The public has shown increasing interst in the interplay of religion, spirtituality, and health, but many physicians are either openly skeptical or unsure how bet to respond. Physicians neet to learn ...to be open to discussing spiritual concerns with their patients; to addressing these issues in a respectful, careful and professional way; and to knowing how and when to refer patients to other members of the helath care tam for spiritual support.
Electroactive polymers (EAPs) are functional materials that, stimulated by an electric field, change its composition or molecular structure so that the material expands, contracts, or bends (Guzmán ...et al. in J Appl Polymer Sci 112:3284–32931, 2009) and (Rappaport et al. in A glucose fuiel cell for implantable brain machine interfaces, Massachusetts Institute of Technology, Cambridge, 2012). The literature has shown that Chitin and Chitosan are considerably versatile and promising biomaterials to be used as EAPs in medical and biomedical applications as cochlear implant, and due to its chemical structure, is considered a biocompatible, bio-adhesive and biodegradable polymer (Falguni et al. in Proceedings of the 2010 IEEE Students Technology Simposium, IIT Kharagpur, 2010). Their amino and hydroxyl groups can be easily modified by organic (Younes et al. in Process Biochem 47:2032–2039, 2012) or cross-linked reactions, to obtain sophisticated functional medical devices (Wongpaint et al. in Micromol Biosci 5:1001–1012, 2005). This research collaboration aims to prove that Chitosan-based membranes could be synthetized as EAPs; as well as determine that there are useful ionic flow and movement responses on them. Chitosan-based membranes were prepared by the film-casting traditional method, treated with Tetraammineplatinum (II) chloride hydrate and Silver Nitrate by the ion exchange polymer method; and then cast with Sodium and Potassium Chloride as conductive salts. Membranes were tested at different voltages, as well as the chemical tests as FTIR, XRD, TGA and tensile strength and elongation as a function of the treatment applied. Film properties depended on its morphology, which is affected by Molecular Weight, degree of
N
-acetylation (DDA%), solvent evaporation and free amine regenerating mechanism (Younes et al. in Process Biochem 47:2032–2039, 2012) and (Wongpaint et al. in Micromol Biosci 5:1001–1012, 2005). Samples exhibited good displacement increasing as the applied voltage increased; best tip displacement was located as 17 mm at 7 V; and best theoretical δ value is found at 29.6 mm.
The State of the Science in Spirituality and Palliative Care was convened to address the current landscape of research at the intersection of spirituality and palliative care and to identify critical ...next steps to advance this field of inquiry. Part II of the SOS-SPC report addresses the state of extant research and identifies critical research priorities pertaining to the following questions: 1) How do we assess spirituality? 2) How do we intervene on spirituality in palliative care? And 3) How do we train health professionals to address spirituality in palliative care? Findings from this report point to the need for screening and assessment tools that are rigorously developed, clinically relevant, and adapted to a diversity of clinical and cultural settings. Chaplaincy research is needed to form professional spiritual care provision in a variety of settings, and outcomes assessed to ascertain impact on key patient, family, and clinical staff outcomes. Intervention research requires rigorous conceptualization and assessments. Intervention development must be attentive to clinical feasibility, incorporate perspectives and needs of patients, families, and clinicians, and be targeted to diverse populations with spiritual needs. Finally, spiritual care competencies for various clinical care team members should be refined. Reflecting those competencies, training curricula and evaluation tools should be developed, and the impact of education on patient, family, and clinician outcomes should be systematically assessed.
Spirituality and health is a growing field of healthcare. It grew out of courses in spirituality and health developed for medical students in the United States. Research in this area over the last 30 ...years has also formed an evidence base for spirituality and health. Studies have demonstrated an association between spiritual beliefs and values and a variety of healthcare outcomes. More recent research has also shown a strong desire on the part of patients to have their spirituality addressed as part of their care. Studies also show that spiritual care has an impact on patient decision making, particularly in end-of-life care. The Association of American Medical Colleges developed a broad definition of spirituality as well as learning objectives and guidelines for teaching. Standards in organizations such as the American College of Physicians support physicians treating the whole person, that is, the body, mind, and spirit. In 2009, National Competencies in Spirituality and Health education were developed in the United States with schools currently working on curriculum projects based on these competencies. Models are being developed for all members of the healthcare team to address patient distress, in cooperation with chaplains as spiritual care experts. The goals are to develop a biopsychosocial and spiritual assessment and treatment as part of compassionate whole-person care of all patients.
REASONS FOR PERFORMING THE STUDY: Distal deep digital flexor tendinopathy is an important cause of foot lameness in horses that is difficult to diagnose with radiography and ultrasonography. Magnetic ...resonance imaging is a well‐accepted and validated technique for the identification of deep digital flexor tendon (DDFT) lesions, but has some practical and financial drawbacks. Contrast‐enhanced computed tomography (CECT) has been proposed as a suitable alternative, but validation studies are currently lacking. OBJECTIVE: To assess the accuracy of CECT for the identification and characterisation of deep digital flexor tendinopathy. STUDY DESIGN: Descriptive study of CT, macroscopic and histological findings of the DDFT. METHODS: Plain and CECT scans were acquired of 23 limbs of 16 horses with clinical lameness localised to the foot. All horses had lesions of the DDFT that were identified and characterised with CT and CECT with respect to their anatomic location and extent. All horses underwent post mortem examination and gross abnormalities were described. Samples of the DDFT were taken at specific sites (lesion and nonlesion) for histological evaluation. Macroscopic and histological outcomes were compared with CECT findings. RESULTS: Of 67 sites in 23 DDFTs that were evaluated, 42 sites in 18 tendons had lesions on CECT images. These 42 sites also had lesions on macroscopic evaluation. There were 3 false negative and 3 false positive results identified on CECT. The sensitivity of CECT for diagnosing lesions of the DDFT in the equine foot was 93%. CONCLUSION: CECT is an effective adjunct to the more commonly used diagnostic techniques in equine foot pain.
First-principles calculations are presented for fundamental vibrational splitting energies of tritium-bearing molecular hydrogen species with the improved treatment of the nonrelativistic, ...relativistic, and quantum electrodynamic energy contributions resulting in a total uncertainty of 0.00011 cm^{−1} for DT, or about a 100-times improvement over previous results. Precision coherent Raman spectroscopic measurements of Q(J=0–5) transitions in DT were performed at an accuracy of <0.0004 cm^{−1}, representing an even larger 250-fold improvement over previous experiments. Perfect agreement between experiment and theory is found, within 1σ, for all six transitions studied.
•This ESMO Clinical Practice Guideline provides key recommendations for end-of-life care for patients with advanced cancer.•It details care that is focused on comfort, quality of life and approaching ...death of patients with advanced cancer.•All recommendations were compiled by a multidisciplinary group of experts.•Recommendations are based on available scientific data and the authors’ collective expert opinion.
Summary
Reasons for performing study: Veterinarians have observed a putative change in the location of humeral stress remodelling in Thoroughbred racehorses with change from dirt to synthetic ...racetrack surfaces.
Objectives: To determine whether the location and severity of humeral stress remodelling differs between Thoroughbred racehorses exercising on dirt and synthetic racetrack surfaces, the potential significance of different locations of stress remodelling, and the potential usefulness of scintigraphy for prevention of complete humeral fracture.
Methods: Scintigraphic images of humeri from 841 Thoroughbred racehorses at 3 racetracks during 2 years before and after conversion from dirt to synthetic surfaces were evaluated for location and severity of lesions. The effects of surface on lesion distributions were examined using Chi‐square or Fisher's exact tests. Archived fractured humeri were examined to determine the location and severity of stress remodelling associated with complete fracture. Databases were queried to determine whether racehorses with scintigraphic lesions suffered humeral fracture and whether racehorses with a complete humeral fracture had had a scintigraphic examination.
Results: Horses at synthetic racetracks had a greater proportion of distal humeral lesions, whereas horses at dirt racetracks had a greater proportion of caudoproximal lesions (P<0.001). Proximal lesions were more likely to be severe than distal lesions (P<0.001). Most complete fractures were associated with caudoproximal lesions, which were more often severe than distal lesions (P = 0.002). None of the horses with a scintigraphic lesion had a complete humeral fracture. None of the horses with a complete humeral fracture underwent scintigraphic examination.
Conclusions: Race surface affected humeral scintigraphic lesion location and hence the location of stress remodelling. Lesion severity was associated with lesion location. Complete humeral fracture was associated with caudoproximal stress remodelling and lack of scintigraphic examination.
Potential relevance: Risk for complete humeral fracture may be lower on synthetic surfaces than on dirt surfaces, and, by inference, for horses examined using scintigraphy.
PDF
