Search

Abstract Background Aims/Objectives Materials and method Results Conclusion Significance National standards for nursing homes in Ireland require that residents are offered a choice of recreational and stimulating activities to meet their needs and preferences.To investigate residents’ perceptions of leisure and social occupational choice in nursing homes in Ireland to determine if occupational choice is facilitated.Qualitative-descriptive design – nursing home residents completed two semi-structured interviews that explored their experiences of leisure and social occupational engagement.Two overarching themes with six associated sub-themes emerged. From residents’ perspectives, social and leisure occupational choice was dependent on: Environmental factors (nursing homes’ Cultural, Social, Physical, and Temporal Environments) and Personal factors (residents’ Health Status and Personal Attitudes).The cultural environment had the most significant influence on residents’ leisure and social occupational choice, highlighting the importance of person-centred care within nursing homes, to promote occupational choice. Resident’s health status was also identified as a contributing factor.Occupational therapists could play a critical role in supporting the leisure and social occupational choices of nursing home residents by developing residents’ skills, educating staff and adapting tasks and the environment to limit/reduce occupational deprivation. [ABSTRACT FROM AUTHOR]

The suppression of apoptosis is essential to the propagation of viruses, and to the control of development and homeostasis in insects and mammals. The central components of all apoptotic pathways are proteases of the caspase family. Therefore, it is not surprising that the processes of natural selection, as well as pharmaceutical chemists, have designed compounds that directly target caspase activity in attempts to regulate apoptosis. The mechanisms used by highly specialized naturally occurring caspase inhibitors (both host and viral) have remained obscure for some time. However, recently there has been significant progress in this field, particularly because of the structural elucidation of the complexes between caspases and an endogenous inhibitor (XIAP) and a viral inhibitor (p35). This article reviews the newly defined molecular basis for the regulation of the caspases by viral and endogenous inhibitors.

Barrett's esophagus (BE) is the main pathological precursor of esophageal adenocarcinoma (EAC). Progression to high-grade dysplasia (HGD) or EAC from nondysplastic BE (NDBE), low-grade dysplasia (LGD) and indefinite for dysplasia (IND) varies widely between population-based studies and specialized centers for many reasons, principally the rigor of the biopsy protocol and the accuracy of pathologic definition. In the Republic of Ireland, a multicenter prospective registry and bioresource (RIBBON) was established in 2011 involving six academic medical centers, and this paper represents the first report from this network. A detailed clinical, endoscopic and pathologic database registered 3,557 patients. BE was defined strictly by both endoscopic evidence of Barrett's epithelium and the presence of specialized intestinal metaplasia (SIM). A prospective web-based database was used to gather information with initial and follow-up data abstracted by a data manager at each site. A total of 2,244 patients, 1,925 with no dysplasia, were included with complete follow-up. The median age at diagnosis was 60.5 with a 2.1:1 male to female ratio and a median follow-up time of 2.7 years (IQR 1.19–4.04), and 6609.25 person years. In this time period, 125 (5.57%) progressed to HGD/EAC, with 74 (3.3%) after 1 year of follow-up and 38 (1.69%) developed EAC, with 20 (0.89%) beyond 1 year. The overall incidence of HGD/EAC was 1.89% per year; 1.16% if the first year is excluded. The risk of progression to EAC alone overall was 0.57% per year, 0.31% excluding the first year, and 0.21% in the 1,925 patients who had SIM alone at diagnosis. Low-grade dysplasia (LGD) progressed to HGD/EAC in 31% of patients, a progression rate of 12.96% per year, 6.71% with the first year excluded. In a national collaboration of academic centers in Ireland, the progression rate for NDBE was similar to recent population studies. Almost one in two who progressed was evident within 1 year. Crucially, LGD diagnosed and confirmed by specialist gastrointestinal pathologists represents truly high-risk disease, highlighting the importance of expertise in diagnosis and management, and providing indirect support for ablative therapies in this context. [ABSTRACT FROM AUTHOR]

Globally, few precipitation records extend to the 18th century. The England Wales Precipitation (EWP) series is a notable exception with continuous monthly records from 1766. EWP has found widespread use across diverse fields of research including trend detection, evaluation of climate model simulations, as a proxy for mid‐latitude atmospheric circulation, a predictor in long‐term European gridded precipitation data sets, the assessment of drought and extremes, tree‐ring reconstructions and as a benchmark for other regional series. A key finding from EWP has been the multi‐centennial trends towards wetter winters and drier summers. We statistically reconstruct seasonal EWP using independent, quality‐assured temperature, pressure and circulation indices. Using a sleet and snow series for the UK derived by Profs. Gordon Manley and Elizabeth Shaw to examine winter reconstructions, we show that precipitation totals for pre‐1870 winters are likely biased low due to gauge under‐catch of snowfall and a higher incidence of snowfall during this period. When these factors are accounted for in our reconstructions, the observed trend to wetter winters in EWP is no longer evident. For summer, we find that pre‐1820 precipitation totals are too high, likely due to decreasing network density and less certain data at key stations. A significant trend to drier summers is not robustly present in our reconstructions of the EWP series. While our findings are more certain for winter than summer, we highlight (a) that extreme caution should be exercised when using EWP to make inferences about multi‐centennial trends, and; (b) that assessments of 18th and 19th Century winter precipitation should be aware of potential snow biases in early records. Our findings underline the importance of continual re‐appraisal of established long‐term climate data sets as new evidence becomes available. It is also likely that the identified biases in winter EWP have distorted many other long‐term European precipitation series. [ABSTRACT FROM AUTHOR]

A continuous 305-year (1711-2016) monthly rainfall series is created for the Island of Ireland. Two overlapping data sources are employed: i) a previously unpublished UK Meteorological Office note containing annual rainfall anomalies and corresponding proportional monthly totals based on weather diaries and early observational records for the period 1711-1977 and; ii) a long-term, homogenised monthly rainfall series for the island of Ireland for the period 1850-2016. Using estimates of long-term average precipitation from the homogenised series to merge these sources, the new 305-year record is constructed and insights drawn about notable extremes, climate variability and change. The consistency of the resulting series was evaluated by comparison with independent long-term observations and reconstructions of precipitation, temperature and circulation indices from across the British-Irish Isles. Strong decadal consistency is evident throughout the record amongst all series in spring, summer and autumn. The winter series is probably too dry from the 1740s to the 1780s, but strong consistency with other records strengthens confidence from 1790 onwards. The new Island of Ireland series reveals remarkably wet winters during the 1730s, concurrent with a period of strong westerly airflow, glacial advance throughout Scandinavia and near unprecedented warmth in the Central England Temperature record - all consistent with the strong phase of the North Atlantic Oscillation. The driest winter decade in the series coincides with the Laki eruption of 1783-1784. Unusually wet summers occurred in the 1750s, consistent with proxy (tree-ring) reconstructions of summer precipitation in the region. In the annual series, the most recent decade (2006-2015) is found to be the wettest in over 300 years. The new series reveals statistically significant (0.05 level) multi-centennial trends in winter (increasing) and summer (decreasing) seasonal precipitation. However, given uncertainties in the early winter record, the former should be treated as tentative. Importantly, we show that the years 1940 to present - the period with the most widely available digitised records - is unrepresentative of long-term changes in all seasons. Although there are recognized uncertainties in the early record, the derived series offers valuable insights for understanding multi-decadal and centennial rainfall variability in Ireland, and provides a firm basis for benchmarking other long-term records and future reconstructions. [ABSTRACT FROM AUTHOR]