Purpose
Psychosexual distress is known to be a common complication of treatment for gynaecological cancer (GC), affecting the sexual quality of life (SQoL) for an increasing number of young ...gynaecological cancer survivors (YGCS). The SQoL in YGCS study aimed to identify strategies that are acceptable and helpful to YGCS in protecting and improving SQoL, using a salutogenic approach.
Methods
A qualitative study was undertaken with young women aged 18–45 and pre- or perimenopausal at diagnosis. Semi-structured interviews were conducted on Zoom and a thematic analysis of transcripts was completed in NVivo.
Results
Fifteen interviews with YGCS revealed three themes for strategy development: psychosexual education, psychosocial support, and healthcare policy and strategy to establish SQoL as standard care in gynaecologic oncology.
Conclusion
The strategies put forward by YGCS showed the need for a holistic, patient-centric, and multidisciplinary approach to SQoL. A better understanding of the strategies acceptable to YGCS, including the importance of using a trauma-informed approach to communication and care, can help healthcare providers play a vital role in protecting and improving SQoL.
Phosphor-converted white light-emitting diodes (LEDs) are becoming increasingly popular for general lighting. The non-rare-earth phosphor K2SiF6:Mn4+, showing promising saturated red d-d-line ...emission, was investigated. To evaluate the application potential of this phosphor, the luminescence behavior was studied at high excitation intensities and on the microscopic level. The emission shows a sublinear behavior at excitation powers exceeding 40 W/cm², caused by ground-state depletion due to the ms range luminescence lifetime. The thermal properties of the luminescence in K2SiF6:Mn4+ were investigated up to 450 K, with thermal quenching only setting in above 400 K. The luminescence lifetime decreases with increasing temperature, even before thermal quenching sets in, which is favorable to counteract the sublinear response at high excitation intensity. A second, faster, decay component emerges above 295 K, which, according to crystal field calculations, is related to a fraction of the Mn4+ ions incorporated on tetragonally deformed lattice sites. A combined investigation of structural and luminescence properties in a scanning electron microscope using energy-dispersive X-ray spectroscopy and cathodoluminescence mappings showed both phosphor degradation at high fluxes and a preferential location of the light outcoupling at irregularities in the crystal facets. The use of K2SiF6:Mn4+ in a remote phosphor configuration is discussed.
Abstract
Background
Exergames are playful technology-based exercise programs. They train physical and cognitive functions to preserve independence in older adults (OAs) with disabilities in daily ...activities and may reduce their risk of falling. This study gathered in-depth knowledge and understanding of three different user groups’ experiences in and relevant needs, worries, preferences, and expectations of technology-based training, to develop an exergame training device for OAs.
Methods
We conducted a qualitative study using semi-structured focus group interviews of primary (OAs in geriatric or neurological rehabilitation) and secondary (health professionals) end users, as well as expert interviews of tertiary end users (health insurance experts or similar), exploring user perspectives on adjusting an existing exergame to OAs’ needs. Voice-recorded interviews were transcribed by researchers and analyzed using thematic analysis (TA) following an inductive, data-driven, iterative approach.
Results
We interviewed 24 primary, 18 secondary, and 9 tertiary end users at two rehabilitation centers in Austria and Switzerland. Our TA approach identified five to six themes per user group. Themes in the primary end user group reflected aspects of safety, training goals, individuality, game environment, social interactions, and physical and technical overload. Themes in the secondary end user group comprised facets of meaningfulness, distraction through the game environment, safety, gamification elements, the availability and accessibility of the exergame. Tertiary end users’ themes addressed aspects of financial reimbursement, suitable target populations, professional training for the handling of exergame devices, training goals, and concerns about the use of exergames in geriatric rehabilitation.
Conclusions
In conclusion, an exergame for OAs must be safe, motivating and fully adaptable to the target group while promoting the return to or preservation of autonomy and independence in daily life. Our findings contribute to developing hard- and software extensions for the ExerG training device. Further research is needed to expand the validity of our findings to larger populations.
The purpose of the study was to evaluate the growth of patients with isolated cleft lip (CL), with or without cleft palate (CP), or CP during the first few years of life.
A retrospective analysis of ...data from birth to 5 years for 307 patients with isolated CL/CP or CP alone who were seen in a large craniofacial center between 1980 and 2007 was performed. We analyzed growth patterns and feeding interventions. Anthropometric values were plotted onto 2000 Centers for Disease Control and Prevention charts. Longitudinal analyses were performed to estimate age-related changes and to test whether feeding interventions or early education influenced age-related changes.
Including progressive weight, length, and head circumference values, a total of 1944 data points were available. The most frequent diagnosis was unilateral CL with CP (165 53.7% of 307 cases). No patients experienced significant failure to thrive during the study period, although predicted weight and length percentiles for age had initial decreases during the first year of life, with nadirs at 5.2 and 15 months, respectively. These decreases were followed by recovery that started at approximately 12 months for weight and at 20 months for length (P < .0001). Patients who had feeding interventions had a significantly (P = .047) increased gain rate over time for weight for length, compared with those who did not.
In this population, there were weight and length decreases during the first year of life, which were not clinically significant and were followed by statistically significant recovery. Recovery seemed to be related to successful education and feeding interventions. Head circumference and weight for length started at lower percentiles but showed consistent gain over time.
Introduction The American Heart Association’s “Simple 7” offers a practical public health conceptualization of cardiovascular health (CVH). CVH predicts incident cardiovascular disease (CVD) in ...younger populations, but has not been studied in a large, diverse population of aging postmenopausal women. The extent to which CVH predicts cancer in postmenopausal women is unknown. Methods Multivariable Cox regression estimated hazard ratios and 95% CIs for the association between CVH and incident CVD, any cancer, and cancer subtypes (lung, colorectal, and breast) among 161,809 Women’s Health Initiative observational study and clinical trial participants followed from 1993 through 2010. Data were analyzed in 2013. CVH score was characterized as the number (0 worst to 7 best) of the American Heart Association’s ideal CVH behaviors and factors at baseline: smoking, BMI, physical activity, diet, total cholesterol, blood pressure, and fasting glucose. Results Median follow-up was approximately 13 years. Fewer minorities and less educated women achieved ideal CVH, a common benchmark. In adjusted models, compared with women with the highest (best) CVH scores, those with the lowest (worst) CVH scores had nearly seven times the hazard of incident CVD (6.83, 95% CI=5.83, 8.00) and 52% greater risk of incident cancer (1.52, 95% CI=1.35, 1.72). Ideal CVH was most strongly inversely associated with lung cancer, then colorectal cancer, and then breast cancer. Conclusions Lower ideal CVH is more common among minority and less educated postmenopausal women and predicts increased risk of CVD and cancer in this population, emphasizing the importance of prevention efforts among vulnerable older adults.
Team sports athletes need excellent perceptual-cognitive skills, particularly executive functions (EF) to strategically perform on the field. The transfer effect of cognitive training might be ...accomplished by the inclusion of cognitive stimuli into a physically active environment as these couplings are required in real game situations. A training approach that combines both components is exergaming. The primary objective of this study was to gain preliminary insights into the effects of exergaming on cognitive-motor functions in young team sports athletes. The secondary objective was to investigate participants' training experience and well-being over time.
Participants were assigned to the intervention or control group. In the intervention group, participants trained with the ExerCube-a mixed reality exergame. The training was planned for 10 weeks (two sessions per week à 25 min) but had to be shortened by 2 weeks due to COVID-19 restrictions. The control group had no additional training. Outcomes included a computer-based alertness test and a cognitive-motor test battery to assess different EF (flexibility, divided attention, and inhibition) via a FitLight Trainer setup.
Twenty-four athletes mean age (±SD) 15.0 ± 0.7 years, evenly split into the intervention group (
= 12; male
= 6; female
= 6; 14.7 ± 0.5 years) and the control group (
= 12; male
= 7; female
= 5; 15.3 ± 0.8 years), participated in the study. Participants in the intervention group performed on average 9.4 ± 3.3 training sessions over 8 weeks. Significant time x group interaction effects were evident for the cognitive-motor sub-tests flexibility (
= 12.176,
< 0.001,
= 1.488) and divided attention for auditive stimuli (
= 9.776,
= 0.002,
= 1.404) in favour of the intervention group. For the alertness test, a medium effect size (time x group interaction) was seen for the variability of the reaction time (
= 2.196,
= 0.138,
= 0.632) in favour of the intervention group. Training experience and well-being were consistently at medium to high levels.
The ExerCube training yielded positive effects on concentration, flexibility, and divided attention indicating that exergaming can be an innovative training approach for team sports athletes.
Multilateralism characterizes, to varying degrees, patterns of interaction among states and the formal organizations they construct. The utility of multilateral norms or organizations varies with the ...type of cooperation problem states confront. Thus, the functional logic of international cooperation leads to hypotheses about the conditions under which the institution of multilateralism may be a feasible and efficient solution, as in coordination problems, and those under which it will not, as in collaboration problems. Within these constraints, powerful states choose institutions that will serve their interests, with multilateral arrangements becoming more attractive as the future is valued more highly. Multilateral institutions should be stable in circumstances of changing distributions of power, relative to more hierarchical institutions. The vulnerability of patterns of international cooperation to various exogenous changes depends on the type of strategic interaction underlying state behavior.
Pulmonary arterial hypertension (PAH) is characterized by obstruction of pre-capillary pulmonary arteries, which leads to sustained elevation of pulmonary arterial pressure. Identifying those at risk ...through early interventions, such as genetic testing, may mitigate disease course. Current practice guidelines recommend genetic counseling and offering genetic testing to individuals with heritable PAH, idiopathic PAH, and their family members. However, it is unclear if PAH specialists follow these recommendations. Thus, our research objective was to determine PAH specialists’ knowledge, utilization, and perceptions about genetic counseling and genetic testing. A survey was designed and distributed to PAH specialists who primarily work in the USA to assess their knowledge, practices, and attitudes about the genetics of PAH.
Participants’ responses were analyzed using parametric and non-parametric statistics and groups were compared using the Wilcoxon rank sum test. PAH specialists had low perceived and actual knowledge of the genetics of PAH, with 13.2% perceiving themselves as knowledgeable and 27% actually being knowledgeable. Although these specialists had positive or ambivalent attitudes about genetic testing and genetic counseling, they had poor utilization of these genetic services, with almost 80% of participants never or rarely ordering genetic testing or referring their patients with PAH for genetic counseling. Physicians were more knowledgeable, but had lower perceptions of the value of genetic testing and genetic counseling compared to non-physicians (P < 0.05). The results suggest that increased education and awareness is needed about the genetics of PAH as well as the benefits of genetic testing and genetic counseling for individuals who treat patients with PAH.
Lithium is a commonly used drug for the treatment of bipolar disorder. At high doses, lithium becomes teratogenic, which is a property that has allowed this agent to serve as a useful tool for ...dissecting molecular pathways that regulate embryogenesis. This study was designed to examine the impact of lithium on heart formation in the developing frog for insights into the molecular regulation of cardiac specification. Embryos were exposed to lithium at the beginning of gastrulation, which produced severe malformations of the anterior end of the embryo. Although previous reports characterized this deformity as a posteriorized phenotype, histological analysis revealed that the defects were more comprehensive, with disfigurement and disorganization of all interior tissues along the anterior‐posterior axis. Emerging tissues were poorly segregated and cavity formation was decreased within the embryo. Lithium exposure also completely ablated formation of the heart and prevented myocardial cell differentiation. Despite the complete absence of cardiac tissue in lithium treated embryos, exposure to lithium did not prevent myocardial differentiation of precardiac dorsal marginal zone explants. Moreover, precardiac tissue freed from the embryo subsequent to lithium treatment at gastrulation gave rise to cardiac tissue, as demonstrated by upregulation of cardiac gene expression, display of sarcomeric proteins, and formation of a contractile phenotype. Together these data indicate that lithium’s effect on the developing heart was not due to direct regulation of cardiac differentiation, but an indirect consequence of disrupted tissue organization within the embryo.
We tested abortion messaging to develop evidence-based communication recommendations for doctors who provide abortion care.
We conducted an online survey in a nationally representative sample of 1215 ...people, using National Opinion Research Center’s Amerispeak Panel. We surveyed participants before and after viewing two brief videos featuring doctors who provide abortion care speaking about their work. Doctors’ comments were grounded in strategic communications and applied psychology research, and emphasized caregiving roles, avoided political-sounding punditry, and acknowledged abortion’s complexities. We assessed participants’ characterizations of doctors, and how these characterizations impact support for abortion restrictions and views on abortion legality. We analyzed pre–post data using descriptive statistics, t tests, and multivariable regression.
Postmessaging more participants endorsed positive descriptors of doctors who provide abortion care (p < 0.001, t = 8.99); fewer endorsed negative descriptors (p < 0.001, t = 10.32). Increased postmessaging endorsement of positive descriptors predicted declines in support for abortion restrictions (adjusted odds ratio = 1.69, p < 0.01); decreased endorsement of negative descriptors did not. After messaging, 37% of respondents said their views of doctors who provide abortion care made them less likely to support abortion restrictions, compared to 14% before (p < 0.001, t = −6.9). After messaging, there was more overall support for legal abortion and less for abortion being mostly illegal (46% to 48% and 24% to 22%, p < 0.001; t = −4.11).
When doctors who provide abortion care use messaging recommendations that include speaking about abortion’s complexities and avoiding political-sounding punditry, they generate more support for legal abortion and less for restrictions.
The voices of doctors who provide abortion care shape public opinion. When doctors speak from caregiving perspectives, avoid punditry, and acknowledge abortion’s complexities, they generate more support for legal abortion and less for restrictions. However, audiences may not be aware a priori that ideas of doctors shape their views.
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