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The use and disclosure of patient information is subject to multiple legal and ethical obligations. Within European human rights law the differences relating to consent are reflected in the separate requirements of data protection law, the common law, and professional ethics. The GDPR requires explicit consent. This contrasts with the ethical and common law availability of reliance on implied consent for the use of patient information for that patient's care and treatment. For any proposed use of patient information for healthcare purposes other than direct care, even where GDPR may be satisfied if the patient refuses to consent to disclosure, the information should not normally be disclosed. For any proposed use or disclosure outside healthcare the justification should normally be consent. However, consent is often not possible or appropriate and an overriding public interest can be relied upon to justify the use or disclosure, both legally and ethically. [ABSTRACT FROM AUTHOR]

The construction industry has invested considerable effort into integration of project information in the last decade. One such effort is the definition of Industry Foundation Classes (IFCs) to facilitate data sharing across applications through a shared project model. In order to achieve the integration objectives, the industry software vendors need to commit to the implementation of IFC in their products. IFC is defined in EXPRESS, which is a platform-independent, object-flavored, data modeling language. The EXPRESS-based models must be translated into some programming language model for specific implementation. To achieve this, developers need to evaluate and select a suitable model and programming language for their implementation. Developers therefore need to understand both EXPRESS and a host of programming languages. This initial knowledge requirement may hinder the take-off or adoption of IFC-based implementation. This paper describes a software solution that reduces this initial knowledge requirement considerably by providing a .NET class library translation and an implementation view of the IFC model, based on the EXPRESS definitions. Complemented by the online documentation provided with the IFC definitions, the software provides a hierarchical view of the IFC-based programming objects with drill-down facility for developers to capture and appreciate the information requirement for specific objects.

Background: Alterations in the gut microbiota have been observed in patients with mild cognitive impairment and Alzheimer's disease. Dietary consumption directly modulates gut microbiota; therefore, the quality of a diet may impact cognitive function and susceptibility to dementia. We hypothesized that consumption of the nutrient dense Mediterranean diet (MeDi) would improve cognitive function through beneficial changes to the gut microbiota as compared to the diet primarily consumed by Americans, the Western diet (WD). Method: Ten‐week‐old Sprague Dawley male rats were assigned a MeDi (n = 10) or WD (n = 9). After three months, Morris water maze (MWM) was used to assess spatial reference memory cognition. MWM data were analyzed with two‐way RM ANOVA. Fecal samples were collected prior to the MWM. Microbial composition was determined by 16S rRNA sequencing, and analyses included Mann‐Whitney with false discovery rate. Result: The MeDi group also spent significantly more time in the target quadrant during probe testing (p = 0.03) and was quicker to reach the platform on reversal testing (p = 0.004), indicative of improved cognitive flexibility. Microbiota α‐diversity indices, Shannon (p = 0.053), Simpson (p = 0.054), and Chao1 (p = 0.056), had a trend to be increased in the MeDi. Microbiota β‐diversity was dissimilar between diets (p<0.001). At the phylum level, Actinobacteria decreased and Patescibacteria increased with consumption of the MeDi as compared to the WD. Actinobacteria relative abundance correlated with MWM time in target quadrant (r = ‐0.58, p = 0.009). Further, relative abundance of Actinobacteria and Patescibacteria correlated with MWM reversal distance to reach platform (Actinobacteria, r = 0.77, p = 0.0001; Patescibacteria, r = ‐0.59, p = 0.007). Conclusion: The MeDi maintained long‐term spatial memory, as measured by the MWM, compared to the WD. Additionally, diet‐modulated gut microbiota at the phylum level and these changes were correlated with cognitive function. Modulation of the gut microbiota through a neuroprotective diet, such as the MeDi, may serve as a method to improve cognitive function. [ABSTRACT FROM AUTHOR]

Background: Many patients with mild cognitive impairment and Alzheimer's disease have alterations in the gut microbiota. Dietary consumption directly modulates gut microbiota; therefore, the quality of a diet may impact cognitive function and susceptibility to memory impairments. We hypothesized that consumption of the Mediterranean diet (MeDi) versus the Western diet (WD) will improve cognitive function through beneficial changes to the gut microbiota. Method: Twelve‐month‐old male Fischer 344 rats (n = 14/group) were randomly assigned to a MeDi, WD, or Chow diet (positive control to MeDi) for three months. Animals then underwent neurobehavioral assessments (n = 10/group) including the Morris water maze and radial arm water maze to assess aspects of short‐ and long‐term memory. Data were analyzed via One‐ or Two‐Way Repeated Measures ANOVA where appropriate. Fecal samples were collected prior to the behavior. Microbial composition was determined by 16S rRNA sequencing. Result: The MeDi and WD groups consumed more kcals (p<0.05) at various weeks and weighed more compared to the chow group (p<0.05). There was no difference in time to reach the platform between the MeDi and WD or Chow groups in the Morris water maze, however, animals consuming the chow diet were quicker to reach the platform compared to the WD (p = 0.046). There were no differences in total errors measured by the radial arm water maze (p = 0.50) between diets. Gut microbiota composition (β‐diversity) was distinct between diets (Weighted and Unweighted UniFrac, p<0.001). Conclusion: There were no differences in short‐ or long‐term memory in aged animals consuming a MeDi or WD for three months. Diet‐modulated the gut microbiota as exhibited by differences in β‐diversity between the MeDi, WD, and Chow. As animals consumed a chow diet throughout their lifespan, the MeDi or WD may need to be started earlier in life to exhibit differences. Funding: NIH Mentoring Research Excellence in Aging and Regenerative Medicine5P20GM103629‐10 [ABSTRACT FROM AUTHOR]

Skeletal muscle aging is associated with a decline in motor function and loss of muscle mass- a condition known as sarcopenia. The underlying mechanisms that drive this pathology are associated with a failure in energy generation in skeletal muscle, either from age-related decline in mitochondrial function, or from disuse. To an extent, lifelong exercise is efficacious in preserving the energetic properties of skeletal muscle and thus may delay the onset of sarcopenia. This review discusses the cellular and molecular changes in skeletal muscle mitochondria during the aging process and how different exercise modalities work to reverse these changes. A key factor that will be described is the efficiency of mitochondrial coupling-ATP production relative to O2 uptake in myocytes and how that efficiency is a main driver for age-associated decline in skeletal muscle function. With that, we postulate the most effective exercise modality and protocol for reversing the molecular hallmarks of skeletal muscle aging and staving off sarcopenia. Two other concepts pertinent to mitochondrial efficiency in exercise-trained skeletal muscle will be integrated in this review, including- mitophagy, the removal of dysfunctional mitochondrial via autophagy, as well as the implications of muscle fiber type changes with sarcopenia on mitochondrial function. [ABSTRACT FROM AUTHOR]

John Miller Jones. New York: Peter Lang, 1995. xvi + 202 pp. $45.95. In its earlier (1993) incarnation as a doctoral thesis this work was entitled 'Hope among the Remnants [...]

Vince Geoghegan. London & New York: Routledge, 1996. viii + 197 pp. A short introduction to the complex thought of Bloch has been overdue for a long time; interest in [...]

The prevalence of diabetes and diabetic retinopathy is increasing around the world. Glycaemic control is important in reducing the long‐term risk of complications of diabetes, however intensive glycaemic control, particularly in patients with longstanding and poorly controlled diabetes, is associated with the risk of early worsening of diabetic retinopathy and vision loss. We present two clinical cases to illustrate the presentation of early worsening and to highlight a role for intravitreal anti‐vascular endothelial growth factor therapies in ameliorating this phenomenon, as well as a review of the current understanding of this phenomenon. We emphasise the importance of identifying individuals at risk of early worsening of diabetic retinopathy and recommend regular ophthalmological review during the period of intensive glycaemic control to ensure optimal visual outcomes. [ABSTRACT FROM AUTHOR]

Although Northern Ireland has high levels of mental health problems, there has been a relative lack of systematic research on mental health services that can provide an evidence base for legal, policy, and service developments. This article aims to provide a review of the central issues relating to mental health service provision in Northern Ireland, and to gather the perceptions of different stakeholders of these services. The study utilised in‐depth qualitative interviews, focus groups, and an online survey to collect data from respondents throughout the region. This method involved the completion of semistructured interviews with significant mental health commissioners and senior managers, and with service‐users and their key workers. Focus groups sessions were also completed with mental health professionals, service‐users, and carers. Data collection occurred between December 2014 and June 2015. Thematic analysis was used to identify key issues. The findings identified that considerable progress had been made not only in the development of mental health services in the last decade, but also highlighted the significant limitations in current services. Most notably, strengths in provision included the transition from long‐stay hospital care to community‐based services and person‐centred approaches. The researchers identified the need to improve funding, address problems with fragmentation, and gaps in service provision. Based on these findings, the authors consider the implications for practice and policy relating to the human and organisational aspects of service development. In particular, services should be developed focusing on a recovery ethos and on person‐centred and relationship‐based approaches. The needs of carers should additionally be considered and programmes developed to tackle stigma. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the similarities and differences of legal responses to older adults who may be at risk of harm or abuse in the UK, Ireland, Australia and the USA. Design/methodology/approach – The authors draw upon a review of elder abuse and adult protection undertaken on behalf of the commissioner for older people in Northern Ireland. This paper focusses on the desk top mapping of the different legal approaches and draws upon wider literature to frame the discussion of the relative strengths and weaknesses of the different legal responses. Findings – Arguments exist both for and against each legal approach. Differences in defining the scope and powers of adult protection legislation in the UK and internationally are highlighted. Research limitations/implications – This review was undertaken in late 2013; while the authors have updated the mapping to take account of subsequent changes, some statutory guidance is not yet available. While the expertise of a group of experienced professionals in the field of adult safeguarding was utilized, it was not feasible to employ a formal survey or consensus model. Practical implications – Some countries have already introduced APL and others are considering doing so. The potential advantages and challenges of introducing APL are highlighted. Social implications – The introduction of legislation may give professionals increased powers to prevent and reduce abuse of adults, but this would also change the dynamic of relationships within families and between families and professionals. Originality/value – This paper provides an accessible discussion of APL across the UK and internationally which to date has been lacking from the literature. [ABSTRACT FROM AUTHOR]

The construction industry has invested considerable effort into integration of project information in the last decade. One such effort is the definition of Industry Foundation Classes (IFCs) to facilitate data sharing across applications through a shared project model. In order to achieve the integration objectives, the industry software vendors need to commit to the implementation of IFC in their products. IFC is defined in EXPRESS, which is a platform-independent, object-flavored, data modeling language. The EXPRESS-based models must be translated into some programming language model for specific implementation. To achieve this, developers need to evaluate and select a suitable model and programming language for their implementation. Developers therefore need to understand both EXPRESS and a host of programming languages. This initial knowledge requirement may hinder the take-off or adoption of IFC-based implementation. This paper describes a software solution that reduces this initial knowledge requirement considerably by providing a .NET class library translation and an implementation view of the IFC model, based on the EXPRESS definitions. Complemented by the online documentation provided with the IFC definitions, the software provides a hierarchical view of the IFC-based programming objects with drill-down facility for developers to capture and appreciate the information requirement for specific objects. [ABSTRACT FROM AUTHOR]