Familial Ménière's disease: clinical and genetic aspects

ABSTRACT Background and purpose:Mre's disease is not uncommon, with an incidence in Caucasians of about one in 2000. The incidence peaks in the fifth decade. Cases are usually isolated or sporadic, but in perhaps five per cent other family members are affected. We report here the clinical and genetic characteristics of a comprehensive set of familial Mre's disease cases from the UK.Methods:Forty-six affected families were studied. All cases were diagnosed using the American Academy of Otolaryngolog 8211;Head and Neck Surgery committee on hearing and equilibrium 1995, or more stringent, criteria.Outcomes and results:Autosomal dominant inheritance with reduced penetrance was the most likely mode of inheritance overall. Apparent genetic anticipation was observed, but may also be a result of ascertainment bias given the collection strategy. There was also a slight tendency for cases to result from maternal transmission within the families in this set. The family pedigrees are presented, and the authors have also set up a website at which all the pedigrees may be viewed in greater detai

Transparency in environment impact assessment decision-making: Recent developments in Western Australia

Transparency in decision-making, involving the establishment of explicit goals and objectives combined with open, facilitative procedures, has recently been advocated as an important principle for effective environmental impact assessment (EIA). This paper examines recent changes to EIA practice in Western Australia that emphasise clear procedures for decision-making. Current practices focus on objectives established for relevant environmental factors identified during the screening and scoping stages of EIA. These objectives are then used as decision criteria for project decision-making following public review. An example from a recent assessment is provided. Some strengths and weaknesses of this approach to transparent EIA decision-making are also examined

Being subject-centred: A philosophy of teaching and implications for higher education

Being subject-centred as a higher education teacher offers a rich and illuminating philosophical and practical understanding of learning. Building upon previous research on subject-centred learning, we draw on reflection, literature review and a phenomenological approach to show how our ways of being infuse the teaching and learning environment. Philosophically, it is our way of being with our subject as teachers that influences the learning within our students. We show how posing the question: 'What is the best way to teach this subject?' helps a teacher find the best way to enhance the learning experience. It entails moving away from reliance solely on approaches that simply 're-present' content, such as lectures and online learning management systems, to interactive classrooms where space is created for the students to enter into their own engagement with the subject in a shared pursuit with the teacher, resulting in more effective teaching and learning. We illustrate this with personal accounts of our own journeys as teachers. We acknowledge that it takes courage to teach and to fully be subject-centred in the face of prevailing trends and pressures for other ways of teaching currently prominent in the higher education sector. But, ultimately, it is who we are as teachers that matters most, and being subject-centred provides the most effective way for us to most meaningfully reach our students

On Krein-like theorems for noncanonical Hamiltonian systems with continuous spectra: application to Vlasov-Poisson

The notions of spectral stability and the spectrum for the Vlasov-Poisson system linearized about homogeneous equilibria, f_0(v), are reviewed. Structural stability is reviewed and applied to perturbations of the linearized Vlasov operator through perturbations of f_0. We prove that for each f_0 there is an arbitrarily small delta f_0' in W^{1,1}(R) such that f_0+delta f_0$is unstable. When$f_0$ is perturbed by an area preserving rearrangement, f_0 will always be stable if the continuous spectrum is only of positive signature, where the signature of the continuous spectrum is defined as in previous work. If there is a signature change, then there is a rearrangement of f_0 that is unstable and arbitrarily close to f_0 with f_0' in W^{1,1}. This result is analogous to Krein's theorem for the continuous spectrum. We prove that if a discrete mode embedded in the continuous spectrum is surrounded by the opposite signature there is an infinitesimal perturbation in C^n norm that makes f_0 unstable. If f_0 is stable we prove that the signature of every discrete mode is the opposite of the continuum surrounding it.Comment: Submitted to the journal Transport Theory and Statistical Physics. 36 pages, 12 figure

Temperature gradient and electric field driven electrostatic instabilities

The stability of electrostatic waves to thermodynamic and electric potential gradients was investigated. It is shown that thermodynamic gradients drive instabilities even when the internal electric field vanishes. Skewing of the distribution function is not included in the dielectric

Possibility of "magic" co-trapping of two atomic species in optical lattices

Much effort has been devoted to removing differential Stark shifts for atoms trapped in specially tailored "magic" optical lattices, but thus far work has focused on a single trapped atomic species. In this work, we extend these ideas to include two atomic species sharing the same optical lattice. We show qualitatively that, in particular, scalar J = 0 divalent atoms paired with non-scalar state atoms have the necessary characteristics to achieve such Stark shift cancellation. We then present numerical results on "magic" trapping conditions for 27Al paired with 87Sr, as well as several other divalent atoms.Comment: 5 pages, 2 figures, 1 tabl

A community-based group-guided self-help intervention for low mood and stress: study protocol for a randomized controlled trial

<br>Background: Depression is a mental health condition which affects millions of people each year, with worldwide rates increasing. Cognitive behavioral therapy (CBT) is recommended in the National Institute for Health and Clinical Excellence (NICE) guidelines for the treatment of depression. However, waiting lists can cause delays for face-to-face therapy. Also a proportion of people decline to present for help through the health service – the so-called treatment gap. Self-referral to CBT using community-based group interventions delivered by a voluntary sector organization may serve to resolve this problem. The aim of this randomized controlled trial (RCT) is to determine the efficacy of such a guided CBT self-help course, the ‘Living Life to the Full’ (LLTTF) classes delivered by the charity Action on Depression (AOD). The primary outcome is level of depression at 6 months assessed using the patient health questionnaire-9 (PHQ9) depression scale. Secondary measures include levels of anxiety and social functioning.</br> <br>Methods/design: Participants with symptoms of low mood will be recruited from the community through newspaper adverts and also via the AOD website. Participants will receive either immediate or delayed access to guided CBT self-help classes - the eight session LLTTF course. The primary endpoint will be at 6 months at which point the delayed group will be offered the intervention. Levels of depression, anxiety and social functioning will be assessed and an economic analysis will be carried out.</br> <br>Discussion: This RCT will test whether the LLTTF intervention is effective and/or cost-effective. If the LLTTF community-based classes are found to be cost effective, they may be helpful as both an intervention for those already seeking care in the health service, as well as those seeking help outside that setting, widening access to psychological therapy.</br&gt

Reynolds number dependence of streamwise velocity spectra in turbulent pipe flow

Spectra of the streamwise velocity component in fully developed turbulent pipe flow are presented for Reynolds numbers up to 5.7×10^6. Even at the highest Reynolds number, streamwise velocity spectra exhibit incomplete similarity only: while spectra collapse with both classical inner and outer scaling for limited ranges of wave number, these ranges do not overlap. Thus similarity may not be described as complete, and a region varying with the inverse of the streamwise wave number, k1, is not expected, and any apparent k1-1 range does not attract any special significance and does not involve a universal constant. Reasons for this are suggested