Strategies for engaging with future radiation protection professionals: a public outreach case study.

It is evident that there is a nuclear skills shortage within the UK, and logically it can be assumed that the shortfall extends to the radiation protection arena. Plans for nuclear new-build and the decommissioning of existing nuclear sites will require many more people with radiological knowledge and practical competencies. This converts to a nuclear industry requirement in the order of 1000 new recruits per year over at least the next ten years, mainly as new apprentices and graduates. At the same time, the strong demand for persons with radiation protection know-how in the non-nuclear and health care sectors is unlikely to diminish. The task of filling this skills gap is a significant one and it will require a determined effort from many UK stakeholders. The Society for Radiological Protection (SRP) has adopted a strategy in recent years to help address this skills gap. The aim is to engage the interest of secondary school students in the science of radiation and inspire them to follow a career in radiation protection. This paper presents the reasoning behind this strategy and, in an 'outreach case study', describes the establishment of the annual SRP Schools Event. This event is becoming an important addition to the national efforts aimed at increasing the numbers of skilled UK radiation protection professionals over the forthcoming decades.

Social deprivation does not affect lung cancer stage at presentation or disease outcome.

INTRODUCTION: Lung cancer mortality rates are higher in more deprived populations. This may simply reflect higher incidence of the disease, or additionally delayed presentation and worse outcomes amongst more deprived patients. Low socio-economic status (SES) has also been linked to cancer fatalism which might account for such differences. We determined the interaction between SES, patient's characteristics at presentation with lung cancer, and disease outcome at a large UK teaching hospital. METHODS: Stage, PS at presentation, treatment and survival data, index of multiple deprivation score and ACORN group (geo-demographic segmentation tool) were analysed for 1432 patients. RESULTS: There were no significant differences in stage or PS distribution by IMD quintile or ACORN group. When patients with stage I/II disease were considered, there were no differences in IMD or ACORN group for those undergoing or not undergoing surgical resection. Similarly when the whole cohort was considered, there were no differences in these parameters between those receiving and not receiving any anti-cancer therapy. There was a non-significant trend to lower IMD score (i.e. less deprivation) in the stage IIIb/IV patients receiving palliative chemotherapy compared to those not receiving chemotherapy. There was no significant difference in median survival or one-year survival according to IMD quintile or ACORN group. CONCLUSION: In our patient cohort, deprivation does not appear to affect stage or performance status at presentation, nor survival from lung cancer. If cancer fatalism is more prevalent in deprived populations, this does not appear to lead to later diagnosis nor worse disease outcome.

Allelic imbalance in Drosophila hybrid heads: exons, isoforms, and evolution.

Unraveling how regulatory divergence contributes to species differences and adaptation requires identifying functional variants from among millions of genetic differences. Analysis of allelic imbalance (AI) reveals functional genetic differences in cis regulation and has demonstrated differences in cis regulation within and between species. Regulatory mechanisms are often highly conserved, yet differences between species in gene expression are extensive. What evolutionary forces explain widespread divergence in cis regulation? AI was assessed in Drosophila melanogaster-Drosophila simulans hybrid female heads using RNA-seq technology. Mapping bias was virtually eliminated by using genotype-specific references. Allele representation in DNA sequencing was used as a prior in a novel Bayesian model for the estimation of AI in RNA. Cis regulatory divergence was common in the organs and tissues of the head with 41% of genes analyzed showing significant AI. Using existing population genomic data, the relationship between AI and patterns of sequence evolution was examined. Evidence of positive selection was found in 30% of cis regulatory divergent genes. Genes involved in defense, RNAi/RISC complex genes, and those that are sex regulated are enriched among adaptively evolving cis regulatory divergent genes. For genes in these groups, adaptive evolution may play a role in regulatory divergence between species. However, there is no evidence that adaptive evolution drives most of the cis regulatory divergence that is observed. The majority of genes showed patterns consistent with stabilizing selection and neutral evolutionary processes.

A glaucoma equity profile: correlating disease distribution with service provision and uptake in a population in Northern England, UK.

AIMS: Glaucoma is a significant health problem, with associated inequalities. Equity profiles are an established public health tool to examine the scale of health inequalities and to imbed action into the commissioning cycle. This is the first equity profile conducted in the United Kingdom for an ophthalmic condition. This methodology also provides a model for use in other localities and for other eye conditions. METHODS: Existing services were mapped and need identified. A wide variety of data sources were analysed. Mapping was undertaken using Mapinfo Professional Geographical Information Systems software. Statistical analysis was conducted using Microsoft Excel 2003. RESULTS: No single data source provided a fully informed perspective. A clear mismatch between areas of deprivation and location of optometry was observed. Secondary analysis of electronic patient records revealed a significant association between 'late presentation' and older age (mean age of late presenters=76.4 years, 95% CI=75.1-77.6 compared with earlier presenters, 72.4 years, 95% CI=71.7-73.1). Late presentation was also associated with living in an area of high deprivation (chi(2)=7.1, df, P<0.05). Ethnicity data was poorly recorded. Qualitative data provided invaluable insights. CONCLUSIONS: Increasing access to services involves collaboration with optometrists, ophthalmologists, public health, and commissioners. It is no longer acceptable to rely on private high street optometry to provide primary eye care services in areas of high need. Outreach services must be developed and evaluated in areas of relative deprivation if world class eye services are to be achieved.

Differences in thermoregulatory ability between slick-haired and wild-type lactating Holstein cows in response to acute heat stress.

Animals inheriting the slick hair gene have a short, sleek, and sometimes glossy coat. The objective of the present study was to determine whether slick-haired Holstein cows regulate body temperature more effectively than wild-type Holstein cows when exposed to an acute increase in heat stress. Lactating slick cows (n = 10) and wild-type cows (n = 10) were placed for 10 h in an indoor environment with a solid roof, fans, and evaporative cooling or in an outdoor environment with shade cloth and no fans or evaporative cooling. Cows were exposed to both environments in a single reversal design. Vaginal temperature, respiration rate, surface temperature, and sweating rate were measured at 1200, 1500, 1800, and 2100 h (replicate 1) or 1200 and 1500 h (replicate 2), and blood samples were collected for plasma cortisol concentration. Cows in the outdoor environment had higher vaginal and surface temperatures, respiration rates, and sweating rates than cows in the indoor environment. In both environments, slick-haired cows had lower vaginal temperatures (indoor: 39.0 vs. 39.4 degrees C; outdoor 39.6 vs. 40.2 degrees C; SEM = 0.07) and respiration rate (indoor: 67 vs. 79 breaths/ min; outdoor 97 vs. 107 breaths/min; SEM = 5.5) than wild-type cows and greater sweating rates in unclipped areas of skin (indoor: 57 vs. 43 g x h(-1)/m(2); outdoor 82 vs. 61 g x h(-1)/m(2); SEM = 8). Clipping the hair at the site of sweating measurement eliminated the difference between slick-haired and wild-type cows. Results indicate that slick-haired Holstein cows can regulate body temperature more effectively than wild-type cows during heat stress. One reason slick-haired animals are better able to regulate body temperature is increased sweating rate.

Ecosystem impacts of three sequential hurricanes (Dennis, Floyd, and Irene) on the United States' largest lagoonal estuary, Pamlico Sound, NC.

Three sequential hurricanes, Dennis, Floyd, and Irene, affected coastal North Carolina in September and October 1999. These hurricanes inundated the region with up to 1 m of rainfall, causing 50- to 500-year flooding in the watershed of the Pamlico Sound, the largest lagoonal estuary in the United States and a key West Atlantic fisheries nursery. We investigated the ecosystem-level impacts on and responses of the Sound to the floodwater discharge. Floodwaters displaced three-fourths of the volume of the Sound, depressed salinity by a similar amount, and delivered at least half of the typical annual nitrogen load to this nitrogen-sensitive ecosystem. Organic carbon concentrations in floodwaters entering Pamlico Sound via a major tributary (the Neuse River Estuary) were at least 2-fold higher than concentrations under prefloodwater conditions. A cascading set of physical, chemical, and ecological impacts followed, including strong vertical stratification, bottom water hypoxia, a sustained increase in algal biomass, displacement of many marine organisms, and a rise in fish disease. Because of the Sound's long residence time ( approximately 1 year), we hypothesize that the effects of the short-term nutrient enrichment could prove to be multiannual. A predicted increase in the frequency of hurricane activity over the next few decades may cause longer-term biogeochemical and trophic changes in this and other estuarine and coastal habitats.

Outcome of anorexia nervosa: eating attitudes, personality, and parental bonding.

BACKGROUND: We examined eating attitudes, personality, and parental bonding in women with a history of anorexia nervosa stratified by degree of recovery in comparison to randomly selected controls. We were interested in the distinguishing characteristics of recovery and of chronic anorexia nervosa. METHOD: All female new referrals to an eating disorders service between January 1, 1981 and December 31, 1984 with probable or definite anorexia nervosa were eligible for inclusion. 86.4% of these women ("cases") were located and agreed to participate. The control group was a random community sample. All subjects were interviewed with a structured diagnostic instrument and completed a battery of psychological inventories including the Eating Disorder Inventory (EDI), the Three-Factor Eating Questionnaire (TFEQ), the Temperament and Character Inventory (TCI), and the Parental Bonding Instrument (PBI). RESULTS: We divided the anorexia follow-up sample into full recovery (n = 21), partial recovery (n = 34), and chronically ill (n = 15) and compared them to community controls (n = 98). The chronically ill group was distinguished by a lower desired body mass index (BMI), higher cognitive restraint on the TFEQ, higher Drive for Thinness and Bulimia on the EDI, lower maternal and paternal care on the PBI, and high harm avoidance and low self-directedness on the TCI. The full recovery group scored high on self-directedness and cooperativeness on the TCI. CONCLUSIONS: The domains of personality, character, and parental bonding differ among categories of recovery in anorexia nervosa. Whether these differences contribute to recovery or emerge during recovery or lack thereof remains an unanswered question.

Isotopic ((13)C) fractionation during plant residue decomposition and its implications for soil organic matter studies.

Carbon isotopic fractionations in plant materials and those occurring during decomposition have direct implications in studies of short-and longer-term soil organic matter dynamics. Thus the products of decomposition, the evolved CO(2) and the newly formed soil organic matter, may vary in their (13)C signature from that of the original plant material. To evaluate the importance of such fractionation processes, the variations in (13)C signatures between and within plant parts of a tropical grass (Brachiaria humidicola) and tropical legume (Desmodium ovalifolium) were measured and the changes in (13)C content (signatures) during decomposition were monitored over a period of four months. As expected the grass materials were less depleted in (13)C (-11.4 to -11.9 per thousand) than those of the legume (-27.3 to -25.8 per thousand). Root materials of the legume were less (1.5 per thousand) depleted in (13)C compared with the leaves. Plant lignin-C was strongly depleted in (13)C compared with the bulk material by up to 2.5 per thousand in the legume and up to 4.7 per thousand in the grass. Plant materials were subsequently incubated in a sand/nutrient-solution/microbial inoculum mixture. The respiration product CO(2) was trapped in NaOH and precipitated as CaCO(3), suitable for analysis using an automated C/N analyser coupled to an isotope ratio mass spectrometer. Significant depletion in (13)C of the evolved CO(2) was observed during the initial stages of decomposition probably as a result of microbial fractionation as it was not associated with the (13)C signatures of the measured more decomposable fractions (non-acid detergent fibre and cellulose). While the cumulative CO(2)-(13)C signatures of legume materials became slightly enriched with ongoing decomposition, the CO(2)-C of the grass materials remained depleted in (13)C. Associated isotopic fractionation correction factors for source identification of CO(2-)C varied with time and suggested errors of 2-19% in the estimation of the plant-derived C at 119 days of incubation in a soil of an intermediate (-20.0 per thousand) (13)C signature. Analysis of the residual material after 119 days of incubation showed little or no change in the (13)C signature partly due to the incomplete decomposition at the time of harvesting. Copyright 1999 John Wiley & Sons, Ltd.

Fertility and reproduction in women with anorexia nervosa: a controlled study.

BACKGROUND: Women who have anorexia nervosa may experience difficulties with fertility and reproduction. METHOD: We examined fertility and reproductive history in 66 women who had a history of anorexia nervosa (DSM-III-R) and 98 randomly selected community controls as part of a follow-up investigation examining the course of anorexia nervosa. RESULTS: Although women with a history of anorexia nervosa and controls did not differ on rate of pregnancy, mean number of pregnancies per woman, or age at first pregnancy, women with anorexia nervosa had significantly more miscarriages and cesarean deliveries, and the offspring of women with anorexia nervosa were significantly more likely to be born prematurely and were of lower birth weight than offspring of controls. There were no differences between women with active versus remitted anorexia nervosa on any of these measures; however, offspring of anorexic women with no history of bulimia nervosa had significantly lower body weight than offspring of anorexic women with a lifetime history of bulimia nervosa. CONCLUSION: Our results argue for intensive prenatal care for women with both active and remitted anorexia nervosa to ensure adequate prenatal nutrition and fetal development.

Eating disorder in a transgendered patient: a case report.

This paper reports the case of a 25-year-old biological male transgendered patient referred to a specialist eating disorder service, and presenting with persistent purging, subjective binging, and restricting. She articulated a close link between transgender issues and the development of eating disorder symptoms. By virtue of its emphasis on estrangement from body, biological gender, and expected social role, transgenderism may constitute a risk factor for developing an eating disorder in certain men.

Outcome of anorexia nervosa: a case-control study.

OBJECTIVE: Although there have been many studies of the outcome of anorexia nervosa, methodological weaknesses limit their interpretation. The authors used a case-control design to try to improve knowledge about the outcome of anorexia nervosa. METHOD: All new female patients referred to an eating disorders service between Jan. 1, 1981, and Dec. 31, 1984, who had probable or definite anorexia nervosa were eligible for inclusion. Of these women, 86.4% (N = 70) were located and agreed to participate. The comparison group (N = 98) was a random community sample. All subjects were interviewed with a structured diagnostic instrument. RESULTS: A minority of the patients (10%) continued to meet the criteria for anorexia nervosa a mean of 12 years after initial referral. Even among those who no longer met these criteria, relatively low body weight and cognitive features characteristic of anorexia nervosa (perfectionism and cognitive restraint) persisted. The rates of lifetime comorbid major depression, alcohol dependence, and a number of anxiety disorders were very high. CONCLUSIONS: In the managed care/brief treatment era, therapeutic approaches with an excessive focus on weight gain that neglect the detection and treatment of associated psychological features and comorbidity may be inappropriate. Anorexia nervosa is a serious psychiatric disorder with substantial morbidity.

Distinct patterns of chemokine expression are associated with leukocyte recruitment in alcoholic hepatitis and alcoholic cirrhosis.

Alcoholic liver disease is associated with three histologically distinct processes: steatosis (parenchymal fat accumulation), alcoholic hepatitis (characterized by parenchymal infiltration by neutrophil polymorphs), and alcoholic cirrhosis (in which chronic inflammation and fibrosis dominate). Chemokines are cytokines that promote subset-specific leukoycte recruitment to tissues and could therefore play a crucial role in determining which leukocyte subsets are recruited to the liver in alcoholic liver disease. This paper reports that chemokine expression is increased in the liver of patients with alcoholic liver disease and, moreover, that distinct patterns of chemokine expression are associated with the different inflammatory responses to alcohol. Interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1 alpha (MIP-1 alpha), and MIP-1 beta were all detected in the parenchyma at sites of inflammation in alcoholic hepatitis, whereas in alcoholic cirrhosis, chemokines were restricted to inflammatory cells and endothelium in the fibrous septa and portal tracts. In alcoholic hepatitis, chemokine transcription was localized to sinusoidal cells, leukocytes, and fibroblasts in areas of parenchymal inflammation, but hepatocytes, despite staining strongly for chemokine protein, were negative. In alcoholic cirrhosis, chemokine mRNA was detected in portal tract endothelium, leukocytes, and fibroblasts. Thus, alcoholic hepatitis and alcoholic cirrhosis are associated with distinct patterns of chemokine expression that are likely to be important factors in determining whether a patient develops acute parenchymal inflammation and alcoholic hepatitis, or chronic septal inflammation and alcoholic cirrhosis.

Eating disorders and antecedent anxiety disorders: a controlled study.

We compared the prevalence and age of onset of adult and childhood anxiety disorders relative to the primary diagnosis in 68 women with anorexia nervosa (AN), 116 women with bulimia nervosa (BN), 56 women with major depression with no eating disorder (MD) and 98 randomly selected controls (RC) in order to determine whether antecedent anxiety disorders are plausible risk factors for AN and BN. Comorbid anxiety disorders were common in all three clinical groups (AN, 60%; BN, 57%; MD, 48%). In 90% of AN women, 94% of BN women and 71% of MD women, anxiety disorders preceded the current primary condition (P = 0.01), although panic disorder tended to develop after the onset of AN, BN or MD. In multivariate logistic regressions, the odds ratios (ORs) for overanxious disorder (OR = 13.4) and obsessive-compulsive disorder (OR = 11.8) were significantly elevated for AN. The ORs for overanxious disorder and social phobia were significantly elevated for BN (OROAD = 4.9; ORSP = 15.5) and MD (OROAD = 6.1; ORSP = 6.4). These data suggest that certain anxiety disorders are non-specific risk factors for later affective and eating disorders, and others may represent more specific antecedent risk factors.

Promotion of leukocyte transendothelial cell migration by chemokines derived from human biliary epithelial cells in vitro.

Biliary epithelial cells are the focus of inflammatory damage in several liver diseases, including allograft rejection wherein intrahepatic bile ducts are infiltrated and damaged by T cells and neutrophils. Locally secreted chemotactic cytokines (chemokines) are important signals for leukocyte recruitment to an inflammatory site and include interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1), potent chemotactic agents for neutrophils and monocyte or T cells, respectively. In this study, we demonstrate that primary cultures of human biliary epithelial cells (BECs) express and secrete IL-8 and MCP-1, both of which are upregulated rapidly and markedly in response to the proinflammatory cytokines IL-1 and tumor necrosis factor-alpha. Interferon-gamma had a differential effect by reducing IL-8 secretion but stimulating MCP-1 secretion. BECs cocultured in transwell chambers below confluent monolayers of endothelial cells promoted the transendothelial migration of neutrophils, which was blocked by antibodies to CD18 or CD11b but only partially inhibited by blocking antibodies to IL-8. We conclude that human BECs produce and secrete potent, functional chemokines when stimulated by proinflammatory cytokines. The ability of BECs to secrete chemokines and thus to promote leukocyte infiltration into portal tracts seems likely to be an important cause of bile duct damage in such conditions as liver allograft rejection and may explain the involvement of intrahepatic bile ducts in a number of inflammatory liver diseases.

Outcome following stroke.

A community study based on an age-stratified sample of those aged 55 years and older in a northern health district in the United Kingdom has been used to consider the implications for purchasing health-care services for those who have survived a stroke. The study showed that while almost a quarter of those reporting a stroke had made a full recovery, a wide range of impairments and disabilities persisted. Almost half reported needing help at least daily. A logistic regression model to predict this level of dependency found that impairments, disabilities and other factors, such as locality, were also predictive of dependency. A second model predicting mobility handicap (dwelling restricted) was found to have a similar mix of predictors. These results show how purchasers must consider the broad outcome in terms of a continuum of impairment, disability and handicap. The results also show that handicap is a distinct concept that draws together many influences which act upon the individual.

Psychopathology and personality of young women who experience food cravings.

The objective of the present study was to investigate the psychopathology and personality characteristics of women who experience food cravings. A total of 101 young women selected at random from the community completed the Diagnostic Interview for Genetic Studies with a trained interviewer. The interview included a section about food-craving experiences and associated factors. Subjects also completed a self-report questionnaire booklet containing the Temperament and Character Inventory (TCI) and the Eating Disorder Inventory (EDI). Compared to noncravers, women who reported food cravings were significantly more likely to report a history of alcohol abuse/dependence (p = .003), significant weight changes (p = .003), and to have undertaken dieting (p = .02), bingeing (p = .05), vomiting (p = .02), exercise (p = .04), diet pill (p = .03), and laxative use (p = .01) to control weight. There was a trend for the cravers to have higher novelty-seeking scores on the TCI (p = .06). Our findings suggest that women who experience food cravings are more likely to have met criteria for alcohol abuse/dependence and tend to have temperament characterized by higher levels of novelty seeking. In addition the high rates of eating-disorder symptomatology implies overconcern with body weight and shape in the women who experienced food cravings.

Prevalence of hip problems in the population aged 55 years and over: access to specialist care and future demand for hip arthroplasty.

To determine the prevalence of hip problems in the population aged 55+, a postal questionnaire was sent to a multistage stratified random sample of residents of a health district with an over-55 population of 210,000. An initial four page postal questionnaire produced an 86% response rate from 18,827 eligible cases. A subsequent detailed questionnaire (with a response rate of 78%) then determined the prevalence of severe pain and severe disability amongst those with hip problems. The prevalence of those with existing hip replacements is estimated at 32.1/1000 (95% CI 29.5-34.9). An estimated 13.5/1000 (95% CI 12.4-14.7/1000) displayed levels of pain and disability consistent with a current need to consider arthroplasty. In addition, it appears that the over 75s are less likely to have access to appropriate surgery. Unless health authorities and, increasingly, general practitioners consider purchasing more hip replacements, the prevalence pool of those who could benefit will inexorably rise.