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Effects of glucose on the cytosolic ratio of reduced/oxidized nicotinamide adenine dinucleotide phosphate in rat islets of Langerhans
No full textLegacy description not available</p
Presence and possible role of calcium-dependent regulator (calmodulin) in rat islets of langerhans
No full textLegacy description not available</p
Daylighting: appraisal at the early design stages
No full textFor a building design team concerned with the quality of the internal environment of buildings the percentage area of glazing on a building facade is one of the most useful criteria for judging the building envelope as a modifier of climate at early design stages since it is at the window that the various environmental parameters (heat, light and sound) remain only minimally modified.The percentage area of glazing can be used to relate the numerous and often conflicting functions of the window such as the provision of daylight, summer time teperatures, sound insulation, energy efficiency and view satisfaction.</p
In defence of a ratio model for movement detection at threshold.
No full textSutherland (1961) proposed that the detection of motion might depend upon the ratios of firings in cells sensitive to movement in opposite directions. Sekuler and his collaborators have argued that the notion of a ratio mechanism at threshold is wrong. The findings and arguments upon which this conclusion was based are challenged, an explicit model is described which provides an account of data previously held to be inconsistent with a ratio model, and an experiment is reported which provides unequivocal support for the ratio model and whose findings are inconsistent with the predictions from Sekuler's “independence” model.</p
A principled approach to N-tuple recognition systems
No full textThe idea of n-tuple sampling as a basis for pattern recognition, as proposed by Bledsoe and Browning (1959), remains a viable approach to a range of pattern classification tasks especially where speed of learning is of importance. The formal relationship between n-tuple neural networks and more mainstream network paradigms, such as radial basis function networks, and classical nonparametric pattern classifiers, such as kernel estimation, is considered, and it is described how the classic n-tuple recogniser and the n-tuple regression network form differing approximations in the classification process</p
Tothan
No full textChildrens illustrated book for the scottish Highlands and Islands, in the Scottish Gaelic language</p
A RURAL-URBAN COMPARISON OF SELF-MANAGEMENT IN PEOPLE AFFECTED BY CANCER FOLLOWING TREATMENT: A MIXED METHODS STUDY
No full textBackground: People affected by cancer have to self-manage the consequences of cancer long after primary treatment has ended. In cancer survivorship, self-management has been defined as awareness and active participation by the individual in their recovery, recuperation and rehabilitation to minimise the consequences of treatment, and promote survival, health and wellbeing (DH, Macmillan Cancer Support and NHS Improvement, 2010).Despite a significant drive towards promoting and supporting self-management with people affected by cancer there is a lack of research examining whether residence (rural-urban) has an influence on self-management following cancer treatment. The primary aim of this thesis was to investigate and compare self-management, in people affected by cancer following treatment from rural and urban areas.Methods: The study utilised a cross-sectional mixed methods design that incorporated both quantitative and qualitative methods of data collection.Firstly, this involved a self-completion postal questionnaire (N=227) that collected quantitative data on demographics, rural-urban residence, health status, health-promoting behaviours, patient activation, cancer-related self-efficacy and qualitative free-text information on self- management behaviours. This was followed by a series of in-depth qualitative interviews (N=34) that aimed to identify, and compare the barriers and facilitators to self-management in people affected by cancer from rural and urban settings in the East Midlands of England. Both datasets were integrated to further explain the quantitative differences that were identified between rural and urban participants.Results: Participants from rural areas reported higher scores across a range of quantitative variables, indicative of greater levels of engagement with health promoting behaviours and self-management compared to those from urban areas. Specifically, rural participants scored higher with regard to health responsibility (p<0.01; nutrition (p<0.001); spiritual growth (p<0.01); and interpersonal relationships (p<0.001). Rural respondents (63.31±13.66) had higher patient activation than those in urban areas (59.59±12.75) although this was not statistically significant at p<0.01. Those residing in rural areas (7.86±1.70) had significantly (p<0.01) greater cancer-related self-efficacy compared to those in urban areas (7.09±1.96). Rural respondents had significantly higher self-efficacy than urban respondents with regard to confidence to manage physical discomfort (p<0.01), emotional distress (p<0.001), and to contact their doctor about problems caused by cancer (p<0.01). The findings from the multivariate analysis highlighted that rural-urban residence was not a significant predictor of health-promoting behaviours, patient activation or cancer-related self-efficacy when adjusting for living arrangement, marital status, qualifications and self-reported health status. Self- reported health status proved to be a significant predictor on all three outcomes when controlling for confounders.Three themes were identified in the qualitative data which related to barriers that prevented participants from engaging with self-management: (1) Location (2) Relationship Based and (3) Personal. In relation to facilitators that enhanced participants’ active participation in their recovery, three subthemes were identified: (1) Effective Communication and Information; (2) Informal and Peer Support and (3) Motivation. The barriers and facilitators that were identified were prevalent in both the rural and urban setting. However, some aspects belonging to these barriers and facilitators were more explicit in the rural or urban environment. For example, there was a lack of bespoke support in rural areas and participants acknowledged how traveling long distances to urban centres for support groups was problematic. Motivation to engage with self-management was not unique and both sets of participants were motivated by a desire to be healthy and take part in group activities and sports. Although rural participants did have easier access to greenspaces and community activities, which could enhance motivation further.Conclusion: The quantitative findings highlighted that people in rural areas were more engaged with health-promoting behaviours and better at self-managing their health compared to those in urban areas. The majority of the barriers and facilitators that were identified were not necessarily unique to the urban or rural environment. Certainly, the qualitative data show that residency is not as unequivocal as the quantitative results would suggest. However, engagement with the local community was greater in rural areas which could account for the differences.Whilst the active treatment phase can present considerable challenges for people affected by cancer in rural areas the findings suggest that the rural environment has the potential to increase engagement with self-management in the transition to survivorship.</p
“Being Human”: A Grounded Theory of Complexity and Serendipity in Cancer Clinical Trials.
No full textAbstractBackgroundCancer presents a complex and intractable disease resulting in millions of deaths worldwide each year. As a metastatic disease bearing metamorphic characteristics, cancer’s emergent properties continue to challenge science, medicine, and society. Cancer research is a specialist field crucial to the advancement of patient treatment and care, yet it faces growing challenges due to the complex nature of an evolving disease, stratified treatments, and intensive trial protocols, compounded by increasing global disease burdens. Human ingenuity and resiliency are central to overcoming the greatest challenges facing contemporary populations, achieved through research innovation and knowledge exchange across ranging disciplines. Improving population health and patient-centred outcomes stands at the fore of global challenges facing society in the twenty first century, requiring novel and dynamic responses to increasing chronic disease burdens and exposure risks to emergent viral pathogens. AimsThe aim of this thesis was to understand the nature of cancer clinical trial operational delivery, evaluating challenges and burdens of professionals and patients participating in cancer research studies. The nature of multi-agency working and transdisciplinarity across health sciences is as complex as the biological and societal challenges that their research seeks to address. Establishing sustainable, cohesive, and collaborative relationships across the medical continuum is pivotal to solving persistent challenges of complex diseases and societal burdens. The study sought to develop a contextualised grounded theory elucidating situated challenges and complexity experienced at NHS sites in the UK. The purpose of the grounded theory would be to support the development of enhanced, person-centred models of clinical research operational delivery, which could respond to emergent and dynamically adaptive healthcare and epidemiological population needs. MethodsEvaluating Follow-up and Complexity in cancer Clinical Trials (EFACCT), the study presented in this thesis, was conducted at ranging NHS secondary care sites in England and Scotland. Drawing on constructivist grounded theory (Charmaz, 2006), the multi-faceted realities of cancer clinical trial delivery are unveiled, using a mixed methods–grounded theory (MM-GT) design. The comprehensive, contextual evaluation combines evidence from quantitative and qualitative paradigms, using inductive and deductive methods. The study drew together multifaceted perspectives and values of 165 participants from six studies; Delphi, questionnaire, and interview studies, separated into patient and professional cohorts. ResultsThe research provides original insights into the nature of cancer research delivery, its challenges and complexities, highlighting the importance of coherency in healthcare systems. The Constructivist Grounded Theory presented in this thesis, provides an organising framework and practical model for managing and embracing transformative learning and practice in response to dynamically evolving challenges that exist within complex healthcare delivery systems and networks. The original data generated provides new knowledge on the human aspects of clinical research and the contexts for its practice. The situated experiences led to the development of a grounded theory of human perceptions of complexity and serendipity in clinical research and the conception of a Prismatic Coherence Model (PCM) for the evaluation and designing of patient care and follow-up and the effective operational management of complex relationships, practices and processes existing within adaptive clinical research and healthcare delivery systems. PCM is an inclusive and responsive strategic design approach, sensitive to variable contexts and system complexities, and promotes transdisciplinarity in order to advance opportunities, knowledge and resources to advance population health through clinical research.</p