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Seeing the fetus from a DOHaD perspective: discussion paper from the advanced imaging techniques of DOHaD applications workshop held at the 2019 DOHaD World Congress
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- Janna L. Morrison, Oyekoya T. Ayonrinde, Alison S. Care, Geoffrey D. Clarke, Jack R.T. Darby, Anna L. David, Justin M. Dean, Stuart B. Hooper, Marcus J. Kitchen, Christopher K. Macgowan, Andrew Melbourne, Erin V McGillick, Charles A. McKenzie, Navin Michael, Nuruddin Mohammed, Suresh Anand Sadananthan, Eric Schrauben, Timothy R.H. Regnault, S. Sendhil Velan
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- Journal:
- Journal of Developmental Origins of Health and Disease / Volume 12 / Issue 2 / April 2021
- Published online by Cambridge University Press:
- 21 September 2020, pp. 153-167
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Advanced imaging techniques are enhancing research capacity focussed on the developmental origins of adult health and disease (DOHaD) hypothesis, and consequently increasing awareness of future health risks across various subareas of DOHaD research themes. Understanding how these advanced imaging techniques in animal models and human population studies can be both additively and synergistically used alongside traditional techniques in DOHaD-focussed laboratories is therefore of great interest. Global experts in advanced imaging techniques congregated at the advanced imaging workshop at the 2019 DOHaD World Congress in Melbourne, Australia. This review summarizes the presentations of new imaging modalities and novel applications to DOHaD research and discussions had by DOHaD researchers that are currently utilizing advanced imaging techniques including MRI, hyperpolarized MRI, ultrasound, and synchrotron-based techniques to aid their DOHaD research focus.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Acceptance and valued living as critical appraisal and coping strengths for caregivers dealing with terminal illness and bereavement
- Esther L Davis, Frank P. Deane, Geoffrey C.B. Lyons
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- Journal:
- Palliative & Supportive Care / Volume 13 / Issue 2 / April 2015
- Published online by Cambridge University Press:
- 30 April 2014, pp. 359-368
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Objective:
Informal caregivers of palliative care patients play an essential role in the coordination of care for patients during their final phases of life. However, undertaking a caregiving role can have enduring psychological consequences for caregivers and interfere with functioning. Studies have investigated a variety of factors associated with individual differences in caregiver psychosocial outcomes, but little is known about their relative impact, and there is a need for guiding models to support research in this area.
Method:A review of the literature was conducted on factors influencing the psychological distress and grief of caregivers. Drawing from acceptance and commitment therapy (ACT) and Stroebe and colleagues' integrative risk factor framework, we developed a process model to describe individual differences in caregiver psychological distress and grief.
Results:The model presents caregiver psychological distress and grief as functions of death attitudes and communication about death and dying, mediated by acceptance and valued living from an ACT perspective. An outline of the empirical and theoretical underpinnings for each component in the model is provided.
Significant of results:The presented model is an inherently strengths-based model that is concordant with acceptance- and values- (ACT) based interventions to facilitate coping in caregivers.
Contributors
- Edited by Cristian Tileagă, Loughborough University, Jovan Byford, The Open University, Milton Keynes
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- Psychology and History
- Published online:
- 05 March 2014
- Print publication:
- 20 February 2014, pp viii-xi
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- By J. William Allwood, Eleni T. Bairaktari, Jean-Pierre Bellocq, Malika A. Benahmed, Hanne Christine Bertram, Zaver M. Bhujwalla, Ulrich Braumann, Juan Casado-Vela, Marta Cascante, Arancha Cebrián, Albert Chen, Man Ho Choi, Bong Chul Chung, Yuen-Li Chung, Morten Rahr Clausen, Patrick J. Cozzone, Ralph J. DeBerardinis, Julien Detour, Santiago Díaz-Moralli, Warwick B. Dunn, Karim Elbayed, Udo Engelke, Teresa W.-M. Fan, Ana M. Gil, Kristine Glunde, Markus Godejohann, Teresa Gómez del Pulgar, Royston Goodacre, Angelina Goudswaard, Gonçalo Graça, Richard W. Gross, Herbert H. Hill, Ralph E. Hurd, Alessio Imperiale, Kimberly A. Kaplan, Neil L. Kelleher, Michael A. Kiebish, Ann M. Knolhoff, Christina E. Kostara, Juan Carlos Lacal, Andrew N. Lane, Martin O. Leach, Norbert W. Lutz, Elizabeth Maher, Craig R. Malloy, Isaac Marin-Valencia, Laura Menchén, Bruce Mickey, Fanny Mochel, Éva Morava, François-Marie Moussallieh, Izzie J. Namer, Peter Nemes, Ioanna Ntai, Geoffrey S. Payne, Marie-France Penet, Martial Piotto, Stanislav S. Rubakhin, Elsa Sánchez-López, A. Dean Sherry, Bindesh Shrestha, Jonathan V. Sweedler, Akos Vertes, Mark R. Viant, Ralf J. M. Weber, Ron Wehrens, Ron A. Wevers, Catherine L. Winder, David S. Wishart, Kui Yang, Yi-Fen Yen
- Edited by Norbert W. Lutz, Jonathan V. Sweedler, University of Illinois, Urbana-Champaign, Ron A. Wevers
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- Methodologies for Metabolomics
- Published online:
- 05 January 2013
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- 21 January 2013, pp viii-xii
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- By Jane E. Adcock, Yahya Aghakhani, A. Anand, Eva Andermann, Frederick Andermann, Alexis Arzimanoglou, Sandrine Aubert, Nadia Bahi-Buisson, Carman Barba, Agatino Battaglia, Geneviève Bernard, Nadir E. Bharucha, Laurence A. Bindoff, William Bingaman, Francesca Bisulli, Thomas P. Bleck, Stewart G. Boyd, Andreas Brunklaus, Harry Bulstrode, Jorge G. Burneo, Laura Canafoglia, Laura Cantonetti, Roberto H. Caraballo, Fernando Cendes, Kevin E. Chapman, Patrick Chauvel, Richard F. M. Chin, H. T. Chong, Fahmida A. Chowdhury, Catherine J. Chu-Shore, Rolando Cimaz, Andrew J. Cole, Bernard Dan, Geoffrey Dean, Alessio De Ciantis, Fernando De Paolis, Rolando F. Del Maestro, Irissa M. Devine, Carlo Di Bonaventura, Concezio Di Rocco, Henry B. Dinsdale, Maria Alice Donati, François Dubeau, Michael Duchowny, Olivier Dulac, Monika Eisermann, Brent Elliott, Bernt A. Engelsen, Kevin Farrell, Natalio Fejerman, Rosalie E. Ferner, Silvana Franceschetti, Robert Friedlander, Antonio Gambardella, Hector H. Garcia, Serena Gasperini, Lorenzo Genitori, Gioia Gioi, Flavio Giordano, Leif Gjerstad, Daniel G. Glaze, Howard P. Goodkin, Sidney M. Gospe, Andrea Grassi, William P. Gray, Renzo Guerrini, Marie-Christine Guiot, William Harkness, Andrew G. Herzog, Linda Huh, Margaret J. Jackson, Thomas S. Jacques, Anna C. Jansen, Sigmund Jenssen, Michael R. Johnson, Dorothy Jones-Davis, Reetta Kälviäinen, Peter W. Kaplan, John F. Kerrigan, Autumn Marie Klein, Matthias Koepp, Edwin H. Kolodny, Kandan Kulandaivel, Ruben I. Kuzniecky, Ahmed Lary, Yolanda Lau, Anna-Elina Lehesjoki, Maria K. Lehtinen, Holger Lerche, Michael P. T. Lunn, Snezana Maljevic, Mark R. Manford, Carla Marini, Bindu Menon, Giulia Milioli, Eli M. Mizrahi, Manish Modi, Márcia Elisabete Morita, Manuel Murie-Fernandez, Vivek Nambiar, Lina Nashef, Vincent Navarro, Aidan Neligan, Ruth E. Nemire, Charles R. J. C. Newton, John O'Donavan, Hirokazu Oguni, Teiichi Onuma, Andre Palmini, Eleni Panagiotakaki, Pasquale Parisi, Elena Parrini, Liborio Parrino, Ignacio Pascual-Castroviejo, M. Scott Perry, Perrine Plouin, Charles E. Polkey, Suresh S. Pujar, Karthik Rajasekaran, R. Eugene Ramsey, Rahul Rathakrishnan, Roberta H. Raven, Guy M. Rémillard, David Rosenblatt, M. Elizabeth Ross, Abdulrahman Sabbagh, P. Satishchandra, Swati Sathe, Ingrid E. Scheffer, Philip A. Schwartzkroin, Rod C. Scott, Frédéric Sedel, Michelle J. Shapiro, Elliott H. Sherr, Michael Shevell, Simon D. Shorvon, Adrian M. Siegel, Gagandeep Singh, S. Sinha, Barbara Spacca, Waney Squier, Carl E. Stafstrom, Bernhard J. Steinhoff, Andrea Taddio, Gianpiero Tamburrini, C. T. Tan, Raymond Y. L. Tan, Erik Taubøll, Robert W. Teasell, Mario Giovanni Terzano, Federica Teutonico, Suzanne A. Tharin, Elizabeth A. Thiele, Pierre Thomas, Paolo Tinuper, Dorothée Kasteleijn-Nolst Trenité, Sumeet Vadera, Pierangelo Veggiotti, Jean-Pierre Vignal, J. M. Walshe, Elizabeth J. Waterhouse, David Watkins, Ruth E. Williams, Yue-Hua Zhang, Benjamin Zifkin, Sameer M. Zuberi
- Edited by Simon D. Shorvon, Frederick Andermann, Renzo Guerrini
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- Book:
- The Causes of Epilepsy
- Published online:
- 05 March 2012
- Print publication:
- 14 April 2011, pp ix-xvi
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Chapter 32 - Porphyria
- from Section 3 - Symptomatic epilepsy
- Edited by Simon D. Shorvon, Frederick Andermann, Renzo Guerrini
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- The Causes of Epilepsy
- Published online:
- 05 March 2012
- Print publication:
- 14 April 2011, pp 231-236
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Summary
Lafora disease typically starts between ages 12 and 17 years, after a period of apparently normal development. Lafora disease-associated mutations are scattered all along the coding regions of the EPM2A and NHLRC1 genes, but also accumulate in discrete spots of high recurrence. The main seizure types in Lafora disease include myoclonic seizures and occipital seizures, although generalized tonic-clonic seizures, atypical absence seizures, and atonic and complex partial seizures may occur. Studies of the combined mutation detection frequency of sequence analysis in EPM2A and NHLRC1 reveal that between 88% and 97% of mutations in these two genes can be detected using sequence analysis alone. Antiepileptic drugs have a major effect against generalized seizures, sometimes controlling seizures for many months. Valproic acid is the traditional antiepileptic treatment for Lafora disease because it is a broad-spectrum drug that controls both the generalized tonic-clonic seizures and myoclonic jerks.
18 - Emergency Ultrasonography of the Kidneys and Urinary Tract
- from PART II - ULTRASOUND
- Edited by J. Christian Fox, University of California, Irvine
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- Book:
- Clinical Emergency Radiology
- Published online:
- 07 December 2009
- Print publication:
- 29 September 2008, pp 268-279
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Summary
The principal indication for renal ultrasound is in the diagnosis of ureteral calculi, which, if they cause obstruction, will give rise to unilateral hydronephrosis. Less commonly, retroperitoneal processes or pelvic pathology originating in the prostate, ovaries, or urethra may give rise to bilateral hydronephrosis. Patients being evaluated for hydronephrosis should be adequately hydrated, but not overhydrated. Renal ultrasonography may be limited by technical challenges in obtaining the images or be due to inherent characteristics of the test itself. False-negative exams for hydronephrosis occur when there is actual obstruction without calyceal dilation, which is rare unless the kidney was already nonfunctioning. The diagnosis of renal tumors is not within the standard purview of the emergency ultrasonographer. Ultrasound is limited in the identification of renal masses by both their size and sonographic appearance. Expertise and sonographic skill play an important role in accurate identification of renal masses.
20 - Alcohol, Heroin and AIDS
- Geoffrey Dean
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- Book:
- The Turnstone
- Published by:
- Liverpool University Press
- Published online:
- 25 July 2017
- Print publication:
- 31 December 2002, pp 188-194
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Summary
Thou hast the keys of Paradise; oh just, subtle, and mighty opium
Thomas de Quincey, The Pleasures of OpiumFrom the inception of the Medico-Social Research Board, we carried out studies of drug taking, including cigarette smoking and alcohol, among children in primary and secondary schools. In the 1970s there was no serious problem of illegal drug taking in Ireland, although about 10 per cent of school children had experimented with marijuana and an even smaller percentage, particularly in the inner city of Dublin, had used ‘uppers’, the amphetamine group of drugs, and ‘downers’, generally barbiturate sedatives. By far the commonest drug used by young people was alcohol, cider in particular. We organised a number of programmes to persuade the government to stop all advertising of alcohol and cigarettes in the media and to persuade young people not to start smoking.
In the nineteenth century in Ireland, when alcohol abuse was an even greater problem than today, Father Theobald Mathew introduced the concept of ‘taking a pledge’ not to drink alcohol. Father James Cullen founded the ‘Pioneers’ in 1898. Pioneers not only take a very solemn pledge but also wear a pin in their jacket lapel to show that they are total abstainers. While the ‘rounds’ system was very common in Ireland – a system by which everybody in a group was expected to stand a round of drinks – a pioneer is not persuaded to drink alcohol.
In the late 1970s a number of chemists’ shops were burgled and morphine and opium derivatives, such as Diaconal and Palfium, were stolen. From 1980, heroin was being imported into Dublin, and an epidemic of heroin injecting began in the inner city, where over half the population were unemployed. This heroin epidemic particularly affected young people of between fifteen and twenty-four. In 1982, when discussing this problem with Michael Woods, the Minister for Health at the time, I decided to ascertain how common the use of heroin was in Dublin.
Dedication
- Geoffrey Dean
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- Book:
- The Turnstone
- Published by:
- Liverpool University Press
- Published online:
- 25 July 2017
- Print publication:
- 31 December 2002, pp v-vi
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24 - Inshallah – God Willing
- Geoffrey Dean
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- Book:
- The Turnstone
- Published by:
- Liverpool University Press
- Published online:
- 25 July 2017
- Print publication:
- 31 December 2002, pp 222-228
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Summary
Chaos umpire sits,
And by decision more embroils the fray
By which he reigns; next him high arbiter
Chance governs all.
John Milton, Paradise LostIn 1976 Dr Patricia Sheehan, a Dublin doctor, was talking to a mother who had a Down syndrome child. Down syndrome, a disorder in which there are three chromosomes number 21 instead of the usual two, is also called trisomy 21. It causes changes in appearance which gave the disorder its old name, ‘mongolism’, and usually causes mental retardation. The mother told Dr Sheehan that there were other girls who had attended her school, St Louis, in Dundalk, Co. Louth, in 1956/57 who also had Down syndrome babies and that the mothers were young when the babies were born.
Patricia Sheehan decided to investigate the story and spent the next eighteen years finding out what had happened to the 178 girls who were attending the school at that time. She was able to trace 159 of them, 89 per cent, and questionnaires were completed by them and returned. She found six of the mothers had given birth to Down syndrome babies. Patricia Sheehan and a microbiologist, Professor Irene Hillary, published an account about this cluster in the British Medical Journal in 1983. In a follow-up letter, the number of girls at the school in 1956/57 reported to have had Down syndrome babies increased to eight.
In October 1957 there was a fire at Windscale, now Sellafield, the nuclear power and reprocessing station which is across the Irish Sea from Dundalk. At about the same time as the fire, there was also an influenza epidemic which affected many people in Dundalk, including girls at the school. The question was raised: was radiation from the fire at Windscale responsible for damage to the ova of some of the children attending the school, which had caused them to give birth to a child with an extra chromosome 21.
After the Chernobyl disaster in 1986 there was greatly increased concern about the possible effects of radiation on health. This was made more acute by the reported increase in leukaemia in Cumbria around the Sellafield site. In Ireland it was feared that not only Down syndrome, but various forms of cancer and other disorders might be due to radioactive material escaping from the reprocessing plant in Cumbria.
6 - South Africa
- Geoffrey Dean
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- Book:
- The Turnstone
- Published by:
- Liverpool University Press
- Published online:
- 25 July 2017
- Print publication:
- 31 December 2002, pp 51-60
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Summary
The most stately thing, and the fairest
Cape we saw in the whole circumference of the earth.
Sir Francis DrakeThe view of Cape Town nestling under Table Mountain when I arrived on the Priam on 24 June 1947 confirmed the words of Francis Drake. At that time, Cape Town was a relatively liberal city. Jan Smuts was the Prime Minister of South Africa and the leader of the United Party, which mainly represented the English-speaking white population, descendants of British settlers. The opposition Nationalist Party represented the Afrikaner white community, who predominated in the rural areas, but Afrikaners had also moved into the cities. Descendants of the Boers, they spoke Afrikaans, a dialect of Dutch. In 1947, the white population was 2.4 million. There were also people of mixed race in the Cape, known as the Coloureds, descendants of early white Dutch-speaking settlers and their Malay and Hottentot (Koi) slaves; they spoke Afrikaans. There were a million Coloured people in South Africa, a third of a million Asian, mostly of Hindu origin and living in Natal, and seven million black or, as they were known at the time, Bantu (‘Bantu’ meaning ‘the people’). Democracy was restricted to the white population. When the early Dutch settlers first came to South Africa in 1652, the native people of the Cape were the Hottentots. The Bantu people, at that time invading from the north, had reached the border of the Cape Province at the Fish River but not the Western Cape.
On the day we docked, the ship's officers decided to take the unattached ladies from the ship to dinner. We wandered around the streets of Cape Town and found what appeared to be a pleasant place for supper. When we sat down, we were told that only drinks were served and so we decided to leave. The proprietor, a Portuguese, then told us that we could not leave without paying an entrance fee of £2 per head. There were fourteen of us. We continued to argue, but the manager would not let us to leave and locked the door! It looked to me as if we were going to have an unpleasant quarrel and perhaps a fight because some of the waiters had put on knuckle-dusters.
5 - Peace
- Geoffrey Dean
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Summary
War lays a burden on the reeling state,
And peace does nothing to relieve the weight.
William Cowper, ConversationsOn returning to Liverpool in September 1945 I found life very dreary; it was a great anti-climax after the excitement of Water-beach and Bomber Command. Rationing had become worse; even bread was rationed. Nonie was pregnant again. We found a first-floor flat at 29 Ullet Road, near Sefton Park, and I bought a 1939 Morris 8 from Nonie's brother Brian for £120. There had been remarkably little inflation during the war because of the government's tight control of prices and wages. Nevertheless, great social changes had occurred. The poor people in Liverpool were better fed than they had been before the war because, as a result of food rationing, price control and work for all, everyone could afford the limited rations and, for children, there was a free issue of milk. We were able to afford a live-in maid at a salary of £1 per week and, since her father had retired from practice after the war, Nonie had a relatively easy life. Nevertheless, there was general gloom from the strict rationing of food and clothes.
I called to the medical school to see Professor Tom Davie, the professor of pathology, who had been appointed Director of Post-War Medical Establishments. Although it was not immediately apparent, Britain was moving rapidly towards a National Health Service and, in order to help re-establish discharged doctors from the services, additional registrar posts had been made available at the teaching hospitals at a salary of £600 a year, paid by the state. I was fortunate to be appointed medical registrar to Robert Coope with whom I had worked in 1942 at Broadgreen Hospital. He was a consultant physician at the Liverpool Royal Infirmary.
As more and more doctors were demobilised and given registrar posts, the number of registrars at the Royal Infirmary was two or three times what it had been before the war, and so the amount of work for each doctor was not great. Once again I went back to the study of medicine; my enthusiasm had been increased by the encouragement I had received from Cony while I was in the RAF. I also attended the dramatic ward rounds of Henry Cohen.
15 - Multiple Sclerosis
- Geoffrey Dean
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What have we done, oh! Zeus!
to deserve this destiny?
Our fathers were wanting, but we,
what have we done?
often quoted by Jean-Martin Charcot, 1825–93
I have already described how my interest in the cause of multiple sclerosis (MS) arose when I first emigrated to South Africa. MS is the most common disabling neurological disorder of young adults in the western world. It seldom occurs before the age of fifteen or sixteen and reaches its peak prevalence in persons in their early thirties. The disorder is more common in women than men, afflicting about three females for every two males, and it is typically a disease of exacerbations and remissions. The nineteenth-century neurologist Jean-Martin Charcot, of the Salpêtrière Hospital in Paris, first gave a good medical account of the disorder in 1857 when he showed that its victims had plaques, or patches of hardening, scattered throughout their brains and spinal cords. He called the disorder sclerose en plaques. The plaques are caused by the loss of myelin, the fatty material that makes up the sheath covering the nerve fibre. When the myelin sheath breaks down, conduction along the nerve fibre is disrupted. It can be compared to the insulation around a telephone wire.
Often the first symptoms of MS are caused by patches of demyelination in the optic nerves, resulting in a blurring of vision in one or both eyes (known as optic neuritis). This visual disturbance may last for a few days or up to six weeks, after which the person's vision generally returns to normal. 35 per cent of men and 75 per cent of women who have an attack of optic neuritis will then go on to develop MS during the ensuing fifteen years. Because the plaques of MS occur anywhere in the central nervous system, they can cause sensory symptoms, such as loss of sensation in any part of the body, loss of muscle power, or ataxia – uncoordination of movement. When the ataxia is severe, it may result in what is known as ‘scanning speech’, a slow enunciation, with a tendency to hesitate at the beginning of a syllable or word.
Frontmatter
- Geoffrey Dean
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25 - My Family and Personal Life
- Geoffrey Dean
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The friends thou hast, and their adoption tried,
Grapple them to thy soul with hoops of steel…
William Shakespeare, HamletIn the account of my work after leaving South Africa, I have said very little about my private life. It is difficult to do so when immediate family and personal friends are alive. It is easy enough to praise and say good things about those we know, but not so easy to be objective. Nor is it easy to be dispassionate about the decisions I have made, good and bad, in my own life.
On coming to Ireland, Maria and I, Gordon and Elizabeth spent a year in a rented house and then, in 1970, bought a house in Donnybrook, very close to St Vincent's Hospital and University College, Dublin. It was within walking distance of Baggot Street and my office. The house cost £9,700, which I obtained by selling some of my South African shares. Gordon and Elizabeth first went to a local convent school and then, when Gordon was about seven, he went to a boys’ school, St Michael's, and Elizabeth to Mount Anville Convent.
Maria is Serbian. She is a loving and good wife. Settling in Ireland, where she at first did not know anyone, must have been difficult for her because I was away a great deal attending conferences, undertaking research, and representing Ireland on the EEC committee on epidemiology. Fortunately, she has an outgoing personality and soon made many friends.
In London we often met Maria's friends from her schooldays in Belgrade. I was told how, during the German occupation, she would steal candles from the Catholic church and sell them; then with some of the money, she and her friends would buy loaves of bread and throw them over the barbed wire to the Yugoslav Jews and gypsies who were kept in an enclosure, open to the sky, in the town square, before being sent to camps where most of them died. From all I heard, Maria was the most popular girl in her class at school.
13 - Porphyria: The Master Family Tree
- Geoffrey Dean
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The study of things caused must precede the study of the cause of things Claude Bernard, Introduction à l’étude de la médecine experimentale, 1865
Whenever I saw a patient suffering from porphyria variegata, I interviewed all the relatives I could find, examined them for porphyria and drew up a family tree. In this way I was able to find out from which side of the family porphyria had been inherited. All the families I studied came from Afrikaner, or Boer, stock. It was possible to trace the ancestors from the family bibles and from the baptismal records of the Dutch Reformed Church. The way the Afrikaners named their children was also a great help; the first son was always given the names of the father's father, the second son those of the mother's father, and the third son the father's own names. The first daughter was given the names of the mother's mother, the second those of the father's mother, and the third the mother's names. This meant that the first-born uncle would have the same names as the great-grandfather. I was able to trace the families on the affected side back about 150 years, to the early part of the nineteenth century. After a great deal of research, I traced 32 family groups to their ancestors back about five or six generations.
Tracing the porphyric families to earlier than the nineteenth century was made easier by research carried out by Christoffel Coetzee de Villiers, the editor of the Het Volksblad newspaper, in the 1870s and 1880s. He found the names of the ancestors of his own family and those of most of the old Boer families from their baptismal records back to their ancestors who had come from Europe, many in the latter half of the seventeenth century. When he died in 1884, de Villiers's register of the old Cape families was published in three volumes. Dr J. Hoge studied the families of the early German settlers, while C.G. Botha made a careful examination of French Huguenot refugee families who had come to the Cape about 1688.
4 - Bomber Command
- Geoffrey Dean
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They shall not grow old, as we that are left grow old;
Age shall not weary them, nor the years condemn.
R. Laurence Binyon, Poems for the FallenIn August 1943 I received my call-up papers to join the Royal Air Force as a medical officer with the rank of flying officer. This rank was equivalent to that of a first lieutenant in the army. The newly recruited doctors first reported to a training centre where there were about ten other doctors who had been conscripted at the same time. We were given a week's preliminary training: how to salute, how to march reasonably in step and the structure of the RAF. Since I had been in the Officer Training Corps at Ampleforth, this was straightforward.
After a few days of basic training, we were sent to a large air force station at Halton, Buckinghamshire, to learn something about aviation medicine and tropical medicine. In order to impress on us how important it was to use oxygen, we were put into a decompression chamber. As the atmospheric pressure was lowered, we were asked to do simple sums, such as 13 take away 6. I wrote down the wrong answer. I remember little after this until I woke up on the floor of the decompression chamber, the sergeant in charge having plugged in my oxygen mask. We were not likely to forget the importance of using our masks. On another occasion an aeroplane flew overhead and dropped an irritant gas, such as is used to disperse a crowd, so we quickly appreciated the importance of always carrying our gas masks. Fortunately, poison gas was never used in the Second World War.
The officers’ mess at Halton had formerly been a palace belonging to the Rothschild family. There was a magnificent hall in which we normally took afternoon tea. After I had been at Halton about ten days, I was talking to my friends in the hall while having tea and was leaning negligently against one of the tables.
22 - Retirement and a Shotgun Marriage
- Geoffrey Dean
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Life is short, the art is long;
The occasion fleeting,
Experience fallacious;
And judgement difficult.
Hippocrates of KosTowards the end of 1985, when I was about to retire as director of the Medico-Social Research Board, I was asked by the medical adviser of the Agricultural Institute of Ireland, Dr Alan O'Grady, if I would undertake a study on the cause of death in men in the research and technical staff at the institute, because there appeared to be a high number of deaths from cancer among them before they reached retirement age.
The national agricultural research organisation, now renamed the Agriculture and Food Development Authority, has its headquarters in Dublin and has seven major centres. The research programme carried out at the centres covers a broad spectrum of activities relevant to the agricultural industry. The director of the institute, Dr Pierce Ryan, through the personnel officers, provided me with a list of the research and technical workers who had died while still working at the institute and a breakdown of the work-force by age. I obtained copies of their death certificates and their hospital records. The work and medical histories of those who had died were also obtained from the personnel officers’ records.
There had been, in the previous twenty years, twenty-one deaths among the research and seven among the technical staff, all men; eleven of the twenty-eight deaths were from cancer. Four of the eleven cancer deaths were from primary brain cancers; three were from leukaemia, and one death was from Hodgkin's disease, a disorder related to leukaemia. There were also two deaths from abdominal cancers of unknown primary source, probably due to cancer of the pancreas, and one from cancer of the stomach. Approximately one in thirty of all cancer deaths, or one per cent of all deaths, would have been the ‘expected’ number from primary brain tumours in males in the age-group 40–64 years. Leukaemia and lymphatic cancers are relatively uncommon cancers to cause death.
Index
- Geoffrey Dean
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