How do patients from South Asian backgrounds experience life on haemodialysis in the UK? : A multicentre qualitative study

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVES: End-stage kidney disease disproportionately affects people of South Asian origin. This study aimed to uncover the lived experiences of this group of patients on centre-based haemodialysis (HD), the most prevalent dialysis modality. DESIGN: The study utilised a qualitative focus group methodology. Seven focus groups were conducted across four NHS Trusts in the UK including three in Gujarati and two each in Punjabi and Urdu. This provided an inclusive opportunity for South Asian patients to contribute in their language of origin. A total of 24 patients participated. Focus groups were facilitated by bilingual project workers and data were forward translated and analysed using thematic analysis. RESULTS: Four themes were identified. This included (1) 'treatment imposition', which comprised of the restrictive nature of HD, the effects of treatment and the feeling of being trapped in an endless process. (2) The 'patient-clinician relationship' centred around the impact of a perceived lack of staff time, and inadequacies in the quality of interactions. (3) 'Coping strategies' highlighted the role of cognitive reappraisal, living in the moment and family support networks in facilitating adjustment. (4) 'Pursuit of transplantation' included equating this form of treatment with restoring normality, alongside cultural factors limiting hopefulness for receiving an organ. CONCLUSIONS: In general, the experiences of South Asian patients receiving HD were not unique to this ethnic group. We did find distinct issues in relation to interactions with healthcare professionals, views on access to transplantation and the importance of family support networks. The study provides useful insights which may help enhance culturally tailored renal care.Peer reviewe

Um exame sobre a disponibilização de vagas nas creches municipais da cidade de Florianópolis no período de agosto de 2014 a agosto de 2017

TCC(graduação) - Universidade Federal de Santa Catarina. Centro de Ciências Jurídicas. Direito.O ordenamento jurídico brasileiro concede, com fundamento na Doutrina da Proteção Integral, proteções especiais às crianças e aos adolescentes, de modo a assegurar seu pleno desenvolvimento enquanto indivíduos e cidadãos. Em meio a um panorama bastante amplo de prerrogativas, dada justamente a importância da tutela da infância na construção de uma sociedade sustentável e igualitariamente desenvolvida, o direito fundamental, de titularidade das crianças de até cinco anos de idade, de acesso à educação infantil de qualidade merece especial destaque, possuindo metas e diretrizes bem delineadas e devendo ser objeto prioritário das políticas públicas, sobretudo municipais. Nesse contexto, observa-se, atualmente, no Município de Florianópolis (SC), um cenário de clara defasagem entre oferta e demanda por vagas nas creches municipais - sobretudo no que diz respeito às vagas em período integral. Essa pesquisa, portanto, configura-se como de abordagem qualitativa, no formato de monografia, com o objetivo de examinar, utilizando-se do método de abordagem dedutivo, como tais discrepâncias concernentes à disponibilização de vagas nos centros de educação infantil da cidade de Florianópolis violam as prerrogativas das quais as crianças de até cinco anos de idade são titulares. Assim, faz-se uso do (a) método de procedimento revisão narrativa, pelas técnicas bibliográfica e documental, para a compreensão das conceituações necessárias atinentes ao tema; e do (b) método de procedimento de estudo de caso descritivo, com técnica documental. Para exame dos dados coletados, utiliza-se a análise do discurso jurídico, com fulcro nas balizas legais e teóricas sobre o tema. Para tanto, fez-se a análise das ações de vaga em creche ajuizadas, com a devida assistência da Defensoria Pública do Estado de Santa Catarina, pelas famílias hipossuficientes florianopolitanas que, entre agosto de 2014 e agosto de 2017, optaram pela via jurisdicional para garantir os direitos de seus filhos, comparando as informações obtidas às disposições e determinações legais, procurando-se compreender as razões e as consequências das desconformidades constatadas, sobretudo no que diz respeito à atuação insuficiente da Administração Pública no sentido de atender plenamente a demanda por acesso à educação infantil na cidade e às relações existentes entre a (não) disponibilização de vagas em período integral e a vulnerabilidade das famílias monoparentais femininas, que constituem parcela expressiva dos núcleos familiares nos quais estão inseridos os requerentes das ações de vaga em creche.The Brazilian legal system grants, based on the Doctrine of Integral Protection, special protections for children and adolescents, in order to ensure their full development as individuals and citizens. Amidst a fairly broad picture of prerogatives, given the importance of the guardianship of children aiming to building a sustainable and egalitarian society, a special emphasis must be given to the fundamental right of children under five years old to access child education, having well defined goals and guidelines and it should be a priority subject of public policies, especially the municipal ones. In this context, the city of Florianópolis (SC) has been shown a clear gap between vacancies search and availability in municipal nurseries - especially regarding to the full-time vacancies. This research, therefore, is configured as a qualitative approach, in a undergraduate thesis format, with the objective of examining, using the deductive approach method, how such discrepancies concerning the availability of vacancies in the centers of early childhood education in the city of Florianópolis violate the prerogatives of children under five years old. Thus, it is used (a) the method of procedure narrative revision, by the bibliographical and documentary techniques, for the understanding of the necessary conceptions related to the theme; and (b) a descriptive case study procedure method, with documentary technique. To analyze the collected data, it was used the analysis of the legal discourse, with fulcrum in the legal and theoretical beacons on the subject. In order to do this, were analyzed the vacancy cases in nursery, with the appropriate assistance of the Public Defender's Office of the State of Santa Catarina, by the Florianopolitan families who, between August of 2014 and August of 2017, opted for the judicial route to ensure the rights of their children. The obtained information was then compared to the legal provisions. with the legal provisions and determinations, seeking to understand the reasons and consequences of the nonconformities found. It was mainly made with regard to the insufficient performance of the Public Administration in order to fully meet the demand for access to the education in the city and the relationship between the (non) availability of full-time positions and the vulnerability of female single-parent families, which constitute a significant part of the family nuclei in which the applicants for vacancies in day-care centers are inserted

Biocontrol of Chromolaena odorata in Timor Leste

Chromolaena odorata (L.) King and Robinson (Asteraceae) is a major weed in Timor Leste, affecting grazing lands and subsistence farms, reducing productivity and food security. It was the focus of a biocontrol project funded by the Australian Government from 2005-2009. During this period, the gall fly Cecidochares connexa (Macquart) (Diptera: Tephritidae) was introduced from Papua New Guinea and Indonesia, where it is widespread. From these initial releases, the gall fly established at seven sites and was subsequently re-distributed to most areas in Timor Leste where chromolaena was a problem. It established at most of the release sites that were revisited and caused a visible reduction in plant density and height. Overall, control of chromolaena by the gall fly in Timor Leste is limited by the severe dry season and the widespread use of fire in clearing lands for agriculture, both of which reduce the ability of gall fly populations to persist at damaging levels. Thus additional agents that can tolerate prolonged dry periods are required to increase the level of control of chromolaena

Functionalised thermally induced phase separation (TIPS) microparticles enabled for “click” chemistry

Due to their homogeneity, tuneable properties, low cost and ease of manufacture, thermally induced phase separation (TIPS) polymeric microparticles are emerging as an exciting class of injectable device for the treatment of damaged tissue or complex diseases, such as cancer. However, relatively little work has explored enhancing surface functionalisation of this system. Herein, we present the functionalisation of TIPS microparticles with both small molecules and an antibody fragment of Herceptin™, via a heterobifunctional pyridazinedione linker capable of participating in SPAAC “click” chemistry, and compare it to the traditional method of preparing active-targeted microparticle systems, that is, physisorption of antibodies to the microparticle surface. Antigen-binding assays demonstrated that functionalisation of microparticles with Herceptin Fab, via a pyridazinedione linker, provided an enhanced avidity to HER2+ when compared to traditional physisorption methods

Preparations for field testing for the performance validation of piled wind turbine foundations in expansive clays

Field-testing of piles in an expansive clay is required for the validation of the design criteria for wind turbine foundations in such soil profiles. The test programme includes lateral load tests to investigate the horizontal stiffness of the soil and vertical plug pull-out tests to examine the axial capacity of pile-soil interface. These tests will be conducted in both dry and wet conditions to study the range of expected responses of the pile and evaluate how the changing soil moisture condition affects the pile behaviour. In addition, an instrumented pile socketed into bedrock will be used to determine the strain induced in the pile due to soil heave as the soil saturation levels increase. For the execution of these tests, a large open area with expansive clay of a sufficient depth is required; a stable stratum below the clay is desirable for the socketing of the long piles. An important component of the investigation is the characterisation of the expansive clay profile. A preliminary site investigation has been carried out on the field-testing site which will be supported by further laboratory testing. Details of the soil profile and site characterisation which will be used in the future analyses of the fieldtesting results are presented

Prediction of sarcomere mutations in subclinical hypertrophic cardiomyopathy.

BACKGROUND: Sarcomere protein mutations in hypertrophic cardiomyopathy induce subtle cardiac structural changes before the development of left ventricular hypertrophy (LVH). We have proposed that myocardial crypts are part of this phenotype and independently associated with the presence of sarcomere gene mutations. We tested this hypothesis in genetic hypertrophic cardiomyopathy pre-LVH (genotype positive, LVH negative [G+LVH-]). METHODS AND RESULTS: A multicenter case-control study investigated crypts and 22 other cardiovascular magnetic resonance parameters in subclinical hypertrophic cardiomyopathy to determine their strength of association with sarcomere gene mutation carriage. The G+LVH- sample (n=73) was 29 ± 13 years old and 51% were men. Crypts were related to the presence of sarcomere mutations (for ≥1 crypt, β=2.5; 95% confidence interval [CI], 0.5-4.4; P=0.014 and for ≥2 crypts, β=3.0; 95% CI, 0.8-7.9; P=0.004). In combination with 3 other parameters: anterior mitral valve leaflet elongation (β=2.1; 95% CI, 1.7-3.1; P<0.001), abnormal LV apical trabeculae (β=1.6; 95% CI, 0.8-2.5; P<0.001), and smaller LV end-systolic volumes (β=1.4; 95% CI, 0.5-2.3; P=0.001), multiple crypts indicated the presence of sarcomere gene mutations with 80% accuracy and an area under the curve of 0.85 (95% CI, 0.8-0.9). In this G+LVH- population, cardiac myosin-binding protein C mutation carriers had twice the prevalence of crypts when compared with the other combined mutations (47 versus 23%; odds ratio, 2.9; 95% CI, 1.1-7.9; P=0.045). CONCLUSIONS: The subclinical hypertrophic cardiomyopathy phenotype measured by cardiovascular magnetic resonance in a multicenter environment and consisting of crypts (particularly multiple), anterior mitral valve leaflet elongation, abnormal trabeculae, and smaller LV systolic cavity is indicative of the presence of sarcomere gene mutations and highlights the need for further study

Emergence of pseudogap from short-range spin-correlations in electron doped cuprates

Electron interactions are pivotal for defining the electronic structure of quantum materials. In particular, the strong electron Coulomb repulsion is considered the keystone for describing the emergence of exotic and/or ordered phases of quantum matter as disparate as high-temperature superconductivity and charge- or magnetic-order. However, a comprehensive understanding of fundamental electronic properties of quantum materials is often complicated by the appearance of an enigmatic partial suppression of low-energy electronic states, known as the pseudogap. Here we take advantage of ultrafast angle-resolved photoemission spectroscopy to unveil the temperature evolution of the low-energy density of states in the electron-doped cuprate Nd$_{\text{2-x}}$Ce$_{\text{x}}$CuO$_{\text{4}}$, an emblematic system where the pseudogap intertwines with magnetic degrees of freedom. By photoexciting the electronic system across the pseudogap onset temperature T*, we report the direct relation between the momentum-resolved pseudogap spectral features and the spin-correlation length with an unprecedented sensitivity. This transient approach, corroborated by mean field model calculations, allows us to establish the pseudogap in electron-doped cuprates as a precursor to the incipient antiferromagnetic order even when long-range antiferromagnetic correlations are not established, as in the case of optimal doping.Comment: 17 pages, 3 figure

Investigation of fiber/matrix adhesion: test speed and specimen shape effects in the cylinder test

The cylinder test, developed from the microdroplet test, was adapted to assess the interfacial adhesion strength between fiber and matrix. The sensitivity of cylinder test to pull-out speed and specimen geometry was measured. It was established that the effect of test speed can be described as a superposition of two opposite, simultaneous effects which have been modeled mathematically by fitting two parameter Weibull curves on the measured datas. Effects of the cylinder size and its geometrical relation on the measured strength values have been analyzed by finite element method. It was concluded that the geometry has a direct influence on the stress formation. Based on the results achieved, recommendations were given on how to perform the novel single fiber cylinder test