Coping with HIV-seropositive status: a psychoneuroimmunological perspective

Twenty-seven HIV-infected homosexual men participating in an experimental drug trial were included in a psychoneuroimmunological investigation of the association between levels of short-term emotional distress, methods of coping, hopelessness, loneliness, joy, and CDS-cell counts, CD4-cell counts, and the cumulative rate of CD4-cell decline since infection. A survey of needs was included. The sample (n = 27) was significantly more depressed (p p 0.05) were found for all problem-focused coping and emotion-focusing coping scales, nor for coping by means of focusing upon and venting of emotions. Five subjects who had been infected for less than two years were excluded from analyses regarding immune functioning. For the remaining 22 subjects, no significant associations between psychosocial factors and CDS-cell counts were found (p > 0.05), nor were there any significant associations between measures of short A regression model containing the coping scales of suppression of competing activities and mental disengagement predicted 33.3 percent of cross-sectional CD4-cell counts (f = 4.737, df = 2, 19, p < 0.05). Both factors were negatively associated with CD4-cell counts. A regression model containing the coping methods of focusing upon and venting of emotions and mental disengagement predicted 29 percent of CD4- rates of decline over time (f = 3.874, df = 2, 19, p < 0.05). The venting of emotions scale was associated with slower rates of CD4-cell decline over time (r = -0.433, df = 21, p < 0.05), while mental disengagement coping was associated with faster rates of CD4-cell decline (r = + 0.314, df = 21, p = 0.16). A median-split of scores on the focusing upon and venting of emotions coping scale and CD4-rates of decline reveals that high venting scores are found in 77 percent of subjects with slow rates of decline, while low scores are evident for 78 percent of those with fast rates of cumulative CD4-cell decline since infection. It was concluded that these results are consistent with previous research concerning with the immunosuppressive effects of habitual repression of emotions and the long-term maladaptive effects of avoidance coping. -term POMS scales of emotional distress and CD4-cell counts and rates of decline over time

Patterns of care for diabetes: risk factors for vision-threatening retinopathy

OBJECTIVES: In Australia, diabetes causes significant morbidity and mortality. Whilst the need to prevent diabetes and its complications has been widely recognised, the capacity of health care systems - which organise diabetes care - to facilitate prevention has not been fully established. METHODS: A series of seven population-based case-control studies were used to examine the effectiveness of the Australian health care system and its capacity to manage diabetes. Six of the studies compared the patterns of care of patients who had developed advanced diabetes complications in 2000 (cases), to similar patients who remained free of the condition (controls) across Australia and for various risk groups. A secondary study investigated the role of treating GPs in the development of the outcome. RESULTS: A strong relationship between the patterns of care and the development of advanced diabetes complications was found and is described in Chapter 4. In Chapter 5, this same relationship was investigated for each Australian state and territory, and similar findings were made. The study in Chapter 6 investigated whether late diagnosis or the patterns of care was the stronger risk factor for advanced diabetes complications, finding that the greatest risk was associated with the latter. In Chapter 7 the influence of medical care during the pre-diagnosis period was explored, and a strong relationship between care obtained in this period and the development of advanced complications was found. In Chapter 8, which investigated the role of socio-economic status in the development of advanced complications, found that the risk of advanced diabetes complications was higher in low socio-economic groups. Chapter 9 investigated geographic isolation and the development of advanced diabetes complications and found that the risk of advanced complications was higher in geographically isolated populations. Finally, Chapter 10, which utilised a provider database, found that some GP characteristics were associated with the development of advanced diabetes complications in patients. CONCLUSION: A number of major risk factors for the development of advanced complications in Australia was found. These related to poorer diabetes management, later diagnosis, low socioeconomic status and geographic isolation. Strategies must be devised to promote effective diabetes management and the early diagnosis of diabetes across the Australian population

Patterns of care for diabetes: risk factors for vision-threatening retinopathy

OBJECTIVES: In Australia, diabetes causes significant morbidity and mortality. Whilst the need to prevent diabetes and its complications has been widely recognised, the capacity of health care systems - which organise diabetes care - to facilitate prevention has not been fully established. METHODS: A series of seven population-based case-control studies were used to examine the effectiveness of the Australian health care system and its capacity to manage diabetes. Six of the studies compared the patterns of care of patients who had developed advanced diabetes complications in 2000 (cases), to similar patients who remained free of the condition (controls) across Australia and for various risk groups. A secondary study investigated the role of treating GPs in the development of the outcome. RESULTS: A strong relationship between the patterns of care and the development of advanced diabetes complications was found and is described in Chapter 4. In Chapter 5, this same relationship was investigated for each Australian state and territory, and similar findings were made. The study in Chapter 6 investigated whether late diagnosis or the patterns of care was the stronger risk factor for advanced diabetes complications, finding that the greatest risk was associated with the latter. In Chapter 7 the influence of medical care during the pre-diagnosis period was explored, and a strong relationship between care obtained in this period and the development of advanced complications was found. In Chapter 8, which investigated the role of socio-economic status in the development of advanced complications, found that the risk of advanced diabetes complications was higher in low socio-economic groups. Chapter 9 investigated geographic isolation and the development of advanced diabetes complications and found that the risk of advanced complications was higher in geographically isolated populations. Finally, Chapter 10, which utilised a provider database, found that some GP characteristics were associated with the development of advanced diabetes complications in patients. CONCLUSION: A number of major risk factors for the development of advanced complications in Australia was found. These related to poorer diabetes management, later diagnosis, low socioeconomic status and geographic isolation. Strategies must be devised to promote effective diabetes management and the early diagnosis of diabetes across the Australian population

Refining the real estate pricing model

Investment theory dictates that capitalisation (cap) rates for freehold real estate should be determined by the risk free nominal rate of return plus the risk premium (RP) less the expected growth rate, with an allowance for depreciation. However, importing the concept of the RP from the capital markets fails to guide investors through the complexities of the asset, or enable exploration of purchaser preferences and behaviour. A refined pricing model for real estate is proposed, based on a concept termed a risk scale, to distinguish between macro (market) and micro (stock) determinants of risk and growth within the RP. This pricing model is estimated for a major global investment market, using a cross-sectional inter-temporal framework, with a dataset of 497 transactions in the London office sector over 2010Q2-2012Q3. Average cap rates are estimated at just over 5%, with asset-specific attributes dominating yield determination, with submarket quality and tenant covenant most important; and unexpired term insignificant, surprising during the “flight to safety” characterising the period. International investors bought at lower cap rates, despite the ongoing economic and financial instability of the study period. Improving understanding of pricing behaviour and market transparency is important and may be advanced through the pricing model

132 kV optical voltage sensor for wide area monitoring, protection and control applications

This paper reports on the design, construction and initial testing of a fiber-optic voltage sensor for applications in the field of wide area monitoring, protection and control of high voltage power networks. The 132-kV sensor prototype, combining a capacitive voltage divider (CVD) and an optical low voltage transducer (LVT), was evaluated through laboratory testing and its performance was assessed based on the accuracy requirements specified by the IEC standards for low-power passive voltage transformers. The preliminary results show that the device has the potential to comply with the requirements of the 0,2 class for metering devices, and the 3P and 0,5P classes for protective and multipurpose devices, respectively, as specified by IEC 61869-11. As the device is based on a fiber Bragg grating written in a standard, low-loss, single-mode telecommunication fiber, it has the potential to be deployed as part of a distributed network of sensors along the power network over a wide geographical area, enabling novel power system protection and control strategies

A focused telephonic nursing intervention delivers improved adherence to A1c testing

Compliance with hemoglobin A1c (A1c) testing is suboptimal despite the clear national recommendations and guidelines established for care of patients with diabetes. Recent studies have demonstrated a relationship between participation in a diabetes disease management (DM) program and improved adherence to A1c testing. A focused intervention study was initiated to investigate the ability of a DM program to drive improvement in A1c testing. A cohort of 36,327 members experienced a statistically significant increase (29%) in A1c testing while participating in the 6-month focused intervention. This finding demonstrated that a focused DM intervention is able to deliver improvement in a clinical process metric critical for managing patients with diabetes, thereby reducing their risk of disease exacerbation

Single-ended differential protection in MTDC networks using optical sensors

This paper presents a method for rapid detection of faults on VSC multi-terminal HVDC transmission networks using multi-point optical current sensing. The proposed method uses differential protection as a guiding principle, and is implemented using current measurements obtained from optical current sensors distributed along the transmission line. Performance is assessed through detailed transient simulation using Matlab/Simulink® models, integrating inductive DC-line terminations, detailed DC circuit breaker models and a network of fiber-optic current sensors. Moreover, the feasibility and required performance of optical-based measurements is validated through laboratory testing. Simulation results demonstrate that the proposed protection algorithm can effectively, and within very short period of time, discriminate between faults on the protected line (internal faults), and those occurring on adjacent lines or busbars (external faults). Hardware tests prove that the scheme can be achieved with the existing, available sensing technology

Dependence on Mincle and Dectin-2 Varies With Multiple Candida Species During Systemic Infection

FUNDING SO was supported by a Sir Henry Dale Fellowship jointly funded by the Wellcome Trust and the Royal Society (Grant No. 099953/Z/12/Z) and by a Wellcome Trust Cross-Disciplinary Award. NG acknowledges Wellcome Trust support of a Senior Investigator (101873/Z/13/Z), Collaborative (200208/A/15/Z) and Strategic Awards (097377/Z11/Z) and the MRC Centre for Medical Mycology (MR/N006364/2). PT was funded by a Wellcome Trust Investigator Award (107964/Z/15/Z) and the UK Dementia Research Institute. ACKNOWLEDGMENTS We wish to acknowledge the NIH-sponsored Mutant Mouse Regional Resource Center (MMRRC) National System as the source of genetically altered mice (C57BL/6-Clec4et m1. 1C fg /Mmucd 031936-UCD) for use in this study. The mice were produced and deposited to the MMRRC by the Consortium for Functional Glycomics supported by the National Institute of General Medical Sciences (GM62116). We also thank the Microscopy and Histology Core Facility at the University of Aberdeen for expert assistance with TEM.Peer reviewedPublisher PD