What is known about the care and support provided for an ageing population with lived experience of chronic viral hepatitis as they near end-of-life: A scoping review

Ageing with a chronic hepatitis B (HBV) or hepatitis C (HCV) infection is an emerging public health priority. For people living with chronic viral hepatitis, their disease progression into old age is both underpinned by their existing blood borne virus and the potential emergence of other infectious and non-infectious conditions. These twinned pathways bring additional challenges to the care and support for people as they near end of life. This scoping review sought to examine what is known about the experiences of the end-of-life phase of an increasing population ageing with HBV and HCV in studies conducted in high-income settings and published in peer reviewed literature (2010–2021). In interpreting this literature, we found that challenges in determining the end-of life phase for people with lived experience of HBV or HCV are exacerbated by the conflation of aetiologies into a singular diagnosis of end-stage liver disease. Studies overwhelmingly reported the clinical aspects of end-of-life care (i.e. prognosis assessment and symptom management) with less attention paid to educative aspects (i.e. advance care directives and surrogate decision makers, discussion of treatment options and determining goals of care). Psychosocial interventions (i.e. quality of life beyond symptom management, including emotional/spiritual support and family and bereavement support) received limited attention in the literature, though there was some recognition that psychosocial interventions should be part of end-of-life care provision. Given the focus on the prominent disease presentation of liver cirrhosis and/or end-stage liver disease, the social and cultural dimensions of these infections have received less attention in the literature on end-of-life in the context of chronic viral hepatitis

Sudden hearing loss in sarcoidosis: otoneurological study and neuroradiological correlates

Sarcoidosis is an inflammatory multisystem disorder of unknown cause. Approximately 5-7% of patients manifest symptoms of central nervous system involvement, or neurosarcoidosis. Cranial neuropathy usually entails facial nerve palsy and optic neuritis. Sudden hearing loss has been reported in fewer than 20 cases. Herewith, two new cases of sudden hearing loss due to probable neurosarcoidosis are reported, each having a quite different clinical course. In one case, unilateral sudden hearing loss and facial palsy were the presenting symptoms of systemic sarcoidosis, while in the second, unilateral sudden deafness occurred despite ongoing immunosuppressive treatment for systemic sarcoidosis

Differences in stigma reduction related to injection drug use between people expressing conservative, moderate and progressive values following an online intervention

Introduction: Contact interventions have shown short-term effectiveness in reducing stigmatising attitudes and behaviours of the public towards marginalised population groups, including people who inject drugs. We theorised that the effectiveness of an intervention differs according to peoples' underlying social values and undertook a study to test this. Methods: We recruited participants from the Australian public by social media and measured their attitudes, desire to maintain personal distance, and support for structural stigma towards people who inject drugs before and after a brief online video intervention (n = 314). We divided participants into tertile groups according to their responses to a conservatism scale and compared group differences in post-intervention stigma scores (n = 242–244), controlling for pre-intervention scores and demographic variables. Results: Adjusting for baseline levels, the post-intervention scores in all measures showed significant improvement but scores of the moderate group were consistently most improved. Stigmatising attitudes in the moderate group were significantly reduced when compared with the conservative and progressive groups. However, reductions in desire for personal distance and support for structural stigma did not significantly differ by conservatism group. Discussion and Conclusions: A brief online contact intervention showed immediate effectiveness in reducing stigma towards people who inject drugs. As people with moderate values were found to be more amenable to changing their perspectives, audience social values may need consideration when designing and evaluating stigma interventions. More research is needed to understand how to influence people with more conservative values, and how to increase public support for policies and practices that reduce stigma

OPA1-related auditory neuropathy: site of lesion and outcome of cochlear implantation.

Hearing impairment is the second most prevalent clinical feature after optic atrophy in Dominant Optic Atrophy associated with mutations in the OPA1 gene. In this study we characterized the hearing dysfunction in OPA1-linked disorders and provided effective rehabilitative options to improve speech perception. We studied two groups of OPA1 subjects, one comprising 11 patients (7 males; age range 13-79 years) carrying OPA1 mutations inducing haploinsufficiency, the other, 10 subjects (3 males; age range 5-58 years) carrying OPA1 missense mutations. Both groups underwent audiometric assessment with pure tone and speech perception evaluation, and otoacoustic emissions and auditory brainstem response recording. Cochlear potentials were recorded through transtympanic electrocochleography from the group of patients harboring OPA1 missense mutations and were compared to recordings obtained from 20 normally-hearing controls and from 19 subjects with cochlear hearing loss. Eight patients carrying OPA1 missense mutations underwent cochlear implantation. Speech perception measures and electrically-evoked auditory nerve and brainstem responses were obtained after one year of cochlear implant use. Nine out of 11 patients carrying OPA1 mutations inducing haploinsufficiency had normal hearing function. In contrast, all but one subject harboring OPA1 missense mutations displayed impaired speech perception, abnormal brainstem responses and presence of otoacoustic emissions consistent with auditory neuropathy. In electrocochleography recordings, cochlear microphonic had enhanced amplitudes while summating potential showed normal latency and peak amplitude consistent with preservation of both outer and inner hair cell activities. After cancelling the cochlear microphonic, the synchronized neural response seen in both normally-hearing controls and subjects with cochlear hearing loss was replaced by a prolonged, low-amplitude negative potential that decreased in both amplitude and duration during rapid stimulation consistent with neural generation. The use of cochlear implant improved speech perception in all but one patient. Brainstem potentials were recorded in response to electrical stimulation in five subjects out of six, whereas no compound action potential was evoked from the auditory nerve through the cochlear implant. These findings indicate that underlying the hearing impairment in patients carrying OPA1 missense mutations is a disordered synchrony in auditory nerve fiber activity resulting from neural degeneration affecting the terminal dendrites. Cochlear implantation improves speech perception and synchronous activation of auditory pathways by by-passing the site of lesion

Addressing injecting related risks among people who inject both opioids and stimulants: Findings from an Australian survey of people who inject drugs

Background: Opioids and stimulants are the most commonly injected illicit drugs worldwide and in Australia. While some people who inject drugs (PWID) prefer either opioids or stimulants, others regularly use both opioids and stimulants. Limited available research indicates that those who use opioids and stimulants together, either in combination or alternating between the two, may engage in injection-related practices which potentially place them at greater health risk and could lead to poorer health outcomes. Methods: Participants were recruited nationally through member organizations of the Australian Injecting and Illicit Drug Users League (AIVL); these organizations represent PWID in each Australian state and territory. This study compared a sample of PWID (N = 535) who reported past-month injection of opioids only (N = 173), stimulants only (N = 208), or both (N = 154) on a range of health and wellbeing outcomes. PWID completed a survey assessing drugs injected, frequency of injecting, receptive equipment sharing, psychological distress, self-reported hepatitis C (HCV) status, experienced and internalized stigma, drug use salience, and community attachment. Results: People who injected both opioids and stimulants reported more frequent injecting, more experiences of stigma, and greater reported HCV diagnosis than people who injected stimulants or opioids alone. They also showed greater attachment to a community of PWID and greater salience of drug use to their identity. Conclusions: The findings of increased injecting and broader harms associated with injecting both stimulants and opioids are important for tailoring harm reduction and intervention designs for people who use both opioid and stimulant drugs, including prioritizing peer-based approaches

Analysis of adenomatous polyposis coli gene in thyroid tumours.

Familial adenomatous polyposis (FAP) is known to be associated with neoplasia of various tissues, including thyroid carcinoma. Germline mutations of the tumour-suppressor gene APC, responsible for the predisposition to FAP, may therefore be involved in the pathogenesis of these tumours. In this report the structure of the APC gene has been investigated in 26 thyroid tumours, at different stages of dedifferentiation, that were surgically excised from patients with a negative history of FAP. Approximately 35% of the APC gene coding region, where most of the mutations are clustered, has been analysed by a combination of single-strand conformation polymorphism and direct sequencing. No significant alterations could be demonstrated in any sample examined. It is concluded that, at least in patients not affected by FAP, APC gene abnormalities do not seem to play a relevant role in the pathogenesis of thyroid carcinoma

A multi-scale regional landslide susceptibility assessment approach: the SUFRA_SICILIA (SUscettibilit\ue0 da FRAna in Sicilia) project

The SUFRA project is based on a three level susceptibility mapping. According to the availability of more detailed data, the three scale for susceptibility mapping are increased respect to the ones suggested by the TIER group to 1:100,000, 1:50,000 and 1:25,000/1:10,000. The mapping levels exploit climatic, soil use (CORINE2009) and seismic informative layers, differentiating in the details of the core data (geology and topography), in the quality and resolution of the landslide inventory and in the modelling approach (Tab. 1). SUFRA_100 is based on a heuristic approach which is applied by processing a geologic layer (produced by ARTA integrating pre-CARG 1:100,000 geologic maps); the DEM exploited are IGMI 250m and the mapping units are 1km side square cells. Models are validated with respect to the PAI LIPs (Landslide Identification Points) which are reclassified adopting a simplified scheme. Output cuts of SUFRA100 will be referred to administrative boundaries (provinces). SUFRA50 is based on statistical analysis of new CARG geologic maps and 20m (ITA2000) - 2m (ATA2007) DEM. The mapping units are 500m and 50m cells, hydrographic and hydro-morphometric units. The landslide inventory is the IFFI2012_LIPs (first level) which is the result of the conversion in IFFI format of the PAI archive, which will be supported by remote landslide mapping (exploiting the ATA2007 aerial photos), according to the IFFI first level approach. Validation of the models will be performed exploiting both random spatial partition and temporal partition methods. Output cuts of SUFRA50 will be based on physiographic (basin) and administrative (municipalities) boundaries. SUFRA10/25 is based on statistical analysis of new CARG geologic maps (remotely and field adapted) and 2m (ATA2007) DEM. The mapping units are the slope units (SLUs) which are derived by further partitioning the hydro-morphometric units so to obtain closed morphodynamic units. The landslide inventories is the IFFI2012 which is the results of a field supported (on focus) landslide remote systematic mapping, according to the IFFI full level approach. Examples of SUFRA_100, SUFRA_50 and SUFRA_10 are presented for some representative key sector of Sicily. First results attest for the feasibility and goodness of the proposed protocol. The SUFRA program aims at enabling the regional governmental administration to cope with landslide prevision, which is the required operational concept in land management and planning. PAI has been a great advance with respect to the \u201cpre-SARNO\u201d conditions, but it is very exposed to fail: it is a blind approach for new activations; it is critically dependent on the quality of the landslide inventories; it cannot project the susceptibility outside the landslide area

Analysis of navigation pattern in the sport of rowing

The effect of weather and environmental conditions on sports has been extensively studied over the last few years (Pezzoli et al., 2010). Based upon the studies of Lobozewicz (1981) and of Kay and Vamplew (2002), Pezzoli and Cristofori (2008) have studied the impact of some specific environmental parameters over different sports using a particular impact index divided into five classes. This analysis clearly shows that most of the outdoor sport activities are strongly influenced by the variation of meteorological parameters. However the impact of meteorological conditions on outdoor sport activities has not yet been extensively studied. The aim of this research is to show that an accurate assessment of wind and wave parameters enables decisive improvements in both training and race strategy planning. Furthermore this analysis provide a very innovative working method for the applied sport research. The work has been based on in-situ measurements of both environmental and performance parameters (wind direction, wind velocity, boat speed and stroke rate) made over different classes and in different race conditions during the 2009 FISA World Championship (Poznan, Poland). In particular a detailed environmental analysis was performed by measuring the wind direction, the wind speed and by evaluating the significant wave height and the wave peak period for each class during the semi-final phase and the final phase. It should be noted that, since wind is a key parameter affecting not only the boat speed but also the race strategy, the assessment of the wind velocity and of the wind direction has been made in connection with the boat movement. The comparison between coupled wind-wave data, boat speed and stroke rate evidently demonstrates that only crews that managed the adaption to changing in the environmental conditions from semi-final to final phase of the race, were able to get better results. References Kay, J., & Vamplew, W. (2002) Weather beaten: sport in the British climate. London: Ed. Mainstream Publishing. Lobozewicz, T. (1981) Meteorology in sport. Frankfurt: Ed. Sportverlag. Pezzoli, A,, Moncalero, M., Boscolo, A., Cristofori, E., Giacometto, F., Gastaldi, S., & Vercelli, G. (2010) The meteo-hydrological analysis and the sport performance: which are the connections? The case of the XXI Winter Olympic Games, Vancouver 2010, Journal of Sports Medicine and Physical Fitness, 50: 19-20. Pezzoli, A., & Cristofori, E. (2008) Analisi, previsioni e misure meteorologiche applicate agli sport equestri, in: 10th Congress “New findings in equine practices, Druento: Centro Internazionale del Cavallo Ed., p.38-43

BRCA1 and BRCA2 mutations in breast/ovarian cancer patients from central Italy

n/