805 research outputs found

    How the economics profession got it wrong on Brexit

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    Some of the most widely cited predictions of the economic effects of Brexit rely on flawed analysis, particularly of the performance of the UK after it joined the EEC, and on the link between trade and productivity, write Ken Coutts (left), Graham Gudgin (University of Cambridge) and Jordan Buchanan (right) (Ulster University Economic Policy Centre). In order to restore public confidence in economic forecasting for major policy issues, economists need to use more relevant analyses, based on a wider range of evidence

    Context, mechanisms and outcomes in end of life care for people with advanced dementia

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    yesBackground: The majority of people with dementia in the UK die in care homes. The quality of end of life care in these environments is often suboptimal. The aim of the present study was to explore the context, mechanisms and outcomes for providing good palliative care to people with advanced dementia residing in UK care homes from the perspective of health and social care providers. Method: The design of the study was qualitative which involved purposive sampling of health care professionals to undertake interactive interviews within a realist framework. Interviews were completed between September 2012 and October 2013 and were thematically analysed and then conceptualised according to context, mechanisms and outcomes. The settings were private care homes and services provided by the National Health Service including memory clinics, mental health and commissioning services in London, United Kingdom. The participants included 14 health and social care professionals including health care assistants, care home managers, commissioners for older adults’ services and nursing staff. Results: Good palliative care for people with advanced dementia is underpinned by the prioritisation of psychosocial and spiritual care, developing relationships with family carers, addressing physical needs including symptom management and continuous, integrated care provided by a multidisciplinary team. Contextual factors that detract from good end of life care included: an emphasis on financial efficiency over person-centred care; a complex health and social care system, societal and family attitudes towards staff; staff training and experience, governance and bureaucratisation; complexity of dementia; advance care planning and staff characteristics. Mechanisms that influence the quality of end of life care include: level of health care professionals’ confidence, family uncertainty about end of life care, resources for improving end of life care and supporting families, and uncertainty about whether dementia specific palliative care is required. Conclusions: Contextual factors regarding the care home environment may be obdurate and tend to negatively impact on the quality of end of life dementia care. Local level mechanisms may be more amenable to improvement. However, systemic changes to the care home environment are necessary to promote consistent, equitable and sustainable high quality end of life dementia care across the UK care home secto

    Визначення понять «резидент» і «нерезидент»: проблеми теорії і практики

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    Досліджено практику застосування понять «резидент» та «нерезидент» у як в Україні так і окремих зарубіжних країнах, а також надано авторське бачення щодо визначення даних термінів. Автори статті визначають умови оподаткування операцій з нерезидентами з огляду на існуючі особливості правозастосовної діяльності і вно­сять окремі пропозиції щодо удосконалення процедури адміністрування податків, що стягуються з нерезидентів.Исследована практика применения понятий «резидент» и «нерезидент» как в Украине, так и отдельных зарубежных странах, а также предоставлено авторское виденье относительно определения данных терминов. Авторы статьи определяют условия налогообложения операций с нерезидентами, учитывая существующие особен­ности правоприменительной деятельности, вносят отдельные предложения относи­тельно усовершенствования процедуры администрирования налогов, которые удержи­ваются из нерезидентов.Іn this article practice of application of concepts «resident» and «non­resident» are explored both in Ukraine and some foreign countries, and granted the author’s view on the definition of these terms. The authors of the article determine the term of taxation of operations with non­residents, taking into account the existing features of legal activity and make some suggestions in relation to the improvement of procedure of administration of taxes which are tightened from non­residents

    North Flinders Reef (Coral Sea, Australia) Porites sp. corals as a candidate Global Boundary Stratotype Section and Point for the Anthropocene Series

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    Corals are unique in the suite of proposed Anthropocene Global Boundary Stratotype Section and Point (GSSP) archives, as living organisms that produce aragonite exoskeletons preserved in the geological record that contain highly accurate and precise (<±1 year) internal chronologies. The GSSP candidate site North Flinders Reef in the Coral Sea (Australia) is an offshore oceanic reef, and therefore less vulnerable to local human influences than those closer to the coast. Here, we present geochemical records from two Porites sp. corals sampled at an annual to pluri-annual (i.e. 3–5 years) resolution that shows clear global and regional human impacts. Atmospheric nuclear bomb testing by-products (14C,239+240Pu) show a clear increase in the Flinders Reef corals coincident with well-dated nuclear testing operations. By contrast, the radionuclides 241Am and 137Cs are present at low or undetectable levels, as are spheroidal carbonaceous fly-ash particles. Coral δ13C shows centennial variability likely influenced by growth effects in the 18th century and with a progression to lower values starting in 1880 and accelerating post-1970. The latter may be related to the Suess Effect resulting from 13C-depleted fossil fuel burning. Coral δ15N decreased between 1710 and 1954 with a reversal post-1954. Coral temperature proxies indicate prominent centennial variability with equally warm conditions in the 18th and end of 20th century. However, the exact mechanisms responsible for the mid-20th century changes in these parameters need to be scrutinised in further detail. Plain Language summary: This work proposes a candidate natural archive for the official marker of the Anthropocene that geologists will use to mark this important interval in time. Our candidate is a live coral from North Flinders Reef in the Coral Sea (Australia), located 150 km east of the Great Barrier Reef, a location that is remote from direct local human influences. Corals are a unique archive of tropical ocean change because they incorporate the geochemical signature from seawater into their limestone skeleton during their long life-spans. Here we investigated a number of geochemical markers in yearly growth layers of the corals to define several markers for the Anthropocene based on changes in temperature, water chemistry, chemicals from pollution and fertilisers, radioactive products from nuclear bomb testing, and by-products from burning fossil fuels. We have detected clear human influences in several of these markers

    CAR-T cell. the long and winding road to solid tumors

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    Adoptive cell therapy of solid tumors with reprogrammed T cells can be considered the "next generation" of cancer hallmarks. CAR-T cells fail to be as effective as in liquid tumors for the inability to reach and survive in the microenvironment surrounding the neoplastic foci. The intricate net of cross-interactions occurring between tumor components, stromal and immune cells leads to an ineffective anergic status favoring the evasion from the host's defenses. Our goal is hereby to trace the road imposed by solid tumors to CAR-T cells, highlighting pitfalls and strategies to be developed and refined to possibly overcome these hurdles

    The first definitive carcharodontosaurid (Dinosauria:Theropoda) from Asia and the delayed ascent of tyrannosaurids

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    Little is known about the evolution of large-bodied theropod dinosaurs during the Early to mid Cretaceous in Asia. Prior to this time, Asia was home to an endemic fauna of basal tetanurans, whereas terminal Cretaceous ecosystems were dominated by tyrannosaurids, but the intervening 60 million years left a sparse fossil record. Here, we redescribe the enigmatic large-bodied Chilantaisaurus maortuensis from the Turonian of Inner Mongolia, China. We refer this species to a new genus, Shaochilong, and analyze its systematic affinities. Although Shaochilong has previously been allied with several disparate theropod groups (Megalosauridae, Allosauridae, Tyrannosauroidea, Maniraptora), we find strong support for a derived carcharodontosaurid placement. As such, Shaochilong is the first unequivocal Asian member of Carcharodontosauridae, which was once thought to be restricted to Gondwana. The discovery of an Asian carcharodontosaurid indicates that this clade was cosmopolitan in the Early to mid Cretaceous and that Asian large-bodied theropod faunas were no longer endemic at this time. It may also suggest that the ascent of tyrannosaurids into the large-bodied dinosaurian predator niche was a late event that occurred towards the end of the Cretaceous,between the Turonian and the Campanian

    Safety of a new extensively hydrolysed formula in children with cow's milk protein allergy: a double blind crossover study

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    BACKGROUND: Formulae for infants with cow's milk protein allergy (CMA) should be based on extensively hydrolysed protein. 'Extensively' however is not strictly defined. Differences in molecular weight and peptide chain length may affect its clinical outcome. We studied the safety of a new extensively hydrolysed casein based formula (Frisolac Allergycare(®): FAC) for children with IgE mediated CMA. METHODS: Thirty children, aged 1.5 – 14.8 years old (median 4.9 years) with persistent CMA were enrolled in this double-blind reference product (Nutramigen(®): NUT) controlled crossover study. All had positive skin prick tests (SPT) and IgE mediated allergy, showing immediate reactions after ingestion of small amounts of milk. Twenty-five children also had positive radio allergen sorbent tests (RAST) to cow's milk. Formulae provided consisted of 80% elementary formula in combination with 20% reference or test product. Crossover periods lasted for two weeks. From both products molecular weight (MALDI-TOF method and HPLC) and peptide chain length distribution (adapted Edman degradation) were determined. RESULTS: Maximum molecular weights of NUT and FAC are 2.1 and 2.56 kDa, respectively. The contribution of free amino acids and small peptides <0.5 kDa is 46% for FAC and 53% for NUT. About 50% of the protein fraction of both products consists of peptides longer than four amino acids. Three children did not complete the study. The other children all tolerated FAC very well; no adverse reactions were reported. CONCLUSIONS: The new extensively hydrolysed casein-based formula (FAC) can safely be used in children with IgE mediated cow's milk allergy
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