden and unanticipated death of his or her partner. The use of Husserllan phenomenologlcal research Into thanatologlcal study Is a valuable method of exposing the experiences of bereaved people In a vibrant and deep manner. Husserlian phenomenology allowed the surviving partner to reveal every aspect of his or her everyday life and experlencas. It Included what grief meant to them, how It was manifested In their everyday lives and how their partner\u27s death had Impacted upon his or her relationship with themselves, with others and the world. The stories told by the surviving partner were unique, however shared common themes

The importance of English in the world of commerce and literature.

ArticleMS201

An approach to the development of expert systems within production planning and control

The thesis presents an account of an attempt to utilize expert systems within the domain of production planning and control. The use of expert systems was proposed due to the problematical nature of a particular function within British Steel Strip Products' Operations Department: the function of Order Allocation, allocating customer orders to a production week and site. Approaches to tackling problems within production planning and control are reviewed, as are the general capabilities of expert systems. The conclusions drawn are that the domain of production planning and control contains both `soft' and `hard' problems, and that while expert systems appear to be a useful technology for this domain, this usefulness has by no means yet been demonstrated. Also, it is argued that the main stream methodology for developing expert systems is unsuited for the domain. A problem-driven approach is developed and used to tackle the Order Allocation function. The resulting system, UAAMS, contained two expert components. One of these, the scheduling procedure was not fully implemented due to inadequate software. The second expert component, the product routing procedure, was untroubled by such difficulties, though it was unusable on its own; thus a second system was developed. This system, MICRO-X10, duplicated the function of X10, a complex database query routine used daily by Order Allocation. A prototype version of MICRO-X10 proved too slow to be useful but allowed implementation and maintenance issues to be analysed. In conclusion, the usefulness of the problem-driven approach to expert systems development within production planning and control is demonstrated but restrictions imposed by current expert system software are highlighted in that the abilities of such software to cope with `hard' scheduling constructs and also the slow processing speeds of such software can restrict the current usefulness of expert systems within production planning and control

Environmental process improvement feasibility study and demonstration program

This report is the final product of an environmental study conducted by Western Commercial Space Center, Inc. under contract to Tennessee-Calspan Center for Space Transportation and Applied Research. The purpose of this investigation is to accurately document the current environmental and permitting processes associated with commercial space launch activity at Vandenberg AFB, and make recommendations to streamline those processes. The particular areas of interest focus on: identifying applicable Federal, state, and local laws, Department of Defense directives, and Air force regulations; defining the environmental process on Vandenberg AFB and how it relates with other agencies, including Federal and state regulatory agencies; and defining the air quality permit process. Study investigation results are applied to an example Pilot Space Launch Vehicle (PSLV) planning to launch from Vandenberg AFB. The PSLV space hardware is analyzed with respect to environmental and permitting issues associated with vehicle processing, facilities required (existing or new), and launch. The PSLV verified the earlier findings of the study and gave insight into streamlining recommendations

Pilot Study of Aprepitant for Prevention of Post-ERCP Pancreatitis in High Risk Patients: A Phase II Randomized, Double-Blind Placebo Controlled Trial

Objectives Animal studies have demonstrated a role for substance P binding to neurokinin-1 receptor in the pathogenesis of acute pancreatitis. Our aim was to assess the efficacy of a neurokinin-1 receptor antagonist (aprepitant) at preventing post-ERCP pancreatitis in high risk patients. Design Randomized, double-blind, placebo controlled trial at a single academic medical center. Intervention Patients at high risk for post-ERCP pancreatitis received either placebo or oral aprepitant administered 4 hours prior to ERCP, 80 mg 24 hours after the first dose, and then 80 mg 24 hours after the second dose. Patients Thirty-four patients received aprepitant and 39 patients received placebo. Statistics Fisher’s exact test was used to compare incidence of post-ERCP pancreatitis in the two groups. Results Baseline characteristics were similar between the two groups. Incidence of acute pancreatitis was 7 in the aprepitant group and 7 in the placebo group. Hospitalization within 7 days post-procedure for abdominal pain that did not meet criteria for acute pancreatitis occurred in 6 and 9 patients in the aprepitant and placebo groups respectively (P=0.772). Conclusions Aprepitant did not lower incidence of post-ERCP pancreatitis in this preliminary human study. Larger studies potentially using the recently available intravenous formulation are necessary to conclusively clarify the efficacy of aprepitant in this setting.Image: Duke University  School of Medicine. Durham, VA, USA

UK guideline for the use of HIV Post-Exposure Prophylaxis Following Sexual Exposure, 2015.

We present the updated British Association for Sexual Health and HIV guidelines for HIV post-exposure prophylaxis following sexual exposure (PEPSE). This document includes a review of the current data to support the use of PEPSE, considers how to calculate the risks of infection after a potential exposure, and provides recommendations on when PEPSE should and should not be considered. We also review which medications to use for PEPSE, provide a checklist for initial assessment, and make recommendations for monitoring individuals receiving PEPSE. Special scenarios, cost-effectiveness of PEPSE, and issues relating to service provision are also discussed. Throughout the document, the place of PEPSE within the broader context of other HIV prevention strategies is considered

The 'Antiretrovirals, Sexual Transmission Risk and Attitudes' (ASTRA) study. Design, methods and participant characteristics.

Life expectancy for people diagnosed with HIV has improved dramatically however the number of new infections in the UK remains high. Understanding patterns of sexual behaviour among people living with diagnosed HIV, and the factors associated with having condom-less sex, is important for informing HIV prevention strategies and clinical care. In addition, in view of the current interest in a policy of early antiretroviral treatment (ART) for all people diagnosed with HIV in the UK, it is of particular importance to assess whether ART use is associated with increased levels of condom-less sex. In this context the ASTRA study was designed to investigate current sexual activity, and attitudes to HIV transmission risk, in a large unselected sample of HIV-infected patients under care in the UK. The study also gathered background information on demographic, socio-economic, lifestyle and disease-related characteristics, and physical and psychological symptoms, in order to identify other key factors impacting on HIV patients and the behaviours which underpin transmission. In this paper we describe the study rationale, design, methods, response rate and the demographic characteristics of the participants. People diagnosed with HIV infection attending 8 UK HIV out-patient clinics in 2011-2012 were invited to participate in the study. Those who agreed to participate completed a confidential, self-administered pen-and-paper questionnaire, and their latest CD4 count and viral load test results were recorded. During the study period, 5112 eligible patients were invited to take part in the study and 3258 completed questionnaires were obtained, representing a response rate of 64% of eligible patients. The study includes 2248 men who have sex with men (MSM), 373 heterosexual men and 637 women. Future results from ASTRA will be a key resource for understanding HIV transmission within the UK, targeting prevention efforts, and informing clinical care of individuals living with HIV

Disciplinary Social Policy and the Failing Promise of the New Middle Classes: The Troubled Families Programme

This article looks at the promise of the ‘New Middle Class’ (NMC) inherent in the neoliberal ideological ideal of individualising societal responsibility for well-being and success. The article points to how this promise enables a discourse and practice of welfare reform and a disciplining of life styles particularly targeting the very poor in society. Women and some ethnic minorities are particularly prone to poverty and then therefore also discipline. The article then provides a case study of the Troubled Families Programme (TFP) and shows how the programme and the way it is constructed and managed partly undermines the provision of the material needs to alleviate people from poverty and re-produces discourses of poor lifestyle and parenting choices as sources of poverty, thereby undermining the ‘middle-class’ promise

HCV reinfection incidence and spontaneous clearance rates in HIV-positive men who have sex with men in Western Europe

BACKGROUND & AIMS: Moderate cure rates of acute hepatitis C virus (HCV) infections with pegylated interferon and ribavirin have been described in the last decade in men who have sex with men (MSM), who are also coinfected with the human immunodeficiency virus (HIV). However, a subsequent high incidence of HCV reinfections has been reported regionally in men who both clear the infection spontaneously or who respond to treatment. METHODS: Retrospective analysis of reinfections in HIV infected MSM in eight centers from Austria, France, Germany, and the UK within the NEAT network between May 2002 and June 2014. RESULTS: Of 606 individuals who cleared HCV spontaneously or were successfully treated, 149 (24.6%) presented with a subsequent HCV reinfection. Thirty out of 70 (43%) who cleared again or were successfully treated, presented with a second reinfection, 5 with a third, and one with a fourth reinfection. The reinfection incidence was 7.3/100 person-years (95% CI 6.2-8.6). We found a trend for lower incidence among individuals who had spontaneously cleared their incident infection than among individuals who were treated (Hazard ratio 0.62, 95% CI 0.38-1.02, p=0.06). Spontaneous clearance of reinfection was associated with ALT levels >1000IU/ml and spontaneous clearance of a prior infection. CONCLUSIONS: HCV reinfection is an issue of major concern in HIV-positive MSM. Prevention strategies are needed for high risk groups to reduce morbidity and treatment costs. HIV-positive MSM with a prior HCV infection should be tested every 3 to 6months for reinfection. Those who had achieved a reinfection should be tested every 3months. LAY SUMMARY: We evaluated the occurrence of HCV reinfection in HIV-positive men who have sex with men. We found an alarming incidence of 7.3/100 person-years. Prevention measures need to address this specific subgroup of patients at high risk for HCV