Barriers to reporting non-motor symptoms to health-care providers in people with Parkinson's

Background: Non-motor symptoms (NMS) are common in Parkinson's disease (PD) and cause significant distress. A high rate of non-declaration of NMS by patients to healthcare providers (HCP) means that many NMS remain untreated. Current understanding of the factors preventing disclosure of NMS to HCPs is limited. The present study aimed to i) further assess the prevalence of NMS and associated distress, ii) establish current rates of NMS reporting across a range of sources, and iii) explore overall and any symptom specific barriers to help-seeking for NMS. Methods: 358 PD patients completed a cross-sectional survey of NMS severity, reporting and barriers to help-seeking. A series of Generalised Estimating Equations were used to determine whether barriers were symptom specific. Results: A mean of 10.5 NMS were reported by each patient. Rates of non-reporting of NMS ranged from 15 to 72% of those experiencing distressing symptoms. The most commonly reported barriers to help-seeking were acceptance of symptoms; lack of awareness that a symptom was associated with PD, and belief that no effective treatments were available. Symptom specific barriers were found for sexual dysfunction (embarrassment), unexplained pain and urinary problems (belief about lack of treatment availability). Conclusion: A diverse range of barriers prevent PD patients reporting NMS to HCPs and these barriers differ between NMS. The study provides the foundations for developing interventions to increase reporting by targeting individual NMS. Increasing rates of help-seeking for NMS by patients to their Parkinson's healthcare providers will increase appropriate clinical care which may improve quality of life and well-being

Extended Molecular Gas in the Nearby Starburst Galaxy Maffei 2

We present a 9'x9' fully-sampled map of the CO J=1-0 emission in the nearby starburst galaxy Maffei 2 obtained at the Five College Radio Astronomy Observatory. The map reveals previously known strong CO emission in the central starburst region as well as an extended asymmetric distribution with bright CO lines at the ends of the bar and in a feature at the north-east edge of the molecular disk. This northern feature, proposed previously to be an interacting companion galaxy, could be a dwarf irregular galaxy, although the CO data are also consistent with the feature being simply an extension of one of the spiral arms. We estimate the total molecular gas mass of Maffei 2 to be (1.4-1.7)x10^9 Mo or ~3-4% of its dynamical mass. Adopting the recently determined lower value for the CO-to-H2 conversion factor in the central region, our data lead to the surprising result that the largest concentrations of molecular gas in Maffei 2 lie at the bar ends and in the putative dwarf companion rather than in the central starburst. A gravitational stability analysis reveals that the extended disk of Maffei 2 lies above the critical density for star formation; however, whether the central region is also gravitationally unstable depends both on the details of the rotation curve and the precise value of the CO-to-H2 conversion factor in this region.Comment: accepted to ApJ (Sept 10 2004 issue

The Purdue Center for Commercial Agriculture Crop Basis Tool

The Purdue Center for Commercial Agriculture Crop Basis Tool is an open-access web-based tool that provides members of the grain industry with access to weekly historical and contemporaneous corn and soybean basis data for local market regions in the eastern Corn Belt. Previously unavailable to most producers in the region, the information the Crop Basis Tool provides has the potential to greatly improve producers\u27 marketing risk management decisions through improved basis forecasts. In addition, there are a myriad of opportunities for Extension personnel to incorporate the Crop Basis Tool in their marketing risk management education and outlook programming

Guided Poster Tour

Objective 1) To identify patient barriers to help-seeking for non-motor symptoms (NMS) from their Parkinson’s healthcare provider, 2) To determine whether barriers are symptom specific (e.g. embarrassment disclosing sexual problems) or patient specific (e.g. misattribution of a range of NMS to old age). Background NMS are common in Parkinson’s disease (PD) and cause significant distress and decreased quality of life. A high rate of non-declaration of NMS by patients to healthcare providers means that many NMS remain unrecognized and untreated, even in specialist clinical services. Current understanding of the factors preventing disclosure of NMS to healthcare professions is limited. Method 358 PD patients completed the Non-motor Symptom Questionnaire and a barriers to help-seeking for NMS questionnaire developed from previous qualitative work. A Generalised Estimating Equation was used to determine whether barriers were symptom or individual specific. Results The sample had a mean age of 66.3 years, mean disease duration of 5.9 years and were 52.5% male. Urinary urgency was the most common NMS (65%) and sexual dysfunction was the symptom most frequently not disclosed (52%). Barriers to symptom disclosure varied dependent on symptom type. Pain and sleep problems were commonly not thought to be symptoms of PD. Bowel and bladder symptoms were often simply accepted as part of daily life and participants were unsure about the availability of effective treatments. Patients experienced embarrassment discussing sexual dysfunction. Conclusion Our results highlight the barriers which prevent PD patients reporting NMS to their Parkinson’s clinical team and the diversity of these barriers between different NMS. Strategies to improve rates of reporting must target individual NMS. For example, effective interventions might provide information regarding treatment efficacy for bowel and bladder symptoms or develop communication skills and normalising information for sexual dysfunction. The study provides the information needed to develop such individualised interventions. Increasing rates of disclosure of NMS by patients to their Parkinson’s healthcare providers will ensure patients receive appropriate clinical care which may increase quality of life and well-being

UV Imaging Polarimetry of the Seyfert 2 Galaxy Mrk 3

We present UV imaging polarimetry data of the Seyfert 2 galaxy Mrk 3 taken by the Hubble Space Telescope. The polarized flux is found to be extended to ~1 kpc from the nucleus, and the position angles of polarization are centrosymmetric, confirming that the polarization is caused by scattering. We determine the location of the hidden nucleus as the center of this centrosymmetric pattern. From the polarization images taken in two broad bands, we have obtained the color distribution of the polarized flux. Some regions have blue polarized flux, consistent with optically-thin dust scattering, but some bright knots have a color similar to that of Seyfert 1 nucleus. Also, the recent Chandra X-ray observation suggests that the ratio of scattered UV flux to scattered X-ray flux is rather similar to the intrinsic UV/X-ray ratio in a Seyfert 1 nucleus, if the observed extended X-ray continuum is scattered light. While the scattered X-ray would be essentially from electron scattering, the UV slope and UV/X-ray ratio both being similar to Seyfert 1's would lead to two possibilities as to the nature of the UV scatterers. One is that the UV may also be scattered by electrons, in which case the scattering gas is somehow dust-free. The other is that the UV is scattered by dust grains, but the wavelength-independent UV scattering with low efficiency indicated by the UV slope and UV/X-ray ratio would suggest that the grains reside in UV-opaque clouds, or the dust might be mainly composed of large grains and lacks small-grain population.Comment: 15 pages, 8 figures (plus 2 color versions of grayscale figures), To appear in ApJ; minor corrections for the proofs of the manuscrip

Biogenesis of mitochondrial porin

We review here the present knowledge about the pathway of import and assembly of porin into mitochondria and compare it to those of other mitochondrial proteins. Porin, like all outer mitochondrial membrane proteins studied so far is made as a precursor without a cleavble lsquosignalrsquo sequence; thus targeting information must reside in the mature sequence. At least part of this information appears to be located at the amino-terminal end of the molecule. Transport into mitochondria can occur post-translationally. In a first step, the porin precursor is specifically recognized on the mitochondrial surface by a protease sensitive receptor. In a second step, porin precursor inserts partially into the outer membrane. This step is mediated by a component of the import machinery common to the import pathways of precursor proteins destined for other mitochondrial subcompartments. Finally, porin is assembled to produce the functional oligomeric form of an integral membrane protein wich is characterized by its extreme protease resistance

Motion-base simulator study of control of an externally blown flap STOL transport aircraft after failure of an outboard engine during landing approach

A moving-base simulator investigation of the problems of recovery and landing of a STOL aircraft after failure of an outboard engine during final approach was made. The approaches were made at 75 knots along a 6 deg glide slope. The engine was failed at low altitude and the option to go around was not allowed. The aircraft was simulated with each of three control systems, and it had four high-bypass-ratio fan-jet engines exhausting against large triple-slotted wing flaps to produce additional lift. A virtual-image out-the-window television display of a simulated STOL airport was operating during part of the investigation. Also, a simple heads-up flight director display superimposed on the airport landing scene was used by the pilots to make some of the recoveries following an engine failure. The results of the study indicated that the variation in visual cues and/or motion cues had little effect on the outcome of a recovery, but they did have some effect on the pilot's response and control patterns

Examining Chemotherapy-Related Cognitive Changes in Colorectal Cancer Patients: A Feasibility Trial

Introduction: Research suggests that chemotherapy may be related to decline in patients’ cognitive functions. Objectives: To assess the feasibility and acceptability of a multi-site study designed to examine the nature and extent of chemotherapy-related cognitive changes in colorectal cancer patients. Method: Data was collected over 8 months using objective and self-reported measures of cognitive functioning and self-reported quality of life, fatigue and mood questionnaires. The assessment battery was administered pre- and mid-chemotherapy treatment to a consecutive sample of colorectal cancer patients across three Londonbased NHS Trusts. Participants included patients who had undergone colorectal surgery and were scheduled to have adjuvant chemotherapy treatment, or no further cancer treatment. Main outcome measures: Recruitment procedures, rate of recruitment, suitability of exclusion/inclusion criteria, acceptability of data collection procedures and the battery, and attrition rates. Results: From 1 April 2014 to 1 December 2014, 42 eligible participants were invited to take part in the trial. Of the 17 that completed pre-chemotherapy assessments, only 1 withdrew at follow-up due to reasons of ill health from disease recurrence. All participants completed the entire battery and indicated that they found the trial acceptable. Conclusions: What went wrong: Strained researcher resources; loss of eligible participants to competing studies, restrictive upper age limit. Possible solutions: Removal of upper age limit, an increased dedicated research team to increase rate of recruitment. The large multi-site study is feasible with suggested amendments and is acceptable to patients and medical teams. Acceptability of trial to medical teams is further evidenced by requests of collaboration from two additional London based NHS Trusts. Lessons learned: This feasibility trial provides evidence to other researchers designing similar studies in this area of an acceptable design and the need for appropriate funding for resources to recruit large enough consecutive samples of patients with solid tumour cancers