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Previous explanations on China's counterterrorism strategy have highlighted the results of China's strategy of repression in Xinjiang, the historical antecedents and institutional foundations of its counterterrorism policies, as well as international and domestic sources of China's counterterrorism strategy. While acknowledging the importance of all these dimensions, this article draws attention to a largely neglected feature of China's counterterrorism strategy: the Chinese party-state's social engineering of Xinjiang. Building on Maoist-era practices such as the mass line and the 'friend vs. enemy' binary, the Communist party under Xi Jinping has integrated surveillance technologies as part of its strategy of preventive counterterrorism and 'de-extremization'. This article argues that the Chinese party-state's embrace of modern technologies, a weak liberal tradition in China, Xi Jinping's rise to power in late 2012, and the appointment of Chen Quanguo as Xinjiang's party-secretary in 2016, provides the socio-political background for the intensification of securitization, surveillance and introduction of 're-education and training centres' in Xinjiang. Surveillance technologies now complement collective, face-to-face methods of surveillance and Maoist-era techniques of mass mobilization, enabling the Chinese party-state to govern and manage the biopolitical spaces of Uyghurs with greater intensity, according to the state's precise norms. The legalization and institutionalization of 'de-extremization' has also led to the shift from mass 'de-extremization' propaganda to 'drip-irrigation' ideological and political re-education of individuals deemed at risk of extremism. The result is an increased capacity by the Chinese party-state to surveil and control the region, and to more effectively negate the possibility of individual resistance. [ABSTRACT FROM AUTHOR]

Paracaecal hernia is a rare type of internal hernia usually presenting with a picture of small bowel obstruction. In this report we present a 68-year-old woman who was admitted with colicky lower abdominal pain, vomiting and abdominal distention. A computed tomography scan of her abdomen and pelvis demonstrated multiple dilated small bowel loops with a transition point in the right iliac fossa. After a trial of conservative treatment, the patient was taken to theatre where she underwent laparoscopic reduction of a strangulated paracaecal hernia. The patient had an uneventful post-operative recovery and was discharged home. Despite being a rare cause for small intestinal obstruction, this should be part of the differential diagnosis especially in the absence of previous abdominal operations. Early recognition and prompt surgical treatment is the key to prevent complications. A laparoscopic approach is feasible if expertise is available. [ABSTRACT FROM AUTHOR]

Background National and international guidelines recommend the use of effective vascular access (VA) and infection prevention and control practices within the haemodialysis environment. Establishing an arterio-venous fistula (AVF) and preventing central venous catheter (CVC)-related infections are ongoing challenges for all dialysis settings. We surveyed VA and routine infection prevention and control practices in dialysis units, to provide national data on these practices in Ireland. Methods A descriptive survey was emailed to nurse managers at all adult (n = 19) and children (n = 1) outpatient haemodialysis units in the Republic of Ireland. Data collected included AVF formation, CVC insertion and maintenance practices, VA use and surveillance of infection and screening protocols. Nineteen of the 20 units responded to the survey. Results The AVF prevalence was 49% for 1370 patients in 17 units who provided these data [mean prevalence per unit: 45.7% (SD 16.2)]; the CVC mean prevalence per unit was 52.5% (SD 16.0). Fourteen dialysis units experienced inadequate access to vascular surgical procedures either due to a lack of dedicated theatre time or hospital beds. Six units administered intravenous prophylactic antimicrobials prior to CVC insertion with only two units using a CVC insertion checklist at the time of catheter insertion. Conclusion In general, dialysis units in Ireland show a strong adherence to national guidelines. Compared with the 12 countries participating in the Dialysis Outcomes Practice Patterns Study (DOPPS 4), in 2010, AVF prevalence in Irish dialysis units is the second lowest. Recommendations include establishing an AVF national prevalence target rate, discontinuing the administration of intravenous prophylactic antimicrobials prior to CVC insertion and promoting the use of CVC insertion checklists. [ABSTRACT FROM PUBLISHER]

Parkinson's disease, typically thought of as a movement disorder, is increasingly recognized as causing cognitive impairment and dementia. Eye movement abnormalities are also described, including impairment of rapid eye movements (saccades) and the fixations interspersed between them. Such movements are under the influence of cortical and subcortical networks commonly targeted by the neurodegeneration seen in Parkinson's disease and, as such, may provide a marker for cognitive decline. This study examined the error rates and visual exploration strategies of subjects with Parkinson's disease, with and without cognitive impairment, whilst performing a battery of visuo-cognitive tasks. Error rates were significantly higher in those Parkinson's disease groups with either mild cognitive impairment (P = 0.001) or dementia (P < 0.001), than in cognitively normal subjects with Parkinson's disease. When compared with cognitively normal subjects with Parkinson's disease, exploration strategy, as measured by a number of eye tracking variables, was least efficient in the dementia group but was also affected in those subjects with Parkinson's disease with mild cognitive impairment. When compared with control subjects and cognitively normal subjects with Parkinson's disease, saccade amplitudes were significantly reduced in the groups with mild cognitive impairment or dementia. Fixation duration was longer in all Parkinson's disease groups compared with healthy control subjects but was longest for cognitively impaired Parkinson's disease groups. The strongest predictor of average fixation duration was disease severity. Analysing only data from the most complex task, with the highest error rates, both cognitive impairment and disease severity contributed to a predictive model for fixation duration [F(2,76) = 12.52, P ≤ 0.001], but medication dose did not (r = 0.18, n = 78, P = 0.098, not significant). This study highlights the potential use of exploration strategy measures as a marker of cognitive decline in Parkinson's disease and reveals the efficiency by which fixations and saccades are deployed in the build-up to a cognitive response, rather than merely focusing on the outcome itself. The prolongation of fixation duration, present to a small but significant degree even in cognitively normal subjects with Parkinson's disease, suggests a disease-specific impact on the networks directing visual exploration, although the study also highlights the multi-factorial nature of changes in exploration and the significant impact of cognitive decline on efficiency of visual search. [ABSTRACT FROM AUTHOR]

Background: visual and cognitive impairments are common in later life. Yet there are very few cognitive screening tests for the visually impaired.Objective: to screen for cognitive impairment in the visually impaired.Methods: case–control study including 150 elderly participants with visual impairment (n = 74) and a control group without visual impairment (n = 76) using vision-independent cognitive tests and cognitive screening tests (MMSE and clock drawing tests (CDT)) which are in part vision dependent.Results: the scoring of the two groups did not differ in the vision-independent cognitive tests. Visually impaired patients performed poorer than controls in the vision-dependent items of the MMSE (T = 7.3; df: 148; P < 0.001) and in CDT (T = 3.1; df: 145; P = 0.003). No group difference was found when vision-independent items were added to MMSE and CDT. The test score gain by the use of vision-independent items correlated with the severity of visual impairment (P < 0.002).Conclusion: visually impaired patients benefit from cognitive tests, which do not rely on vision. The more visually impaired the greater the benefit. [ABSTRACT FROM PUBLISHER]

Poorly regulated tissue remodeling results in increased breast cancer risk, yet how breast cancer stem cells (CSC) participate in remodeling is unknown. We performed in vivo imaging of changes in fluorescent, endogenous duct architecture as a metric for remodeling. First, we quantitatively imaged physiologic remodeling of primary branches of the developing and regenerating mammary tree. To assess CSC-specific remodeling events, we isolated CSC from MMTV-Wnt1 (mouse mammary tumor virus long-term repeat enhancer driving Wnt1 oncogene) breast tumors, a well studied model in which tissue remodeling affects tumorigenesis. We confirm that CSC drive tumorigenesis, suggesting a link between CSC and remodeling. We find that normal, regenerating, and developing gland maintain a specific branching pattern. In contrast, transplantation of CSC results in changes in the branching patterns of endogenous ducts while non-CSC do not. Specifically, in the presence of CSC, we identified an increased number of branches, branch points, ducts which have greater than 40 branches (5/33 for CSC and 0/39 for non-CSC), and histological evidence of increased branching. Moreover, we demonstrate that only CSC implants invade into surrounding stroma with structures similar to developing mammary ducts (nine for CSC and one for non-CSC). Overall, we demonstrate a novel approach for imaging physiologic and pathological remodeling. Furthermore, we identify unique, CSC-specific, remodeling events. Our data suggest that CSC interact with the microenvironment differently than non-CSC, and that this could eventually be a therapeutic approach for targeting CSC. S TEM C ells 2012;30:2114-2127 [ABSTRACT FROM AUTHOR]

Isolated complex I deficiency is the most frequently observed oxidative phosphorylation defect in children with mitochondrial disease, leading to a diverse range of clinical presentations, including Leigh syndrome. For most patients the genetic cause of the biochemical defect remains unknown due to incomplete understanding of the complex I assembly process. Nonetheless, a plethora of pathogenic mutations have been described to date in the seven mitochondrial-encoded subunits of complex I as well as in 12 of the nuclear-encoded subunits and in six assembly factors. Whilst several mitochondrial DNA mutations are recurrent, the majority of these mutations are reported in single families. We have sequenced core structural and functional nuclear-encoded subunits of complex I in a cohort of 34 paediatric patients with isolated complex I deficiency, identifying pathogenic mutations in 6 patients. These included a novel homozygous NDUFS1 mutation in an Asian child with Leigh syndrome, a previously identified NDUFS8 mutation (c.236C>T, p.P79L) in a second Asian child with Leigh-like syndrome and six novel, compound heterozygous NDUFS2 mutations in four white Caucasian patients with Leigh or Leigh-like syndrome. Three of these children harboured an identical NDUFS2 mutation (c.875T>C, p.M292T), which was also identified in conjunction with a novel NDUFS2 splice site mutation (c.866+4A>G) in a fourth Caucasian child who presented to a different diagnostic centre, with microsatellite and single nucleotide polymorphism analyses indicating that this was due to an ancient common founder event. Our results confirm that NDUFS2 is a mutational hotspot in Caucasian children with isolated complex I deficiency and recommend the routine diagnostic investigation of this gene in patients with Leigh or Leigh-like phenotypes. [ABSTRACT FROM PUBLISHER]

As a more complete picture of the clinical phenotype of Parkinsons disease emerges, non-motor symptoms have become increasingly studied. Prominent among these non-motor phenomena are mood disturbance, cognitive decline and dementia, sleep disorders, hyposmia and autonomic failure. In addition, visual symptoms are common, ranging from complaints of dry eyes and reading difficulties, through to perceptual disturbances (feelings of presence and passage) and complex visual hallucinations. Such visual symptoms are a considerable cause of morbidity in Parkinsons disease and, with respect to visual hallucinations, are an important predictor of cognitive decline as well as institutional care and mortality. Evidence exists of visual dysfunction at several levels of the visual pathway in Parkinsons disease. This includes psychophysical, electrophysiological and morphological evidence of disruption of retinal structure and function, in addition to disorders of ‘higher’ (cortical) visual processing. In this review, we will draw together work from animal and human studies in an attempt to provide an insight into how Parkinsons disease affects the retina and how these changes might contribute to the visual symptoms experienced by patients. [ABSTRACT FROM AUTHOR]

European security depends on the effective collaboration of the five major powers; it will be undermined by the extension of NATO, a policy driven by US domestic politics. The main threats to security are: the breakdown of political and economic stability; unintended nuclear proliferation and/or failure of the START process; Russia's evolving political and territorial aspirations. All three will remain marginal as long as Russia is constructively engaged with the West. NATO expansion threatens that engagement. It is seen by all strands of Russian opinion as violating the bargain struck in 1990 and will likely lead to the withdrawal of cooperation. Invitations to Poland, Hungary and the Czech Republic cannot be rescinded, but the consequences can be mitigated by refraining from integrating them into NATO's military structure, by ceasing to insist that NATO membership is open to all, and by perpetuating the de facto nuclear-weapons-free zone that presently exists in Central and Eastern Europe. Britain's stance could be pivotal. [ABSTRACT FROM AUTHOR]

Cooperatively breeding bell miners (Manorina melanophrys) have numerous male helpers assisting at multiple nests. Helpers are often related to the brood they aid, consistent with kin selection. However, there are also unrelated helpers for which other direct fitness benefits are likely to accrue. Bell miner nestlings can become infested by the larvae of a parasitic fly (Passeromyia indecora), which reduce growth and can be fatal. We investigated the amount of time that breeding pairs and helpers closely inspected nests and preened nestlings, behaviors apparently directed at detecting and removing parasites, a form of helping previously unstudied in a cooperative bird. Female breeders provided the greatest antiparasite effort, with breeding males and helpers not differing in effort regardless of their relatedness to the breeding female or brood. We also experimentally infested nests with nonparasitic flies and larvae. All individuals removed the introduced “parasites” if and when they encountered them. Compared with control sessions, inspection effort increased for all birds immediately after the experimental infestations, but only for a short, 5-min period. Further, we detected no changes in helper antiparasite behaviors after the temporary experimental removal of either breeding females or males. Such consistent helping behavior, independent of relatedness and potential audience effects, suggests that antiparasite behavior in bell miners is not particularly kin directed or operating as a signal of helper quality. Our results instead suggest that helper antiparasite effort appears to represent adaptive investment in the welfare of the brood, consistent with direct fitness benefits from group augmentation. [ABSTRACT FROM PUBLISHER]

The authors tested the hypothesis that the birth prevalence of gastroschisis is positively associated with use of recreational drugs in early pregnancy. A matched case-control study was carried out in three regions of the United Kingdom over the period January 2001 through August 2003. For each case, three liveborn controls were matched by initial intended place of delivery, region, and maternal age. Maternal hair analysis provided independent verification of recreational drug use. Conditional logistic regression was used to estimate mutually adjusted odds ratios. Estimates were revised using data from hair analysis. Statistically significant adjusted odds ratios for gastroschisis were associated with first-trimester use of 1) any recreational drug (odds ratio (OR) = 2.2, 95% confidence interval (CI): 1.2, 4.3) and 2) vasoconstrictive recreational drugs (defined as cocaine, amphetamines, and ecstasy) (OR = 3.3, 95% CI: 1.0, 10.5). Other significant exposures included aspirin use (OR = 20.4, 95% CI: 2.2, 191.5), cigarette smoking (OR = 1.7, 95% CI: 1.1, 2.6), and prior history of gynecologic infection/disease (OR = 2.6, 95% CI: 1.2, 5.6). Recreational drug use is a significant risk factor for gastroschisis and is one of a constellation of potentially preventable exposures which include cigarette smoking, aspirin use, and history of gynecologic infection/disease. Maternal hair analysis proved an acceptable and valuable method of independently verifying recreational drug use. [ABSTRACT FROM PUBLISHER]

In human breast cancers, a phenotypically distinct minority population of tumorigenic (TG) cancer cells (sometimes referred to as cancer stem cells) drives tumor growth when transplanted into immunodeficient mice. Our objective was to identify a mouse model of breast cancer stem cells that could have relevance to the study of human breast cancer. To do so, we used breast tumors of the mouse mammary tumor virus (MMTV)-Wnt-1 mice. MMTV-Wnt-1 breast tumors were harvested, dissociated into single-cell suspensions, and sorted by flow cytometry on Thy1, CD24, and CD45. Sorted cells were then injected into recipient background FVB/NJ female syngeneic mice. In six of seven tumors examined, Thy1 + CD24 + cancer cells, which constituted approximately 1%-4% of tumor cells, were highly enriched for cells capable of regenerating new tumors compared with cells of the tumor that did not fit this profile ("not-Thy1+CD24+"). Resultant tumors had a phenotypic diversity similar to that of the original tumor and behaved in a similar manner when passaged. Microarray analysis comparing Thy1 + CD24+ tumor cells to not-Thy1 + CD24+ cells identified a list of differentially expressed genes. Orthologs of these differentially expressed genes predicted survival of human breast cancer patients from two different study groups. These studies suggest that there is a cancer stem cell compartment in the MMTV-Wnt-1 murine breast tumor and that there is a clinical utility of this model for the study of cancer stem cells. [ABSTRACT FROM AUTHOR]

The ability to self-renew is essential for all kinds of stem cells regardless of tissue type. One of the best candidate genes involved in conferring self-renewal capacity is Bmi-1, which has been proven to be essential for the maintenance of both normal adult hematopoietic and leukemia stem cells, as well as adult neural stem cells. To investigate the possible role of Bmi-1 in other cell types that also self-renew, we generated Bmi-1-green fluorescent protein (GFP)-knock-in mice, in which GFP was expressed under the endogenous transcriptional regulatory elements of the Bmi-1 gene. Using these targeted reporter mice, we demonstrated that Bmi-1 is expressed in hematopoietic stem cells (HSCs) at its highest levels and downregulated upon commitment to differentiation. An in vivo reconstitution assay revealed that the frequency of HSCs was 1/16 in Bmi-1highc-kit+lin-Sca-1+ bone marrow (BM) cells and 1/49 in Bmi-1highlin- BM cells, suggesting that Bmi-1 may serve as a marker for normal HSCs. In murine leukemia models induced by P210BCR/ABL or TEL/PDGFßR + AML1/ETO, Bmi-1 was not overexpressed in leukemic HSCs, despite the increase in the HSC numbers. Bmi-1 was expressed at its highest levels in undifferentiated leukemia cells. Furthermore, in several other nonhematopoietic tissues, cells could be separated into distinct subpopulations with differential Bmi-1 expression. Thus, these mice allow for the isolation of viable Bmi-1-expressing cells and have the potential to become a useful tool for understanding the role of Bmi-1 in normal and cancer stem cells in multiple tissue types. [ABSTRACT FROM AUTHOR]

The United Kingdom's present strategic nuclear deterrent, the Trident submarine-based system, has been in full operation for less than four years. But the government will have to consider questions about the follow-on to this system before the end of this parliament and its successor government will almost certainly have to start taking, and implementing, decisions before 2008–9. In the past, political and public debates about the UK's nuclear weapons tended to flow forward on their own technical momentum, backed by the strategic imperatives of the Cold War. The next successor decisions, however, will be made in an era where both the technical questions and the strategic environment will be radically different. There may or may not be another vigorous public debate, but the present, and next, government will face some fundamental [ABSTRACT FROM AUTHOR]

Presents information on a study which assessed whether there is an enduring gender difference in the ability of self-rated health to predict mortality. Possible role of self-reported physical health in the difference; Statistical methods; Results and discussion.

Background The aim of the study was to investigate the feasibility of monitoring older people's health by measuring active life expectancy among older people with and without diabetes using routinely collected primary care data. [ABSTRACT FROM PUBLISHER]

Presents a study that examined the apportionment of genetic diversity in the noisy miner Manorina melanocephala in Brisbane, Queensland. Analysis of the DNA microsatellite loci of the birds; Estimation of the heterozygosity and number alleles of the microsatellite; Examination of the pairwise patterns of genetic differentiation in noisy miners.

Background. The aim of the study was to establish the prevalence of urinary symptoms and felt the need in adults. This paper discusses problems with setting thresholds to distinguish cases from non-cases in this field of research. Few studies have provided detailed age- and sex-specific prevalence estimates for felt need in relation to urinary symptoms. [ABSTRACT FROM PUBLISHER]

The effect of varying algal availability on byssal thread production by re–attaching zebra mussels (Dreissena polymorpha) was quantified. The byssal apparatus was severed and mussels allowed to re–attach to a hard substratum for a 21 day period during which they were fed at algal concentrations of 0.0, 0.1, 0.5, 1.0 or 2.0 mg C l−1. Byssal thread production was quantified by counting the number of new attachment plaques present each day. Results showed that starved mussels continued to partition organic carbon towards thread production but the resultant byssal mass was compromised, containing fewer threads than those produced by fed mussels. The daily average byssal thread production by mussels fed at 2.0 mg C l−1 was greater than that of starved mussels and the final mean dry soft tissue weight higher. At algal C concentrations below maintenance requirements byssal thread production was elevated compared to starved mussels, but there was no concurrent increase in soft tissue. This suggests that below maintenance levels assimilated carbon was solely partitioned towards byssus production and stored reserves may have been utilized. The ratio of organic carbon contained in the byssus to that in the soft tissues remained relatively constant across all feeding levels. This suggests that the carbon content of the byssus is a constant function of that of the soft tissue mass. These results may explain seasonal variation in attachment strength of numerous byssate species and seasonal vertical migrations by D. polymorpha. [ABSTRACT FROM PUBLISHER]

Mutations of the human PAX6 gene underlie aniridia (congenital absence of the iris), a rare dominant malformation of the eye. The spectrum of PAX6 mutations in aniridia patients is highly biased, with 92% of all reported mutations leading to premature truncation of the protein (nonsense, splicing, insertions and deletions) and just 2% leading to substitution of one amino acid by another (missense). The extraordinary conservation of the PAX6 protein at the amino acid level amongst vertebrates predicts that pathological missense mutations should in fact be common even though they are hardly ever seen in aniridia patients. This indicates that there is a heavy ascertainment bias in the selection of patients for PAX6 mutation analysis and that the `missing' PAX6 missense mutations frequently may underlie phenotypes distinct from textbook aniridia. Here we present four novel PAX6 missense mutations, two in association with atypical phenotypes: ectopia pupillae (displaced pupils) and congenital nystagmus (searching gaze), and two in association with more recognizable aniridia phenotypes. Strikingly, all four mutations are located within the PAX6 paired domain and affect amino acids which are highly conserved in all known paired domain proteins. Our results support the hypothesis that the under-representation of missense mutations is caused by ascertainment bias and suggest that a substantial burden of PAX6-related disease remains to be uncovered. [ABSTRACT FROM AUTHOR]

Investigates parentage among Bell Miner nestlings, examining the degree of relatedness between parents and helpers at the nest. Use of deoxyribonucleic acid (DNA) fingerprinting in this investigation; Overview of cooperative breeding in birds; Analysis of species investigated.

In 1981 a survey was undertaken of the physical and mental health and social status of all those aged 75 years and over belonging to a large general practice which alone served the town of Melton Mowbray and its surrounding area. Seven years later the survey was repeated. This elderly population had increased by almost 30% in number between the two surveys despite a relatively stable practice population over this time period. After adjustment for the different age and sex distributions of the two survey populations, significant increases in independence levels were found over the time period for: getting in and out of a chair and bed, dressing, bathing and getting to and from the toilet. No differences were found for mobility around the home, feeding or continence of urine or faeces. A higher prevalence of cognitive impairment was found in 1988 than in 1981, 7.0% compared with 4.5%, but this appeared to be due to the larger number of unclassifiable respondents in 1981. A re-analysis of the data, excluding those living in the area less than five years confirmed that the differences found in health over time were not due to a group of elderly migrating into the area. This study provides evidence that the elderly of today appear fitter than previous cohorts of elderly. Service planners will need to take this into account if sensible provision of resources for this age group are to be made. [ABSTRACT FROM PUBLISHER]

The health and social status was assessed by interview for all people aged 75 years and over, living in and around Melton Mowbray. This initial survey took place in 1981 and five years later, data are now available on the mortality status of the original survey population. Significantly lower survival rates were found for various subgroups including those respondents who perceived their health poor, those with high disability scores and severe cognitive impairment and those taking hypoglycaemic agents and diuretics. [ABSTRACT FROM PUBLISHER]

Doubts raised by research evaluation of traditional casework have been increased by the perception by radical social workers that some clients' difficulties derive from their involvement with state machinery rather than personal capacity or circumstances, and that many can be helped by working collectively with others in their community rather than striving alone in a dependent relationship with a caseworker. Radical aspirations, however, assume that all clients have the capacity to overcome their difficulties and that none are so damaged as to be able realistically barely to cope with them. The radicals' doubts about the usefulness of individual support and emphasis on collective self help raise the danger of neglecting those who are unable to participate effectively and gain from such efforts. [ABSTRACT FROM PUBLISHER]

To better understand the molecular basis of radiation-induced cell death, we studied the role of the oncogene and the tumor suppressor gene in this process. A temperature-sensitive mutant of murine p53 (p53) and/or was transfected into murine erythroleukemia cells (MEL, DP16-1, which are null in p53). We demonstrate that radiation-induced cell death occurs by both p53-dependent and -independent pathways and overexpression of bcl-2 modulates both pathways. When viability was measured 24 h post-radiation, cells that had been briefly exposed to wtp53 immediately after X-ray irradiation had decreased survival as compared to unirradiated cells expressing wtp53 or X-ray irradiated DP16-1 cells. However, at later times X-ray irradiated parental DP16-1 cells also had decreased survival compared to the unirradiated control. This decrease in survival began 48 h following radiation. Bcl-2 prevented radiation-induced cell death in DP16-1 cells expressing wtp53 and delayed radiation-induced cell death in DP16-1 cells without wtp53. X-ray irradiated cells expressing wtp53 displayed microscopic and biochemical characteristics consistent with cell death due to apoptosis. DP16-1 cells which were untransfected or co-transfected with wtp53 and displayed characteristics of cells undergoing necrosis. These results suggest that radiation-induced cell death occurs by both p53-dependent and p53-independent pathways. The p53-dependent pathway results in cell death via apoptosis and occurs approximately 24 h following radiation. The p53-independent pathway does not appear to involve apoptosis and occurs at a later time, starting 48 h after X-ray exposure. Thus, bcl-2 protects cells from p53-dependent radiation-induced apoptotic cell death and attenuates p53-independent radiation-induced cell death. [ABSTRACT FROM PUBLISHER]

This study investigates the subsequent careers of the Senior House Officers (SHOs) who have passed through the Leicestershire SHO training scheme in public health medicine since its inception in 1981 and their views of the scheme. Postal questionnaires were sent to past and current SHOs, using addresses compiled from personnel records, the Medical Directory and the General Medical Council Medical Register. One reminder letter was sent to non-responders. Of the 21 past SHOs, one is now a consultant and four are currently trainees in public health medicine. Other past SHOs have followed diverse careers but the largest group are now in general practice. The four past SHOs who are now trainees in public health gained no further clinical experience before obtaining registrar or lecturer posts. All past SHOs responded favourably when asked about the benefits of the scheme regardless of their subsequent career choice. The continuing need for high-calibre recruits to the specialty and the favourable response from past SHO trainees suggests that this scheme, and no doubt other similar schemes, should be making their benefits known to a wider audience. [ABSTRACT FROM PUBLISHER]

Background: In the UK, the GP contract requires annual consultations and offers of home visits to the elderly. However, as many as 50% of elderly people refuse the offer of a health screen.Objective: To describe the characteristics of elderly people who declined the offer of an annual home visit.Method: All elderly people aged 75 years and over, registered with a general practice of 13 full time and 3 part time doctors with a list size of 33,000 people, were offered a home visit. Data from this prospective cohort were linked with data from a community survey two years previously, which had achieved a 95% response rate. The main outcome measures were perceived health status, perceived loneliness, morale score, physical and mental disability, use of primary care and social services.Results: Thirty-six percent of all elderly people registered with the practice declined to take up the offer of a home visit. Those refusing a visit had not recently joined the practice and had very similar distributions of all demographic and most health and wellbeing characteristics to those who took up the offer. However, those declining appeared to have higher levels of morale (P = 0.010) and less contact with the general practitioner (P = 0.021) including an average of three weeks longer since last consultation with their general practitioner than those accepting the visit.Conclusions: There appears little evidence in this population that elderly people who decline a home visit are necessarily part of an 'iceberg' of unmet need. [ABSTRACT FROM AUTHOR]

Responses to insurance fraud in eight Western industrialized nations are described, and located by reference to the apparent extent of fraud and the degree of organized control. It is clear that the problem has been growing in recent years and that there are similarities in the responses of different nations, but there are also considerable variations both in the willingness to respond collectively and publicly and in the tactics adopted. [ABSTRACT FROM PUBLISHER]

A limited inquiry into how the British retail insurance industry manages fraudulent claims reveals a concentration of frauds in the travel, motor, and home and business contents sectors, with fire an increased hazard, especially in the latter case, where large sums are at risk. The Structure of British insurance in respect of fraud control is described, including the important role of loss adjusters, and a number of recent initiatives at industry level are discussed. These appear to indicate increasing recognition of the damage being done by insurance fraud but, for a variety of reasons, many companies are reluctant to take bold and public steps to combat fraud. Fears are widely expressed that public goodwill, and the relationship based on ulmost good faith, would be eroded by a more aggressive slance. [ABSTRACT FROM PUBLISHER]

The change in mental and physical functioning over 5 years for 594 survivors of a community survey of the elderly is described. An increase in cognitive impairment, physical disability and incontinence over the period was found with increasing age. Women in the two oldest age groups had a significantly greater increase in physical disability than men. An annual incidence of cognitive impairment of 1.4$$$ was found and the implications of this are discussed. [ABSTRACT FROM PUBLISHER]

A prevalence survey of disturbed micturition in the elderly identified 7% with important degrees of disorder, 1% with lesser disorder and 1% who were catheterized. Incontinence, urgency, frequency and nocturia were the symptoms most commonly reported. Fifty-three per cent of people describing incontinuce used preventive aids but one third of these continued to experience wetting of external clothing. Crude categorization of dysfunction on the basis of symptoms suggested that a component of unstable bladder was present in approximately 4% of the elderly population. [ABSTRACT FROM PUBLISHER]

Previous studies have suggested that up to a fifth of people over the age of 80 years may suffer severe dementia-like illnesses. This total population survey of over a thousand people over the age of 75 suggests that the prevalence of marked cognitive impairment is much less than expected. However, differences in the age structure, representativeness, response rates and size of the samples surveyed, together with differences in methods of measurement, make comparison between studies difficult. [ABSTRACT FROM PUBLISHER]

The authors focus on new insights on tumor radioresistance. The authors reflect on the findings by a medical study that cells from breast cancer cell lines radioresistant compared with the remainder of breast cancer cells. These cells, termed as cancer stem cells (CSCs), are driven and maintained by a subpopulation of cells that have a capacity to self-renew. The authors suggest that the studies showed that radioresistance may be a general property of CSCs.

Summary There are some interesting paradoxes in the relationship between local government and the National Health Service (NHS). Local government is responsible for a range of major services, many of which relate to health broadly defined. The NHS provides many services which are often popularly thought to be part of local government (and, indeed, in many countries are). Local government prides itself on its ‘localness’; the NHS, with its services delivered in a very local fashion for the most part, cannot quite decide whether it is a national service or a local one. Yet these two major agencies of governance and public service provision often seem unable to work very well together. In the interests of good government, both agencies need to work together where their interests coincide or abut one another. Differences of perspective, priority, culture and style need to be recognized but resolved. Opportunities for joint working need to be grasped and the experience built on. The paper looks at aseries of issues and opportunities which bring local government and the NHS together. They create an incentive to improve working relationships; at the same time they suggest an agenda of future possibilities. [ABSTRACT FROM PUBLISHER]