Co-construction of chronic illness narratives by older stroke survivors and their spouses

Illness narratives have mainly focused on individual patients' accounts, and particularly those of people experiencing the onset of chronic illness in mid-life. However, a growing number of older people are spending their later life with their partner, with both experiencing complex morbidities. We examine the shared creation of meanings among older stroke survivors and their spouses and the implications for individual and couple identity. Joint biographical narrative interviews were held with 13 stroke survivors aged 75-85 and their spouses. The analysis examined both narrative content and narrative style. Three main types of co-presentation of identity were identified. The 'united couple' described couples who pulled together and emphasised their accommodation of the stroke and normality as a couple, despite often considerable disability, and was strongly underpinned by collaborative interaction in interviews. Caring relationships were distinguished as 'positive', involving self-reliant couples who took pride in how they managed and 'frustrated' in couples who emphasised the difficulties of caring and hardships experienced and were characterised by a conflictual style of narrative. We argue that joint interviews provide new forms of data that extend notions of how illness is lived and demonstrates how the marital relationship can mediate the experience of chronic illness and disability and its impact on identity. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/JohnWiley & Sons Ltd

Perencanaan Suplai Energi Listrik Untuk Mencapai Zero Energy Building Pada Rencana Pusat Kegiatan Kemahasiswaa Dan Olahraga Di Kampus Universitas Kristen Indonesia

This research plans the energy supply will be used for The main of students and sports's program in Universitas Kristen Indonesia. There are three kind of energy supply alternative which available in this research, the first is Offgrid system which only applied by solar panel, and then Off-grid system which lean on a hybird like a solar panel and diesel generator, and the other system is on-grid system activated by solar panel which already linked to the system. The method used is a technical and financial feasibility study for each option. The financial aspects that are taken into account are maintenance costs, operating costs, procurement costs and other costs. Technical aspects are influenced by the type of solar panel, the amount of load, type of battery, and other variables The application used to perform technical and financial analysis is RETScreen. Technical and financial analysis is done after knowing the sum of the load. While an appropriate selection has finished by RETScreen application, there will show the result like the great emission is using a solar panel alternative with 0 tons CO2/year, the next is an alternative by using a solar panel gather with on-grid system to utilize solar rooftop, the result is 559 tons CO2/year and the hybrid option with a yield of 1874 tons of CO2 / year is the worst option. The best cost calculation result is the first option, that is, with solar panels, the positive side is faster when using for 11 years and 6 months, the comparison of the cost of the second option with the first option is 1: 1.02 and the hybrid system as the last option with never results. there is on the positive side (always loss) for 25 years of the project. It can be concluded that the best choice is an off-grid system but the land used is very wide, so another alternative option is the on-grid system by installing rooftop solar. Keywords: solar cells, electrical energy, emissions, calculation of electrical energy, RETScree

Analisis Probabilistik Terhadap Energi Yang Dibangkitkan Oleh Solar Photovoltaic Pada Daerah Berbeda Iklim

Penelitian ini menganalisa energi yang dibangkitkan oleh solar photovoltaic (pv) dengan pendekatan probabilistik di lima daerah yang berbeda keadaan iklimnya di Indonesia. Ke lima daerah ini mewakili semua daerah yang ada di Indonesia. Metode yang digunakan adalah metode Monte Carlo Simulation (MCS). Aplikasi yang digunakan pada penelitian ini adalah @RISK Risk Analysis Project Model. Variabel tak tentu (random variable) yang diperhitungkan dalam penelitian ini adalah suhu rata-rata, lama penyinaran matahari dan radiasi matahari, karena ketiga variabel ini bersifat fluktuatif sehingga masing-masing variabel mempunyai fungsi distribusi. Dalam penelitian ini masing-masing variabel didekati dengan fungsi distribusi uniform. Dari hasil yang diperoleh dapat dilihat bahwa energi tertinggi yang dibangkitkan oleh solar pv dengan kapasitas 100Wp ada pada Kota Surabaya yaitu sebesar 229.73 kWh dalam satu tahun dengan probabilitas 35%. Energi yang dibangkitkan oleh solar pv pada Kota Surabaya tersebut identik dengan capacity factor sebesar 26.22%. Sementara Kabupaten Sorong untuk kapasitas solar pv yang sama 100 Wp, energi yang dibangkitkan adalah sebesar 179.29 kWh dengan probabilitas 31% dan capacity factor 20.47%. Energi yang dibangkitkan di Kabupaten Sorong ini adalah sekitar 78% dari energi yang dibangkitkan di Kota Surabaya. Kabupaten Manggarai untuk kapasitas solar pv yang sama 100 Wp, energi yang dibangkitkan adalah sebesar 178.54 kWh dengan probabilitas 43% dan capacity factor 20.38%. Energi yang dibangkitkan di Kabupaten Manggarai ini adalah sekitar 99% dari energi yang dibangkitkan di Kabupaten Sorong dan sekitar 77% dari energi yang dibangkitkan di Kota Surabaya. Dari hasil ini dapat dilihat bahwa faktor suhu, lama penyinaran matahari dan radiasi matahari sangat menentukan energi yang dapat dibangkitkan oleh solar pv. Jadi jika ingin membangun suatu instalasi suatu solar pv, harus memperhatikan variabel-variabel tersebut agar energi yang diinginkan tercapai

Dynamic clamp with StdpC software

Dynamic clamp is a powerful method that allows the introduction of artificial electrical components into target cells to simulate ionic conductances and synaptic inputs. This method is based on a fast cycle of measuring the membrane potential of a cell, calculating the current of a desired simulated component using an appropriate model and injecting this current into the cell. Here we present a dynamic clamp protocol using free, fully integrated, open-source software (StdpC, for spike timing-dependent plasticity clamp). Use of this protocol does not require specialist hardware, costly commercial software, experience in real-time operating systems or a strong programming background. The software enables the configuration and operation of a wide range of complex and fully automated dynamic clamp experiments through an intuitive and powerful interface with a minimal initial lead time of a few hours. After initial configuration, experimental results can be generated within minutes of establishing cell recording

Point-of-care testing and treatment of sexually transmitted and genital infections during pregnancy in Papua New Guinea (WANTAIM trial): protocol for an economic evaluation alongside a cluster-randomised trial

INTRODUCTION: Left untreated, sexually transmitted and genital infections (henceforth STIs) in pregnancy can lead to serious adverse outcomes for mother and child. Papua New Guinea (PNG) has among the highest prevalence of curable STIs including syphilis, chlamydia, gonorrhoea, trichomoniasis and bacterial vaginosis, and high neonatal mortality rates. Diagnosis and treatment of these STIs in PNG rely on syndromic management. Advances in STI diagnostics through point-of-care (PoC) testing using GeneXpert technology hold promise for resource-constrained countries such as PNG. This paper describes the planned economic evaluation of a cluster-randomised cross-over trial comparing antenatal PoC testing and immediate treatment of curable STIs with standard antenatal care in two provinces in PNG. METHODS AND ANALYSIS: Cost-effectiveness of the PoC intervention compared with standard antenatal care will be assessed prospectively over the trial period (2017-2021) from societal and provider perspectives. Incremental cost-effectiveness ratios will be calculated for the primary health outcome, a composite measure of the proportion of either preterm birth and/or low birth weight; for life years saved; for disability-adjusted life years averted; and for non-health benefits (financial risk protection and improved health equity). Scenario analyses will be conducted to identify scale-up options, and budget impact analysis will be undertaken to understand short-term financial impacts of intervention adoption on the national budget. Deterministic and probabilistic sensitivity analysis will be conducted to account for uncertainty in key model inputs. ETHICS AND DISSEMINATION: This study has ethical approval from the Institutional Review Board of the PNG Institute of Medical Research; the Medical Research Advisory Committee of the PNG National Department of Health; the Human Research Ethics Committee of the University of New South Wales; and the Research Ethics Committee of the London School of Hygiene and Tropical Medicine. Findings will be disseminated through national stakeholder meetings, conferences, peer-reviewed publications and policy briefs. TRIAL REGISTRATION NUMBER: ISRCTN37134032

Prenatal Hypoxic-Ischemic Insult Changes the Distribution and Number of NADPH-Diaphorase Cells in the Cerebellum

Astrogliosis, oligodendroglial death and motor deficits have been observed in the offspring of female rats that had their uterine arteries clamped at the 18th gestational day. Since nitric oxide has important roles in several inflammatory and developmental events, here we evaluated NADPH-diaphorase (NADPH-d) distribution in the cerebellum of rats submitted to this hypoxia-ischemia (HI) model. At postnatal (P) day 9, Purkinje cells of SHAM and non-manipulated (NM) animals showed NADPH-d+ labeling both in the cell body and dendritic arborization in folia 1 to 8, while HI animals presented a weaker labeling in both cellular structures. NADPH-d+ labeling in the molecular (ML), and in both the external and internal granular layer, was unaffected by HI at this age. At P23, labeling in Purkinje cells was absent in all three groups. Ectopic NADPH-d+ cells in the ML of folia 1 to 4 and folium 10 were present exclusively in HI animals. This labeling pattern was maintained up to P90 in folium 10. In the cerebellar white matter (WM), at P9 and P23, microglial (ED1+) NADPH-d+ cells, were observed in all groups. At P23, only HI animals presented NADPH-d labeling in the cell body and processes of reactive astrocytes (GFAP+). At P9 and P23, the number of NADPH-d+ cells in the WM was higher in HI animals than in SHAM and NM ones. At P45 and at P90 no NADPH-d+ cells were observed in the WM of the three groups. Our results indicate that HI insults lead to long-lasting alterations in nitric oxide synthase expression in the cerebellum. Such alterations in cerebellar differentiation might explain, at least in part, the motor deficits that are commonly observed in this model

Inferring the Regulatory Network of the miRNA-mediated Response to Biotic and Abiotic Stress in Melon

[EN] Background: MiRNAs have emerged as key regulators of stress response in plants, suggesting their potential as candidates for knock-in/out to improve stress tolerance in agricultural crops. Although diverse assays have been performed, systematic and detailed studies of miRNA expression and function during exposure to multiple environments in crops are limited. Results: Here, we present such pioneering analysis in melon plants in response to seven biotic and abiotic stress conditions. Deep-sequencing and computational approaches have identified twenty-four known miRNAs whose expression was significantly altered under at least one stress condition, observing that down-regulation was preponderant. Additionally, miRNA function was characterized by high scale degradome assays and quantitative RNA measurements over the intended target mRNAs, providing mechanistic insight. Clustering analysis provided evidence that eight miRNAs showed a broad response range under the stress conditions analyzed, whereas another eight miRNAs displayed a narrow response range. Transcription factors were predominantly targeted by stressresponsive miRNAs in melon. Furthermore, our results show that the miRNAs that are down-regulated upon stress predominantly have as targets genes that are known to participate in the stress response by the plant, whereas the miRNAs that are up-regulated control genes linked to development. Conclusion: Altogether, this high-resolution analysis of miRNA-target interactions, combining experimental and computational work, Illustrates the close interplay between miRNAs and the response to diverse environmental conditions, in melon.The authors thank Dr. A. Monforte for providing melon seeds and Dra. B. Pico (Cucurbits Group - COMAV) for providing melon seeds and Monosporascus isolate respectively. This work was supported by grants AGL2016-79825-R, BIO2014-61826-EXP (GG), and BFU2015-66894-P (GR) from the Spanish Ministry of Economy and Competitiveness (co-supported by FEDER). The funders had no role in the experiment design, data analysis, decision to publish, or preparation of the manuscript.Sanz-Carbonell, A.; Marques Romero, MC.; Bustamante-González, AJ.; Fares Riaño, MA.; Rodrigo Tarrega, G.; Gomez, GG. (2019). Inferring the Regulatory Network of the miRNA-mediated Response to Biotic and Abiotic Stress in Melon. BMC Plant Biology. 1-17. https://doi.org/10.1186/s12870-019-1679-0S117Zhang B. MicroRNAs: a new target for improving plant tolerance to abiotic stress. J Exp Bot. 2015;66:1749–61.Zhu JK. Abiotic stress signaling and responses in plants. Cell. 2016;167:313–24.Bielach A, Hrtyan M, Tognetti VB. Plants under stress: involvement of auxin and Cytokinin. Int J Mol Sci. 2017;4(18):7.Zarattini M, Forlani G. 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A new test of the construct validity of the CarerQol instrument: measuring the impact of informal care giving

Purpose: Most economic evaluations of health care programmes do not consider the effects of informal care, while this could lead to suboptimal policy decisions. This study investigates the construct validity of the CarerQol instrument, which measures and values carer effects, in a new population of informal caregivers. Methods: A questionnaire was distributed by mail (n = 1,100, net response rate = 21%) to regional informal care support centers throughout the Netherlands. Two types of construct validity, i.e., convergent and clinical validity, have been analyzed. Convergent validity was assessed with Spearman's correlation coefficients and multivariate correlation between the burden dimensions (CarerQol-7D) and the valuation component (CarerQol-VAS) of the CarerQol. Additionally, convergent validity was analyzed with Spearman's correlation coefficients between the CarerQol and other measures of subjective caregiver burden (SRB, PU). Clinical validity was evaluated with multivariate correlation between CarerQol-VAS and CarerQol-7D, characteristics of caregivers, care recipients and care situation among the whole sample of caregivers and subgroups. Results: The positive (negative) dimensions of CarerQol-7D were positively (negatively) related to CarerQol-VAS, and almost all had moderate strength of convergent validity. CarerQol-VAS was positively associated with PU and negatively with SRB. The CarerQol-VAS reflects differences in important background characteristics of informal care: type of relationship, age of the care recipient and duration of care giving were associated with higher CarerQol-VAS scores. These results confirmed earlier tests of the construct validity of the CarerQol. Furthermore, the dimensions of CarerQol-7D significantly explained differences in CarerQol-VAS scores among subgroups of carers. Conclusion: Notwithstanding the limitations of our study, such as the low response rate, this study shows that the CarerQol provides a valid means to measure carer effects for use in economic evaluations. Future research should derive a valuation set for the CarerQol and further address the instrument's content validity, sensitivity and reliability