461 research outputs found

    The grammaticalization of modal auxiliaries in Maltese and Arabic vernaculars of the Mediterranean area'

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    The paper presents grammaticalization process in three Arabic-based vernaculars (maltese, Moroccan Arabic and Syro-Egyptian Arabic

    Implementing a step down intermediate care service

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    Purpose: The purpose of this paper is to explore implementation and development of step-down intermediate care (IC) in Glasgow City from the perspective of staff. Design/methodology/approach: The study used qualitative methods. Nine key members of staff were interviewed and three focus groups were run for social work, rehabilitation and care home staff. Framework analysis was used to identify common themes. Findings: The proposed benefits of IC were supported anecdotally by staff. Perceived enablers included: having a range of engaged stakeholders, strong leadership and a risk management system in place, good relationships, trust and communication between agencies, a discharge target, training of staff, changing perception of risk and risk aversion, the right infrastructure and staffing, an accommodation-based strategy for patients discharged from IC, the right context of political priorities, funding and ongoing adaptation of the model in discussion with frontline staff. Potential improvements included a common recording system shared across all agencies, improving transition of patients from hospital to IC, development of a tool for identifying suitable candidates for IC, overcoming placement issues on discharge from IC, ensuring appropriate rehabilitation facilities within IC units, attachment of social work staff to IC units and finding solutions to issues related to variation in health and social care systems between sectors and hospitals. Originality/value: The findings of this study help the ongoing refinement of the IC service. Some of the recommendations have already been implemented and will be of value to similar services being developed elsewhere

    DASHES Protocol:Development and feasibility testing of a tailored community programme to support people in recovery from problematic alcohol and drug use to cut down or stop smoking using co-creation

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    Background: Despite the continued global decline in adult tobacco prevalence, rates continue to be significantly higher in groups with problematic drug or alcohol use (PDA). It is estimated that people with alcohol, drug or mental health problems account for approximately half of all smoking deaths. In the UK, there are free stop smoking services for the general population. However, these services have been criticized as unsuitable for people in recovery from PDA due to their design, time-limited support, strict requirement for smoking abstinence and lack of consideration of harm reduction approaches. This has led to calls for alternative approaches to support this marginalized and underserved group. This research study seeks to respond to this call by co-creating and feasibility testing a tailored, trauma-informed service specifically for people seeking help for PDA, who are not in immediate crisis, and who may also want to reduce or stop their tobacco smoking. Methods: The mixed-method study design has two parts. The development study (part one) will use participatory peer research methods to work with the target client group and key stakeholders involved in service delivery, commissioning, and policy to design the service (intervention). The feasibility study (part two) will test the delivery of the intervention protocol and capture data that will enable the assessment of whether progression to a future pilot randomized control trial is merited. Conclusions: The outcome of this study will be a theoretically informed, co-created intervention with the potential to improve population health by supporting people with problematic drug or alcohol use to cut down or stop tobacco smoking

    The definition of dietary fiber – discussions at the Ninth Vahouny Fiber Symposium: building scientific agreement

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    A definition for dietary fiber was adopted in June 2009 by the Codex Alimentarius Commission based on the recommendation for endorsement of the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU) in November 2008. The definition listed three categories of carbohydrate polymers that are not hydrolyzed by the endogenous enzymes in the small intestine of humans. However, the definition left the inclusion of carbohydrates with degrees of polymerization (DP) in the range of 3 and 9 to the discretion of national authorities and left the ‘physiological effect(s) of benefit to health’ as undefined. The ILSI Europe and ILSI North America's committees on dietary carbohydrates organized a forum at the Ninth Vahouny Fiber Symposium in 2010 to discuss these implementation issues with the objective of building scientific consensus on how to resolve them. The results of this session are encouraging and indicated that the scientific community agrees on maintaining a worldwide consensus regarding the inclusion of non-digestible carbohydrates with ≥DP3 as dietary fiber and on a core, non-exhaustive list of beneficial physiological effects that dietary fibers have. These results are consistent with previous worldwide agreements

    Apoptosis and antigen receptor function in T and B cells following exposure to herpes simplex virus

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    AbstractT cells are an essential component of the immune response against herpes simplex virus (HSV) infection. We previously reported that incubation of T cells with HSV-infected fibroblasts inhibits subsequent T cell antigen receptor signal transduction. In the current study, we found that incubation of T cells with HSV-infected fibroblasts also leads to apoptosis in exposed T cells. Apoptosis was observed in Jurkat cells, a T cell leukemia line, and also in CD4+ cells isolated from human peripheral blood mononuclear cells. Direct infection of these cells with HSV also resulted in apoptosis. Clinical isolates of both HSV type 1 and 2 induced apoptosis in infected T cells at comparable levels to cells infected with laboratory strains of HSV, suggesting an immune evasion mechanism that may be clinically relevant. Further understanding of these viral immune evasion mechanisms could be exploited for better management of HSV infection

    Nonclassic lipoid congenital adrenal hyperplasia masquerading as familial glucocorticoid deficiency

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    Context: Familial glucocorticoid deficiency (FGD) is an autosomal recessive disorder resulting from resistance to the action of ACTH on the adrenal cortex. Affected individuals are deficient in cortisol and, if untreated, are likely to succumb to hypoglycemia and/or overwhelming infection. Mutations of the ACTH receptor (MC2R) and the melanocortin 2 receptor accessory protein (MRAP), FGD types 1 and 2 respectively, account for approximately 45% of cases. Objective: A locus on chromosome 8 has previously been linked to the disease in three families, but no underlying gene defect has to date been identified. Design: The study design comprised single-nucleotide polymorphism genotyping and mutation detection. Setting: The study was conducted at secondary and tertiary referral centers. Patients: Eighty probands from families referred for investigation of the genetic cause of FGD participated in the study. Interventions: There were no interventions. Results: Analysis by single-nucleotide polymorphism array of the genotype of one individual with FGD previously linked to chromosome 8 revealed a large region of homozygosity encompassing the steroidogenic acute regulatory protein gene, STAR. We identified homozygous STAR mutations in this patient and his affected siblings. Screening of our total FGD patient cohort revealed homozygous STAR mutations in a further nine individuals from four other families. Conclusions: Mutations in STAR usually cause lipoid congenital adrenal hyperplasia, a disorder characterized by both gonadal and adrenal steroid deficiency. Our results demonstrate that certain mutations in STAR (R192C and the previously reported R188C) can present with a phenotype indistinguishable from that seen in FGD

    Using Published HRTFS with Slab3D: Metric-Based Database Selection and Phenomena Observed

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    Presented at the 20th International Conference on Auditory Display (ICAD2014), June 22-25, 2014, New York, NY.In this paper, two publicly available head-related transfer function (HRTF) database collections are analyzed for use with the open-source slab3d rendering system. After conversion to the slab3d HRTF database format (SLH), a set of visualization tools and a five-step metric-based process are used to select a subset of databases for general use. The goal is to select a limited subset least likely to contain anomalous behavior or measurement error. The described set of open-source tools can be applied to any HRTF database converted to the slab3d format

    Radiotherapy for marginally resected, unresectable or recurrent giant cell tumor of the bone: a rare cancer network study

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    The role of radiotherapy for local control of marginally resected, unresectable, and recurrent giant cell tumors of bone (GCToB) has not been well defined. The number of patients affected by this rare disease is low. We present a series of 58 patients with biopsy proven GCToB who were treated with radiation therapy. A retrospective review of the role of radiotherapy in the treatment of GCToB was conducted in participating institutions of the Rare Cancer Network. Eligibility criteria consisted of the use of radiotherapy for marginally resected, unresectable, and recurrent GCToB. Fifty-eight patients with biopsy proven GCToB were analyzed from 9 participating North American and European institutions. Forty-five patients had a primary tumor and 13 patients had a recurrent tumor. Median radiation dose was 50 Gy in a median of 25 fractions. Indication for radiation therapy was marginal resection in 33 patients, unresectable tumor in 13 patients, recurrence in 9 patients and palliation in 2 patients. Median tumor size was 7.0 cm. A significant proportion of the tumors involved critical structures. Median follow-up was 8.0 years. Five year local control was 85% . Of the 7 local failures, 3 were treated successfully with salvage surgery. All patients who received palliation achieved symptom relief. Five year overall survival was 94%. None of the patients experienced grade 3 or higher acute toxicity. This study reports a large published experience in the treatment of GCToB with radiotherapy. Radiotherapy can provide excellent local control for incompletely resected, unresectable or recurrent GCToB with acceptable morbidity

    Morphogenesis of growing soft tissues

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    Recently, much attention has been given to a noteworthy property of some soft tissues: their ability to grow. Many attempts have been made to model this behaviour in biology, chemistry and physics. Using the theory of finite elasticity, Rodriguez has postulated a multiplicative decomposition of the geometric deformation gradient into a growth-induced part and an elastic one needed to ensure compatibility of the body. In order to fully explore the consequences of this hypothesis, the equations describing thin elastic objects under finite growth are derived. Under appropriate scaling assumptions for the growth rates, the proposed model is of the Foppl-von Karman type. As an illustration, the circumferential growth of a free hyperelastic disk is studied.Comment: 4 pages, 3 figure

    ‘It looks like an adult sweetie shop’: point-of-sale tobacco display exposure and brand awareness in Scottish secondary school students.

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    Introduction: As further restrictions have been placed on tobacco advertising and promotions, point of sale (PoS) displays of cigarettes in shops have become an increasingly important source of young people’s exposure to tobacco products. This study explored the relationship between PoS displays of cigarettes and brand awareness among secondary school students in Scotland. Methods: Cross-sectional school surveys (n=1406) and focus groups (n=86) were conducted with S2 (13-14yrs) and S4 (15-16yrs) students in four schools of differing socioeconomic status in 2013, prior to the PoS display ban in large shops. Adjusted negative binomial regression analysis examined associations between brand awareness and exposure variables (visiting tobacco retailers, noticing displays of tobacco products). Results: Students visiting small shops more frequently (RRR 1.19, 95% CI 1.01-1.41) and those who noticed cigarette displays in small shops (RRR 1.24 95% CI 1.03-1.51) and large supermarkets (RRR 1.15 95% CI 1.01 -1.30) had higher brand awareness. The focus groups supported these findings. Participants described PoS tobacco displays as being eye-catching, colourful and potentially attractive to young people. Conclusions: This mixed-methods study showed that higher cigarette brand awareness was significantly associated with regularly visiting small shops and noticing PoS displays in small and large shops, even when students’ smoking status, smoking in their social networks, leisure activities and demographics were included as confounding variables. This highlights the importance of PoS displays of tobacco products in increasing brand awareness, which is known to increase youth smoking susceptibility, and thus the importance of implementing PoS display bans in all shops.Publisher PDFPeer reviewe
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