A Qualitative Exploration of Self-Perceived Effects of a Mindfulness-Based Stress Reducation (MBSR) Intervention on Deeply Distressing Experiences. An Interpretative Phenomenological Analysis

Abstract Mindfulness-based stress reduction (MBSR) intervention has been widely used around the globe to improve psychological and physical wellbeing. Considering the extensive evidence-base for the efficacy of MBSR intervention, exploring the lived experiences of individuals experiencing deeply distressing experiences may provide us with a better understanding of this complex phenomenon. The research aimed to examine the understanding and making sense of deeply distressing experiences following MBSR intervention. Seven participants who have completed an 8-week MBSR intervention and who self-identified as having experienced deeply distressing experiences were interviewed. Semi-structured interviews were transcribed and analysed using Interpretative Phenomenological Analysis. Two major themes emerged from the analysis: ‘Facing the emotional rollercoaster’ and ‘A mindful way of being’. Each major theme entails four subthemes. The results reveal new insights into the importance of the process of going through deeply distressing experiences, encapsulating avoidance and fear of facing one’s own reality. The present study draws attention to the significance of embodiment and awareness in the transformative process of shifting deeply distressing experiences and re-connecting with the body as a gateway into an embodied way of being. Clinical implications of the findings are discussed, including moving beyond diagnoses and the potential of using aspects of MBSR in the therapeutic context

Chiral quark dynamics and topological charge: The role of the Ramond-Ramond U(1) Gauge Field in Holographic QCD

The Witten-Sakai-Sugimoto construction of holographic QCD in terms of D4 color branes and D8 flavor branes in type IIA string theory is used to investigate the role of topological charge in the chiral dynamics of quarks in QCD. The QCD theta term arises from a compactified 5-dimensional Chern-Simons term on the D4 branes. This term couples the QCD topological charge to the Ramond-Ramond $U(1)$ gauge field of IIA string theory. The nonzero topological susceptibility of pure-glue QCD can be attributed to the presence of D6 branes, which constitute magnetic sources of the RR gauge field. The topological charge of QCD is required, by an anomaly inflow argument, to coincide in space-time with the intersection of the D6 branes and the D4 color branes. This clarifies the relation between D6 branes and the coherent, codimension-one topological charge membranes observed in QCD Monte Carlo calculations. Using open-string/closed-string duality, we interpret a quark loop (represented by a D4-D8 open string loop) in terms of closed-string exchange between color and flavor branes. The role of the RR gauge field in quark-antiquark annihilation processes is discussed. RR exchange in the s-channel generates a 4-quark contact term which produces an $\eta'$ mass insertion and provides an explanation for the observed spin-parity structure of the OZI rule. The $(\log {\rm Det\;U})^2$ form of the $U(1)$ anomaly emerges naturally. RR exchange in the t-channel of the $q\overline{q}$ scattering amplitude produces a Nambu-Jona Lasinio interaction which may provide a mechanism for spontaneous breaking of $SU(N_f)\times SU(N_f)$.Comment: 20 pages, 7 figure

Engineered Emitters for Improved Silicon Photovoltaics

In 2014, installation of 5.3GW of new Photovoltaic (PV) systems occurred in the United States, raising the total installed capacity to 16.36GW. Strong growth is predicted for the domestic PV market with analysts reporting goals of 696GW by 2020. Conventional single crystalline silicon cells are the technology of choice, accounting for 90% of the installations in the global commercial market. Cells made of GaAs offer higher efficiencies, but at a substantially higher cost. Thin film technologies such as CIGS and CdTe compete favorably with multi-crystalline Si (u-Si), but at 20% efficiency, still lag the c-Si cell in performance. The c-Si cell can be fabricated to operate at approximately 25% efficiency, but commercially the efficiencies are in the 18-21% range, which is a direct result of cost trade-offs between process complexity and rapid throughput. With the current cost of c-Si cell modules at nearly $0.60/W. The technology is well below the historic metric of 1$/W for economic viability. The result is that more complex processes, once cost-prohibitive, may now be viable. An example is Panasonic’s HIT cell which operates in the 22-24% efficiency range. To facilitate research and development of novel PV materials and techniques, RIT has developed a basic solar cell fabrication process. Student projects prior to this work had produced cells with 12.8% efficiency using p type substrates. This thesis reports on recent work to improve cell efficiencies while simultaneously expanding the capability of the rapid prototyping process. In addition to the p-Si substrates, cells have been produced using n-Si substrates. The cell emitter, which is often done with a single diffusion or implant has been re-engineered using a dual implant of the same dose. This dual-implanted emitter has been shown to lower contact resistance, increase Voc, and increase the efficiency. A p-Si substrate cell has been fabricated with an efficiency of 14.6% and n-Si substrate cell with a 13.5% efficiency. Further improvements could be made through the incorporation of a front-surface field, surface texturing and nitride ARC

Wound infection in gynecologic surgery.

OBJECTIVE: We sought to determine the wound infection rate among patients undergoing elective gynecologic surgery at a single tertiary care center and to determine the predictive value of various factors that contribute to infection. We further investigated the adequacy of hospital records in documenting infection rates as well as the timing of presentation of wound infections. METHODS: The records of 115 patients undergoing elective gynecologic surgery at our institution were reviewed. Patients were further subdivided based on route of surgery. We analyzed the importance of antibiotic prophylaxis, route of surgery, smoking, diabetes, and body mass index (BMI). RESULTS: The overall wound infection rate was 12.17% with no significant difference in the subgroups by route of surgery. Overall, antibiotic prophylaxis significantly decreased infection rates (P = 0.0118), but the route of surgery, BMI, smoking, and diabetes were not significant predictors of infection. Only one case of infection was detected during the initial hospital stay (6.1%). Fifty percent of the patients with infection required readmission, and of these 35.7% required an additional surgical procedure. The average length of hospital stay was 2.4 days longer in patients with infection. CONCLUSIONS: Antibiotic prophylaxis has a role in the management of patients undergoing abdominal gynecologic surgery. In today's environment of cost containment, an increased hospital stay and the added likelihood of additional surgical intervention associated with wound infection are important targets for prevention. Most patients with wound infection were diagnosed after discharge from the hospital. In our population, among whom transportation problems and remote residence are prevalent, strategies for infection surveillance should be integral to discharge planning

Prevalence of depression and anxiety in type 2 diabetes mellitus patients in tertiary care hospital

Background: The prevalence of depression and anxiety in diabetes is considerably higher than normal population and found to have a negative impact on diabetes. Objective of the study was to assess the prevalence of depression and anxiety and to identify their associated risk factors among people with type 2 diabetes mellitus.Methods: Descriptive study was done in Endocrine and medicine outpatient Department of Vijaya Hospital in Belagavi, South India. Total 384 patients with type 2 diabetes mellitus were interviewed for depression and anxiety by administering the Hospital Anxiety and Depression Scale (HADS).Results: Of the total 384 patients surveyed, depression and anxiety were found in 32.56%. (95%CI 27.8-37.2%) and 37.76% (95% CI 33.1-42.9%) respectively. In Multiple Logistic regression analysis age, unmarried, religion, duration of type II diabetes and type of treatment were significantly associated with depression symptoms, Anxiety symptoms were associated with age, Qualification, Occupation, Religion, Duration and type of treatment.Conclusions: This study found a high prevalence of depression and anxiety in patients with Type 2 DM. Therefore, the care of individuals with type 2 Diabetes Mellitus (DM) should include the screening and possible treatment of depression and anxiety in order to achieve and sustain treatment goals

A long-term "memory" of HIF induction in response to chronic mild decreased oxygen after oxygen normalization

Background Endothelial dysfunction (ED) is functionally characterized by decreased vasorelaxation, increased thrombosis, increased inflammation, and altered angiogenic potential, has been intimately associated with the progression and severity of cardiovascular disease. Patients with compromised cardiac function oftentimes have a state of chronic mild decreased oxygen at the level of the vasculature and organs, which has been shown to exacerbate ED. Hypoxia inducible factor (HIF) is a transcription factor complex shown to be the master regulator of the cellular response to decreased oxygen levels and many HIF target genes have been shown to be associated with ED. Methods Human endothelial and aortic smooth muscle cells were exposed either to A) normoxia (21% O2) for three weeks, or to B) mild decreased oxygen (15% O2) for three weeks to mimic blood oxygen levels in patients with heart failure, or to C) mild decreased oxygen for two weeks followed by one week of normoxia ("memory" treatment). Levels of HIF signaling genes (HIF-1α, HIF-2α, VEGF, BNIP3, GLUT-1, PAI-1 and iNOS) were measured both at the protein and mRNA levels. Results It was found that chronic exposure to mild decreased oxygen resulted in significantly increased HIF signaling. There was also a "memory" of HIF-1α and HIF target gene induction when oxygen levels were normalized for one week, and this "memory" could be interrupted by adding a small molecule HIF inhibitor to the last week of normalized oxygen. Finally, levels of ubiquitylated HIF-1α were reduced in response to chronic mild decreased oxygen and were not full restored after oxygen normalization. Conclusion These data suggest that HIF signaling may be contributing to the pathogenesis of endothelial dysfunction and that normalization of oxygen levels may not be enough to reduce vascular stress

Optimal timing of chemotherapy and cystectomy

Radical cystectomy with pelvic lymphadenectomy is the standard treatment for muscle-invasive bladder cancer. However, the high recurrence rates and high death rate from metastases after radical cystectomy for locally advanced bladder cancer emphasize the high risk of occult distant disease. To improve patient survival, multimodal therapy whereby chemotherapy and surgery are used in concert with each other is necessary. The preponderance of data suggests that neoadjuvant chemotherapy offers patients a clear - albeit small - survival advantage, whereas the data for adjuvant chemotherapy are less convincing. Currently, trials to improve the results of such neoadjuvant therapy using biologic targets in conjunction with cytotoxic regimens are under way

A retrospective comparative study of multiple choice questions versus short answer questions as assessment tool in evaluating the performance of the students in medical pharmacology

Background: The aim was to assess the effectiveness of multiple choice versus short answer questions (SAQs) as assessment tools for evaluating performance of 2nd MBBS students.Methods: The study was observational, retrospective study of written pen and paper type assessment that utilized a sample of 100 2nd year medical students. Study consisted of two parts; part I was multiple-choice questions (MCQs) based on endocrine system where four options were given for a question and the single best answer was to be ticked. MCQ was timed at 20 mins for 30 questions with 1 mark each. There was no negative marking. Part II was SAQ on same system where 16 SAQ were given. SAQ was timed at 60 mins for 30 marks questions. After the test students had to reply on a feedback form.Result: There was a strong correlation between the marks scored in two formats of test and there was no statistical difference between the two set of marks.Conclusion: SAQs are as effective as MCQs in assessing the performance of the students in medical pharmacology