What Patients and Families Don't Hear: Backstage Communication in Hospice Interdisicplinary Team Meetings

Article on the backstage communication in hospice interdisciplinary team meetings and what families and patients don't hear

Recognising facial expressions in video sequences

We introduce a system that processes a sequence of images of a front-facing human face and recognises a set of facial expressions. We use an efficient appearance-based face tracker to locate the face in the image sequence and estimate the deformation of its non-rigid components. The tracker works in real-time. It is robust to strong illumination changes and factors out changes in appearance caused by illumination from changes due to face deformation. We adopt a model-based approach for facial expression recognition. In our model, an image of a face is represented by a point in a deformation space. The variability of the classes of images associated to facial expressions are represented by a set of samples which model a low-dimensional manifold in the space of deformations. We introduce a probabilistic procedure based on a nearest-neighbour approach to combine the information provided by the incoming image sequence with the prior information stored in the expression manifold in order to compute a posterior probability associated to a facial expression. In the experiments conducted we show that this system is able to work in an unconstrained environment with strong changes in illumination and face location. It achieves an 89\% recognition rate in a set of 333 sequences from the Cohn-Kanade data base

No straight lines – young women’s perceptions of their mental health and wellbeing during and after pregnancy: a systematic review and meta-ethnography

Background: Young mothers face mental health challenges during and after pregnancy including increased rates of depression compared to older mothers. While the prevention of teenage pregnancy in countries such as the United States and the United Kingdom has been a focus for policy and research in recent decades, the need to understand young women’s own experiences has been highlighted. The aim of this meta-ethnography was to examine young women’s perceptions of their mental health and wellbeing during and after pregnancy to provide new understandings of those experiences. Methods: A systematic review and meta-ethnographic synthesis of qualitative research was conducted. Seven databases were systematically searched and forward and backward searching conducted. Papers were included if they were from Organisation for Economic Co-operation and Development countries and explored mental health and wellbeing experiences of young mothers (age under 20 in pregnancy; under 25 at time of research) as a primary research question – or where evidence about mental health and wellbeing from participants was foregrounded. Nineteen papers were identified and the Critical Appraisal Skills Programme checklist for qualitative research used to appraise the evidence. Following the seven-step process of meta-ethnography, key constructs were examined within each study and then translated into one another. Results: Seven translated themes were identified forming a new line of argument wherein mental health and wellbeing was analysed as relating to individual bodily experiences; tied into past and present relationships; underpinned by economic insecurity and entangled with feelings of societal surveillance. There were ‘no straight lines’ in young women’s experiences, which were more complex than dominant narratives around overcoming adversity suggest. Conclusions: The synthesis concludes that health and social care professionals need to reflect on the operation of power and stigma in young women’s lives and its impact on wellbeing. It adds to understanding of young women’s mental health and wellbeing during and after pregnancy as located in physical and structural factors rather than individual capacities alone

Spark plasma sintering of TiyNb1-yCxN1-x monolithic ceramics obtained by mechanically induced self-sustaining reaction

Nanometer-sized titanium-niobium carbonitride powders (TiyNb1-yCxN1-x) with different Ti/Nb atomic ratios were obtained by a mechanically induced self-sustaining reaction, and sintered by spark plasma sintering technique at 1500 degrees C for 1 min in a vacuum atmosphere. Mechanical properties such as hardness and Young's modulus were determined by nanoindentation technique and friction and wear coefficients assessed by ball-on-disk testing using alumina ball in dry sliding conditions. The fracture surface and wear tracks of samples were examined by scanning electron microscopy. Results showed that it is possible to obtain dense monolithic ceramics from the solid solution (TiyNb1-yCxN1-x) with good mechanical properties and excellent wear resistance. The optimum values of nanomechanical properties were found for the Ti0.3Nb0.7C0.5N0.5 ceramic composition, which exhibited a high hardness over 26.0 GPa and Young's modulus around 400 GPa. Crown Copyright (C) 2012 Published by Elsevier B.V. All rights reserved.The authors would like to thank Dr. Emilio Rayon for performing the nanoindentation analysis in the Materials Technology institute (ITM) of the Polytechnic University of Valencia and to acknowledge the financial support received from Spanish Ministry of Science and Innovation for FPI grant (MAT2006-01783). This work was supported by the Spanish government under grant (MAT2010-17046), which is financed in part by the European Regional Development Fund of 2007-2013. E. Chicardi was supported by CSIC through a JAE-Pre grant, which is financed in part by the European Social Fund (ESF).Borrell Tomás, MA.; Salvador Moya, MD.; Garcia-Rocha, V.; Fernandez, A.; Chicardi, E.; Gotor, FJ. (2012). Spark plasma sintering of TiyNb1-yCxN1-x monolithic ceramics obtained by mechanically induced self-sustaining reaction. Materials Science and Engineering: A. 543:173-179. https://doi.org/10.1016/j.msea.2012.02.071S17317954

First evidence of Renlandian (c. 950–940 Ma) orogeny in mainland Scotland:Implications for the status of the Moine Supergroup and circum-North Atlantic correlations

Central problems in the interpretation of the Neoproterozoic geology of the North Atlantic region arise from uncertainties in the ages of, and tectonic drivers for, Tonian orogenic events recorded in eastern Laurentia and northern Baltica. The identification and interpretation of these events is often problematic because most rock units that record Tonian orogenesis were strongly reworked at amphibolite facies during the Ordovician-Silurian Caledonian orogeny. Lu-Hf and Sm-Nd geochronology and metamorphic modelling carried out on large (>1 cm) garnets from the Meadie Pelite in the Moine Nappe of the northern Scottish Caledonides indicate prograde metamorphism between 950 and 940 Ma at pressures of 6–7 kbar and temperatures of 600 °C. This represents the first evidence for c. 950 Ma Tonian (Renlandian) metamorphism in mainland Scotland and significantly extends its geographic extent along the palaeo-Laurentian margin. The Meadie Pelite is believed to be part of the Morar Group within the Moine Supergroup. If this is correct: 1) the Morar Group was deposited between 980 ± 4 Ma (age of the youngest detrital zircon; Peters, 2001, youngest published zircon date is 947 ± 189 (Friend et al., 2003)) and c. 950 Ma (age of regional metamorphism reported here), 2) an orogenic unconformity must separate the Morar Group from the 883 ± 35 Ma (Cawood et al., 2004) Glenfinnan and Loch Eil groups, and 3) the term ‘Moine Supergroup’ may no longer be appropriate. The Morar Group is broadly correlative with similar aged metasedimentary successions in Shetland, East Greenland, Svalbard, Ellesmere Island and northern Baltica. All these successions were deposited after c. 1030 Ma, contain detritus from the Grenville orogen, and were later deformed and metamorphosed at 950–910 Ma during accretionary Renlandian orogenesis along an active plate margin developed around this part of Rodinia

Evaluating the cost implications of integrating SARS-CoV-2 genome sequencing for infection prevention and control investigation of nosocomial transmission within hospitals

OBJECTIVES: The COG-UK hospital-onset COVID-19 infection (HOCI) trial evaluated the impact of SARS-CoV-2 whole genome sequencing (WGS) on acute infection, prevention, and control (IPC) investigation of nosocomial transmission within hospitals. We estimated the cost implications of using the information from the sequencing reporting tool (SRT), used to determine likelihood of nosocomial infection in IPC practice. METHODS: We conducted a micro-costing approach for SARS-CoV-2 WGS. Data on IPC management resource use and costs were collected from interviews with IPC teams from 14 participating sites and used to assign cost estimates for IPC activities as collected in the trial. Activities included IPC specific actions following a suspicion of healthcare-associated infection (HAI) or outbreak, as well as changes to practice following the return of data via SRT. RESULTS: The mean per sample costs of SARS-CoV-2 sequencing was estimated at £77.10 for rapid and £66.94 for longer turnaround phases. Over the 3 months interventional phases, the total management cost of IPC-defined HAIs and outbreak events across the sites was estimated at £225,070 and £416,447, respectively. Main cost drivers were bed-day lost due to wards closures because of outbreaks followed by outbreak meetings and bed-day lost due to cohorting contacts. Actioning SRTs, the cost of HAIs increased by £5,178 due to unidentified cases and the cost of outbreaks lowered by £11,246 as SRTs excluded hospital outbreaks. CONCLUSIONS: Although, SARS-CoV-2 WGS adds to the total IPC management cost, additional information provided could balance out the additional cost, depending on identified design improvements and effective deployment

LSST Science Book, Version 2.0

A survey that can cover the sky in optical bands over wide fields to faint magnitudes with a fast cadence will enable many of the exciting science opportunities of the next decade. The Large Synoptic Survey Telescope (LSST) will have an effective aperture of 6.7 meters and an imaging camera with field of view of 9.6 deg^2, and will be devoted to a ten-year imaging survey over 20,000 deg^2 south of +15 deg. Each pointing will be imaged 2000 times with fifteen second exposures in six broad bands from 0.35 to 1.1 microns, to a total point-source depth of r~27.5. The LSST Science Book describes the basic parameters of the LSST hardware, software, and observing plans. The book discusses educational and outreach opportunities, then goes on to describe a broad range of science that LSST will revolutionize: mapping the inner and outer Solar System, stellar populations in the Milky Way and nearby galaxies, the structure of the Milky Way disk and halo and other objects in the Local Volume, transient and variable objects both at low and high redshift, and the properties of normal and active galaxies at low and high redshift. It then turns to far-field cosmological topics, exploring properties of supernovae to z~1, strong and weak lensing, the large-scale distribution of galaxies and baryon oscillations, and how these different probes may be combined to constrain cosmological models and the physics of dark energy.Comment: 596 pages. Also available at full resolution at http://www.lsst.org/lsst/sciboo

Spleen Tyrosine Kinase (Syk) Regulates Systemic Lupus Erythematosus (SLE) T Cell Signaling

Engagement of the CD3/T cell receptor complex in systemic lupus erythematosus (SLE) T cells involves Syk rather than the zeta-associated protein. Because Syk is being considered as a therapeutic target we asked whether Syk is central to the multiple aberrantly modulated molecules in SLE T cells. Using a gene expression array, we demonstrate that forced expression of Syk in normal T cells reproduces most of the aberrantly expressed molecules whereas silencing of Syk in SLE T cells normalizes the expression of most abnormally expressed molecules. Protein along with gene expression modulation for select molecules was confirmed. Specifically, levels of cytokine IL-21, cell surface receptor CD44, and intracellular molecules PP2A and OAS2 increased following Syk overexpression in normal T cells and decreased after Syk silencing in SLE T cells. Our results demonstrate that levels of Syk affect the expression of a number of enzymes, cytokines and receptors that play a key role in the development of disease pathogenesis in SLE and provide support for therapeutic targeting in SLE patients