Qualitatively understanding patients' and health professionals' experiences of the BRECONDA breast reconstruction decision aid

Copyright © 2016 John Wiley & Sons, Ltd. Objective: Women diagnosed with breast cancer or ductal carcinoma in situ and those with a genetic susceptibility to developing this disease face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial, this qualitative study examined women's experiences of using the Breast RECONstruction Decision Aid (BRECONDA) and health professionals' feedback regarding the impact of this resource on patients' knowledge and decision making about breast reconstruction. Method: Semistructured interviews were conducted with women who accessed the BRECONDA intervention (N=36) and with their healthcare providers (N=6). All interviews were transcribed verbatim and subjected to thematic analysis by 3 independent coders. Results: Participants reported an overall positive impression, with all interviewees endorsing this decision aid as a useful resource for women considering reconstructive surgery. Thematic analysis of patient interviews revealed 4 themes: overall impressions and aesthetics; personal relevance and utility; introducing BRECONDA; and advantages and suggested improvements. Analysis of health professionals' interviews also revealed 4 themes: need for BRECONDA, impact of BRECONDA, potential difficulties that may arise in using the decision aid, and recommending BRECONDA to patients. Patients indicated that they derived benefit from this resource at all stages of their decision-making process, with the greatest perceived benefit being for those early in their breast reconstruction journey. Conclusion: These findings support the use of BRECONDA as an adjunct to clinical consultation and other information sources

Higher Education Exchange: 2008

This annual publication serves as a forum for new ideas and dialogue between scholars and the larger public. Essays explore ways that students, administrators, and faculty can initiate and sustain an ongoing conversation about the public life they share.The Higher Education Exchange is founded on a thought articulated by Thomas Jefferson in 1820: "I know no safe depository of the ultimate powers of the society but the people themselves; and if we think them not enlightened enough to exercise their control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."In the tradition of Jefferson, the Higher Education Exchange agrees that a central goal of higher education is to help make democracy possible by preparing citizens for public life. The Higher Education Exchange is part of a movement to strengthen higher education's democratic mission and foster a more democratic culture throughout American society.Working in this tradition, the Higher Education Exchange publishes interviews, case studies, analyses, news, and ideas about efforts within higher education to develop more democratic societies

UK sustainable drainage systems: past, present and future

Urban drainage has developed from an engineering discipline, concerned principally with public health and safety outcomes, into a multifaceted vision linking drainage with environmental and wider social and economic imperatives to deliver multifunctional outcomes. UK attention is too often focused on surface water as ‘a problem’, despite international progress and initiatives showing that an ‘opportunity-centred’ approach needs to be taken. Sustainable drainage systems, or ‘Suds’, can, when they are part of an integrated approach to water management, cost-effectively provide many benefits beyond management of water quality and quantity. New tools are available that can design Suds for maximum value to society but this requires greater collaboration across disciplines to seize all of the opportunities available. This paper introduces those tools and a roadmap for their use, including guidance, design objectives and criteria for maximising benefits. These new supporting tools and guidance can help to provide a business case for greater use of Suds in future

Cross-linked single-walled carbon nanotube aerogel electrodes via reductive coupling chemistry

Single-walled carbon nanotube (SWCNT) anions can be cross-linked by a dielectrophile to form covalent, carbon-bonded organogels. Freeze-drying produces cryogels with low density (2.3 mg cm−3), high surface area (766 m2 g−1), and high conductivity (9.4 S m−1), showing promise as supercapacitor electrodes. Counterion concentration controls debundling, grafting ratio, as well as all the resulting properties

Crowdsourcing Content Creation for SQL Practice

Crowdsourcing refers to the act of using the crowd to create content or to collect feedback on some particular tasks or ideas. Within computer science education, crowdsourcing has been used -- for example -- to create rehearsal questions and programming assignments. As a part of their computer science education, students often learn relational databases as well as working with the databases using SQL statements. In this article, we describe a system for practicing SQL statements. The system uses teacher-provided topics and assignments, augmented with crowdsourced assignments and reviews. We study how students use the system, what sort of feedback students provide to the teacher-generated and crowdsourced assignments, and how practice affects the feedback. Our results suggest that students rate assignments highly, and there are only minor differences between assignments generated by students and assignments generated by the instructor.Peer reviewe

Epigenetic gene regulation by Janus kinase 1 in diffuse large B-cell lymphoma

Janus kinases (JAKs) classically signal by activating STAT transcription factors but can also regulate gene expression by epigenetically phosphorylating histone H3 on tyrosine 41 (H3Y41-P). In diffuse large B-cell lymphomas (DLBCLs), JAK signaling is a feature of the activated B-cell (ABC) subtype and is triggered by autocrine production of IL-6 and IL-10. Whether this signaling involves STAT activation, epigenetic modification of chromatin, or both mechanisms is unknown. Here we use genetic and pharmacological inhibition to show that JAK1 signaling sustains the survival of ABC DLBCL cells. Whereas STAT3 contributed to the survival of ABC DLBCL cell lines, forced STAT3 activity could not protect these cells from death following JAK1 inhibition, suggesting epigenetic JAK1 action. JAK1 regulated the expression of nearly 3,000 genes in ABC DLBCL cells, and the chromatin surrounding many of these genes was modified by H3Y41-P marks that were diminished by JAK1 inhibition. These JAK1 epigenetic target genes encode important regulators of ABC DLBCL proliferation and survival, including IRF4, MYD88, and MYC. A small molecule JAK1 inhibitor cooperated with the BTK inhibitor ibrutinib in reducing IRF4 levels and acted synergistically to kill ABC DLBCL cells, suggesting that this combination should be evaluated in clinical trials.This research was supported by the Intramural Research Program of the NIH National Cancer Institute, the University of Wisconsin–Madison (UW–Madison) start-up funds, KL2 Scholar Awards UL1TR0000427 and KL2TR000428, the National Cancer Institute Grant 1R01 CA187299 (to L.R.), and the UW–Madison T32 Hematology Training Award T32 HL07899 (to A.C.D.)