146 research outputs found

    Grid workflow scheduling in WOSE

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    Decision-making in childhood cancer: parents’ and adolescents’ views and perceptions

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    Purpose: Few studies have addressed the way in which families of children with cancer make treatment decisions, and how we can meet parents’ and young peoples’ decisional involvement needs. We aimed to explore parents’ and adolescents’ views and perceptions of making medical decisions in pediatric oncology. Methods: We conducted semi-structured interviews with 25 parents of children diagnosed with cancer in the past 12 months, and 5 adolescents diagnosed in the past 12 months. Our interview schedule was underpinned by Elwyn and Miron-Shatz’s decision-making model. The model acknowledges the deliberation (process of coming to a decision) and determination (making a choice) phases of decision-making. We conducted a thematic analysis. Results: Our findings indicate that information provision is not enough to facilitate parents’ decision-making involvement. Many parents sought additional information to meet their individual needs and preferences. While many parents and young people desired decisional involvement, they trusted the doctors to make treatment decisions. Feelings of distress, inadequacy, and lack of choice impacted decision-making participation. Regardless, many parents in our study were satisfied with treatment decisions, but this was largely dependent on positive treatment outcomes. Conclusion: Our study contributes to understanding how families of a child with cancer make treatment decisions. Families tend to rely on doctors to make treatment decisions, but often seek additional information to help them feel involved in the decision process. Findings highlight that decision-making in pediatric oncology should focus on involving families in the deliberation phase, rather than just determination of choice

    Interactive video games to reduce paediatric procedural pain and anxiety: a systematic review and meta-analysis

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    Background: Procedural pain and anxiety in children can be poorly controlled, leading to significant short- and long-term sequelae, such as longer procedure times or future healthcare avoidance. Caregiver anxiety can exacerbate these effects. We aimed to evaluate the effect of interactive video game interventions on children's procedural pain and anxiety, including the effect of different types of video games on those outcomes. Methods: We conducted a systematic review and meta-analysis of the effectiveness of interactive video games compared with standard care in children (0–18 yr) undergoing painful procedures. We searched the databases MEDLINE, Embase, and PsycINFO. We conducted random-effects meta-analysis using ‘R’ of children's procedural pain and anxiety and caregivers' anxiety. Results: Of 2185 studies screened, 36 were eligible (n=3406 patients). Studies commonly involved venous access (33%) or day surgery (31%). Thirty-four studies were eligible for meta-analyses. Interactive video games appear to reduce children's procedural pain (standardised mean difference [SMD]=–0.43; 95% confidence interval [CI]: –0.67 to –0.20), anxiety (SMD=0.61; 95% CI: –0.88 to –0.34), and caregivers' procedural anxiety (SMD=–0.31; 95% CI: –0.58 to –0.04). We observed no difference between preparatory and distracting games, or between virtual reality and non-virtual reality games. We also observed no difference between interactive video games compared with standard care for most medical outcomes (e.g. procedure length), except a reduced need for restraint. Studies reported minimal adverse effects and typically had high intervention acceptability and satisfaction. Conclusions: Our findings support introducing easily available video games, such as distraction-based conventional video games, into routine practice to minimise paediatric procedural pain and child/caregiver anxiety

    Systematic review of the health-related quality of life issues facing adolescents and young adults with cancer

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    PURPOSE: For adolescents and young adults (AYAs), the impact of a cancer diagnosis and subsequent treatment is likely to be distinct from other age groups given the unique and complex psychosocial challenges of this developmental phase. In this review of the literature, we report the health-related quality of life (HRQoL) issues experienced by AYAs diagnosed with cancer and undergoing treatment. METHODS: MEDLINE, EMBASE, CINAHL, PsychINFO and the Cochrane Library Databases were searched for publications reporting HRQoL of AYAs. Issues generated from interviews with AYAs or from responses to patient reported outcome measures (PROMs) were extracted. RESULTS: 166 papers were reviewed in full and comprised 72 papers covering 69 primary studies, 49 measurement development or evaluation papers and 45 reviews. Of the 69 studies reviewed, 11 (16%) used interviews to elicit AYAs’ descriptions of HRQoL issues. The majority of the PROMs used in the studies represent adaptations of paediatric or adult measures. HRQoL issues were organised into the following categories: physical, cognitive, restricted activities, relationships with others, fertility, emotions, body image and spirituality/outlook on life. CONCLUSION: The HRQoL issues presented within this review are likely to be informative to health care professionals and AYAs. The extensive list of issues suggests that the impact of a cancer diagnosis and treatment during adolescence and young adulthood is widespread and reflects the complexities of this developmental phase

    Proceedings of the Salford Postgraduate Annual Research Conference (SPARC) 2011

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    These proceedings bring together a selection of papers from the 2011 Salford Postgraduate Annual Research Conference(SPARC). It includes papers from PhD students in the arts and social sciences, business, computing, science and engineering, education, environment, built environment and health sciences. Contributions from Salford researchers are published here alongside papers from students at the Universities of Anglia Ruskin, Birmingham City, Chester,De Montfort, Exeter, Leeds, Liverpool, Liverpool John Moores and Manchester

    Beyond Teenage and Young Adult Cancer Care: Care Experiences of Patients Aged 25-39 Years Old in the UK National Health Service.

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    AimsAdolescents and young adults aged 15-39 years with cancer face unique medical, practical and psychosocial issues. In the UK, principal treatment centres and programmes have been designed to care for teenage and young adult patients aged 13-24 years in an age-appropriate manner. However, for young adults (YAs) aged 25-39 years with cancer, little access to age-specific support is available. The aim of this study was to examine this possible gap by qualitatively exploring YA care experiences, involving patients as research partners in the analysis to ensure robust results.Materials and methodsWe conducted a phenomenological qualitative study with YAs diagnosed with any cancer type between ages 25 and 39 years old in the last 5 years. Participants took part in interviews or focus groups and data were analysed using inductive thematic analysis. Results were shaped in an iterative process with the initial coders and four YA patients who did not participate in the study to improve the rigor of the results.ResultsSixty-five YAs with a range of tumour types participated. We identified seven themes and 13 subthemes. YAs found navigating the healthcare system difficult and commonly experienced prolonged diagnostic pathways. Participants felt under-informed about clinical details and the long-term implications of side-effects on daily life. YAs found online resources overwhelming but also a source of information and treatment support. Some patients regretted not discussing fertility before cancer treatment or felt uninformed or rushed when making fertility preservation decisions. A lack of age-tailored content or age-specific groups deterred YAs from accessing psychological support and rehabilitation services.ConclusionsYAs with cancer may miss some benefits provided to teenagers and young adults in age-tailored cancer services. Improving services for YAs in adult settings should focus on provision of age-specific information and access to existing relevant support

    Análise integrada de sistemas de produção de tomateiro com base em indicadores edafobiológicos.

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    A análise integrada de indicadores edafobiológicos ligados ao manejo do solo constitui uma ferramenta importante para estimar níveis de sustentabilidade do agroecossistema, detectando-se pontos críticos para a devida correção de manejo. Essa ferramenta foi empregada na avaliação de sistemas de produção orgânica e convencional de tomate, em cultivo protegido e a campo aberto, no estado de São Paulo. Tomaram-se como referência solos de mata nativa e/ou pastagem natural, dependendo do local de estudo. Em Serra Negra, o solo sob sistema orgânico apresentou maior capacidade de campo e teor de argila dispersa mais baixo, indicativos da estabilidade dos agregados. No sistema convencional observou-se uma elevada condutividade elétrica, evidenciando a alta disponibilidade de sais solúveis. A análise de componentes principais (ACP) permitiu concluir que há maior grau de similaridade entre o solo sob sistema orgânico e aqueles das bases referenciais, com respeito aos indicadores químicos e biológicos. Constatou-se que C org, N total, polissacarídeos, FDA (hidrólise de diacetato de fluoresceína) e atividade enzimática de desidrogenase estão positivamente relacionados com o sistema orgânico, a mata nativa e a pastagem. Em contrapartida, a saturação por bases (V%), pH, teores de Mn, Mg e Ca, bem como a razão de dispersão estão inversamente relacionadas ao manejo orgânico. Já em Araraquara, os resultados da ACP distinguiram as áreas organicamente cultivadas das matas nativas, principalmente, com base nos indicadores biológicos

    Loss of flight promotes beetle diversification

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    The evolution of flight is a key innovation that may enable the extreme diversification of insects. Nonetheless, many species-rich, winged insect groups contain flightless lineages. The loss of flight may promote allopatric differentiation due to limited dispersal power and may result in a high speciation rate in the flightless lineage. Here we show that loss of flight accelerates allopatric speciation using carrion beetles (Coleoptera: Silphidae). We demonstrate that flightless species retain higher genetic differentiation among populations and comprise a higher number of genetically distinct lineages than flight-capable species, and that the speciation rate with the flightless state is twice that with the flight-capable state. Moreover, a meta-analysis of 51 beetle species from 15 families reveals higher genetic differentiation among populations in flightless compared with flight-capable species. In beetles, which represent almost one-fourth of all described species, repeated evolution of flightlessness may have contributed to their steady diversification since the Mesozoic era

    Childhood emotional problems and self-perceptions predict weight gain in a longitudinal regression model

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    <p>Abstract</p> <p>Background</p> <p>Obesity and weight gain are correlated with psychological ill health. We predicted that childhood emotional problems and self-perceptions predict weight gain into adulthood.</p> <p>Methods</p> <p>Data on around 6,500 individuals was taken from the 1970 Birth Cohort Study. This sample was a representative sample of individuals born in the UK in one week in 1970. Body mass index was measured by a trained nurse at the age of 10 years, and self-reported at age 30 years. Childhood emotional problems were indexed using the Rutter B scale and self-report. Self-esteem was measured using the LAWSEQ questionnaire, whilst the CARALOC scale was used to measure locus of control.</p> <p>Results</p> <p>Controlling for childhood body mass index, parental body mass index, and social class, childhood emotional problems as measured by the Rutter scale predicted weight gain in women only (least squares regression <it>N </it>= 3,359; coefficient 0.004; <it>P </it>= 0.032). Using the same methods, childhood self-esteem predicted weight gain in both men and women (<it>N </it>= 6,526; coefficient 0.023; <it>P </it>< 0.001), although the effect was stronger in women. An external locus of control predicted weight gain in both men and women (<it>N </it>= 6,522; coefficient 0.022; <it>P </it>< 0.001).</p> <p>Conclusion</p> <p>Emotional problems, low self-esteem and an external locus of control in childhood predict weight gain into adulthood. This has important clinical implications as it highlights a direction for early intervention strategies that may contribute to efforts to combat the current obesity epidemic.</p

    A Symmetric Dual Feedback System Provides a Robust and Entrainable Oscillator

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    Many organisms have evolved molecular clocks to anticipate daily changes in their environment. The molecular mechanisms by which the circadian clock network produces sustained cycles have extensively been studied and transcriptional-translational feedback loops are common structures to many organisms. Although a simple or single feedback loop is sufficient for sustained oscillations, circadian clocks implement multiple, complicated feedback loops. In general, different types of feedback loops are suggested to affect the robustness and entrainment of circadian rhythms
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