The social effects of juvenile chronic arthritis

We are continually expanding our knowledge of JCA and establishing our understanding on an ever-increasing knowledge base encompassing immunology, immunogenetics, physiology, psychology and sociology. The causes and treatment of this condition are multifactoral and no one discipline can hope to embrace all of them. Nurses, particularly those with rheumatological and/or paediatric expertise, are uniquely placed to provide the link between patient, the family and health care team and thus to coordinate treatment and ensure that care meets the needs of youngsters with JCA and their families.     

Policies to reduce energy use and carbon emissions in the UK

The UK differs from may other industrialized nations in that its carbon dioxide (CO₂) emissions from energy use have declined in recent years despite relatively rapid economic growth. In all sectors but transport, substantial reductions have already occurred in the level of carbon emissions per unit of GDP output. At the same time, a number of official and unofficial studies have pointed out that the UK has one of the largest remaining potentials amongst comparable industrialized countries for achieving further CO₂ reductions through the implementation of cost-effective energy efficiency and fuel switching measures. This paper discusses past and present patterns of energy use and carbons emissions in the UK. The analysis then examines historical trends in UK energy policy and presents policy options for further reducing the UK's energy-use and carbon emissions in the future.     

Mechanical properties of poly(ether-ether-ketone) for engineering applications

An outline of the characteristics of PEEK and the versatility of its compositional forms (micro and macro composites) are given to illustrate its wide potential for success in engineering applications. Although it is necessary to have particular tabulations of mechanical properties for engineering design, these are seldom available and consequently it is argued that an understanding of stiffness, toughness and strength properties are required to fully exploit available manufacturer's data and thus develop the full potential of PEEK and its composites. Stiffness characteristics are considered in terms of a modulus function which is dependent on time under load and temperature. In its composite forms, whether reinforced with short or continuous fibres, stiffness anistropy can be both considerable and complex, but some empirical ground-rules are apparent. For continuous fibre composites even in the form of complex lay-ups, it is also possible to attempt some stiffness prediction from certain pseudo-elastic constants. Toughness of PEEK and its composites is described in terms of both comparative and intrinsic properties. Instrumented falling weight impact data, particularly as a function of temperature enable some insight into ductile-brittle transitions for the unreinforced material, but crack initiation and crack propagation processes for the various fibre reinforced forms. Intrinsic toughness is described in terms of linear elastic fracture mechanics theory. Strength properties are described for static and dynamic loading configurations. In particular, PEEK and its composites are evaluated for increasing test severities for strength characteristics; stress concentration, loading form and test temperature are considered.     

Improving user security behaviour

Many organisations suspect that their internal security threat is more pressing than their external security threat. The internal threat is predominantly the result of poor user security behaviour. Yet, despite that, security awareness programmes often seem more likely to put users to sleep than to improve their behaviour. This article discusses the influences that affect a user's security behaviour and outlines how a well structured approach focused on improving behaviour could be an excellent way to take security slack out of an organisation and to achieve a high return for a modest, low-risk investment.     

Sheet molding compound characterization using spiral flow

Sheet molding compound (SMC) is a fiber‐reinforced polymeric composite. It is often used in automotive, marine, and industrial applications over other materials because of its high strength to density ratio, resistance to corrosion, and low cost. There is a demand in the SMC industry to be able to characterize SMC processability. This is particularly true for heavy truck body panels, one of the fastest growing applications of SMC. Because of their large size and high strength requirement, the molding forces have a major influence in the molding cycle. Also because of the long flow paths involved, the ability of the paste to carry glass needs to be properly characterized when developing new SMC materials. In this article, we demonstrate the benefits of using spiral flow as a processability tester. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008     

Juvenile myoclonic epilepsy

CONCLUSION: We conclude that despite inevitable variability the clinical picture of JME is characteristic. It is easy to diagnose JME if one thinks of it while the history should be thoroughly analyzed. An EEG recording during sleep confirms the diagnosis. An early diagnosis of JME permits adequate prognosis of the subsequent course of epilepsy, and adequate therapy brings remission in most of the patients. If treatment starts following the large number of severe GTC seizures, the response to therapy is incomplete. The persistency of the illness throughout the life, the need for continuous medication and therapeutic unresponsiveness in cases with late diagnosis, do not justify the increasing misconception that JME is of benign nature. Diagnosis of JME is rare because of insufficient familiarily of physicians with the illness. BACKGROUND: Juvenile myoclonic epilepsy (JME) is an idiopathic generalized epileptic syndrome characterized with the combination of myoclonic, generalized tonic-clonic (GTC) and absence seizures that are readily provoked by sleep deprivation. PATIENTS: Forty-three patients, aged from 14 to 51 years, participated in a 5-year follow-up study. Diagnosis was made according to the criteria (Table 1) for diagnosis of JME set by Panayiotopoulos et al. (1994). Nineteen patients made their first contact with a neurologist at the Institute of Neurology and were diagnosed as JME, while the remaining 24 were referred to from other medical institutions with a diagnosis of therapy resistant to focal epilepsy. All patients underwent a somatic and neurological examination, "mini mental test," EEG in waking and CT scan of the brain. Some patients had EEG performed during sleep and some had MRI of the head. RESULTS: JME began between 9 and 26 (average 17) years. All patients had myoclonic seizures, 98% had GTC and 23% absence seizures. The first myoclonic seizure occurred between 9 and 24 years while the frst GTC seizure occurred between 10 and 32 years. Myoclonic seizures (83% of patients) and GTC seizures (70% of patients) occurred most often immediately after awaking. The most frequent provocative factors were insufficient sleep, alcohol abuse and tiredness. Epilepsy in the family was present in 39%, focal neurological deficiency in 9% and pathological findings on of CT and MRI in 7% of patients. Waking EEG was pathological in 77% of patients; it included generalized spike-wave discharges in 73%, multiple spike-wave complexes in 33% and focal discharges in 12% of patients, respectively. In all 26 patients tested, sleep EEG was pathological most often with multiple spike-wave complexes in 85% and 3-4 Hz spike-wave complexes in 57% of patients. The correct diagnosis of JME following a comprehensive examination was made in 24 (56%) patients after a delay of 1 to 35 years. In 24 patients with delayed diagnosis of JME the replacement of earlier medication with valproic acid (VPA) induced remission in 18 patients (75%) while 1 patient (4%) experienced a reduction in the number of seizures. Five patients (21%) did not respond to VPA medication: 2 due to a weak compliance, another 2 due to inefficient medication and 1 because of the preexistent malabsorption syndrome. In 19 patients (44%) with initial diagnosis of JME, VPA was introduced immediately upon diagnosis. Of them, 15 (79%) had excellent response to VPA, 1 refused therapy and for 3 patients there is no information. In 2 patients VPA was substituted due to side effects (hepatotoxicity and alopetia) with lamotrigine (low doses), which brought about decrease in frequency and mitigation in myoclonic seizures.     

Predicting change for individual psychotherapy clients on the basis of their nearest neighbors.

This study extended client-focused research by using the nearest neighbor (NN) approach, a client-specific sampling and prediction strategy derived from research on alpine avalanches. Psychotherapy clients (N = 203) seen in routine practice settings in the United Kingdom completed a battery of intake measures and then completed symptom intensity ratings before each session. Forecasts of each client's rate of change and session-by-session variability were computed on the basis of that client's NNs (n = 10-50 in different comparisons). Alternative forecasts used linear or log-linear slopes and were compared with an alternative prediction strategy. Results showed that the NN approach was superior to the alternative model in predicting rate of change, though the advantage was less clear for predicting variability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Localized Heat Therapy Improves Mitochondrial Respiratory Capacity but Not Fatty Acid Oxidation

AIM: Mild heat stress can improve mitochondrial respiratory capacity in skeletal muscle. However, long-term heat interventions are scarce, and the effects of heat therapy need to be understood in the context of the adaptations which follow the more complex combination of stimuli from exercise training. The purpose of this work was to compare the effects of 6 weeks of localized heat therapy on human skeletal muscle mitochondria to single-leg interval training. METHODS: Thirty-five subjects were assigned to receive sham therapy, short-wave diathermy heat therapy, or single-leg interval exercise training, localized to the quadriceps muscles of the right leg. All interventions took place 3 times per week. Muscle biopsies were performed at baseline, and after 3 and 6 weeks of intervention. Mitochondrial respiratory capacity was assessed on permeabilized muscle fibers via high-resolution respirometry. RESULTS: The primary finding of this work was that heat therapy and exercise training significantly improved mitochondrial respiratory capacity by 24.8 ± 6.2% and 27.9 ± 8.7%, respectively (p < 0.05). Fatty acid oxidation and citrate synthase activity were also increased following exercise training by 29.5 ± 6.8% and 19.0 ± 7.4%, respectively (p < 0.05). However, contrary to our hypothesis, heat therapy did not increase fatty acid oxidation or citrate synthase activity. CONCLUSION: Six weeks of muscle-localized heat therapy significantly improves mitochondrial respiratory capacity, comparable to exercise training. However, unlike exercise, heat does not improve fatty acid oxidation capacity.