'Who Cares?' The experiences of caregivers of adults living with heart failure, chronic obstructive pulmonary disease and coronary artery disease: a mixed methods systematic review

Objective: To assess the experiences of unpaid caregivers providing care to people with heart failure (HF) or chronic obstructive pulmonary disease (COPD) or coronary artery disease (CAD). Design: Mixed methods systematic review including qualitative and quantitative studies. Data sources: Databases searched: Medline Ebsco, PsycInfo, CINAHL Plus with Full Text, Embase, Web of Science, Ethos: The British Library and ProQuest. Grey literature identified using: Global Dissertations and Theses and Applied Sciences Index and hand searches and citation checking of included references. Search time frame: 1 January 1990 to 30 August 2017. Eligibility criteria for selecting studies: Inclusion was limited to English language studies in unpaid adult caregivers (>18 years), providing care for patients with HF, COPD or CAD. Studies that considered caregivers for any other diagnoses and studies undertaken in low-income and middle-income countries were excluded. Quality assessment of included studies was conducted by two authors. Data analysis/synthesis: A results-based convergent synthesis was conducted. Results: Searches returned 8026 titles and abstracts. 54 studies—21 qualitative, 32 quantitative and 1 mixed method were included. This totalled 26 453 caregivers who were primarily female (63%), with median age of 62 years. Narrative synthesis yielded six concepts related to caregiver experience: (1) mental health, (2) caregiver role, (3) lifestyle change, (4) support for caregivers, (5) knowledge and (6) relationships. There was a discordance between paradigms regarding emerging concepts. Four concepts emerged from qualitative papers which were not present in quantitative papers: (1) expert by experience, (2) vigilance, (3) shared care and (4) time. Conclusion: Caregiving is life altering and complex with significant health implications. Health professionals should support caregivers who in turn can facilitate the recipient to manage their long-term condition. Further longitudinal research exploring the evolution of caregiver experiences over time of patients with chronic cardiopulmonary conditions is required

Technological progress observed for fixed-bottom offshore wind in the EU and UK

Offshore wind is a rapidly maturing low-carbon energy technology, for which the technology cost has increased before starting to decline. In literature, the cost development trends of offshore wind and factors responsible were poorly studied. Understanding the factors contributing to the cost developments and their individual impacts are vital for long-term energy policy actions and investment decisions. Therefore, this study combined three different but highly complementary quantitative methodologies to analyze the technological progress observed for fixed-bottom offshore wind in the EU and UK. The technology diffusion curve was first applied to identify the individual development phases of offshore wind technology. Then, the cost developments observed across the identified phases were quantified using experience curve and bottom-up cost modeling methodologies. In the formative phase of the development process, the offshore wind farm's specific capital expenditure had increased from 2 M€/MW in 2000 to 5 M€/MW in 2010, thereby resulting in negative LR. The increase in specific capital expenditure increased the Levelized Cost of Energy (LCoE) from ~110 €/MWh to above 150 €/MWh. After that, during the upscaling and growth phase, the specific capital expenditure declined from 5.4 M€/MW in 2011 to 3.3 M€/MW in 2020. LR of 8–11 % was observed for specific capital expenditure in this phase. In the same phase, the LCoE declined more rapidly than the specific capital expenditure, i.e., from roughly 150 €/MWh in 2011 to 69 €/MWh in 2020, a 54 % decline. This rapid decline observed in recent years was due to the favorable financing conditions, increased capacity factor, and decreased technology costs, including investment and operational costs. Based on the technological progress assessed for offshore wind and its contributing factors in this study, we also estimated the near-term offshore wind LCoE, 55 €/MWh in 2021–2023 and 48 €/MWh in 2024–2026, which aligns well with recent auction outcomes

Life cycle assessment of four floating wind farms around Scotland using a site-specific operation and maintenance model with SOVs

This paper presents a life cycle assessment (LCA) of the International Energy Agency (IEA) 15 MW Reference Wind Turbine (RWT), on floating platforms, deployed in commercial-scale arrays at multiple locations around Scotland in the ScotWind leasing round. Site-specific energy production and vessel operations are provided by a dedicated offshore wind farm operations and maintenance (O&M) model, COMPASS, allowing service operation vessel (SOV) O&M impacts to be assessed with increased confidence. For climate change, the median global warming impact varied from 17.4 to 26.3 gCO2eq/kWh across the four sites within a 95% confidence interval using an uncertainty assessment of both foreground and background data. As is common with other offshore renewable energy systems, materials and manufacture account for 71% to 79% of global warming impact, while O&M comprise between 9% and 16% of the global warming impacts. High-voltage direct current (HVDC) export cables, floating platforms, and composite blades are significant contributors to the environmental impacts of these arrays (by mass and material choice), while the contributions from ballast, vessel transportation emissions, and power-train components are lower. The results suggest that material efficiencies, circularity, and decarbonizing material supply inventories should be a priority for the Scottish floating wind sector, followed by minimizing vessel operations and the decarbonization of vessel propulsion, while avoiding burden shifting to other impact categories

Levelised Cost of Energy assessment for offshore wind farms - an examination of different methodologies, input variables and uncertainty

Levelised Cost of Energy (LCoE) is the most common metric used in renewable energy assessments. However, this can be a very complex calculation with numerous methodologies depending on the perspective taken. Inputs including costs, energy production are generally forecasts and predictions based on publicly available information; therefore they are key areas of uncertainty. Elements of the calculation are site or region specific such as the tax rate or inclusion of grid connection costs. The business case and financial assumptions applied will be very project specific e.g. the discount rate applied. These numerous variables and uncertainties must be fully understood in order to effectively apply the metric or review and compare LCoEs. Therefore, this paper provides a comprehensive set of LCoE methodologies that provide a reference basis for researchers. A case study demonstrates the application of these methods and the variation in results illustrates the importance of correctly selecting the discount rate and cash flow based on the perspective and motivation of the user. Sensitivity studies further investigates the potential impact of key variables and areas of uncertainty on results. Analysis indicates that the energy production and discount rate applied will have the most significant impact on LCoE, followed by CAPEX costs. While the key areas of uncertainties cannot necessarily be solved, this paper promotes consistency in the application and understanding of the metric, which can help overcome its limitations

Melanoma induction by ultraviolet A but not ultraviolet B radiation requires melanin pigment

Malignant melanoma of the skin (CMM) is associated with ultraviolet radiation exposure, but the mechanisms and even the wavelengths responsible are unclear. Here we use a mammalian model to investigate melanoma formed in response to precise spectrally defined ultraviolet wavelengths and biologically relevant doses. We show that melanoma induction by ultraviolet A (320–400 nm) requires the presence of melanin pigment and is associated with oxidative DNA damage within melanocytes. In contrast, ultraviolet B radiation (280–320 nm) initiates melanoma in a pigment-independent manner associated with direct ultraviolet B DNA damage. Thus, we identified two ultraviolet wavelength-dependent pathways for the induction of CMM and describe an unexpected and significant role for melanin within the melanocyte in melanomagenesis

Technological progress observed for fixed-bottom offshore wind in the EU and UK

Offshore wind is a rapidly maturing low-carbon energy technology, for which the technology cost has increased before starting to decline. In literature, the cost development trends of offshore wind and factors responsible were poorly studied. Understanding the factors contributing to the cost developments and their individual impacts are vital for long-term energy policy actions and investment decisions. Therefore, this study combined three different but highly complementary quantitative methodologies to analyze the technological progress observed for fixed-bottom offshore wind in the EU and UK. The technology diffusion curve was first applied to identify the individual development phases of offshore wind technology. Then, the cost developments observed across the identified phases were quantified using experience curve and bottom-up cost modeling methodologies. In the formative phase of the development process, the offshore wind farm's specific capital expenditure had increased from 2 M€/MW in 2000 to 5 M€/MW in 2010, thereby resulting in negative LR. The increase in specific capital expenditure increased the Levelized Cost of Energy (LCoE) from ~110 €/MWh to above 150 €/MWh. After that, during the upscaling and growth phase, the specific capital expenditure declined from 5.4 M€/MW in 2011 to 3.3 M€/MW in 2020. LR of 8–11 % was observed for specific capital expenditure in this phase. In the same phase, the LCoE declined more rapidly than the specific capital expenditure, i.e., from roughly 150 €/MWh in 2011 to 69 €/MWh in 2020, a 54 % decline. This rapid decline observed in recent years was due to the favorable financing conditions, increased capacity factor, and decreased technology costs, including investment and operational costs. Based on the technological progress assessed for offshore wind and its contributing factors in this study, we also estimated the near-term offshore wind LCoE, 55 €/MWh in 2021–2023 and 48 €/MWh in 2024–2026, which aligns well with recent auction outcomes

A melanin-independent interaction between Mc1r and Met signalling pathways is required for HGF-dependent melanoma

Melanocortin 1 receptor (MC1R) signaling stimulates black eumelanin production through a cAMP-dependent pathway. MC1R polymorphisms can impair this process, resulting in a predominance of red phaeomelanin. The red hair, fair skin and UV sensitive phenotype is a well-described melanoma risk factor. MC1R polymorphisms also confer melanoma risk independent of pigment. We investigated the effect of Mc1r deficiency in a mouse model of UV-induced melanoma. C57BL/6-Mc1r+/+-HGF transgenic mice have a characteristic hyperpigmented black phenotype with extra-follicular dermal melanocytes located at the dermal/epidermal junction. UVB induces melanoma, independent of melanin pigmentation, but UVA-induced and spontaneous melanomas are dependent on black eumelanin. We crossed these mice with yellow C57BL/6-Mc1re/e animals which have a non-functional Mc1r and produce predominantly yellow phaeomelanin. Yellow C57BL/6-Mc1re/e-HGF mice produced no melanoma in response to UVR or spontaneously even though the HGF transgene and its receptor Met were expressed. Total melanin was less than in C57BL/6-Mc1r+/+-HGF mice, hyperpigmentation was not observed and there were few extra-follicular melanocytes. Thus, functional Mc1r was required for expression of the transgenic HGF phenotype. Heterozygous C57BL/6-Mc1re/+-HGF mice were black and hyperpigmented and, although extra-follicular melanocytes and skin melanin content were similar to C57BL/6-Mc1r+/+-HGF animals, they developed UV-induced and spontaneous melanomas with significantly less efficiency by all criteria. Thus, heterozygosity for Mc1r was sufficient to restore the transgenic HGF phenotype but insufficient to fully restore melanoma. We conclude that a previously unsuspected melanin-independent interaction between Mc1r and Met signaling pathways is required for HGF-dependent melanoma and postulate that this pathway is involved in human melanoma

1999-2000 Tribute - Music by Women Composers

This concert is presented by Palm Beach County Music Teacher\u27s Association.https://spiral.lynn.edu/conservatory_otherseasonalconcerts/1109/thumbnail.jp