NICPRINT-50, Being some account of the history of the printing, packaging and newspaper industry of South Africa, and of the National Industrial Council for Printing, prepared to mark the Jubilee of the Council 1919-1969

The National Industrial Council of the Printing and Newspaper Industry of South Africa celebrates its Golden Jubilee in 1969 and this thesis was undertaken primarily to examine and record the Socio-economic effects of its work. To set the achievements of the Council in perspective it was proposed to preface the record with a brief sketch of the industry itself, but what was intended as an introduction has grown into a major part of the finished work which therefore contains more history and less economics than originally planned. It is hoped that the work will be no less acceptable for this change of emphasis

Access to Principal Treatment Centres and survival rates for children and young people with cancer in Yorkshire, UK

Background: Principal Treatment Centres (PTC) were established to provide age-appropriate care as well as clinical expertise for children and young people with cancer. However, little is known about the effects of specialist treatment centres on survival outcomes especially for teenagers and young adults. This population-based study aimed to describe access to PTC and the associated trends in survival for 0–24 year olds accounting for stage of disease at presentation and treatment. Methods: Patients diagnosed from 1998–2009 aged 0–24 years were extracted from the Yorkshire Specialist Register of Cancer in Children and Young People, including information on all treating hospitals, followed-up until 31st December 2014. The six commonest cancer types were included: leukaemia (n = 684), lymphoma (n = 558), CNS tumours (n = 547), germ cell tumours (n = 364), soft tissue sarcomas (n = 171) and bone tumours (n = 163). Treatment was categorised into three groups: ‘all’, ‘some’ or ‘no’ treatment received at a PTC. Treatment at PTC was examined by diagnostic group and patient characteristics. Overall survival was modelled using Cox regression adjusting for case-mix including stage, treatment and other socio-demographic and clinical characteristics. Results: Overall 72% of patients received all their treatment at PTC whilst 13% had no treatment at PTC. This differed by diagnostic group and age at diagnosis. Leukaemia patients who received no treatment at PTC had an increased risk of death which was partially explained by differences in patient case-mix (adjusted Hazard Ratio (HR) = 1.73 (95%CI 0.98–3.04)). Soft tissue sarcoma patients who had some or no treatment at PTC had better survival outcomes, which remained after adjustment for patient case-mix (adjusted HR = 0.48 (95%CI 0.23–0.99)). There were no significant differences in outcomes for other diagnostic groups (lymphoma, CNS tumours, bone tumours and germ cell tumours). For leukaemia patients survival outcomes for low risk patients receiving no treatment at PTC were similar to high risk patients who received all treatment at PTC, implying a benefit for care at the PTC. Conclusion: This study demonstrates that for leukaemia patients receiving treatment at a PTC is associated with improved survival that may compensate for a poorer prognosis presentation. However, further information on risk factors is needed for all diagnostic groups in order to fully account for differences in patient case-mix

Why we should understand the patient experience: clinical empathy and medicines optimisation

Objectives To critically discuss the need for pharmacists to underpin their consultations with appropriate ‘clinical empathy’ as part of effective medicines optimisation. Methods Use of literature around empathy, consultation and pharmacy practice to develop a case for greater clinical empathy in pharmacy consultations. Key findings Clinical empathy is defined from the literature and applied to pharmacy consultations, with a comparison to empathy in other clinical professions. Historical barriers to the embedding of clinical empathy into pharmacy consultations are also explored. Conclusions We challenge the pharmacy profession to consider how clinical empathy should underpin consultations with a series of introspective questions and provide some sample questions to support pharmacy consultations. We also make the case for appropriate education and professional development of consultation skills at undergraduate and postgraduate level. We contend that patients’ relationships with practitioners are critical, and a lack of empathy can impact the effectiveness of care

After-exercise heart rate variability is attenuated in postmenopausal women and unaffected by estrogen therapy

Delayed heart rate (HR) recovery in the immediate postexercise period has been linked to adverse cardiovascular prognosis. The after effects of an acute bout of exercise on HR modulation in postmenopausal women (PMW) and the influence of estrogen therapy are unknown.In 13 sedentary PMW (54 ± 2 y, mean ± SEM), we assessed HR variability (HRV) -an index of HR modulation-and the influence of estrogen therapy on HRV. HRV in the frequency domain was quantified during supine rest and again 60 minutes after treadmill exercise for 45 minutes, at 60% VO2peak. PMW were studied before and after 4 weeks of oral estradiol. To obtain reference values for the after effects of exercise on HRV in healthy young women, 14 premenopausal women (PreM) completed the identical exercise protocol.Compared with PreM, PMW demonstrated lower high frequency (vagal modulation) and total HRV (P < 0.05) at rest. In PreM, all HRV values were similar before and after exercise. In contrast, in PMW after exercise, despite having identical HR to PreM, high frequency and total HRV were all lower (all P ≤ 0.01) compared with pre-exercise HRV values. Estrogen therapy had no effect on pre or postexercise values for HRV.When compared with PreM, PMW have identical HR, but lower vagal HR modulation at rest and delayed HRV recovery after exercise. Estrogen does not restore baseline HRV or accelerate HRV recovery postexercise, suggesting aging rather than estrogen deficiency per se may lower HRV in PMW

Down-regulation of human osteoblast PTH/PTHrP receptor mRNA in end-stage renal failure

Down-regulation of human osteoblast PTH/PTHrP receptor mRNA in end-stage renal failure.BackgroundResistance to the action of parathyroid hormone (PTH) has been demonstrated in end-stage renal failure and is considered to be important in the pathogenesis of secondary hyperparathyroidism. The mechanism of resistance is unknown. However, altered regulation of cellular PTH/PTH-related protein (PTH/PTHrP) receptor (PTH1R) has been assumed to be important.MethodsWe have used in situ hybridization to examine PTH1R mRNA expression by osteoblasts in human bone and have compared the expression in high- and low-turnover renal bone disease, high-turnover nonrenal bone disease (healing fracture callus and Pagetic bone), and normal bone. Bone biopsies were formalin fixed, ethylenediaminetetraacetic acid decalcified, and paraffin wax embedded. A 1.8kb PTH1R cDNA probe, labeled with 35S, was used, and the hybridization signal was revealed by autoradiography. The density of signal over osteoblasts was quantitated using a semiautomated Leica™ image analysis software package.ResultsThe mean density of PTH1R mRNA signal over osteoblasts in renal high-turnover bone was only 36% of that found in nonrenal high-turnover bone (P < 0.05) and 51% of that found in normal bone (P < 0.05). Osteoblast PTH1R mRNA signal in adynamic bone from individuals with diabetes mellitus was 28% of normal bone (P < 0.05) and 54% of that found in renal high-turnover bone (P < 0.05).ConclusionsThese results demonstrate a down-regulation of osteoblast PTH1R mRNA in end-stage renal failure in comparison to normal and high-turnover bone from otherwise healthy individuals, and provide an insight into the mechanisms of “skeletal resistance” to the actions of PTH

The presentation and management of post-partum choriocarcinoma

Post-partum choriocarcinoma is a rare complication of pregnancy. We have analysed a series of nine consecutive patients presenting with choriocarcinoma after a full-term non-molar pregnancy. All patients were managed at the Supraregional Trophoblastic Disease Screening and Treatment Centre at Weston Park Hospital, Sheffield between 1987 and 1996. All presented with persistent primary or secondary post-partum haemorrhage. Treatment with multiagent chemotherapy (initially methotrexate, dactinomycin and etoposide) was successful in all cases. Early diagnosis is important because this rare condition is potentially curable with appropriate chemotherapy. © 1999 Cancer Research Campaig

Learner success and digital technologies

This entry examines the role digital technologies play in learner success, both as a factor that impacts on learner success and in the context of digital technology’s role in institutional initiatives and supports designed to enhance learner success. The common goal of learners and educational institutions is that a learner will achieve their educational goals within that institution. When a learner withdraws from the institution this represents a loss of opportunity for that individual to achieve those goals, a loss to the institution in terms of mission and income, as well as a loss to society with regard to the benefits that accrue from an educated populace. Where students do not exit the institution, but progress through a programme without achieving the success of which they are capable, this also represents a loss of potential for the individual, the institution, and society. Learner success is impacted by both learner characteristics and institutional structures and processes. Institutions can enhance learner success through strategic initiatives and the targeted deployment of effective learner supports (Thomas, Hill, O’Mahony, & Yorke, 2017). In most cases such initiatives and supports are mediated through digital technologies, as their use now permeates most forms of teaching and learning activity

An ArcGIS Tool for Modeling the Climate Envelope with Feed-Forward ANN

This paper is about the development and the application of an ESRI ArcGIS tool which implements multi-layer, feed-forward artificial neural network (ANN) to study the climate envelope of species. The supervised learning is achieved by backpropagation algorithm. Based on the distribution and the grids of the climate (and edaphic data) of the reference and future periods the tool predicts the future potential distribution of the studied species. The trained network can be saved and loaded. A modeling result based on the distribution of European larch (Larix decidua Mill.) is presented as a case study