Causes and assessment of faecal incontinence

Faecal incontinence remains a taboo subject and patients frequently conceal their symptoms, because of fear and embarrassment. Sensitive and appropriate assessment will encourage people to seek advice and treatment if required. This article discusses the causes and assessment of faecal incontinence. It explains the structure and function of the anal sphincters in maintaining continence. Assessment of bowel control is discussed in depth. Questions are suggested which will help to identify problems and thereby enable access to appropriate care

Shades of Belonging

Examines data from the 2000 Census and information from surveys and focus groups conducted by the center to look at how Hispanics view their racial identities

Effect of cultivar, time of sowing and fungicide application on seed yield of cocksfoot (Dactylis glomerata L) : a thesis presented in partial fulfilment of the requirements for the degree of Master of Agricultural Science in Plant Science in Seed Technology at Massey University, Palmerston North, New Zealand

Three New Zealand (Grasslands Wana, Grasslands Kara, Grasslands Tekapo) and two Japanese (Akimidori, Makibamidori) cocksfoot cultivars were sown in spring (23 September 1991) and again the following autumn (6 April 1992) at AgResearch Grassland's Aorangi Research Farm in the Manawatu. Seed was sown at 3 kg/ha with a 30 cm row spacing. Plot size was 1.2 x 3.0 m2, with each plot containing 4 rows. A randomised block design was utilised with 8 replicates of each cultivar for each sowing time. For each cultivar and sowing time four of the eight replicates were sprayed with propiconazole (125 g a.i/ha) on 17 November 1992 and 8 December 1992. Spring sowings outyielded autumn sowings by 150 to 482 kg/ha depending on cultivar The ability of the spring sown cultivars to outproduce autumn sown cultivars was due largely to their ability to produce a greater number of fertile tillers. Autumn sown cultivars failed to produce a large number of fertile tillers which lead to a reduced potential seed yield. This was further exaserbated by the fact that the floret site utilisation (FSU) of the autumn sown cultivars was lower than that of the spring sown cultivars. Cultivar Wana was the only cultivar able to produce a reasonable number of fertile tillers following autumn sowing. It was also able to double the number of florets/tiller compared to that of spring sown cv Wana, thus allowing it to produce a reasonable seed yield. Cultivar Wana produced 557 kg seed/ha from the autumn sowing, and cv. Tekapo 244 kg seed/ha, but yields for the other three cultivars were less than 100 kg/ha following autumn sowing. Spring sowing produced pure seed yields of 707, 566, 593, 383 and 307 kg/ha for cv. Wana, Tekapo, Kara, Akimidori and Makibamidori respectively. Apart from cv Wana, fungicide application to autumn sown plots did not significantly increase seed yield, and similarly no differences were recorded for spring sown cv Akimidori and Makibamidori. However fungicide application significantly increased seed yieid in cv Wana, Kara and Tekapo, the increases being 521 (+ 74%), 119 (+ 21%) and 564 (+ 95%) kg/ha respectively, even though the incidences of fungal pathogens was less than 1%. These seed yield increases were due to an increase in the green area of the leaves and stem. In cv Wana and Tekapo there was also a significant increase in FSU due to the application of fungicide. Following harvest stubble was removed and the area retained for another year and subsequent harvest. As the effects of time of sowing were considered no longer significant, the trial was run as one block of 80 plots, thus giving 16 replicates of each cultivar. For each cultivar, four replicates received one of four different fungicide (188 g ai/ha of terbuconazole) treatments; a nil application, one application at approximately 10% ear emergence, one application at approximately 10% car emergence followed by another at early anthesis and one application at early anthesis followed by one post anthesis (10 days after full anthesis). In the absence of fungicide pure seed yields produced were 1133, 1208, 915, 556 and 671 kg/ha for cv. Wana, Kara, Tekapo, Makibamidori and Akimidori respectively. Although once again the incidence of fungal pathogens was less than 1%, fungicide increased the seed yield of all cultivars. The best results came from two applications of fungicide, one at ear emergence and one at anthesis. The exception to this was for cv Tekapo which gained the greatest increase from one application at ear emergence. These treatments increased the pure seed yield by 29%, 15%, 23%, 43% and 19% for cv Wana, Kara, Tekapo, Makibamidori and Akimidori respectively. Different cultivars reacted differently to the application of fungicide, with fungicide significantly increasing the thousand seed weight of cv Kara. Tekapo Akimidori and Makibamidori, although it had no such effect on cv Wana. Fungicide application increased the FSU of cv Wana and Tekapo but did not significantly affect cv Akimidori, Makibamidori and Kara. Cultivars Wana and Makibamidori showed a significant association between green area and seed yield, but these relationships were not significant for the other three cutivars. There was a significant association between FSU and seed yield after fungicide application for all the cultivars except cv Kara. The most cost effect return for the application of fungicide was that of a single application at ear emergence. Keywords: Cocksfoot, Dactylis glomerata, rust, eyespot, propiconazole, terbuconazole, fungicide, sowing date, cultivar

Honor and Destruction: The Conflicted Object in Moral Rights Law

In 1990, the Copyright Act was amended to name visual artists, alone among protected authors, possessors of moral rights, a set of non-economic intellectual property rights originating in nineteenth-century Europe. Although enhancing authors\u27 rights in a user-oriented system was a novel undertaking, it was rendered further anomalous by the statute\u27s designated class, given copyright\u27s longstanding alliance with text. And although moral rights epitomize the legacy of the Romantic author as a cultural trope embedded in the law, American culture offered little to support or explain the apparent privileging of visual artists over other authors. What, if not a legal or cultural disposition toward visual artists, precipitated the enactment of a moral rights statute like the Visual Artists Rights Act of 1990 (\u27\u27VARA )? This Article demonstrates that the answer is less related to authorship concerns than would reasonably be surmised from a doctrine premised on the theory that a creative work embodies the author\u27s honor, personhood, and even soul

The Role of Follicular Dendritic Cells in Human Immunodeficiency Virus Pathogenesis

Infection with Human Immunodeficiency Virus-1(HIV) results in a disease process characterized by three stages: an acute phase characterized by viremia, a clinically latent stage with little or no detection of virus in the blood, and the last stage, AIDS, which. is characterized. by marked immunodeficiency. During clinical latency, CD4+ T cells decline over a period lasting from a few to several years. Throughout this period, HIV is found trapped on the surface of follicular dendritic cells(FDC) in the germinal centers of secondary lymphoid tissues and this is the primary site of active viral replication. We hypothesize that FDC, and the unique microenvironment they help provide, play a critical role in HIV pathogenesis. The objective of these studies was to begin to characterize the role of FDC in HIV pathogenesis by determining if HIV immune complexes trapped on FDC are infectious. To begin to test this, HIV(IIIB) immune complexes were formed by incubating\u27 virus with serum from. HIV infected individuals as a source of virus-specific antibody. Highly enriched tonsilar FDC (from non-infected individuals)were then incubated with these HIV-complexes to allow FDC trapping in Vitro. HIV binding to FDC was confirmed by electron microscopy(EM). Unbound HIV was removed by washing the cells and FDC bearing HIV immune complexes or control FDC were cultured for four days with superantigen activated, FACS sorted, autologous CD4+ tonsilar T lymphocytes to determine if the T cells could be infected by the FDC trapped virus. HIV infection was detected using PCR amplification of proviral gag sequences that would be present in DNA isolated from the cultures. To ensure that our in Vitro cultures were representative of in vivo events, we used a xenogeneic model where HIV immune complexes were formed and trapped on murine FDC in Vivo. Immune complexes were formed by injection of virus-specific antibody followed by HIV (IIIB). Murine FDC bearing HIV trapped in vivo were isolated and incubated with activated human CD4+ T cells as the only source of virus for infection. Infection was assessed as before. HIV infection of T cells was detected in cultures containing FDC bearing HIV immune complexes trapped in vitro whereas no infection was detected in controls. Furthermore, murine FDC bearing in vivo trapped HIV immune complexes also infected human CD4+ T cells. In some in Vivo experiments, HIV immune complexes were formed using a neutralizing antibody that could block infection. FDC bearing these neutralized HIV immune complexes also transmitted infection to T cells. This prompted the hypothesis that FDC may be able to negate the effects of neutralizing antibody. To test this, we formed HIV immune complexes with several doses (picogram to milligram) of neutralizing antibody and cultured these with T cells ± FDC. No infection was present in cultures of immune complexes and T cells without FDC, however, infection was clearly seen when FDC were added. Furthermore, neither macrophages, dendritic cells, nor FDC depleted populations of tonsilar cells could replace FDC in negating the effect of neutralizing antibody and this effect could be observed with different neutralizing antibodies and several strains of virus including a primary isolate. These data indicate that FDC associated HIV is infectious and that FDC can negate the effects of high levels of neutralizing antibody thus permitting infection to occur. This finding may help explain why HIV infected individuals with neutralizing antibody still have ongoing infection. In addition, this data may cause us to reshape our thinking about vaccination and treatment strategies. Finally, this work supports our hypothesis that FDC play an important role in HIV pathogenesis

Who is most likely to remain on welfare?

Recent welfare reform legislation imposes a five year limit on federal welfare benefits. This study examines earnings, family structure and race to determine their impact on the associated probabilities of remaining on welfare. Data of families that received AFDC in the first year of a two-year period is analyzed. In the second year, some of these families stopped receiving benefits while others continued on welfare. Based on characteristics from the first year, a logit model develops the probabilities of leaving welfare rolls in the second year. These characteristics include earnings, employment, the average state benefit, age, gender, marital status, children, education and race. The results of the model indicate that low earning, unemployed, unmarried women with children, in high-benefit states are least likely to leave welfare rolls. Findings on education and race show that having a college degree and being black also increase the likelihood of staying on welfare

Dispersal and Concentration: Patterns of Latino Residential Settlement

Uses 1990 and 2000 Census data to determine how trends in residential settlement patterns among the Hispanic population changed over the course of a decade

Bowel problems and coping strategies in people with multiple sclerosis.

Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in the UK. Bowel symptoms are reported to be common in MS, with constipation affecting 29-43% and faecal incontinence affecting just over 50%. Both have an impact on quality of life. Very little is known about how people with MS manage their bowels and the effectiveness of different interventions. We conducted a 2-part survey of people with MS and bowel problems. MS Society members were invited to participate in an online survey: 155 replied. 47 people additionally filled in a more detailed postal questionnaire. In this self-selected sample, 34% spend more than 30 minutes a day managing their bowel. Managing bowel function was rated as having an impact equal to mobility difficulties on quality of life. Respondents used a wide range of strategies to manage their bowel but few were rated as very helpful. There is a need for high quality research on all aspects of managing bowel dysfunction in MS in order to improve patients' quality of life

Using therapeutic groups to support women with faecal incontinence.

In this paper, the authors describe the use of facilitated patient groups, in the management of women with faecal incontinence (FI). Two types of groups are discussed--a psychoeducational group and a psychotherapy group. Detailed descriptions of some of the themes which emerged in these groups are provided. The effectiveness of such groups is described, with regard to both psychological and physical functioning. Further investigation into the use of groups for this patient population is recommended

A nursing assessment tool for adults with fecal incontinence.

Fecal incontinence affects slightly more than 1% of community-dwelling adults. This article describes an assessment format, with a research basis when available, that has been developed in a specialist nursing clinic in the United Kingdom. The focus is on how to obtain the most useful information from the patient to plan appropriate nursing interventions. A subsequent article will describe the biofeedback program developed as part of a package of care to meet individual needs of persons with fecal incontinence