Communication in cross-cultural consultations in primary care in Europe: the case for improvement. The rationale for the RESTORE FP 7 project

The purpose of this paper is to substantiate the importance of research about barriers and levers to the implementation of supports for cross-cultural communication in primary care settings in Europe. After an overview of migrant health issues, with the focus on communication in cross-cultural consultations in primary care and the importance of language barriers, we highlight the fact that there are serious problems in routine practice that persist over time and across different European settings. Language and cultural barriers hamper communication in consultations between doctors and migrants, with a range of negative effects including poorer compliance and a greater propensity to access emergency services. It is well established that there is a need for skilled interpreters and for professionals who are culturally competent to address this problem. A range of professional guidelines and training initiatives exist that support the communication in cross-cultural consultations in primary care. However, these are commonly not implemented in daily practice. It is as yet unknown why professionals do not accept or implement these guidelines and interventions, or under what circumstances they would do so. A new study involving six European countries, RESTORE (REsearch into implementation STrategies to support patients of different ORigins and language background in a variety of European primary care settings), aims to address these gaps in knowledge. It uses a unique combination of a contemporary social theory, normalisation process theory (NPT) and participatory learning and action (PLA) research. This should enhance understanding of the levers and barriers to implementation, as well as providing stakeholders, with the opportunity to generate creative solutions to problems experienced with the implementation of such interventions

Hepatic Expression of Insulin-Like Growth Factor-1 in Underfed Pregnant Ewes

The liver is one of the most important visceral organs, which represents a large contribution to whole animal energy expenditure and the major synthetic site of insulin-like growth factor-1 (IGF-1) peptide. Decreased plane of nutrition acts by reducing the metabolic rate and mass of metabolic tissues, such as liver. Also, undernutrition results in the reduced circulating IGF-1 concentrations, due to the uncoupled growth hormone-IGF (GH-IGF) axis. This study investigated whether a 22-day period of undernutrition (half maintenance) could affect liver mass and IGF-1 protein and gene expression. Sixteen pregnant ewes fed all (n = 9) or half (n = 7) of their maintenance energy requirements were slaughtered on day 7 of pregnancy (oestrus = day 0). Body and liver mass, IGF-1 plasmatic concentrations and liver IGF-1 mRNA and protein expression were determined. Liver mass and the proportion of liver mass to empty body weight were lower in underfed animals. While IGF-1 plasmatic concentrations were lower in undernourished ewes, no differences in liver mRNA expression were found. This is the first time that differences in immunohistochemistry intensity and total content are reported in sheep. In summary, the decreased plasma IGF-1 concentrations induced by undernutrition in ewes was not associated with its reduced hepatic mRNA or protein expression, but to a decrease in liver mass

Exploring the Galaxy at TeV energies: Latest results from the H.E.S.S. Galactic Plane Survey

The High Energy Stereoscopic System (H.E.S.S.) is an array of four imaging atmospheric-Cherenkov telescopes located in Namibia and designed to detect extensive air showers initiated by gamma-rays in the very-high-energy domain. It is an ideal instrument for surveying the Galactic plane in search of new sources, thanks to its location in the Southern Hemisphere, its excellent sensitivity, and its large field-of-view. The efforts of the H.E.S.S. Galactic Plane Survey, the first comprehensive survey of the inner Galaxy at TeV energies, have contributed to the discovery of an unexpectedly large and diverse population of over 60 sources of VHE gamma rays within its current range of l=250 to 65 degrees in longitude and |b|<=3.5 degrees in latitude. The population of VHE gamma-ray emitters is dominated by the pulsar wind nebula and supernova remnant source classes, although nearly a third remain unidentified or confused. The sensitivity of H.E.S.S. to sources in the inner Galaxy has improved significantly over the past two years, from continued survey observations, dedicated follow-up observations of interesting source candidates, and from the development of advanced methods for discrimination of gamma-ray-induced showers from the dominant background of hadron-induced showers. The latest maps of the Galaxy at TeV energies will be presented, and a few remarkable new sources will be highlighted.Comment: 4 pages, 2 figures, appears in the Proceedings of the 32nd International Cosmic Ray Conference (ICRC 2011), Beijing, China, 11th to 18th August 201

An Imaging and Spectroscopic Study of the z=3.38639 Damped Lyman Alpha System in Q0201+1120: Clues to Star Formation Rate at High Redshift

We present the results of a series of imaging and spectroscopic observations aimed at identifying and studying the galaxy responsible for the z = 3.38639 damped lya system in the z = 3.61 QSO Q0201+1120. We find that the DLA is part of a concentration of matter which includes at least four galaxies (probably many more) over linear comoving dimensions, greater than 5h^-1Mpc. The absorber may be a 0.7 L* galaxy at an impact parameter of 15 h^-1 kpc, but follow-up spectroscopy is still required for positive identification. The gas is turbulent, with many absorption components distributed over approximately 270 km/s and a large spin temperature, T_s greater than 4000K. The metallicity is relatively high for this redshift, Z(DLA) approximately 1/20 Z(solar). From consideration of the relative ratios of elements which have different nucleosynthetic timescales, it would appear that the last major episode of star formation in this DLA occurred at z greater than 4.3, more than approximately 500 Myr prior to the time when we observe it.Comment: Accepted for publication in Ap

Quantum baker maps with controlled-NOT coupling

The characteristic stretching and squeezing of chaotic motion is linearized within the finite number of phase space domains which subdivide a classical baker map. Tensor products of such maps are also chaotic, but a more interesting generalized baker map arises if the stacking orders for the factor maps are allowed to interact. These maps are readily quantized, in such a way that the stacking interaction is entirely attributed to primary qubits in each map, if each subsystem has power-of-two Hilbert space dimension. We here study the particular example of two baker maps that interact via a controlled-not interaction. Numerical evidence indicates that the control subspace becomes an ideal Markovian environment for the target map in the limit of large Hilbert space dimension.Comment: 8 page

HSP60 activity on human bronchial epithelial cells

HSP60 has been implicated in chronic inflammatory disease pathogenesis, including chronic obstructive pulmonary disease (COPD), but the mechanisms by which this chaperonin would act are poorly understood. A number of studies suggest a role for extracellular HSP60, since it can be secreted from cells and bind Toll-like receptors; however, the effects of this stimulation have never been extensively studied. We investigated the effects (pro- or anti-inflammatory) of HSP60 in human bronchial epithelial cells (16-HBE) alone and in comparison with oxidative, inflammatory, or bacterial challenges. 16-HBE cells were cultured for 1-4 h in the absence or presence of HSP60, H2O2, lipopolysaccharide (LPS), or cytomix. The cell response was evaluated by measuring the expression of IL-8 and IL-10, respectively, pro- and anti-inflammatory cytokines involved in COPD pathogenesis, as well as of pertinent TLR-4 pathway mediators. Stimulation with HSP60 up-regulated IL-8 at mRNA and protein levels and down-regulated IL-10 mRNA and protein. Likewise, CREB1 mRNA was up-regulated. H2O2 and LPS up-regulated IL-8. Experiments with an inhibitor for p38 showed that this mitogen-activated protein kinase could be involved in the HSP60-mediated pro-inflammatory effects. HSP60 showed pro-inflammatory properties in bronchial epithelial cells mediated by activation of TLR-4-related molecules. The results should prompt further studies on more complex ex-vivo or in-vivo models with the aim to elucidate further the role of those molecules in the pathogenesis of COPD

A major electronics upgrade for the H.E.S.S. Cherenkov telescopes 1-4

The High Energy Stereoscopic System (H.E.S.S.) is an array of imaging atmospheric Cherenkov telescopes (IACTs) located in the Khomas Highland in Namibia. It consists of four 12-m telescopes (CT1-4), which started operations in 2003, and a 28-m diameter one (CT5), which was brought online in 2012. It is the only IACT system featuring telescopes of different sizes, which provides sensitivity for gamma rays across a very wide energy range, from ~30 GeV up to ~100 TeV. Since the camera electronics of CT1-4 are much older than the one of CT5, an upgrade is being carried out; first deployment was in 2015, full operation is planned for 2016. The goals of this upgrade are threefold: reducing the dead time of the cameras, improving the overall performance of the array and reducing the system failure rate related to aging. Upon completion, the upgrade will assure the continuous operation of H.E.S.S. at its full sensitivity until and possibly beyond the advent of CTA. In the design of the new components, several CTA concepts and technologies were used and are thus being evaluated in the field: The upgraded read-out electronics is based on the NECTAR readout chips; the new camera front- and back-end control subsystems are based on an FPGA and an embedded ARM computer; the communication between subsystems is based on standard Ethernet technologies. These hardware solutions offer good performance, robustness and flexibility. The design of the new cameras is reported here.Comment: Proceedings of the 34th International Cosmic Ray Conference, 30 July- 6 August, 2015, The Hague, The Netherland

Hubble Space Telescope Observations of Element Abundances in Low-redshift Damped Lyman-alpha Galaxies and Implications for the Global Metallicity-Redshift Relation

Most models of cosmic chemical evolution predict that the mass-weighted mean interstellar metallicity of galaxies should rise with time from a low value $\sim 1/30$ solar at $z \sim 3$ to a nearly solar value at $z = 0$. In the absence of any selection effects, the damped Lyman-alpha absorbers (DLAs) in quasar spectra are expected to show such a rise in global metallicity. However, it has been difficult to determine whether or not DLAs show this effect, primarily because of the very small number of DLA metallicity measurements at low redshifts. In an attempt to put tighter constraints on the low-redshift end of the DLA metallicity-redshift relation, we have observed Zn II and Cr II lines in four DLAs at $0.09 < z < 0.52$, using the Space Telescope Imaging Spectrograph (STIS) onboard the Hubble Space Telescope (HST). These observations have provided the first constraints on Zn abundances in DLAs with $z < 0.4$. In all the three DLAs for which our observations offer meaningful constraints on the metallicity, the data suggest that the metallicities are much lower than the solar value. These results are consistent with recent imaging studies indicating that these DLAs may be associated with dwarf or low surface brightness galaxies. We combine our results with higher redshift data from the literature to estimate the global mean metallicity-redshift relation for DLAs. We find that the global mean metallicity shows at most a slow increase with decreasing redshift. ...(Please see the paper for the complete abstract).Comment: 56 pages, including 13 figures. Accepted for publication in the Astrophysical Journa