SCUBA photometry of candidate Vega-like sources

New SCUBA measurements at millimetre wavelengths are presented for a sample of Vega-like stars. Six stars were detected, while sensitive upper limits were obtained for a further 11 sources. Most of the sample selected from a recent catalogue of Vega-like stars have infrared excesses similar to those of the prototype Vega-like stars α Lyr and α PsA. Their IR–submm spectral indices are steep, indicating that the submm emission from the discs is dominated by grains which are smaller than the wavelength of observation and that only small grains exist in those dusty discs. HD 98800 has an IR–submillimetre spectral index of less than two, which suggests that grains have grown to more than 0.3 mm in size. Hipparcos parallax data for HD 42137 and HD 123160 suggest that these two stars are giants rather than dwarfs, similar to the situation previously found for HD 233517. Dust masses, or upper limits, were derived for the sample; these indicate that most of the sources do not have as much dust as Herbig Ae/Be or T Tauri stars, but are likely to have dust masses comparable to those of the prototype Vega-like stars

Comparing Dutch Case management care models for people with dementia and their caregivers: The design of the COMPAS study

<p>Abstract</p> <p>Background</p> <p>Dementia care in the Netherlands is shifting from fragmented, ad hoc care to more coordinated and personalised care. Case management contributes to this shift. The linkage model and a combination of intensive case management and joint agency care models were selected based on their emerging prominence in the Netherlands. It is unclear if these different forms of case management are more effective than usual care in improving or preserving the functioning and well-being at the patient and caregiver level and at the societal cost. The objective of this article is to describe the design of a study comparing these two case management care models against usual care. Clinical and cost outcomes are investigated while care processes and the facilitators and barriers for implementation of these models are considered.</p> <p>Design</p> <p>Mixed methods include a prospective, observational, controlled, cohort study among persons with dementia and their primary informal caregiver in regions of the Netherlands with and without case management including a qualitative process evaluation. Inclusion criteria for the cohort study are: community-dwelling individuals with a dementia diagnosis who are not terminally-ill or anticipate admission to a nursing home within 6 months and with an informal caregiver who speaks fluent Dutch. Person with dementia-informal caregiver dyads are followed for two years. The primary outcome measure is the Neuropsychiatric Inventory for the people with dementia and the General Health Questionnaire for their caregivers. Secondary outcomes include: quality of life and needs assessment in both persons with dementia and caregivers, activity of daily living, competence of care, and number of crises. Costs are measured from a societal perspective using cost diaries. Process indicators measure the quality of care from the participant’s perspective. The qualitative study uses purposive sampling methods to ensure a wide variation of respondents. Semi-structured interviews with stakeholders based on the theoretical model of adaptive implementation are planned.</p> <p>Discussion</p> <p>This study provides relevant insights into care processes, description of two case management models along with clinical and economic data from persons with dementia and caregivers to clarify important differences in two case management care models compared to usual care.</p

Evaluating teaching effectiveness in nursing education:An Iranian perspective

BACKGROUND: The main objective of this study was to determine the perceptions of Iranian nurse educators and students regarding the evaluation of teaching effectiveness in university-based programs. METHODS: An exploratory descriptive design was employed. 143 nurse educators in nursing faculties from the three universities in Tehran, 40 undergraduate, and 30 graduate students from Tehran University composed the study sample. In addition, deans from the three nursing faculties were interviewed. A researcher-developed questionnaire was used to determine the perceptions of both faculty and students about evaluating the teaching effectiveness of nurse educators, and an interview guide was employed to elicit the views of deans of faculties of nursing regarding evaluation policies and procedures. Data were analyzed using parametric and nonparametric statistics to identify similarities and differences in perceptions within the Iranian nurse educator group and the student group, and between these two groups of respondents. RESULTS: While faculty evaluation has always been a major part of university based nursing programs, faculty evaluation must be approached more analytically, objectively, and comprehensively to ensure that all nursing educators receive the fairest treatment possible and that the teaching-learning process is enhanced. CONCLUSION: Educators and students stressed that systematic and continuous evaluation as well as staff development should be the primary goals for the faculty evaluation process. The ultimate goals is the improvement of teaching by nurse educators

Measuring student attitude and knowledge in technology-rich biology classrooms

The use of technology in schools is now ubiquitous, but the effectiveness on the learning environment has mixed results. This paper describes the development and validation of an instrument to measure students’ attitudes toward and knowledge of technology with the aim of investigating any differences based on gender after a course where the science department made use of technology as an integral part of teaching biology. In this study, conducted in one school in the state of New York, in the United States of America, the Students’ Attitudes Toward and Knowledge of Technology Questionnaire was administered to nearly 700 high school science students. A principal component and principal factor analysis resulted in new scales from the validation of the instrument that demonstrated high reliabilities. There were statistically significant gender differences in all the scales of the questionnaire in favor of males

The value of haptic feedback in conventional and robot-assisted minimal invasive surgery and virtual reality training: a current review

BACKGROUND: Virtual reality (VR) as surgical training tool has become a state-of-the-art technique in training and teaching skills for minimally invasive surgery (MIS). Although intuitively appealing, the true benefits of haptic (VR training) platforms are unknown. Many questions about haptic feedback in the different areas of surgical skills (training) need to be answered before adding costly haptic feedback in VR simulation for MIS training. This study was designed to review the current status and value of haptic feedback in conventional and robot-assisted MIS and training by using virtual reality simulation. METHODS: A systematic review of the literature was undertaken using PubMed and MEDLINE. The following search terms were used: Haptic feedback OR Haptics OR Force feedback AND/OR Minimal Invasive Surgery AND/OR Minimal Access Surgery AND/OR Robotics AND/OR Robotic Surgery AND/OR Endoscopic Surgery AND/OR Virtual Reality AND/OR Simulation OR Surgical Training/Education. RESULTS: The results were assessed according to level of evidence as reflected by the Oxford Centre of Evidence-based Medicine Levels of Evidence. CONCLUSIONS: In the current literature, no firm consensus exists on the importance of haptic feedback in performing minimally invasive surgery. Although the majority of the results show positive assessment of the benefits of force feedback, results are ambivalent and not unanimous on the subject. Benefits are least disputed when related to surgery using robotics, because there is no haptic feedback in currently used robotics. The addition of haptics is believed to reduce surgical errors resulting from a lack of it, especially in knot tying. Little research has been performed in the area of robot-assisted endoscopic surgical training, but results seem promising. Concerning VR training, results indicate that haptic feedback is important during the early phase of psychomotor skill acquisitio

Pilot parallel randomised controlled trial of protective socks against usual care to reduce skin tears in high risk people: 'STOPCUTS'.

Skin tears are common in older adults and those taking steroids and warfarin. They are traumatic, often blunt injuries caused by oblique knocks to the extremities. The epidermis may separate from the dermis or both layers from underlying tissues leaving a skin flap or total loss of tissue, which is painful and prone to infection. 'Dermatuff™' knee-length socks containing Kevlar fibres (used in stab-proof vests and motorcyclists' clothing) aim to prevent skin tears. The acceptability of the socks and the feasibility of a randomised controlled trial (RCT) had not been explored.Royal Devon & Exeter NHS Foundation TrustThis article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's site.NIHR Research for Patient BenefitEDGE Project ID: 1854

Informal caregiver burden in middle-income countries Results from Memory Centers in Lima - Peru

Objective: The aim of this study was to evaluate caregiver burden based on Zarit Burden Interview (ZBI) and depression in caregivers on the Beck Depression Inventory-II (BDI-II). Methods: Literate individuals, 18 years or older, who spoke Spanish as their native language were included. Demographic characteristics: Age, sex, education, relationship to person with dementia, length of time caregiving, other sources of help for caring, impact on the household economy, family support, and perception of impaired health; and Clinical data on care-recipients: type of dementia, time since diagnosis, treatment, and Global Deterioration Scale (GDS); the ZBI and BDI-II. Descriptive and analytical statistics were employed to assess caregiver burden and predictors of higher burden in caregivers. Results: A total of 92 informal caregivers were evaluated. Regarding care-recipients, 75% were 69 years old or over, 75% had at least one year since diagnosis, 73.9% had Alzheimer’s disease, 84.8% received treatment, 75% scored 5 or over on the GDS. For caregivers, 75% were 55.5 years old or over, predominantly female (81.5%), married (83.7%), the spouse of care-recipients (60.87%), had at least 10 years of education (75.0%) and one year of caregiving (75%), reduced entertainment time (90.2%) and self-perception of impaired health (83.7%). Median score on the ZBI was 37.5 (minimum value = 3; and maximum value = 74). The coefficient of BDI was 1.38 (p-value <0.001). Conclusion: This sample of Peruvian informal caregivers showed elevated ZBI values. Self-perception of worsened health, repercussion on the family economy and time caregiving were the main determinants of ZBI, although only BDI was a consistent predictor of ZBI

High-resolution spectroscopy of Vega-like stars .1. Effective temperatures, gravities and photospheric abundances

Vega-like stars are young main-sequence stars exhibiting an excess emission of infrared radiation. Modelling this excess depends not only on the parameters assigned to the grains, but on those assigned to the stars themselves. In an effort to update and improve the information available on this class of star, we have analysed 13 stars classed as Vega-like, having an infrared excess attributable to dust emission, along with two spectral standards which have also been found to show excess emission from dust. In this, the first of two papers, we derive stellar properties (spectral type, effective temperature and log g) and photospheric abundances. The spectral types derived revealed that one of the sample was a luminosity class III giant, ruling it out of the Vega-like class, and two others underwent a significant reclassification. The remainder had their type confirmed. All but two programme stars have been found to be emission-line stars — their emission-line properties are discussed in Paper II. Attention has recently been drawn to the possible link between Vega-like stars and the photospheric metal-depleted class of A-type stars, the λ Boötis stars. These latter stars are hypothesized to have obtained their underabundances by the accretion of depleted circum-stellar gas on to the photosphere of the star. Since Vega-like stars are expected to have discs of dust, it might be expected that accretion may cause this same phenomenon. We have analysed four A-type stars in our sample and two A-type standards, deriving photospheric abundances for up to 10 elements. No pattern of underabundance similar to λ Boötis stars was found, although a depletion of silicon was found in two stars (up to 0.86 dex below solar) and of magnesium in one star (0.56 dex lower). The depletion could be attributable to the accretion of those elements on to grains in the circumstellar environment of these stars

Medical students' learning of the consultation and the patient-doctor relationship

Background: In medical education, learning about the consultation and the patient-doctor relationship is nowadays highly recommended. However, research from educational practice from students’ perspective is needed to facilitate a better understanding of students’ learning. The thesis is based on four studies. Aims: The overall aims were to study and analyse medical students’ learning of the consultation and patient-doctor relationship. Specific aims were to analyse students’ descriptive evaluations of a Consultation skills course and course development over five years (I), to explore final-year students’ abilities to communicate with patients (II), to analyse final-year students’ written reflective accounts of a memorable consultation (III), to assess students’ patient-centred attitudes at various stages of undergraduate medical education and to explore the association between patient-centred attitudes and gender, age and work experience in health care (IV). Method: A qualitative content analysis method was used in studies I-III, covering term 5 and term 10 (T5, T10). T5 students’ descriptive evaluations and teachers’ documentation were analysed 1995-1999. Experienced supervisors assessed T10 students’ communication abilities in video consultations with patients and supervisors’ focus group meetings were analysed. T10 students’ written reflective accounts of a memorable consultation were analysed. A cross-sectional study of students’ patient-centred attitudes was performed across the curriculum by an internationally validated instrument (Patient-Practitioner Orientation Scale, PPOS). Students’ gender, age and earlier work experience in health care were also collected and analysed statistically. Results: Learning of the consultation was facilitated when the T5 student was active in practice and could have a choice, by a link between explicit learning goals, learning activities and an examination in practice including feedback. Students’ descriptions of awareness and confidence corresponded to a strengthened relation with the facilitator and reflection. In exploring T10 students’ video consultations, an instrumental strategy was suggested as a stage in students’ consultation training. However, analysis of T10 students’ written reflective accounts of a memorable consultation displayed a view of the patient as a person beyond symptoms, an insight into the complexity of medical work and students’ search for a professional role. In contrast to previous reports, no decline of students’ patient-centred attitudes at the end of education was found. Independent of age or work experience in health care, female students had higher PPOS scores compared to men. Female students also had significantly more work experience in health care. Conclusions: Students’ learning of the skills and attitudes needed for the consultation and the patient-doctor relationship is complex. Senior students display patient-centeredness in writing but might have difficulties in integrating their know-how with the performance of physician’s clinical tasks. Learning the consultation and the patient –doctor relationship is suggested to benefit from integrating a patient-centred perspective in a student-centred learning relationship through clinical education; and by adopting a process-oriented and experience-based model including feedback and reflection