Emotive responses to ethical challenges in caring:A Malawi perspective

AbstractThis article reports findings of a hermeneutic phenomenological study that explored the clinical learning experience for Malawian undergraduate student nurses. The study revealed issues that touch on both nursing education and practice, but the article mainly reports the practice issues. The findings reveal the emotions that healthcare workers in Malawi encounter as a consequence of practising in resource-poor settings. Furthermore, there is severe nursing shortage in most clinical settings in Malawi, and this adversely affects the performance of nurses because of the excess workload it imposes on them. The results of the study also illustrate loss of professional pride among some of the nurses, and the article argues that such a demeanour is a consequence of burnout. However, despite these problems, the study also reveals that there are some nurses who have maintained their passion to care

The Radiative Corrections to the Mass of the Kink Using an Alternative Renormalization Program

In this paper we compute the radiative correction to the mass of the kink in $\phi^4$ theory in 1+1 dimensions, using an alternative renormalization program. In this newly proposed renormalization program the breaking of the translational invariance and the topological nature of the problem, due to the presence of the kink, is automatically taken into account. This will naturally lead to uniquely defined position dependent counterterms. We use the mode number cutoff in conjunction with the above program to compute the mass of the kink up to and including the next to the leading order quantum correction. We discuss the differences between the results of this procedure and the previously reported ones.Comment: 8 pages, 2 figures. arXiv admin note: substantial text overlap with arXiv:0806.036

Twistor description of spinning particles in AdS

The two-twistor formulation of particle mechanics in D-dimensional anti-de Sitter space for D=4,5,7, which linearises invariance under the AdS isometry group Sp(4;K) for K=R,C,H,, is generalized to the massless N-extended ``spinning particle''. The twistor variables are gauge invariant with respect to the initial N local worldline supersymmetries; this simplifies aspects of the quantum theory such as implications of global gauge anomalies. We also give details of the two-supertwistor form of the superparticle, in particular the massive superparticle on AdS5

Impacts of Unattended Train Operations (UTO) on Productivity and Efficiency in Metropolitan Railways

Urban metro subway systems (metros) around the world are choosing increasing levels of automation for new and existing lines: the global length of metro lines capable of unattended train operation (UTO) is predicted to triple in the next 10 years. Despite significant investment in this technology, empirical evidence for the financial and service quality impacts of UTO in metros remains scarce. This study used questionnaires and semistructured interviews with the Community of Metros and Nova Group benchmarking groups to assemble emerging evidence of how automation affected costs, staffing, service capacity, and reliability. The results from an analysis of data from 23 lines suggested that UTO could reduce staff numbers by 30% to 70%, with the amount of wage cost reduction depending on whether staff on UTO lines were paid more. On the basis of the experience of seven metros, the capital costs of lines capable of UTO were higher, but the internal rate of return had been estimated by two metros at 10% to 15%. Automated lines were capable of operating at the highest service frequencies of up to 42 trains per hour, and the limited available data suggested that automated lines were more reliable. The findings indicated that UTO was a means to a more flexible and reliable operating model that could increase metro productivity and efficiency. The study identified important work needed to understand the impacts of UTO and identify where statistical analyses would add value once sufficiently large data sets became available

Simple and Nearly Optimal Polynomial Root-finding by Means of Root Radii Approximation

We propose a new simple but nearly optimal algorithm for the approximation of all sufficiently well isolated complex roots and root clusters of a univariate polynomial. Quite typically the known root-finders at first compute some crude but reasonably good approximations to well-conditioned roots (that is, those isolated from the other roots) and then refine the approximations very fast, by using Boolean time which is nearly optimal, up to a polylogarithmic factor. By combining and extending some old root-finding techniques, the geometry of the complex plane, and randomized parametrization, we accelerate the initial stage of obtaining crude to all well-conditioned simple and multiple roots as well as isolated root clusters. Our algorithm performs this stage at a Boolean cost dominated by the nearly optimal cost of subsequent refinement of these approximations, which we can perform concurrently, with minimum processor communication and synchronization. Our techniques are quite simple and elementary; their power and application range may increase in their combination with the known efficient root-finding methods.Comment: 12 pages, 1 figur

A survey of people with foot problems related to rheumatoid arthritis and their educational needs

Background Up to 50% of people with rheumatoid arthritis (RA) have foot symptoms at diagnosis, hence early foot health intervention is recommended and this should include patient education. This study identifies, for the first time, the foot health education (FHE) needs of people with RA. Methods An online survey of people with RA (n = 543) captured quantitative data in relation to the aims, methods of delivery, content, timing and accessibility of FHE. Results The majority concurred about the aims of FHE. Verbal delivery and websites were the most common methods. Written and verbal FHE were perceived to be the most effective methods. The point of diagnosis was the preferred time to receive it. Lack of access to FHE included minimal focus on foot health during consultations by both health practitioners and patients with RA. Participant gender, age, disease duration and living situation had a statistically significant influence on the results. Conclusion Foot health education is rarely considered within the medical consultation. There is a lack of patient and/or health professional awareness of this need with a detrimental impact on foot health. Patients require health professionals to identify their foot education health needs. Tailored foot health education should begin at initial diagnosis

Quantum states on supersymmetric minisuperspace with a cosmological constant

Spatially homogeneous models in quantum supergravity with a nonvanishing cosmological constant are studied. A class of exact nontrivial solutions of the supersymmetry and Lorentz constraints is obtained in terms of the Chern-Simons action on the spatially homogeneous 3-manifold, both in Ashketar variables where the solution is explicit up to reality conditions, and, more concretely, in the tetrad-representation, where the solutions are given as integral representations differing only by the contours of integration. In the limit of a vanishing cosmological constant earlier exact solutions for Bianchi type IX models in the tetrad-representation are recovered and additional asymmetric solutions are found.Comment: 14 pages, late

Gaps in detailed knowledge of human papillomavirus (HPV) and the HPV vaccine among medical students in Scotland

<p>Background: A vaccination programme targeted against human papillomavirus (HPV) types16 and 18 was introduced in the UK in 2008, with the aim of decreasing incidence of cervical disease. Vaccine roll out to 12–13 year old girls with a catch-up programme for girls aged up to 17 years and 364 days was accompanied by a very comprehensive public health information (PHI) campaign which described the role of HPV in the development of cervical cancer.</p> <p>Methods: A brief questionnaire, designed to assess acquisition of knowledge of HPV infection and its association to cervical cancer, was administered to two different cohorts of male and female 1st year medical students (school leavers: 83% in age range 17–20) at a UK university. The study was timed so that the first survey in 2008 immediately followed a summer's intensive PHI campaign and very shortly after vaccine roll-out (150 students). The second survey was exactly one year later over which time there was a sustained PHI campaign (213 students).</p> <p>Results: We addressed three research questions: knowledge about three specific details of HPV infection that could be acquired from PHI, whether length of the PHI campaign and/or vaccination of females had any bearing on HPV knowledge, and knowledge differences between men and women regarding HPV. No female student in the 2008 cohort had completed the three-dose vaccine schedule compared to 58.4% of female students in 2009. Overall, participants’ knowledge regarding the sexually transmitted nature of HPV and its association with cervical cancer was high in both year groups. However, in both years, less than 50% of students correctly identified that HPV causes over 90% of cases of cervical cancer. Males gave fewer correct answers for these two details in 2009. In 2008 only around 50% of students recognised that the current vaccine protects against a limited subset of cervical cancer-causing HPV sub-types, although there was a significant increase in correct response among female students in the 2009 cohort compared to the 2008 cohort.</p> <p>onclusions: This study highlights a lack of understanding regarding the extent of protection against cervical cancer conferred by the HPV vaccine, even among an educated population in the UK who could have a vested interest in acquiring such knowledge. The intensive PHI campaign accompanying the first year of HPV vaccination seemed to have little effect on knowledge over time. This is one of the first studies to assess detailed knowledge of HPV in both males and females. There is scope for continued improvements to PHI regarding the link between HPV infection and cervical cancer.</p&gt

Measuring Metacognition in Cancer: Validation of the Metacognitions Questionnaire 30 (MCQ-30)

Objective The Metacognitions Questionnaire 30 assesses metacognitive beliefs and processes which are central to the metacognitive model of emotional disorder. As recent studies have begun to explore the utility of this model for understanding emotional distress after cancer diagnosis, it is important also to assess the validity of the Metacognitions Questionnaire 30 for use in cancer populations. Methods 229 patients with primary breast or prostate cancer completed the Metacognitions Questionnaire 30 and the Hospital Anxiety and Depression Scale pre-treatment and again 12 months later. The structure and validity of the Metacognitions Questionnaire 30 were assessed using factor analyses and structural equation modelling. Results Confirmatory and exploratory factor analyses provided evidence supporting the validity of the previously published 5-factor structure of the Metacognitions Questionnaire 30. Specifically, both pre-treatment and 12 months later, this solution provided the best fit to the data and all items loaded on their expected factors. Structural equation modelling indicated that two dimensions of metacognition (positive and negative beliefs about worry) were significantly associated with anxiety and depression as predicted, providing further evidence of validity. Conclusions These findings provide initial evidence that the Metacognitions Questionnaire 30 is a valid measure for use in cancer populations

Associations between cardiorespiratory fitness, physical activity and clustered cardiometabolic risk in children and adolescents: the HAPPY study

Clustering of cardiometabolic risk factors can occur during childhood and predisposes individuals to cardiometabolic disease. This study calculated clustered cardiometabolic risk in 100 children and adolescents aged 10-14 years (59 girls) and explored differences according to cardiorespiratory fitness (CRF) levels and time spent at different physical activity (PA) intensities. CRF was determined using a maximal cycle ergometer test, and PA was assessed using accelerometry. A cardiometabolic risk score was computed as the sum of the standardised scores for waist circumference, blood pressure, total cholesterol/high-density lipoprotein ratio, triglycerides and glucose. Differences in clustered cardiometabolic risk between fit and unfit participants, according to previously proposed health-related threshold values, and between tertiles for PA subcomponents were assessed using ANCOVA. Clustered risk was significantly lower (p < 0.001) in the fit group (mean 1.21 ± 3.42) compared to the unfit group (mean -0.74 ± 2.22), while no differences existed between tertiles for any subcomponent of PA. Conclusion These findings suggest that CRF may have an important cardioprotective role in children and adolescents and highlights the importance of promoting CRF in youth