First, whereas professionals reviewed all questions, patients were only asked selected questions as deemed appropriate from within the DT protocol framework. Second, due to repeated words or phrases, the questions may appear more similar than they actually are. Finally, patients might appreciate the chance to build on their responses, based on questions

that are thematically linked. Adjustments: None. (5) ‘Inappropriate words/phrases’ Professionals, and to a lesser extent patients, noted a number of instances Inhibitors,research,lifescience,medical of inappropriate GSK2118436 solubility dmso wording in the Danish translation of the DTQP. Recommendation: Despite the modifications listed below, some patients may still need rewording or explanation for comprehension of specific questions. Dignity Therapy should always be offered in a fashion that makes it accessible and comfortable, irrespective of the cultural context Inhibitors,research,lifescience,medical or language in which it is being conducted. Adjustments: The terms ‘specific’, ‘particular’ and ‘would want’ (questions 3, 7, and 9) were removed from the Danish version to make these questions less formal and less complex. To deemphasize the term ‘roles’ (question 4) – which is an uncommon Danish term – and to create more awareness of the examples, the word ‘roles’ and the brackets were removed from the examples ‘e.g. in Inhibitors,research,lifescience,medical the family, job wise or in the community etc’. To shorten question 7, the formulation ‘take the time to’ was removed. Inhibitors,research,lifescience,medical “Other things” in question 12 became

“more” in the Danish version, which is considered to be more inclusive. (6) Interference with the lives of others Both professionals and patients reacted to particular words in question 10 and 11 that were considered to be too interfering or demanding on the relatives. This was not the original intent

of the questions, which were designed to give patients an opportunity to provide their family members messages of comfort and support. Adjustments: Inhibitors,research,lifescience,medical To make the issue of passing on comforting and helpful messages more clear, the first part of question 11 including the word ‘instructions’ was changed into “Is there anything you could say.” Questions 1, 5, 8, and 10 were not changed in the Danish version as there was no support of the professionals’ concerns in the patient data and as we wanted to make adaptations to the DTQP only when necessary. Adaptation of DT in general Even though several Ergoloid Danish patients questioned the term ‘dignity’, it is important to note that the term ‘dignity’ is not referenced in the DTQP. While it was beyond the scope of this study to address this issue adequately, the patients response suggests that a future study of Dignity Therapy would demand that careful attention be paid to how DT is introduced, ensuring that the language used and the rationale provided not be overly existentially confrontative. In practice, the title would also have to be deemphasized when presenting the intervention, and more emphasis be placed on the content of the intervention.

Of special relevance to the symptoms of PTSD, lesions to the PFC impair selleck products the ability to concentrate or focus attention (Wilkins et al., 1987 and Chao and Knight, 1995), and can weaken impulse control and produce reckless behavior (Aron, 2011). Bilateral

lesions to the vmPFC impair modulation of emotional reactions, including increased irritability, impaired decision-making, and lack of insight (Barrash et al., 2000). PFC lesions can also impair the ability to inhibit cognitive interference, e.g. inhibiting inappropriate memories (Thompson-Schill et al., 2002), or inappropriate dimensions as tested by the Stroop interference task (Golden, 1976). The dorsal PFC is needed for reality testing (Simons et al., 2008), a property Birinapant important for distinguishing a vivid memory from an actual event, i.e. the flashbacks that occur in PTSD. Finally, the PFC can regulate our state of arousal, e.g. through projections to the NE neurons where it can inhibit LC firing (Sara and Herve-Minvielle, 1995), and reduce the stress response (Amat et al., 2006). Thus, the PFC can provide widespread orchestration of brain physiology needed for calm, rational and flexible responding. The amygdala also has Modulators extensive connections through much of the brain, and is positioned to initiate and coordinate an unconscious, primitive stress reaction throughout the brain and body (Fig. 2; reviewed in Davis, 1992 and Price and Amaral,

1981). The amygdala can Levetiracetam activate the traditional HPA axis (hypothalamus–pituitary–adrenal gland) via projections

to the hypothalamus, and the sympathetic nervous system through projections to hypothalamus and brainstem (Davis, 1992). It can rapidly alter behavior as well, e.g. inducing the freezing response through projections to the peri-aqueductal gray, and increasing the startle response through parallel brainstem projections (Davis, 1992). Amygdala projections to striatum strengthen habitual responses (Elliott and Packard, 2008), while those to hippocampus can strengthen the consolidation of emotionally-charged memories (Roozendaal and McGaugh, 2011) (although with severe stress the hippocampus may also be weakened, perhaps contributing to amnesia (Kim and Yoon, 1998)). Importantly, the amygdala mediates fear conditioning, whereby a previously neutral stimulus (e.g. a hot day), can trigger a fear response after it is paired with a traumatic event (Phelps and LeDoux, 2005). Thus, the amygdala can perpetuate a stress response long after a trauma is over. In contrast, circuits within the PFC are needed to extinguish a conditioned response to a traumatic event and return to normative behavior (Quirk and Mueller, 2008). The amygdala also drives the arousal systems, e.g. increasing the firing of the NE neurons of the LC (Van Bockstaele et al., 1998), and dopaminergic (DA) neurons in the midbrain (Phillipson, 1979).

The quantitative nature of these dimensions should also prove to be another important, asset, as it will add statistical power and readily allow the inclusion of subthreshold cases across a broad range of studies, including populationbased studies.81 As we are currently in the

midst of revising our diagnostic manuals, it is worth noting that the available data strongly support, current dimensional views of psychopathology in general and OCD in particular and have implications for DSM-V. First, the specification of subtypes of OCD as well as the major symptom dimensions of OCD in the DSM-V would Inhibitors,research,lifescience,medical better capture the heterogeneity of the disorder and encourage further research in the field.132 Second, it will be important to specify the presence of subsyndromal OCD, Inhibitors,research,lifescience,medical as it. is frequently associated with help-seeking behavior and a variety of comorbid conditions.81 Selected abbreviations and acronyms

obsessive-compulsive OC OCD obsessive-compulsive disorder Y-BOCS-SC Yale-Brown Obsessive-Compulsive ScaleSymptom Checklist TS Tourelle syndrome SSRI selective serotonin reuptake inhibitor Inhibitors,research,lifescience,medical CBT cognitive-behavioral therapy PANDAS pediatric autoimmune neuropsychiatrie disorders associated with streptococcal infections GABHS group A β-hemolytic, streptococci ADHD attention deficit-hyper activity disorder
There Inhibitors,research,lifescience,medical has been great public and academic interest in the diagnosis and treatment of bipolar disorders (BD) in children and adolescents over the past decade, Panobinostat research buy originally in the US but now extending internationally. Thus, in the US in the past decade, diagnoses of BD in children under 18 years old

have risen 4000% in the community.1 Whether this increase is due to increased recognition, Inhibitors,research,lifescience,medical increased incidence, or overdiagnosis is not clear. However, it is becoming clear that BD begins in childhood 50% to 66% of the time.2,3 Therefore, if the incidence of BD (I or II) in adults is 4%,4 then there are at least 1 to 2 million children in the US alone with BD or the beginning manifestations of the disorder. A recent study comparing age at onset of BD in a US population found that 30% of adults with BD in the Netherlands many and Germany had childhood/adolescent onset.5 Thus, while possibly fewer than in the US, there are also likely great numbers of youth in Europe with BD. Much of the interest in pediatric BD has focused on the unique manifestation of mania in younger populations. Academic controversy has centered around the role of extreme irritability in pediatric mania: whether it can be a proxy for euphoria6; whether Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria can be used in children under 12; and whether children with BD eventually become adults with DSM-IV-defined BD.

, 2010 and Hammes and

Schmid, 2009). inhibitors highly weathered soils, which account for approximately 10% of Taiwan, are some of the most common types of agricultural soils in Taiwan. Bortezomib in vivo This is particularly true in northern Taiwan (a subtropical climate), an area of rice and tea production, and in southern Taiwan (a tropical climate), an area of rice and pineapple production. Under humid subtropical and tropical climates, highly weathered soils with intensive cultivation are characterized by a very low pH (≤ 5.0), and low soil organic matter (≤ 1%), CEC, and base saturation percentage (BS). Huang (1986), Lin and Hung (2000), and Lin (2002) studied the soil erosion rates of highly weathered soils in Taiwan, and indicated that the soils have moderate to serious soil Selleck DAPT losses ranging from 10 to 280 tons ha− 1 yr− 1. Similar climates and soil degradation problems appear in Trinidad and Tobago (Wuddivira and Camps-Roach, 2007 and Wuddivira et al., 2009), where the most critical factors influencing the degradation are SOM content and soil aggregation stability. Previous studies on amending soils with biochar typically focused on restoring soil fertility and crop production. Few studies have discussed the influences of biochar on the physical

properties of soil and erodibility in highly weathered soils. The objectives of this study were (1) to evaluate the effects of wood biochar on the physical properties and erosion potential of highly weathered soils, and (2) to assess the relationships between soil properties and soil erosion potential. Soil samples (0–25 cm) were collected from a terrace located at field erosion Terminal deoxynucleotidyl transferase experimental plots at the National Pingtung University of Science and Technology, southern Taiwan (about E 120°37′11″; N 22°38′54″). The soil was classified as a Typic Paleudults based on Soil Taxonomy (Soil Survey Staff, 2010). Pineapple (Ananas comosus (L.) Merr.) is the dominant crop on this terrace. The biochar used in this study was supplied by Taiwan Forestry Research Institute (TFRI) and was produced from the wood of white

lead trees (Leucaena leucocephala (Lam.) de Wit). The waste wood of the white lead trees, which are commonly invasive plants, was collected from a clearcutting program in Kenting National Park, southern Taiwan. The biochar was produced at a pyrolysis temperature of 700 °C based on the recommendation of Lehmann (2007). After pyrolysis, the biochar was ground to pass through a 2 mm sieve to ensure that all biochar had the similar particle size in subsequent experiments. Incubation experiments were conducted to evaluate the effects of biochar on the physiochemical properties of soil. Fifteen kg samples of the study soils were placed in plastic pots (measuring approximately 30 cm in width and 40 cm in depth) and then mixed with biochar at three application rates (0%, 2.5% and 5% (w/w)).

This effect was also found even in nonphagocytic cells, although, for these cells, free CLO was more efficient. In vivo, dogs with spontaneous

malignant histiocytosis and treated with CLO-containing liposomes elicited significant tumor regression in two of five treated animals. The authors also reported an antitumor activity following i.v. administration of CLO-containing liposomes in several different nonhistiocytic mouse tumor models, thus suggesting the antitumor activity may have been mediated by a combination Inhibitors,research,lifescience,medical of both direct and indirect tumor effects [38]. Liposomes have been used to deliver BPs directly to cancer cells (Table 1). Neridronate (NER) encapsulated into liposomes increased the inhibition activity on cell growth on human breast cancer cells (MDA-MB-231) by 50 times, compared to the free drug [39]. Table 1 Summary of the most meaningful Protein Tyrosine Kinase inhibitor studies published on nanotechnology to deliver BPs in cancer. Moreover, even at a lower concentration, liposomal Inhibitors,research,lifescience,medical NER showed a suppressive effect on tumor cell mobility in vitro, whereas free NER showed almost no effect. Reasonably, liposomes should mediate the enhanced bisphosphonate uptake into the cells, although this hypothesis Inhibitors,research,lifescience,medical was demonstrated only by indirect evidence by

co-encapsulation of fluorescent dye together with the drug. In order to directly deliver BP in tumor cells, accumulation in MPS should be avoided. Thus, nanocarriers with stealth properties able to avoid opsonization should be preferred. In the light

of this consideration, stealth liposomes encapsulating ZOL (lipoZOL) designed for tumor targeting Inhibitors,research,lifescience,medical were developed [40, 42]. ZOL was encapsulated into liposomes by different strategies, and the reverse-phase evaporation technique was selected to achieve the highest encapsulation efficiency (unpublished data). With this technique, the use of an alkaline buffer improved the ZOL solubility into the aqueous phase of liposomes, thus increased the drug encapsulation efficiency up to about 5% [40]. Liposomes were able to significantly prolong Inhibitors,research,lifescience,medical ZOL circulation time. Free ZOL was quickly cleared too from blood, with 0.1-0.2% of the injected dose still present 1h after injection. ZOL encapsulation into liposomes, especially PEGylated liposomes, significantly increased ZOL circulation time, with more than 10% of the injected dose still present into the blood 24h following the injection [42]. Concerning the in vitro activity of lipoZOL, contrasting results have been found. In particular, our group demonstrated that the use of lipoZOL, compared with free ZOL, increased the cytotoxic effect until a potentiation factor of about 20 [40]. The effect was confirmed in cell lines of different cancer, namely, prostate, breast, head/neck, lung and pancreas, and multiple myeloma, with an IC50 ranging from 4 to about 200μM.

However, other studies showed higher percentage of hospitalization through the ED [7,14]. These variations in hospital admission rates could be due to several factors including hospital size, number and types of specialties in the hospital, triage system, patients’ eligibility, and insurance coverage. Admission rates are generally correlated with CTAS triage level; in this study, the majority of our ED patients were Inhibitors,research,lifescience,medical categorized as levels IV and V. Furthermore, our hospital is a specialized tertiary care institute, where patients are transferred from other hospitals in the region. This may explain, in part, the low admission

rates through the ED. Previous studies showed that up to 15% of patients left ED without receiving any medical attention [15-18]. Likewise, our ED’s estimated LWBS rate is approximately 9.8%, however, this Inhibitors,research,lifescience,medical is higher than our quality indicator of < 2%. Using CTAS, recent study in United Arab Emirates, showed a rate of 4.7% LWBS [19], Canadian studies reported rates between 3 - 3.57% [20,21], and 7.4 - 15.0% in the USA [17,22-24]. These international variations in LWBS may reflect differences in culture, ED structure or service delivery. "Left without being seen" is related to many factors, such as ED efficiency, patient volume and Inhibitors,research,lifescience,medical acuity, understaffing and overcrowding [23,25]. In keeping with CTAS objectives, our data demonstrated that of 118 patients, who

left without being seen during the study period, none Inhibitors,research,lifescience,medical were in Levels I or II (Resuscitation or Emergent), and only 14 (11.9%) were in Level III. This SCR7 implies that in our ED patients who LWBS, generally, have conditions of a less acute and less urgent nature. Waiting time studies offer constructive information to identify system inefficiencies and for benchmarking purposes. With a growing population Inhibitors,research,lifescience,medical and an increasing

demand for medical care in EDs throughout the Gulf region and elsewhere, there is a need for comparative studies both locally, as well as, internationally to document and account for avoidable areas of delay in the care of emergency patients, and hence, improve quality of care. Our study is one of a few, which examines the CTAS in EDs outside of Canada. Limitations The data presented in this study comes from only one institution, which may limit the ability to generalize our results to other facilities, because this institute has different setting and patient characteristics, than most of the CTAS published studies. However, we believe that the outcomes Dipeptidyl peptidase reflect the reality of most EDs that use CTAS. Conclusion We conclude that the CTAS may be implemented, with achievable objectives, in hospitals outside Canada. Time to see physician, total LOS, and LWBS are effective markers of performance of ED and the quality of triage. RTP and LOS profiles, stratified by triage level, are essential for the management of ED and improving patient flow through collaborative efforts. Competing interests The authors declare that they have no competing interests.

In general, IO and TrA muscles have anatomical similarities in that both are among the muscles comprising the structure of the lower abdominal wall and they have similar functions. However, unlike the TrA, the IO affects the spine because of its direction.4 The IO attaches

to the posterior layer of the thoracolumbar fascia. Contraction of this Apoptosis Compound Library chemical structure muscle creates a lateral tension force on the thoracolumbar fascia, which creates the intrinsic translational and rotational stabilization of the spinal unit.20 This should be a reason for the higher activation of this muscle during the bird-dog position. Also, Huang23 stated that the unilateral multifidus activation increased in the bird-dog Inhibitors,research,lifescience,medical position. Inhibitors,research,lifescience,medical Because the body weight is supported by one knee and elbow in the bird-dog position, which is an unstable status, the torque of the arm and leg is greater and the multifidus muscle shows a higher activation potential. On the other hand, lumbar multifidus and erector spine muscles have a relatively high proportion of type 1 (slow twitch)

muscle fibers, which makes them well-suited for endurance or sustaining contraction activities. During the bird-dog exercise, these muscles produce EMG signal amplitudes of 29% maximal isometric voluntary contraction (MIVC).23 According to Arokoski,16 Inhibitors,research,lifescience,medical in the bird-dog exercise with weights on the hand, unilateral leg extension, and unbalanced limb movements, there is an increase in the trunk muscle activation, which contributes to the preservation of the spinal

stability. Inhibitors,research,lifescience,medical The increase in the activation of left IO and left and right multifidus muscles in the bird-dog exercise may be related to the unstable body position. Accordingly, the core muscles are recruited for proprioception, balance, and energy transfer from the lower extremity to the upper extremity and hold a neutral abdominal posture.24 In the present study, the left TrA activation in left leg extension was higher than that in right arm extension. Callaghan reported that in order to reduce loads on the spine in exercises such as leg extension with the Inhibitors,research,lifescience,medical spine being held isometrically, the trunk muscles exhibited asymmetrical activity.25 In single leg extension, while the subject is Cediranib (AZD2171) on the hands and knees, he/she produces mild extensor activity and lower spine compression less than 2005 N. Raising the contralateral arm (bird-dog) increases extensor muscle activation and also spine compression to more than 3000 N. Sufficient stability is ensured with mild abdominal bracing.26 According to a recent study, the reciprocal index of the TrA depended on the magnitude and direction of perturbation, refuting the “corset hypothesis” as a normal mechanism for the TrA prior to arm movement. Therefore, the feed-forward activity of the TrA is asymmetric and depends on the direction of perturbation due to arm movement.

Good epidemiological data are not available since sexual disorders have not been included in the major population studies conducted; indeed, it is difficult to see how these disorders could have been covered adequately since the likelihood of obtaining honest replies seems minimal. Estimates of the prevalence of SC range from 3% to 6%.117 Paraphiliac sexual behaviors are thought to begin in childhood, adolescence, or early adulthood,118

Inhibitors,research,lifescience,medical and PRDs are thought to begin around age 18 on average.119,120 SC tends to be cyclical, but there is generally a worsening trend with the sexual activities becoming more extreme and functioning becoming more disrupted over time.121 SC is three times more common in males than females.122,123 This is a more extreme preponderance of males than found in PG, which is in contrast to the gender neutrality often found in clinical OCD and BDD samples. Research on the pharmacotherapy Inhibitors,research,lifescience,medical of SC is limited, to date only case reports and small, non–placebo-controlled studies have been published, although we are currently conducting a placebo-controlled trial of citalopram in narcissistic Inhibitors,research,lifescience,medical personality disorder. As was found for OCD, there is evidence that SRIs are beneficial

in SC.This is probably due in part to the side effect of decreasing libido, but it seems that SRIs also work by reducing obsessive thoughts and behaviors more directly. Their efficacy, however, seems to be more complex than that found for OCD. Stein124 found that while patients with sexual obsessions had a strong response to SRIs, those with paraphilias had a more moderate response and those with PRD had a positive response Inhibitors,research,lifescience,medical on low doses, but a worsening of symptoms on high doses. www.selleckchem.com/products/ulixertinib-bvd-523-vrt752271.html Open-label trials of fluoxetine125 and sertraline126 found behavioral improvement in men with paraphilias and in men with PRDs. Sertraline Inhibitors,research,lifescience,medical was also found helpful in reducing pedophiliac fantasy in an open-label trial.127 A retrospective study of SSRIs found them useful in reducing fantasies in men with paraphilias.128 Overall, these studies suggest that, in contrast

to OCD, symptom improvement in the SC can be seen in the first few weeks of treatment and at relatively low doses. Most of these trials were of short duration, and so response maintenance is unclear; however, there is indication that response may not be maintained in some patients.126 In addition, compared with OCD and BDD, case reports indicate that SC may have a less preferential response to SRIs, also responding to monotherapy with mood stabilizers129-131 and non-SRI antidepressants.131-133 In terms of SRI dosage, time to response, response maintenance, and response to other pharmacotherapies, SC is more like PG, another disorder characterized by impulsivity, rather than OCD or BDD, which are more compulsive. One successful augmentation strategy has been reported.

10 The Blue Mountains Eye Study was approved by the Human Research Ethics Committee of the University of Sydney for investigation of the epidemiology and genetics of ocular disease. The BMES has been described previously.10 Briefly, the BMES is a population-based study of individuals living in the Blue Mountains region west of Sydney, Australia. Any permanent, noninstitutionalized resident of the defined geographic region born before January 1, 1943 (aged over 49 years at time of recruitment) and able to give written

informed consent was eligible for enrollment in BMES and was contacted by door-to-door canvassing. Participants underwent a baseline visit, with follow-up at 5 years and at 10 years. At baseline, find more all participants received a detailed eye examination, including applanation tonometry, suprathreshold automated perimetry (Humphrey 76-point test, followed by 30-2 fields [Humphrey Visual Field

Analyser 630 with StatPac 2, Humphrey Instruments, Inc, San Leandro, California, USA]), and stereoscopic optic disc photography (Carl Zeiss Australia, Sydney, New South Wales, Australia). The current sub-study consisted of a case-control design from within the BMES cohort study. Participants with normal threshold or suprathreshold field tests and no sign of glaucoma at the baseline visit were included in the current study. Participants with OAG at baseline (prevalent OAG) were excluded. As previously reported,11 incident OAG cases were defined as participants free of OAG at baseline who showed glaucomatous field loss on full-threshold perimetry (Humphrey 24-2 or Vorinostat 30-2), which matched the optic disc appearance, at either the 5-year or 10-year follow-up visit, without reference to intraocular pressure. Patients with pseudoexfoliation syndrome

were not excluded (n = 7). DNA was extracted from peripheral whole blood using standard techniques. Genotyping was performed on the HumanHap670 array (Illumina, San Diego, California, USA) as part of the ADAMTS5 Wellcome Trust Case Control Cohort 2 Genome-Wide Association Study. Data were cleaned and genotypes called as previously described.12 No significant population stratification was detected in this population.12 Single nucleotide polymorphisms (SNPs) were selected for analysis if they had been previously reported to be associated with OAG (including normal Modulators tension glaucoma) at genome-wide significance in white populations. The reported SNPs with the smallest P values at each locus were chosen for this analysis. In the case of the 9p21 locus reported independently in 2 papers, 7 and 9 the top SNP from each paper was chosen, as well as a third SNP at genome-wide significance in the replication cohorts of Burdon and associates (rs1412829). 7 We hypothesize that if this SNP had been typed in the discovery cohort for this study, it would likely have been the top-ranked SNP at this locus. Seven SNPs at 5 loci were chosen for analysis in total.

The prevalence of musculoskeletal pain is known

to increase with age until it stabilises around age 65 [17]. However, the prevalence of disabling pain that impacts on life increases notably among older people into the oldest age-groups [18]. The impact on individuals can be significant [3]. A review of chronic pain prevalence in older people found estimates ranging from 18-57% [19]. The wide range was partly explained by the variation in definitions used for chronic pain [19]. There is less precise information about the prevalence, impact or treatment of musculoskeletal Inhibitors,research,lifescience,medical pain at the end of life. Consequently it is possible that a major cause of pain is being overlooked and a potential target for improving quality of life is being ignored. The objective of this study was to conduct a systematic search of the literature with the aim of highlighting what is currently known about musculoskeletal pain in older adults at the end of life and the identification Inhibitors,research,lifescience,medical of priorities for future research. Methods Search strategy A modified PICO search [18]

was used to identify information regarding musculoskeletal pain at the end of life. No comparison group was included as a scoping search had shown that there was limited literature available Inhibitors,research,lifescience,medical and we therefore planned to keep the search parameters as broad as possible. The key words used to define the population were ‘palliative’, ‘end of life’, ‘death and dying’, ‘terminal care’ or ‘terminally ill’. Inhibitors,research,lifescience,medical ‘Musculoskeletal’, ‘arthritis’, ‘osteoarthritis’ or ‘rheumatoid’ were used to define the exposure whilst ‘pain’, ‘arthralgia’ or ‘polyarthralgia’ were used to define outcome. The databases searched were Amed, Cinahl, Internurse, Medline, PsychInfo,and Web of Knowledge (from inception to September 2012). (See Table 1 for further details). Inhibitors,research,lifescience,medical As Internurse had a more limited search function it was searched separately. The Cochrane database was searched but no relevant review was found. The grey literature was

searched using http://www.opengrey.eu. The reference lists of all relevant research papers found were searched for further citations. Independent advice about the search strategy was obtained from an information specialist. Table 1 Search process Study selection Inclusion criteria were that papers must be written in English and report original research that considered adults aged 50 or older. There is no general agreement about when old age begins [20]. This search used also the broad definition of 50+ as used by the World Health Organisation [20], both to maximise the potential literature found and to acknowledge that socially constructed Selleckchem PI3K Inhibitor Library concepts of age often include biological as well as chronological factors. (However, no papers were found which had to be excluded because they only focused on younger adults). Papers that highlighted pain as a diagnostic feature of disease with the aim of delaying or preventing death were excluded.