Patient and Family Caregivers’ Experiences of Living With a Jejunostomy Feeding Tube After Surgery for Esophagogastric Cancer

BACKGROUND: Jejunostomy feeding tubes (JFTs) can be used to provide nutrition support to patients who have had surgery for esophagogastric cancer. Although previous research reports how patients cope with a gastrostomy tube, little is known about the impact of having a JFT. The aim of this qualitative study was to explore how patients and their informal caregivers experience living with a JFT in the first months following surgery. METHODS: Participants were purposively sampled from a cohort of patients recruited to a trial investigating home enteral nutrition vs standard care after esophagogastric surgery for cancer. The sampling framework considered age, sex, and marital status. Informal caregivers were also invited to participate. Interviews were audio recorded, transcribed verbatim, and anonymized. Inductive thematic analysis was used to identify key themes related to living with a JFT. RESULTS: Fifteen patient interviews were conducted; 8 also included a family caregiver. Analysis of the data resulted in 2 main themes: "challenges" and "facilitators" when living with a JFT. While "physical effects," "worries" and "impact on routine" were the main challenges, "support," "adaptation" and "perceived benefit" were what motivated continuation of the intervention. CONCLUSION: Findings suggest that participants coped well with a JFT, describing high levels of compliance with stoma care and the feeding regimen. Nonetheless, disturbed sleep patterns and stoma-related problems proved troublesome. A better understanding of these practical challenges, from the patient and family caregiver perspective, should guide healthcare teams in providing proactive support to avoid preventable problems

A random matrix decimation procedure relating β=2/(r+1)\beta = 2/(r+1) to β=2(r+1)\beta = 2(r+1)

Classical random matrix ensembles with orthogonal symmetry have the property that the joint distribution of every second eigenvalue is equal to that of a classical random matrix ensemble with symplectic symmetry. These results are shown to be the case $r=1$ of a family of inter-relations between eigenvalue probability density functions for generalizations of the classical random matrix ensembles referred to as $\beta$-ensembles. The inter-relations give that the joint distribution of every $(r+1)$-st eigenvalue in certain $\beta$-ensembles with $\beta = 2/(r+1)$ is equal to that of another $\beta$-ensemble with $\beta = 2(r+1)$. The proof requires generalizing a conditional probability density function due to Dixon and Anderson.Comment: 19 pages, 1 figur

Controlling a leaky tap

We apply the Ott, Grebogy and Yorke mechanism for the control of chaos to the analytical oscillator model of a leaky tap obtaining good results. We exhibit the robustness of the control against both dynamical noise and measurement noise.A possible way of controlling experimentally a leaky tap using magnetic-field-produced variations in the viscosity of a magnetorheological fluid is suggested.Comment: 14 pages, 12 figures. Submitted to Physics Letters

Epistemic and social scripts in computer-supported collaborative learning

Collaborative learning in computer-supported learning environments typically means that learners work on tasks together, discussing their individual perspectives via text-based media or videoconferencing, and consequently acquire knowledge. Collaborative learning, however, is often sub-optimal with respect to how learners work on the concepts that are supposed to be learned and how learners interact with each other. One possibility to improve collaborative learning environments is to conceptualize epistemic scripts, which specify how learners work on a given task, and social scripts, which structure how learners interact with each other. In this contribution, two studies will be reported that investigated the effects of epistemic and social scripts in a text-based computer-supported learning environment and in a videoconferencing learning environment in order to foster the individual acquisition of knowledge. In each study the factors ‘epistemic script’ and ‘social script’ have been independently varied in a 2×2-factorial design. 182 university students of Educational Science participated in these two studies. Results of both studies show that social scripts can be substantially beneficial with respect to the individual acquisition of knowledge, whereas epistemic scripts apparently do not to lead to the expected effects

Residual cognitive deficits 50 years after lead poisoning during childhood

The long term neurobehavioural consequences of childhood lead poisoning are not known. In this study adult subjects with a documented history of lead poisoning before age 4 and matched controls were examined with an abbreviated battery of neuropsychological tests including measures of attention, reasoning, memory, motor speed, and current mood. The subjects exposed to lead were inferior to controls on almost all of the cognitive tasks. This pattern of widespread deficits resembles that found in children evaluated at the time of acute exposure to lead rather than the more circumscribed pattern typically seen in adults exposed to lead. Despite having completed as many years of schooling as controls, the subjects exposed to lead were lower in lifetime occupational status. Within the exposed group, performance on the neuropsychological battery and occupational status were related, consistent with the presumed impact of limitations in neuropsychological functioning on everyday life. The results suggest that many subjects exposed to lead suffered acute encephalopathy in childhood which resolved into a chronic subclinical encephalopathy with associated cognitive dysfunction still evident in adulthood. These findings lend support to efforts to limit exposure to lead in childhood

Reactive intermediate phase cold sintering in strontium titanate

Dense (>96% theoretical) strontium titanate ceramics were fabricated at 950 °C (conventional sintering temperature > 1400 °C) using a reactive intermediate phase cold sintering process. An aqueous solution of SrCl2 mixed with TiO2 nanoparticles was added to SrTiO3 powders and pressed at 180 °C to obtain a highly compacted green body. During the post-press heating step at 950 °C, the TiO2 and SrCl2 create in-filling micro-reactions around each grain resulting in dense (>96%) SrTiO3 ceramics. Nano- and micron-sized starting powders were used, demonstrating that this reactive intermediate phase cold sintering route can densify a wide range of starting powder sizes, as it not reliant on an amorphous-to-crystalline precipitation through the terrace ledge kink mechanism, as has been identified repeatedly in previous cold sintering mechanisms. Moreover, this process has the potential to densify a wide variety of functional oxides, as a range of different low-temperature chemical synthesis routes could be used

Summing up the perturbation series in the Schwinger Model

Perturbation series for the electron propagator in the Schwinger Model is summed up in a direct way by adding contributions coming from individual Feynman diagrams. The calculation shows the complete agreement between nonperturbative and perturbative approaches.Comment: 10 pages (in REVTEX

The orbit rigidity matrix of a symmetric framework

A number of recent papers have studied when symmetry causes frameworks on a graph to become infinitesimally flexible, or stressed, and when it has no impact. A number of other recent papers have studied special classes of frameworks on generically rigid graphs which are finite mechanisms. Here we introduce a new tool, the orbit matrix, which connects these two areas and provides a matrix representation for fully symmetric infinitesimal flexes, and fully symmetric stresses of symmetric frameworks. The orbit matrix is a true analog of the standard rigidity matrix for general frameworks, and its analysis gives important insights into questions about the flexibility and rigidity of classes of symmetric frameworks, in all dimensions. With this narrower focus on fully symmetric infinitesimal motions, comes the power to predict symmetry-preserving finite mechanisms - giving a simplified analysis which covers a wide range of the known mechanisms, and generalizes the classes of known mechanisms. This initial exploration of the properties of the orbit matrix also opens up a number of new questions and possible extensions of the previous results, including transfer of symmetry based results from Euclidean space to spherical, hyperbolic, and some other metrics with shared symmetry groups and underlying projective geometry.Comment: 41 pages, 12 figure

PAM50 molecular intrinsic subtypes in the nurses' health Study cohorts

Background: Modified median and subgroup-specific gene subtypes by PAM50 and IHC surrogates improved to fair centering are two essential preprocessing methods to assign when Luminal subtypes were grouped together. Using the breast cancer molecular subtypes by PAM50. We evaluated the modified median method, our study consisted of 46% PAM50 subtypes derived from both methods in a subset of Luminal A, 18% Luminal B, 14% HER2-enriched, 15% Nurses' Health Study (NHS) and NHSII participants; correlat-Basal-like, and 8% Normal-like subtypes; 53% of tumor-ed tumor subtypes by PAM50 with IHC surrogates; and adjacent tissues were Normal-like. Women with the Basal-characterized the PAM50 subtype distribution, proliferation like subtype had a higher rate of relapse within 5 years. scores, and risk of relapse with proliferation and tumor size HER2-enriched subtypes had poorer outcomes prior to weighted (ROR-PT) scores in the NHS/NHSII. 1999. Methods: PAM50 subtypes, proliferation scores, and Conclusions: Either preprocessing method may be uti-ROR-PT scores were calculated for 882 invasive breast tumors lized to derive PAM50 subtypes for future studies. The and 695 histologically normal tumor-adjacent tissues. Cox majority of NHS/NHSII tumor and tumor-adjacent tissues proportional hazards models evaluated the relationship were classified as Luminal A and Normal-like, respectively. between PAM50 subtypes or ROR-PT scores/groups with Impact: Preprocessing methods are important for the recurrence-free survival (RFS) or distant RFS. accurate assignment of PAM50 subtypes. These data provide Results: PAM50 subtypes were highly comparable evidence that either preprocessing method can be used in between the two methods. The agreement between tumor epidemiologic studies