Cancer Rehabilitation: Experience, Symptoms, and Needs

The aim of this study was to examine the experience of cancer patients undergoing rehabilitation, to identify symptoms associated with rehabilitation from cancer, and to assess the need for rehabilitation services for cancer patients. Cancer patients (n = 402) at the Asan Medical Center (Seoul, Korea) were enrolled from June to September 2008. A chart review was used to collect demographic and clinical data, including type of cancer, current treatment, time from initial diagnosis to screening, and cancer stage. Each participant provided informed consent and was then given a questionnaire that asked about experience with rehabilitation, symptoms associated with rehabilitation, and the need for different types of rehabilitation services. Clinicians recommended rehabilitation for 8.5% of patients, and 6.7% underwent rehabilitation. Among study patients, 83.8% had one or more symptoms associated with rehabilitation, and 71.6% of patients with symptoms wanted rehabilitation management. The need for rehabilitation was associated with the presence of metastasis, advanced cancer stage, time to diagnosis, and type of current treatment. Our results provide specific information about particular functional symptoms and the rehabilitative needs of subgroups of cancer patients. It is suggested to develope and implement rehabilitation programs for cancer patients

The conditional inactivation of the β-catenin gene in endothelial cells causes a defective vascular pattern and increased vascular fragility

Using the Cre/loxP system we conditionally inactivated β-catenin in endothelial cells. We found that early phases of vasculogenesis and angiogenesis were not affected in mutant embryos; however, vascular patterning in the head, vitelline, umbilical vessels, and the placenta was altered. In addition, in many regions, the vascular lumen was irregular with the formation of lacunae at bifurcations, vessels were frequently hemorrhagic, and fluid extravasation in the pericardial cavity was observed. Cultured β-catenin −/− endothelial cells showed a different organization of intercellular junctions with a decrease in α-catenin in favor of desmoplakin and marked changes in actin cytoskeleton. These changes paralleled a decrease in cell–cell adhesion strength and an increase in paracellular permeability. We conclude that in vivo, the absence of β-catenin significantly reduces the capacity of endothelial cells to maintain intercellular contacts. This may become more marked when the vessels are exposed to high or turbulent flow, such as at bifurcations or in the beating heart, leading to fluid leakage or hemorrhages

Estresse no trabalho segundo o Modelo Demanda-Controle e distúrbios psíquicos menores em trabalhadores de enfermagem

This was a cross-sectional study that aimed to assess the association between work-related stress according to the Demand-Control Model, and the occurrence of Minor Psychic Disorder (MPD) in nursing workers. The participants were 335 professionals, out of which 245 were nursing technicians, aged predominantly between 20 and 40 years. Data were collected using the Job Stress Scale and the Self-Reporting Questionnaire-20. The analysis was performed using descriptive and analytical statistics. The prevalence of suspected MPD was 20.6%. Workers classified in the quadrants active job and high strain of the Demand-Control Model presented higher potential for developing MPD compared with those classified in the quadrant low strain. In conclusion, stress affects the mental health of workers and the aspects related to high psychological demands and high control still require further insight in order to understand their influence on the disease processes of nursing workers.Estudio transversal cuyo objetivo fue evaluar la asociación entre el estrés laboral, según el Modelo Demanda-Control, y la aparición de Trastorno Psíquico Menor (TPM) en los trabajadores de enfermería. Participaron 335 profesionales, siendo 245 técnicos de enfermería, con edad predominante entre 20 y 40 años. Los datos fueron recolectados utilizándose la Job Stress Scale y el Self-Reporting Questionnaire-20. El análisis se realizó mediante estadística descriptiva y analítica. La prevalencia de probable TPM encontrada fue del 20,6%. Los trabajadores en los cuadrantes trabajo activo y alto desgaste, del modelo demanda-control, presentan probabilidades de desarrollar TPM, en comparación con los situados en el cuadrante bajo desgaste. Se concluye que el estrés afecta la salud mental de los trabajadores y que los aspectos relacionados con la alta demanda psicológica y alto control todavía necesitan de mayores conocimientos para comprender su influencia en los procesos de enfermedad de los trabajadores de enfermería.Estudo transversal cujo objetivo foi avaliar a associação entre o estresse no trabalho, segundo o Modelo Demanda-Controle, e a ocorrência de Distúrbio Psíquico Menor (DPM) nos trabalhadores de enfermagem. Participaram 335 profissionais, sendo 245 técnicos de enfermagem, com idade predominante entre 20 e 40 anos. Os dados foram coletados utilizando-se a Job Stress Scale e o Self-Reporting Questionnaire-20. A análise foi realizada utilizando-se estatística descritiva e analítica. A prevalência de suspeição para DPM encontrada foi de 20,6%. Os trabalhadores nos quadrantes trabalho ativo e alto desgaste, do Modelo Demanda-Controle, apresentaram chances de desenvolver DPM, quando comparados com os situados no quadrante baixo desgaste. Conclui-se que o estresse afeta a saúde mental dos trabalhadores e que os aspectos relacionados a alta demanda psicológica e alto controle ainda necessitam de maiores aprofundamentos para que se entenda sua influência nos processos de adoecimento dos trabalhadores de enfermagem

Work-related stress according to the demand-control model and minor psychic disorders in nursing workers

This was a cross-sectional study that aimed to assess the association between work-related stress according to the Demand-Control Model, and the occurrence of Minor Psychic Disorder (MPD) in nursing workers. The participants were 335 professionals, out of which 245 were nursing technicians, aged predominantly between 20 and 40 years. Data were collected using the Job Stress Scale and the Self-Reporting Questionnaire-20. The analysis was performed using descriptive and analytical statistics. The prevalence of suspected MPD was 20.6%. Workers classified in the quadrants active job and high strain of the Demand-Control Model presented higher potential for developing MPD compared with those classified in the quadrant low strain. In conclusion, stress affects the mental health of workers and the aspects related to high psychological demands and high control still require further insight in order to understand their influence on the disease processes of nursing workers

Fuzzy evidence theory and Bayesian networks for process systems risk analysis

YesQuantitative risk assessment (QRA) approaches systematically evaluate the likelihood, impacts, and risk of adverse events. QRA using fault tree analysis (FTA) is based on the assumptions that failure events have crisp probabilities and they are statistically independent. The crisp probabilities of the events are often absent, which leads to data uncertainty. However, the independence assumption leads to model uncertainty. Experts’ knowledge can be utilized to obtain unknown failure data; however, this process itself is subject to different issues such as imprecision, incompleteness, and lack of consensus. For this reason, to minimize the overall uncertainty in QRA, in addition to addressing the uncertainties in the knowledge, it is equally important to combine the opinions of multiple experts and update prior beliefs based on new evidence. In this article, a novel methodology is proposed for QRA by combining fuzzy set theory and evidence theory with Bayesian networks to describe the uncertainties, aggregate experts’ opinions, and update prior probabilities when new evidences become available. Additionally, sensitivity analysis is performed to identify the most critical events in the FTA. The effectiveness of the proposed approach has been demonstrated via application to a practical system.The research of Sohag Kabir was partly funded by the DEIS project (Grant Agreement 732242)

Utilising Bayesian networks to demonstrate the potential consequences of a fuel gas release from an offshore gas-driven turbine

This research proposes the application of Bayesian networks in conducting quantitative risk assessment of the integrity of an offshore gas driven turbine, used for electrical power generation. The focus of the research is centred on the potential release of fuel gas from a turbine and the potential consequences that follow the said release, such as fire, explosion and damage to equipment within the electrical generation module. The Bayesian network demonstrates the interactions of potential initial events and failures, hazards, barriers and consequences involved in a fuel gas release. This model allows for quantitative analysis to demonstrate partial verification of the model. The verification of the model is demonstrated in a series of test cases and through sensitivity analysis. Test case 1 demonstrates the effects of individual and combined control system failures within the fuel gas release model; 2 demonstrates the effects of the 100% probability of a gas release on the Bayesian network model, along with the effect of the gas detection system not functioning; and 3 demonstrates the effects of inserting evidence as a consequence and observing the effects on prior nodes.© IMechE 2018

Model-based assessment of energy-efficiency, dependability, and cost-effectiveness of waste heat recovery systems onboard ship

YesTechnological systems are not merely designed with a narrow function in mind. Good designs typically aim at reducing operational costs, e.g. through achieving high energy efficiency and improved dependability (i.e. reliability, availability and maintainability). When there is a choice of alternative design options that perform the same function, it makes sense to compare alternatives so that the variant that minimises operational costs can be selected. In this paper, we examine this issue in the context of the design of Waste Heat Recovery Systems (WHRS) for main engines of large commercial freight vessels. We propose a method that can predict the operational cost of a WHRS via thermodynamic analysis which shows costs related to energy utilisation, and dependability analysis which shows costs related to system unavailability and repair. Our approach builds on recent advances in thermodynamic simulation and compositional dependability analysis techniques. It is a model-based approach, and allows reuse of component libraries, and a high degree of automation which simplify application of the method. Our case study shows that alternative designs can be explored in fast iterations of this method, and that this facilitates the evidence-based selection of a design that minimises operational costs

OREDA offshore and onshore reliability data

This handbook presents high quality reliability data for offshore equipment collected during phase VI to IX (project period 2000 – 2009) of the OREDA project. The intention of the handbook is to provide both quantitative and qualitative information as a basis for Performance Forecasting or RAMS (Reliability, Availability, Maintainability and Safety) analyses. Volume 1 is about Topside Equipment. Compared to earlier editions, there are only minor changes in the reliability data presentation. To obtain a reasonable population for presenting reliability data for topside equipment in the 2015 edition, some data from phases VI and VII already issued in the previous 2009 handbook (5th edition) have also been included. The 2015 topside volume is divided into two parts. Part I describes the OREDA project, different data collection phases and the estimation procedures used to generate the data tables presented in Part II of the handbook. Topside data are in general not covering the whole lifetime of equipment, but typically a time window of 2 – 4 years of operation. Infant mortality failures are as a rule not collected for topside equipment; hence, the data collected are from the normal steady-state operating time period