Contributors to Surgical In-patient Satisfaction—Development and Reliability of a Targeted Instrument

ObjectivePatient satisfaction is an important indicator of healthcare system performance. High patient satisfaction is associated with greater trust in caregivers, improved compliance with treatment recommendations and a better quality of life (QOL). There are few validated instruments to measure surgical patients' satisfaction. The aim of this study was to develop a culturally-specific patient satisfaction instrument, for use as an outcome measure in evaluating surgical services.DesignPatient focus groups were convened to explore dimensions of the peri-operative hospital experience. Forums uncovered pertinent domains of interest and identified terminology understood by patients. A preliminary set of items reflecting patient satisfaction was developed. Test-retest reliability of a new surgical patient satisfaction instrument was assessed in 42 subjects at hospital discharge.ResultsDomains that emerged included; admission processes and hospital environment, information provision, nursing care, doctor and nurse interaction, and ancillary staff services. Staff attitudes and human qualities were highly valued, as was prompt attention to requests for assistance. Clarity or quality of medical information did not appear to influence in-patient satisfaction. A new measure of surgical patient satisfaction, Hong Kong Index of Inpatient Happiness (HK2Happ), was developed from focus group consultation. Test-retest generated an Intra Class Correlation of 0.868–0.935, indicating a highly stable tool.ConclusionsThe initial version of HK2Happ was reliable in assessing surgical patient satisfaction. The measure is now undergoing validity testing across different surgical patient populations for generalisation and generation of a short form of discriminant items

Auto-tracking system for human lumbar motion analysis

Previous lumbar motion analyses suggest the usefulness of quantitatively characterizing spine motion. However, the application of such measurements is still limited by the lack of user-friendly automatic spine motion analysis systems. This paper describes an automatic analysis system to measure lumbar spine disorders that consists of a spine motion guidance device, an X-ray imaging modality to acquire digitized video fluoroscopy (DVF) sequences and an automated tracking module with a graphical user interface (GUI). DVF sequences of the lumbar spine are recorded during flexion-extension under a guidance device. The automatic tracking software utilizing a particle filter locates the vertebra-of-interest in every frame of the sequence, and the tracking result is displayed on the GUI. Kinematic parameters are also extracted from the tracking results for motion analysis. We observed that, in a bone model test, the maximum fiducial error was 3.7%, and the maximum repeatability error in translation and rotation was 1.2% and 2.6%, respectively. In our simulated DVF sequence study, the automatic tracking was not successful when the noise intensity was greater than 0.50. In a noisy situation, the maximal difference was 1.3 mm in translation and 1° in the rotation angle. The errors were calculated in translation (fiducial error: 2.4%, repeatability error: 0.5%) and in the rotation angle (fiducial error: 1.0%, repeatability error: 0.7%). However, the automatic tracking software could successfully track simulated sequences contaminated by noise at a density ≤ 0.5 with very high accuracy, providing good reliability and robustness. A clinical trial with 10 healthy subjects and 2 lumbar spondylolisthesis patients were enrolled in this study. The measurement with auto-tacking of DVF provided some information not seen in the conventional X-ray. The results proposed the potential use of the proposed system for clinical applications. © 2011 - IOS Press and the authors. All rights reserved.postprin

Vulnerable Users’ Perceptions of Transport Technologies

As the global population continues to grow, age and urbanize, it is vital to provide accessible transport so that neither ageing nor disability constitute barriers to social inclusion. While technology can enhance urban access, there is a need to study the ways by which transport technologies - real-time information, pedestrian navigation, surveillance, and road pricing - could be more effectively adopted by users. The reason for this is that some people, and particularly vulnerable populations, are still likely to reluctantly use (or even avoid using) technologies perceived as 'unknown' and 'complicated'. Based on evidence from British and Swedish case studies on older people's perceptions of the aforementioned transport technologies, as well as on a Swedish case study of visually impaired people's perceptions, this article makes the case that technology is only one tool in a complex socio-technical system, and one which brings challenges. The authors also suggest that although vulnerable populations are not homogeneous when expressing attitudes towards transport technologies, their assessment criteria tend to be 'pro-social' as they usually consider that the societal benefits outweigh the personal benefits. Emphasising aspects linked to the technologies' pro-social potential or relevance to the individual user could increase acceptance

Gendered time in Swedish family farming

Purpose - The agricultural sector has undergone extensive changes in the 20-30 years since the peak academic debate on family farming. Still today, the understanding and concept of family farming has political implications in the processes of rural and agricultural policy. The purpose of this paper is to study the development of agrarian structure by analysing the gendered and family relations of family farming. Design/methodology/approach - This paper examines the concept of the family farm and its utilisation and diversity in the current Swedish agricultural sector from a gender perspective, using empirical data from the Farm Accountancy Data Network. The paper operationalises a situated agrarian typology and examines the gendered position and temporalities of family farms in Sweden, based on patterns of labour use. Findings - A workable, fruitful typology of the agrarian structure suitable for future comparative studies is revealed. It also demonstrates the gendered time in the farm labour process, the different temporalities involved and their interconnection between gender, family and various spheres. The spatial and geographical implications, as well as the increased dependence on family and hired labour in different farm types, are emphasised. Originality/value - The focus of this study contributes to the understanding of spatial-temporal relations of family farm business and organisation in general and in Sweden particularly. It also provides empirical basis for developing and gender mainstreaming rural and agricultural policies

High Energy Resolution-X-ray Absorption Near Edge Structure Spectroscopy Reveals Zn Ligation in Whole Cell Bacteria

Identifying the zinc (Zn) ligation and coordination environment in complex biological and environmental systems is crucial to understand the role of Zn as a biologically essential but sometimes toxic metal. Most studies on Zn coordination in biological or environmental samples rely on the extended X-ray absorption fine structure (EXAFS) region of a Zn K-edge X-ray absorption spectroscopy (XAS) spectrum. However, EXAFS analysis cannot identify unique nearest neighbors with similar atomic number (i.e., O versus N) and provides little information on Zn ligation. Herein, we demonstrate that high energy-resolution X-ray absorption near edge structure (HR-XANES) spectroscopy enables the direct determination of Zn ligation in whole cell bacteria, providing additional insights lost from EXAFS analysis at a fraction of the scan time and Zn concentration. HR-XANES is a relatively new technique that has improved our understanding of trace metals (e.g., Hg, Cu, and Ce) in dilute systems. This study is the first to show that HR-XANES can unambiguously detect Zn coordination to carboxyl, phosphoryl, imidazole, and/or thiol moieties in model microorganisms

Contribution of Alaskan glaciers to sea level rise derived from satellite imagery

International audienceOver the last 50 years, retreating glaciers and ice caps (GIC) contributed 0.5 mm/yr to sea level rises (SLR), and one third is believed to originate from ice masses bordering the Gulf of Alaska. However, these estimates of ice wastage in Alaska are based on methods that measure a limited number of glaciers and extrapolate the results to estimate ice loss for the many thousands of others. How these methods capture the complex pattern of decadal elevation changes at the scale of individual glacier and mountain range is unclear. Here, combining a comprehensive glacier inventory with elevation changes derived from sequential digital elevation models (DEMs), we found that, between 1962 and 2006, Alaskan glaciers lost 41.9 ± 8.6 km**3/yr water equivalent (w.e.) and contributed 0.12±0.02 mm/yr to SLR. Our ice loss is 34% lower than previous estimates. Reasons for our lower values include the higher spatial resolution of our glacier inventory and the reduction of ice thinning under debris and at the glacier margins which were not resolved in earlier work. Estimates of mass loss from GIC in other mountain regions could be subject to similar revisions

Integrated use of residues from olive mill and winery for lipase production by solid state fermentation with Aspergillus sp

Two phase olive mill waste (TPOMW) is presently the major waste produced by the olive mill industry. This waste has potential to be used as substrate for solid state fermentation (SSF) despite of its high concentration of phenolic compounds and low nitrogen content. In this work, it is demonstrated that mixtures of TPOMW with winery wastes support the production of lipase by Aspergillus spp. By agar plate screening, Aspergillus niger MUM 03.58, Aspergillus ibericus MUM 03.49 and Aspergillus uvarum MUM 08.01 were chosen for lipase production by SSF. Plackett-Burman experimental design was employed to evaluate the effect of substrate composition and time on lipase production. The highest amounts of lipase were produced by A. ibericus on a mixture of TPOMW, urea and exhausted grape mark (EGM). Urea was found to be the most influent factor for the lipase production. Further optimization of lipase production by A. ibericus using a full factorial design (32) conducted to optimal conditions of substrate composition (0.073 g urea/g and 25% of EGM) achieving 18.67 U/g of lipolytic activity.Jose Manuel Salgado is grateful for Postdoctoral fellowship (EX-2010-0402) of Education Ministry of Spanish Government. Luis Abrunhosa was supported by the grant SFRH/BPD/43922/2008 from Fundacao para a Ciencia e Tecnologia-FCT, Portugal. Authors thank Fundacao para a Ciencia e a Tecnologia (FCT) for financial support through the project FCT Pest-OE/EQB/LA0023/2011

Uptake and speciation of zinc in edible plants grown in smelter contaminated soils

Heavy metal accumulation in edible plants grown in contaminated soils poses a major environmental risk to humans and grazing animals. This study focused on the concentration and speciation of Zn in different edible plants grown in soils contaminated with smelter wastes (Spelter, WV, USA) containing high levels of the metals Zn, Cu, Pb, Cd. Their accumulation was examined in different parts (roots, stem, and leaves) of plants and as a function of growth stage (dry seed, sprouting seed, cotyledon, and leaves) in the root vegetables radish, the leafy vegetable spinach and the legume clover. Although the accumulation of metals varied significantly with plant species, the average metal concentrations were [Zn] > [Pb] > [Cu] > [Cd]. Metal uptake studies were complemented with bulk and micro X-ray absorption spectroscopy (XAS) at Zn K-edge and micro X-ray fluorescence (μXRF) measurements to evaluate the speciation and distribution of Zn in these plant species. Dynamic interplay between the histidine and malate complexation of Zn was observed in all plant species. XRF mapping of spinach leaves at micron spatial resolution demonstrated the accumulation of Zn in vacuoles and leaf tips. Radish root showed accumulation of Zn in root hairs, likely as ZnS nanoparticles. At locations of high Zn concentration in spinach leaves, μXANES suggests Zn complexation with histidine, as opposed to malate in the bulk leaf. These findings shed new light on the dynamic nature of Zn speciation in plants

Singlet exciton fission in solution.

Singlet exciton fission, the spin-conserving process that produces two triplet excited states from one photoexcited singlet state, is a means to circumvent the Shockley-Queisser limit in single-junction solar cells. Although the process through which singlet fission occurs is not well characterized, some local order is thought to be necessary for intermolecular coupling. Here, we report a triplet yield of 200% and triplet formation rates approaching the diffusion limit in solutions of bis(triisopropylsilylethynyl (TIPS)) pentacene. We observe a transient bound excimer intermediate, formed by the collision of one photoexcited and one ground-state TIPS-pentacene molecule. The intermediate breaks up when the two triplets separate to each TIPS-pentacene molecule. This efficient system is a model for future singlet-fission materials and for disordered device components that produce cascades of excited states from sunlight.B.J.W. was supported by a Herchel Smith Research Fellowship. A.J.M. received funding from a Marie Curie Scholarship. D.B. is a FNRS Research Director. Both A.J.M and D.B. acknowledge support from the European Community’s Initial Training Network SUPERIOR (PITN-GA-2009-238177). Further funding for this project came from the Engineering and Physical Sciences Research Council (EPSRC) and a pump-prime grant from the Winton Programme for the Physics of Sustainability.This is the accepted version of an article originally published in Nature Chemistry 5, 1019–1024 and available online at http://www.nature.com/nchem/journal/v5/n12/full/nchem.1801.html. Nature Publishing Group's conditions for reuse are detailed at http://www.nature.com/authors/policies/license.html