788 research outputs found
Tool Measures Depths of Defects on a Case Tang Joint
A special-purpose tool has been developed for measuring the depths of defects on an O-ring seal surface. The surface lies in a specially shaped ringlike fitting, called a capture feature tang, located on an end of a cylindrical segment of a case that contains a solid-fuel booster rocket motor for launching a space shuttle. The capture feature tang is a part of a tang-and-clevis, O-ring joint between the case segment and a similar, adjacent cylindrical case segment. When the segments are joined, the tang makes an interference fit with the clevis and squeezes the O-ring at the side of the gap
Studies of thermionic materials for space power applications informal monthly report, oct. 1 - oct. 31, 1963
Thermionic space power material - isostatic pressing, vapor deposited tungsten, high temperature properties, cesium thermionic cell life testing, and irradiation studie
Enhancing the experience of carers in the chemotherapy outpatient setting: an exploratory randomised controlled trial to test impact, acceptability and feasibility of a complex intervention co-designed by carers and staff
PurposeSupporting someone through chemotherapy can be emotionally and physically demanding. However, research has yet to establish the type of support carers require or the best way to provide this. This study tested the feasibility and acceptability of a complex intervention for carers that was co-designed by staff and carers of patients starting chemotherapy.MethodsForty-seven carers were recruited, randomised between the intervention (n?=?24) and control (n?=?23) groups. A questionnaire was completed pre- and post-intervention measuring knowledge of chemotherapy and its side effects, experience of care, satisfaction with outpatient services, coping and emotional wellbeing. The intervention process was evaluated by carers and healthcare professionals (HCPs) in focus groups.ResultsRecruitment to the study was unproblematic and attrition from it was low, suggesting the intervention and study processes were acceptable to patients and carers. Carers in receipt of the ‘Take Care’ intervention reported statistically significantly better understanding of symptoms and side effects and their information needs being more frequently met than carers in the control. Confidence in coping improved between baseline and follow-up for the intervention group and declined for the control although differences were insufficient to achieve statistical significance. There was no significant difference between the two groups’ emotional wellbeing. HCP and carer focus groups confirmed the feasibility and acceptability of the intervention.ConclusionsThe ‘Take Care’ intervention proved acceptable to carers and HCPs and demonstrates considerable promise and utility in practice. Study findings support the conduct of a fully powered RCT to determine the intervention’s effectiveness and cost-effectiveness
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Cancer survivors' experience with telehealth: A systematic review and thematic synthesis
Background: Net survival rates of cancer are increasing worldwide, placing a strain on health service provision. There is a drive to transfer the care of cancer survivors—individuals living with and beyond cancer—to the community and encourage them to play an active role in their own care. Telehealth, the use of technology in remote exchange of data and communication between patients and health care professionals (HCPs), is an important contributor to this evolving model of care. Telehealth interventions are “complex,” and understanding patient experiences of them is important in evaluating their impact. However, a wider view of patient experience is lacking as qualitative studies detailing cancer survivor engagement with telehealth are yet to be synthesized.
Objective: To systematically identify, appraise, and synthesize qualitative research evidence on the experiences of adult cancer survivors participating in telehealth interventions, to characterize the patient experience of telehealth interventions for this group.
Methods: Medline (PubMed), PsychINFO, Cumulative Index for Nursing and Allied Health Professionals (CINAHL), Embase, and Cochrane Central Register of Controlled Trials were searched on August 14, 2015, and March 8, 2016, for English-language papers published between 2006 and 2016. Inclusion criteria were as follows: adult cancer survivors aged 18 years and over, cancer diagnosis, experience of participating in a telehealth intervention (defined as remote communication or remote monitoring with an HCP delivered by telephone, Internet, or hand-held or mobile technology), and reporting qualitative data including verbatim quotes. An adapted Critical Appraisal Skill Programme (CASP) checklist for qualitative research was used to assess paper quality. The results section of each included article was coded line by line, and all papers underwent inductive analysis, involving comparison, reexamination, and grouping of codes to develop descriptive themes. Analytical themes were developed through an iterative process of reflection on, and interpretation of, the descriptive themes within and across studies.
Results: Across the 22 included papers, 3 analytical themes emerged, each with 3 descriptive subthemes: (1) influence of telehealth on the disrupted lives of cancer survivors (convenience, independence, and burden); (2) personalized care across physical distance (time, space, and the human factor); and (3) remote reassurance—a safety net of health care professional connection (active connection, passive connection, and slipping through the net). Telehealth interventions represent a convenient approach, which can potentially minimize treatment burden and disruption to cancer survivors’ lives. Telehealth interventions can facilitate an experience of personalized care and reassurance for those living with and beyond cancer; however, it is important to consider individual factors when tailoring interventions to ensure engagement promotes benefit rather than burden.
Conclusions: Telehealth interventions can provide cancer survivors with independence and reassurance. Future telehealth interventions need to be developed iteratively in collaboration with a broad range of cancer survivors to maximize engagement and benefit
Hypoxia induces dilated cardiomyopathy in the chick embryo: mechanism, intervention, and long-term consequences
Background: Intrauterine growth restriction is associated with an increased future risk for developing cardiovascular diseases. Hypoxia in utero is a common clinical cause of fetal growth restriction. We have previously shown that chronic hypoxia alters cardiovascular development in chick embryos. The aim of this study was to further characterize cardiac disease in hypoxic chick embryos. Methods: Chick embryos were exposed to hypoxia and cardiac structure was examined by histological methods one day prior to hatching (E20) and at adulthood. Cardiac function was assessed in vivo by echocardiography and ex vivo by contractility measurements in isolated heart muscle bundles and isolated cardiomyocytes. Chick embryos were exposed to vascular endothelial growth factor (VEGF) and its scavenger soluble VEGF receptor-1 (sFlt-1) to investigate the potential role of this hypoxia-regulated cytokine. Principal Findings: Growth restricted hypoxic chick embryos showed cardiomyopathy as evidenced by left ventricular (LV) dilatation, reduced ventricular wall mass and increased apoptosis. Hypoxic hearts displayed pump dysfunction with decreased LV ejection fractions, accompanied by signs of diastolic dysfunction. Cardiomyopathy caused by hypoxia persisted into adulthood. Hypoxic embryonic hearts showed increases in VEGF expression. Systemic administration of rhVEGF165 to normoxic chick embryos resulted in LV dilatation and a dose-dependent loss of LV wall mass. Lowering VEGF levels in hypoxic embryonic chick hearts by systemic administration of sFlt-1 yielded an almost complete normalization of the phenotype. Conclusions/Significance: Our data show that hypoxia causes a decreased cardiac performance and cardiomyopathy in chick embryos, involving a significant VEGF-mediated component. This cardiomyopathy persists into adulthood
Rating general practitioner consultation performance in cancer care: Does the specialty of assessors matter? A simulated patient study
Background: Patients treated for prostate cancer may present to general practitioners (GPs) for treatment follow up, but may be reticent to have their consultations recorded. Therefore the use of simulated patients allows practitioner consultations to be rated. The aim of this study was to determine whether the speciality of the assessor has an impact on how GP consultation performance is rated.
Methods: Six pairs of scenarios were developed for professional actors in two series of consultations by GPs. The scenarios included: chronic radiation proctitis, Prostate Specific Antigen (PSA) ‘bounce’, recurrence of cancer, urethral stricture, erectile dysfunction and depression or anxiety. Participating GPs were furnished with the patient’s past medical history, current medication, prostate cancer details and treatment, details of physical examinations. Consultations were video recorded and assessed for quality by two sets of assessors- a team of two GPs and two Radiation Oncologists deploying the Leicester Assessment Package (LAP). LAP scores by the GPs and Radiation Oncologists were compared.
Results: Eight GPs participated. In Series 1 the range of LAP scores by GP assessors was 61%-80%, and 67%-86% for Radiation Oncologist assessors. The range for GP LAP scores in Series 2 was 51%- 82%, and 56%-89% for Radiation Oncologist assessors. Within GP assessor correlations for LAP scores were 0.31 and 0.87 in Series 1 and 2 respectively. Within Radiation Oncologist assessor correlations were 0.50 and 0.72 in Series 1 and 2 respectively. Radiation Oncologist and GP assessor scores were significantly different for 4 doctors and for some scenarios. Anticipatory care was the only domain where GPs scored participants higher than Radiation Oncologist assessors.
Conclusion: The assessment of GP consultation performance is not consistent across assessors from different disciplines even when they deploy the same assessment tool
Challenges and new opportunities for detecting endogenous opioid peptides in reward
The endogenous opioid peptide system, comprised of enkephalins, endorphins, dynorphins, and nociceptin, is a highly complex neurobiological system. Opioid peptides are derived from four precursor molecules and undergo several processing events yielding over 20 unique opioid peptides. This diversity together with lo
Accretion of Warm Chondrules in Weakly Metamorphosed Ordinary Chondrites and Their Subsequent Reprocessing
To better understand chondrite accretion and subsequent processes, the textures, crystallography, deformation, and compositions of some chondrite constituents in ten lithologies of different cluster texture strength were studied in seven weakly metamorphosed (Type 3) and variably shocked ordinary chondrites (Ragland—LL3 S1, Tieschitz—H/L3 S1, NWA 5421—LL3 S2, NWA 5205—LL3 S2, NWA 11905—LL3-5 S3, NWA 5781—LL3 S3, NWA 11351—LL3-6 S4) using optical and electron microscopy and microtomography techniques. Results support a four-stage model for chondrite formation. This includes 1) limited annealing following collisions during chondrule crystallization and rapid cooling in space prior to accretion, as evidenced by olivine microstructures consistent with dislocation recovery and diffusion; 2) initial accretion of still-warm chondrules into aggregates at an effective chondrite accretion temperature of ∼900-950 °C with nearly in situ impingement deformation between adjacent chondrules in strongly clustered lithologies (NWA 5781, Tieschitz, NWA 5421, NWA 5205 Lithology A), as evidenced by intragranular lattice distortions in olivine consistent with high-temperature slip systems, and by evidence that some olivine-rich objects in Tieschitz accreted while partly molten; 3) syn- or post-accretion bleaching of chondrule mesostases, which transferred feldspathic chondrule mesostasis to an interchondrule glass deposit found in strongly clustered lithologies, as evidenced by chemical data and textures; and 4) post-bleaching weak or strong shocks that resulted in destruction of interchondrule glass and some combination of brecciation, foliation of metal and sulfide, and melting and shock-overprinting effects, as evidenced by poor cluster textures and presence of clastic texture, alignment of metal and sulfide grains caused by shock compression, presence of impact-generated glass, and changes in olivine slip systems. The data support the model of Metzler (2012), who suggested that chondrules in ordinary chondrites accreted while still warm to form cluster chondrite textures as a “primary accretionary rock” (our Stage 2), and that subsequent brecciation destroyed this texture to create chondrites with weak cluster texture (our Stage 4)
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