Patient education materials (pems) are frequently used to help patients make cancer screening decisions. However, because pems are typically developed by experts, they might inadequately address ...patient barriers to screening. We co-created, with patients, a prostate cancer (pca) screening pem, and we compared how the co-created pem and a pem developed by experts affected decisional conflict and screening intention in patients.
We identified and used patient barriers to pca screening to co-create a pca screening pem with patients, clinicians, and researchers. We then conducted a parallel-group randomized controlled trial with men 40 years of age and older in Ontario to compare decisional conflict and intention about pca screening after those men had viewed the co-created pem (intervention) or an expert-created pem (control). Participants were randomized using dynamic block randomization, and the study team was blinded to the allocation.
Of 287 participants randomized to exposure to the co-created pem, 230 were analyzed, and of 287 randomized to exposure to the expert-created pem, 223 were analyzed. After pem exposure, intervention and control participants did not differ significantly in Decisional Conflict Scale scores mean difference: 0.37 ± 1.23; 95% confidence interval (ci): -2.05 to 2.79; in sure (Sure of myself, Understand information, Risk-benefit ratio, or Encouragement) scores (odds ratio: 0.75; 95% ci: 0.52 to 1.08); or in screening intention (mean difference: 0.09 ± 0.08; 95% ci: -0.06 to 0.24).
The effectiveness of the co-created pem did not differ from that of the pem developed by experts. Thus, pem developers should choose the method that best fits their goals and resources.
This paper presents the design of a front-end circuit for monolithic active pixel sensors. The circuit operates with a sensor featuring a small, low-capacitance (< 2 fF) collection electrode and is ...integrated in the DPTS chip, a proof-of-principle prototype of 1.5 mm × 1.5 mm including a matrix of 32 × 32 pixels with a pitch of 15 μm. The chip is implemented in the 65 nm imaging technology from the Tower Partners Semiconductor Co. foundry and was developed in the framework of the EP-R&D program at CERN to explore this technology for particle detection. The front-end circuit has an area of 42 μm 2 and can operate with a power consumption as low as 12 nW. Measurements on the prototype relevant to the front-end will be shown to support its design.
Introduction: Onycholysis due to repetitive activity in the space suit glove during Neutral Buoyancy Laboratory (NBL) training and during spaceflight extravehicular activity (EVA) is a common ...observation. Moisture accumulates in gloves during EVA task performance and may contribute to the development of pain and damage to the fingernails experienced by many astronauts. The study evaluated the use of a long ventilation tube to determine if improved gas circulation into the hand area could reduce hand moisture and thereby decrease the associated symptoms.
Methods: The current Extravehicular Mobility Unit (EMU) was configured with a ventilation tube that extended down a single arm of the crew member (E) and compared with the unventilated arm (C). Skin surface moisture was measured on both hands immediately after glove removal and a questionnaire administered to determine subjective measures. Astronauts (
n
=
6
) were examined pre- and post-run.
Results: There were consistent trends in the reduction of relative hydration ratios at dorsum (
C
=
3.34
,
E
=
2.11
) and first ring finger joint (
C
=
2.46
,
E
=
1.96
) when the ventilation tube was employed. Ventilation appeared more effective on the left versus the right hand, implying an interaction with hand anthropometry and glove fit. Symptom score was lower on the hand that had the long ventilation tube relative to the control hand in 2/6 EVA crew members.
Conclusions: Increased ventilation to the hand was effective in reducing the risks of hand and nail discomfort symptoms from moderate to low in one-third of the subjects. Improved design in the ventilation capability of EVA spacesuits is expected to improve efficiency of air flow distribution.
We show that a dual clinical ultrasound system (US) is capable to measure the kinematics of C-spine stereographically. The precision of US was validated ex-vivo using phantom and human adult ...cadaveric spines. We compared the ability of US to measure motion of phantom and vertebrae subjected to known motion. The material properties of FSUs were compared to clinical Pfirrmann grades. For in-vivo trials, human subjects are seated on vertical neck motion simulation system. The US transducers measure c-spine displacement and compliance (Dh/DF) in subjects with HSM of varied applied loads. The mean absolute error of US tracking was + or -0.041 mm. Dynamic FSU deformation measured by US was consistent with the IVD deformation measured directly. C6-7 FSU deformation derived from US accounted for 92% of the variation in FSU motion compared to direct measurements for frequencies up to 6Hz and 77% at 8Hz. The C4-5 IVD tended to be more compliant for the younger human subject in US.
To assess the mortality (mostly long-term sequelae) of patients undergoing splenectomy, we carried out a population-based study in Sweden.
Using the unique personal identification number assigned to ...each Swedish resident, we linked centralized hospitalization records with nationwide mortality data. After initially assessing risks within the first 12 months after splenectomy, we excluded deaths during the first year and computed standardized mortality ratios (SMRs) for 1,297 patients splenectomized for external trauma and 991 surgically treated for nonmalignant conditions of adjacent organs who were alive at 12 months following surgery. The general Swedish population was used as the comparison.
Both men and women undergoing splenectomy for external trauma had a 1.6-fold (SMR = 1.6) significantly elevated mortality risk, due mainly to circulatory diseases (particularly thromboembolism), alcoholism, digestive disorders, and external causes. Men also had a 28-fold increased mortality from septicemia and an excess of liver cirrhosis (mostly alcohol-related). Patients of both genders splenectomized for nonmalignant conditions had small but significantly elevated mortality overall (SMR = 1.4 to 1.5) reflecting excess risks for malignancies, diseases of blood-forming organs, external causes, and circulatory, respiratory, and digestive disorders. In addition, men had increased mortality from thromboembolism and pneumonia while women experienced elevated risks from septicemia.
The excess mortality resulted from functional postsplenectomy defects (including sepsis and thromboembolism), behaviors increasing risk of traumatic splenic injury (eg, alcoholism), damage to other organs from the external trauma (eg, traumatic injury to the central nervous system/spinal cord), or the same or recurrent nonmalignant conditions for which surgery was performed (eg, gastric and duodenal ulcers).
Dermatologists can benefit from adopting environmental sustainability in the management of their practices. We can also use opportunities to share best practices in environmental stewardship concepts ...with our colleagues, patients, and communities. Herein, we review easy steps for any health care professional, and dermatologists in particular, to adopt environmental sustainability and become more active in the fight against climate change.
This study included a select literature review, an identification of resources, and an overview of MyGreenDoctor.org.
Many simple, cost effective, energy saving resources were identified. A reference list of climate change resources for health are organizations to help with lower their carbon footprints, educating their staff and patients, and advocacy for better environmental stewardship is presented.
Going green is an easy process that can save money, boost morale, and help educate patients while reducing the carbon footprint of any size medical practice.
Crews who inhabit spacecraft with complex 3D architecture frequently report inflight disorientation and navigation problems. Preflight virtual reality (VR) training may reduce those risks. Although ...immersive VR techniques may better support spatial orientation training in a local environment, a non-immersive desktop (DT) system may be more convenient for navigation training in “building scale” spaces, especially if the two methods achieve comparable results. In this study trainees’ orientation and navigation performance during simulated space station emergency egress tasks was compared while using immersive head-mounted display (HMD) and DT-VR systems. Analyses showed no differences in pointing angular-error or egress time among the groups. The HMD group was significantly faster than DT group when pointing from destination to start location and from start toward different destination. However, this may be attributed to differences in the input device used (a head-tracker for HMD group vs. a keyboard touchpad or a gamepad in the DT group). All other 3D navigation performance measures were similar using the immersive and non-immersive VR systems, suggesting that the simpler desktop VR system may be useful for astronaut 3D navigation training.
The activity budgets of feral goats (Capra hircus) on the Isle of Rum, northwest Scotland, were studied from January to December in 1981 and from May to November in 2000. We investigated differences ...in activity patterns in relation to season, time of day, and agesex classes of goats, and their possible causes. Since the goats spent the night sleeping (or resting) in caves or other sheltered sites, only diurnal activity budgets were considered. Activity patterns were very similar between the two study periods (from May to November). All agesex classes of feral goats spent most of the daytime feeding in both years, especially during autumn and winter. Feral goats increased the percentage of daytime that they spent feeding and decreased their resting time from summer to autumnwinter in response to the decrease in available day length and, possibly, the decrease in forage quality and biomass. Feral goats on Rum had two or three daily peaks of feeding in summer, but showed no obvious daily feeding peaks in winter, although their percentage of feeding time remained relatively high throughout the daytime in winter. No significant differences in general activity budgets between adult males and females were found, but yearlings were found to spend more time feeding than adults and kids. Adult males spent more time in social activities than did other agesex classes, and adult males sharply decreased the percentage of daytime that they spent feeding during rutting periods, which may have contributed to their higher mortality over the subsequent autumn and winter.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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