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This paper is concerned with the experience of service users of a mental health Trust. The shared experience of the particular service user group is that of auditory hallucinations. The paper argues that mental health practitioners have, traditionally, not listened effectively to the subjective experience of voice hearing. By creating an environment in which service users can discuss their shared experience, the mental health practitioner can facilitate learning from experience and the development of 'common-sense' management strategies. Such strategies do not demand, or require, text book answers from health care professionals, but emerge from service users, through living with voice hearing. The work is interpreted through Parse's theory of human becoming and Marius Romme's work with 'Hearing Voices'. [ABSTRACT FROM AUTHOR]

Bere barley ( Hordeum vulgare L.) is a six-row barley landrace, the ancestry of which may go back to the 8th century or earlier. The cultivation of bere on any scale is currently restricted to Orkney, although it was at one time grown more widely in Scotland. Within the UK, bere is unique in being the only barley grown commercially for milling and, in Orkney, flours derived from bere are traditionally used for making bannocks, bread and biscuits. There is potential for the use of bere flours in a much wider range of foods, and for this reason the nutritional properties of such flours were investigated. The energy, macronutrient and micronutrient content of both wholemeal and white flours derived from bere were measured. Flours derived from bere grown in Orkney contain a wide variety of nutrients including significant quantities of folate, thiamin, pantothenic acid, iron, iodine and magnesium. Although the nutrient content of bere bannocks has previously been published, to our knowledge, this is the first study to investigate the nutritional properties of wholemeal and white flours derived from bere. [ABSTRACT FROM AUTHOR]

Background: Polymorphisms in cytokine genes can influence immune responses, inflammation, and tissue injury and may affect the outcome of hematopoietic stem-cell transplantation.Methods: We analyzed single-nucleotide polymorphisms in the genes for interleukin-1beta, interleukin-1-receptor antagonist, interleukin-6, interleukin-10 (IL10), and tumor necrosis factor alpha in 570 transplant recipients and their HLA-identical sibling donors. Genotypes were tested for an association with graft-versus-host disease (GVHD) by multivariable analysis. A second cohort of 423 transplant recipients was independently analyzed for the genotype associations identified in the first cohort.Results: The recipient's IL10 promoter region genotype was significantly associated with the risk of acute GVHD in the first cohort. Analysis of all 993 transplant recipients showed that, as compared with the C/C genotype, the IL10 -592A/A genotype was associated with a decreased risk of grade III or IV acute GVHD (hazard ratio, 0.4; 95 percent confidence interval, 0.2 to 0.9; P=0.02) and death in remission (hazard ratio, 0.6; 95 percent confidence interval, 0.3 to 1.0; P=0.05). A haplotype analysis showed that the IL10 -592A allele was a specific marker for a promoter haplotype, T-C-A-T-A, defined by five polymorphisms at positions -3575, -2763, -1082, -819, and -592, respectively.Conclusions: Among recipients of hematopoietic cells from an HLA-identical sibling, the IL10 -592A allele is a marker of a favorable outcome after transplantation. [ABSTRACT FROM AUTHOR]

Background and aims Arterial remodelling aims at normalising circumferential wall stress (CWS). Greater CWS in the carotid artery has previously been associated with the prevalence and severity of cerebral small vessel disease, a major cause of ageing-related cognitive decline. Here we test the hypothesis that greater carotid CWS is associated with poorer cognitive performance. Methods We studied 722 individuals (60 ± 8 years, 55% men, 42.5% highly educated, blood pressure 137 ± 19/77 ± 11 mmHg, n = 197 with type 2 diabetes) who completed a neuropsychological assessment and underwent vascular ultrasound to measure the intima-media thickness (IMT) and interadventitial diameter (IAD) of the left common carotid artery at a plaque-free site. From IMT and IAD, lumen diameter (LD) was calculated. These structural measures were then combined with local carotid pulse pressure and brachial mean arterial pressure to obtain a measure of pulsatile (CWS pulsatile ) and average (CWS mean ) mechanical load on the vessel wall. Cognitive domains assessed were memory, executive function and attention, and processing speed. Results After adjustment for age, sex, and education, regression analyses showed that neither CWS pulsatile nor CWS mean were associated with measures of cognitive performance (p-values ≥0.31). This null association did not differ by age or educational level, and was observed in both individuals with and without carotid plaque, diabetes and/or hypertension. In addition, none of the individual measures of carotid structure (i.e. IMT, IAD, and LD) was related to cognitive performance. Conclusions The present cross-sectional study shows that carotid CWS is not associated with cognitive performance, at least not among relatively highly educated individuals in late middle age with adequately controlled cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Background It is not clear whether recent increases in life expectancy are accompanied by a concurrent postponement of activity limitations. The objective of this study was to give best estimates of the trend in the prevalence of activity limitations among the non-institutionalized population aged 55–84 years over the period 1990–2007 in The Netherlands.Methods We examined self-reports on 12 measures of moderate or severe activity limitations in stair climbing, walking and getting dressed as assessed by OECD long-term disability questionnaire or Short Form-36 (SF-36) items, using original data from five population-based cross-sectional and longitudinal surveys (n = 54 847 respondents). To account for heterogeneity between surveys, we used meta-analyses to study time trends.Results Time trends of 10 out of the 12 activity limitation variables studied were stable. The prevalence of at least moderate activity limitations in stair climbing [odds ratio (OR) = 1.03)] and getting dressed (OR = 1.04) based on OECD items increased over the study period. Age- and gender-stratified time trend analyses showed consistent patterns.Conclusions No declines were observed in the prevalence of activity limitations in the Dutch older population over the period 1990–2007. The increase in life expectancy in this period is accompanied by a stable prevalence of most activity limitations. [ABSTRACT FROM AUTHOR]

Background: Despite the perceived importance of early life nutrition for mental development, few studies have related gestational undernutrition to later-life cognitive functioning. We investigated the consequences of gestational exposure to the Dutch famine of 1944-45 for cognitive functioning at the age of 59 years.Methods: We recruited men and women who were (i) born in birth clinics in Amsterdam, Rotterdam and Leiden, between January 1945 and March 1946, whose mothers experienced famine during or immediately preceding pregnancy (n = 354); (ii) born in the same three institutions during 1943 and 1947, whose mothers did not experience famine during this pregnancy (n = 292); or (iii) same-sex siblings of those in the first two categories (n = 311). We assessed cognitive performance at the age of 59 years by means of a comprehensive test battery.Results: All cognitive functioning test scores were within normal ranges for this age group. There were no differences in cognitive performance at the age of 59 years between individuals exposed to gestational undernutrition and those without this exposure. For the general cognitive index, a summary measure across six functional domains (mean 100, standard deviation (SD) 15 points), famine exposure was associated with a decrease of 0.57 points [95% confidence interval (95% CI) -2.41 to 1.28] points. Individuals exposed to famine in gestational weeks 1-10 had a cognitive functioning index 4.36 (95% CI 8.04-0.67) points lower than those without this exposure. Within-sibling-pair analyses gave consistent results.Conclusion: We found no overall association between maternal exposure to acute famine in pregnancy and cognitive performance of the offspring at the age of 59 years, but cannot rule out an association specific to early pregnancy exposure. [ABSTRACT FROM AUTHOR]