Statistics and society: a study on the burden experienced by caregivers of patients with Alzheimer

The cost of caring for people with Alzheimer-type diseases is enormous. Caregivers experience emotional, physical and financial stress, and their demands are central to decisions on patient institutionalization. We hereby investigate the burden experienced by caregivers of Alzheimer patients in Cyprus. We explore whether burden is related to variables such as patient psychopathology, caregiver gender, income and level of education. Moreover, we examine if there is a significant difference in the level of burden, depression, or reaction to memory and behavior problems when patients live in the community or in institutions and if the level of burden is associated with the use of different coping strategies by caregivers. Various statistical techniques are implemented for the analysis and all the conclusions are discussed. This work was partially funded by the Cyprus Research Promotion Foundation

Determinants of tourism for “Sun and Sea” Cyprus

Tourism is an essential contributor of economic growth, social and cultural development. Cyprus is now an established tourist destination, which, however, is passing through a slowdown phase. The determinants of tourism have been extensively examined for other countries, but the literature regarding Cyprus is very scarce. This paper examines the factors that affect tourism in Cyprus for the period 1995-2010, using time series regression analysis. Tourism is represented by tourist arrivals and tourism expenditure, while the predictors are relative prices, the Gross Domestic Product (GDP) of Cyprus and the income of the main countries that send tourists to Cyprus. The results show that tourism expenditure is significantly affected by the GDP of Cyprus and the relative prices between Cyprus and its main competitor, Greece, while tourist arrivals are additionally affected by the level of income of the origin countries. Increased competition, high operational costs, standardization of touristic product (sun and sea), as well as the international political instability and global financial crisis, which have raised unemployment and reduced tourists’ disposable income, appear to influence tourism in Cyprus. These findings are discussed, in combination with the corresponding low or high rankings of Cyprus in various pillars of travel and tourism competitiveness.peer-reviewe

The Inclusion of Labor Market Conditions in a Proposed Modeling Framework for Fresh Graduates’ Retention

Fresh graduates are often described as young generations with high productivity potentials but with fewer chances to enter the labor market. After graduation, they frequently find themselves in a complexity of work integration. Employers have expectations from them and they also have their own ambitions that are usually considered as high. Being the promise for a better tomorrow to any labor market, it matters for nations as well as organizations to retain these young generations. Nowadays, retaining fresh graduates has turned to be a great challenge especially that labor market conditions have become very tough and hard hit by economic crises, low wages and unequal labor rights. Although many scholars and practitioners emphasize the importance of retaining fresh graduates in challenging labor markets, research related to the links among fresh graduates, labor market conditions and retention has failed to keep up. Given the importance of this issue, this study seeks to review the existing literature on labor market conditions affecting fresh graduates’ retention and job satisfaction, identify and address the related research gaps and develop an integrated model highlighting how fresh graduates’ retention can be affected by various practices, conditions and psychological states

2003 Philip C. Jessup International Law Moot Court Competition International Court Of Justice At The Peace Palace The Hague, Netherlands

The Republic of Annolay and the Republic of Reston have submitted the present dispute by Special Agreement to the International Court of Justice pursuant to Articles 36(1) and 40(1) of the Statute of the Court for final resolution

Differential gene expression of bone anabolic factors and trabecular bone architectural changes in the proximal femoral shaft of primary hip osteoarthritis patients

Previous studies have shown a generalised increase in bone mass in patients with osteoarthritis (OA). Using molecular histomorphometry, this study examined the in vivo expression of mRNA encoding bone anabolic factors and collagen type I genes (COL1A1, COL1A2) in human OA and non-OA bone. Bone samples were obtained from the intertrochanteric (IT) region of the proximal femur, a skeletal site distal to the active site of disease, from individuals with hip OA at joint replacement surgery and from autopsy controls. Semi-quantitative reverse transcription-polymerase chain reaction analysis revealed elevated mRNA expression levels of alkaline phosphatase (p < 0.002), osteocalcin (OCN) (p < 0.0001), osteopontin (p < 0.05), COL1A1 (p < 0.0001), and COL1A2 (p < 0.002) in OA bone compared to control, suggesting possible increases in osteoblastic biosynthetic activity and/or bone turnover at the IT region in OA. Interestingly, the ratio of COL1A1/COL1A2 mRNA was almost twofold greater in OA bone compared to control (p < 0.001), suggesting the potential presence of collagen type I homotrimer at the distal site. Insulin-like growth factor (IGF)-I, IGF-II, and transforming growth factor-β1 mRNA levels were similar between OA and control bone. Bone histomorphometric analysis indicated that OA IT bone had increased surface density of bone (p < 0.0003), increased trabecular number (Tb.N) (p < 0.0003), and decreased trabecular separation (Tb.Sp) (p < 0.0001) compared to control bone. When the molecular and histomorphometric data were plotted, positive associations were observed in the controls for OCN/glyceraldehyde-3-phosphate dehydrogenase (GAPDH) versus bone tissue volume (r = 0.82, p < 0.0007) and OCN/GAPDH versus Tb.N (r = 0.56, p < 0.05) and a negative association was observed for OCN/GAPDH versus Tb.Sp (r = -0.64, p < 0.02). These relationships were not evident in trabecular bone from patients with OA, suggesting that bone regulatory processes leading to particular trabecular structures may be altered in this disease. The finding of differential gene expression, as well as architectural changes and differences in molecular histomorphometric associations between OA and controls, at a skeletal site distal to the active site of joint degeneration supports the concept of generalised involvement of bone in the pathogenesis of OA

Linking patient satisfaction with nursing care: the case of care rationing -a correlational study

Abstract Background: Implicit rationing of nursing care is the withholding of or failure to carry out all necessary nursing measures due to lack of resources. There is evidence supporting a link between rationing of nursing care, nurses&apos; perceptions of their professional environment, negative patient outcomes, and placing patient safety at risk. The aims of the study were: a) To explore whether patient satisfaction is linked to nurse-reported rationing of nursing care and to nurses&apos; perceptions of their practice environment while adjusting for patient and nurse characteristics. b) To identify the threshold score of rationing by comparing the level of patient satisfaction factors across rationing levels

Circulating RANKL is inversely related to RANKL mRNA levels in bone in osteoarthritic males

Introduction The relationship of circulating levels of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG) with the expression of these molecules in bone has not been established. The objective of this study was to measure, in humans, the serum levels of RANKL and OPG, and the corresponding levels in bone of mRNA encoding these proteins. Methods Fasting blood samples were obtained on the day of surgery from patients presenting for hip replacement surgery for primary osteoarthritis (OA). Intraoperatively, samples of intertrochanteric trabecular bone were collected for analysis of OPG and RANKL mRNA, using real time RT-PCR. Samples were obtained from 40 patients (15 men with age range 50 to 79 years, and 25 women with age range 47 to 87 years). Serum total RANKL and free OPG levels were measured using ELISA. Results Serum OPG levels increased over the age range of this cohort. In the men RANKL mRNA levels were positively related to age, whereas serum RANKL levels were negatively related to age. Again, in the men serum RANKL levels were inversely related (r = -0.70, P = 0.007) to RANKL mRNA levels. Also in the male group, RANKL mRNA levels were associated with a number of indices of bone structure (bone volume fraction relative to bone tissue volume, specific surface of bone relative to bone tissue volume, and trabecular thickness), bone remodelling (eroded surface and osteoid surface), and biochemical markers of bone turnover (serum alkaline phosphatase and osteocalcin, and urinary deoxypyridinoline). Conclusion This is the first report to show a relationship between serum RANKL and the expression of RANKL mRNA in bone.David Findlay, Mellick Chehade, Helen Tsangari, Susan Neale, Shelley Hay, Blair Hopwood, Susan Pannach, Peter O'Loughlin and Nicola Fazzalar

Assessing the effects of parthenolide on inflammation, bone loss, and glial cells within a collagen antibody-Induced arthritis mouse model

Rheumatoid arthritis is characterised by a chronic inflammatory response resulting in destruction of the joint and significant pain. Although a range of treatments are available to control disease activity in RA, bone destruction and joint pain exist despite suppression of inflammation. This study is aimed at assessing the effects of parthenolide (PAR) on paw inflammation, bone destruction, and pain-like behaviour in a mild collagen antibody-induced arthritis (CAIA) mouse model. CAIA was induced in BALB/c mice and treated daily with 1 mg/kg or 4 mg/kg PAR. Clinical paw inflammation was scored daily, and mechanical hypersensitivity was assessed on alternate days. At end point, bone volume and swelling in the paws were assessed using micro-CT. Paw tissue sections were assessed for inflammation and pre-/osteoclast-like cells. The lumbar spinal cord and the periaqueductal grey (PAG) and rostral ventromedulla (RVM) regions of the brain were stained for glial fibrillary acidic protein (GFAP) and ionised calcium-binding adaptor molecule 1 (IBA1) to assess for glial reactivity. Paw scores increased in CAIA mice from days 5-10 and were reduced with 1 mg/kg and 4 mg/kg PAR on days 8-10. Osteoclast-like cells on the bone surface of the radiocarpal joint and within the soft tissue of the hind paw were significantly lower following PAR treatment (p < 0.005). GFAP- and IBA1-positive cells in the PAG and RVM were significantly lower following treatment with 1 mg/kg (p < 0.0001 and p = 0.0004, respectively) and 4 mg/kg PAR (p < 0.0001 and p = 0.001, respectively). In the lumbar spinal cord, IBA1-positive cells were significantly lower in CAIA mice treated with 4 mg/kg PAR (p = 0.001). The findings indicate a suppressive effect of both low- and moderate-dose PAR on paw inflammation, osteoclast presence, and glial cell reactivity in a mild CAIA mouse model.B. Williams, F. Lees, H. Tsangari, M. R. Hutchinson, E. Perilli and T. N. Crott

Sample size considerations for trials using cerebral white matter hyperintensity progression as an intermediate outcome at 1 year after mild stroke: Results of a prospective cohort study

Background: White matter hyperintensities (WMHs) are commonly seen on in brain imaging and are associated with stroke and cognitive decline. Therefore, they may provide a relevant intermediate outcome in clinical trials. WMH can be measured as a volume or visually on the Fazekas scale. We investigated predictors of WMH progression and design of efficient studies using WMH volume and Fazekas score as an intermediate outcome. Methods: We prospectively recruited 264 patients with mild ischaemic stroke and measured WMH volume, Fazekas score, age and cardiovascular risk factors at baseline and 1 year. We modelled predictors of WMH burden at 1 year and used the results in sample size calculations for hypothetical randomised controlled trials with different analysis plans and lengths of follow-up. Results: Follow-up WMH volume was predicted by baseline WMH: a 0.73-ml (95% CI 0.65-0.80, p < 0.0001) increase per 1-ml baseline volume increment, and a 2.93-ml increase (95% CI 1.76-4.10, p < 0.0001) per point on the Fazekas scale. Using a mean difference of 1 ml in WMH volume between treatment groups, 80% power and 5% alpha, adjusting for all predictors and 2-year follow-up produced the smallest sample size (n = 642). Other study designs produced samples sizes from 2054 to 21,270. Sample size calculations using Fazekas score as an outcome with the same power and alpha, as well as an OR corresponding to a 1-ml difference, were sensitive to assumptions and ranged from 2504 to 18,886. Conclusions: Baseline WMH volume and Fazekas score predicted follow-up WMH volume. Study size was smallest using volumes and longer-term follow-up, but this must be balanced against resources required to measure volumes versus Fazekas scores, bias due to dropout and scanner drift. Samples sizes based on Fazekas scores may be best estimated with simulation studies