A discursive psychological investigation of patients' preferences in post-diagnostic prostate cancer treatment appointments

This thesis examines the role of patients' preferences in post-diagnostic prostate cancer treatment appointments, focusing specifically on patients’ preferences as interactive constructions. Patients' preferences are acknowledged as key to shared decision-making while prostate cancer treatment decisions are considered highly preference sensitive. Despite recognition of patients' preferences and a desire for routine shared decision-making, little is known about patients' preferences in situ with empirical observational research scarce. Prostate cancer is an ideal site for investigating patients' preferences because treatment options for localised prostate cancer have equivalent effectiveness. Twenty-one naturally occurring post-diagnostic prostate cancer treatment appointments were recorded to collect the empirical materials. A combination of discursive psychology and conversation analysis was used to analyse the recordings and explore the role of patients' preferences. Across the three analytic chapters I focused on the ways that patients constructed preferences and the forms patients' preferences could take and made the following observations. First, patients indeed constructed preferences in situ and there was heterogeneity both in the forms of preferences and the interactive work comprising their construction. Second, I reported that rather than being straightforwardly elicited and integrated into decision-making business, preferences met with two distinct patterns of receipt and handling by clinical nurse specialists. Third, the production of laughter was revealed to be consequential for decision-making business by functioning to perform subtle preference work and sanction progress. This thesis therefore provides support for treating patients' preferences as interactive constructions and extends our understanding of preference construction in treatment decision-making by demonstrating heterogeneity in the conversational and discursive resources that patients mobilise. Observations about the distinct handling of patients' preferences responsive to their interactional consequences also extend conversation analytic work on differences between shared decision-making behaviour as modelled and attempts at accomplishment in situ

Van Allen Probes, THEMIS, GOES, and Cluster Observations of EMIC waves, ULF pulsations, and an electron flux dropout

We examined an electron flux dropout during the 12-14 November 2012 geomagnetic storm using observations from seven spacecraft: the two Van Allen Probes, Time History of Events and Macroscale Interactions during Substorms (THEMIS)-A (P5), Cluster 2, and Geostationary Operational Environmental Satellites (GOES) 13, 14, and 15. The electron fluxes for energies greater than 2.0 MeV observed by GOES 13, 14, and 15 at geosynchronous orbit and by the Van Allen Probes remained at or near instrumental background levels for more than 24 h from 12 to 14 November. For energies of 0.8 MeV, the GOES satellites observed two shorter intervals of reduced electron fluxes. The first interval of reduced 0.8 MeV electron fluxes on 12-13 November was associated with an interplanetary shock and a sudden impulse. Cluster, THEMIS, and GOES observed intense He+ electromagnetic ion cyclotron (EMIC) waves from just inside geosynchronous orbit out to the magnetopause across the dayside to the dusk flank. The second interval of reduced 0.8 MeV electron fluxes on 13-14 November was associated with a solar sector boundary crossing and development of a geomagnetic storm with Dst<100 nT. At the start of the recovery phase, both the 0.8 and 2.0 MeV electron fluxes finally returned to near prestorm values, possibly in response to strong ultralow frequency (ULF) waves observed by the Van Allen Probes near dawn. A combination of adiabatic effects, losses to the magnetopause, scattering by EMIC waves, and acceleration by ULF waves can explain the observed electron behavior

Early (and Later) LHC Search Strategies for Broad Dimuon Resonances

Resonance searches generally focus on narrow states that would produce a sharp peak rising over background. Early LHC running will, however, be sensitive primarily to broad resonances. In this paper we demonstrate that statistical methods should suffice to find broad resonances and distinguish them from both background and contact interactions over a large range of previously unexplored parameter space. We furthermore introduce an angular measure we call ellipticity, which measures how forward (or backward) the muon is in eta, and allows for discrimination between models with different parity violation early in the LHC running. We contrast this with existing angular observables and demonstrate that ellipticity is superior for discrimination based on parity violation, while others are better at spin determination.Comment: 31 pages, 19 figures. References added, minor modifications made to section

Large CP Violation in B_s Meson Mixing with EDM constraint in Supersymmetry

Motivated by the recent measurement of the like-sign dimuon charge asymmetry, we investigate anomalous CP violation in the B_s- bar{B}_s mixing within the supersymmetry. We show that when gluino diagrams dominate supersymmetry contributions, it is very difficult to realize a large B_s- bar{B}_s mixing phase under the constraint from electric dipole moments barring cancellations. This constraint can be ameliorated by supposing superparticles decoupled. In this limit, we find that it is possible to achieve the large CP asymmetry, and the branching ratio of B_s -> mu^+ mu^- tends to become sizable.Comment: 20 pages, 5 figure

Development of the Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life of young people with malocclusion: part 2 - cross-sectional validation.

OBJECTIVE: To test the items, identified through qualitative inquiry that might form the basis of a new Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life (OHQoL) of young people with malocclusion. METHODS: Piloting with 13 young people reduced the number of items from 37 to 28. Cross-sectional testing involved a convenience sample aged 10-16 years, attending the Orthodontic Department of the Charles Clifford Dental Hospital, Sheffield. The fit and function of the initial MIQ questions were examined using item response theory. RESULTS: 184 participants (113 females; 71 males) completed a questionnaire (response 85%), seven participants were excluded due to missing responses. The mean age of participants was 12·9 years (SD 1·4) and they had a wide range of malocclusions. The majority were White British (67·4%). Data from 47 participants were used to analyse test-retest reliability. Rasch analysis was undertaken, which further reduced the number of items in the questionnaire from 28 to 17. Unidimensionality of the scale was confirmed. The analysis also identified that the original 5-point response scale could be reduced to three points. The new measure demonstrated good criterion validity (r = 0·751; P < 0·001) and construct validity with the two global questions ('Overall bother' ρ = 0·733 and 'Life overall' ρ = 0·701). Internal consistency (Cronbach's alpha = 0·906) and test-retest reliability Intraclass correlation coefficient (ICC = 0·78; 95% CI 0·61-0·88) were also good. CONCLUSION: Cross-sectional testing has shown the new MIQ to be both valid and reliable. Further evaluation is required to confirm the generalisability as well as the ability of the new measure to detect change over time (responsiveness)

Grid-texture mechanisms in human vision:contrast detection of regular sparse micro-patterns requires specialist templates

Previous work has shown that human vision performs spatial integration of luminance contrast energy, where signals are squared and summed (with internal noise) over area at detection threshold. We tested that model here in an experiment using arrays of micro-pattern textures that varied in overall stimulus area and sparseness of their target elements, where the contrast of each element was normalised for sensitivity across the visual field. We found a power-law improvement in performance with stimulus area, and a decrease in sensitivity with sparseness. While the contrast integrator model performed well when target elements constituted 50–100% of the target area (replicating previous results), observers outperformed the model when texture elements were sparser than this. This result required the inclusion of further templates in our model, selective for grids of various regular texture densities. By assuming a MAX operation across these noisy mechanisms the model also accounted for the increase in the slope of the psychometric function that occurred as texture density decreased. Thus, for the first time, mechanisms that are selective for texture density have been revealed at contrast detection threshold. We suggest that these mechanisms have a role to play in the perception of visual textures

No Detectable Fertility Benefit from a Single Additional Mating in Wild Stalk-Eyed Flies

Background: Multiple mating by female insects is widespread, and the explanation(s) for repeated mating by females has been the subject of much discussion. Females may profit from mating multiply through direct material benefits that increase their own reproductive output, or indirect genetic benefits that increase offspring fitness. One particular direct benefit that has attracted significant attention is that of fertility assurance, as females often need to mate multiply to achieve high fertility. This hypothesis has never been tested in a wild insect population.Methodology/Principal Findings: Female Malaysian stalk-eyed flies (Teleopsis dalmanni) mate repeatedly during their lifetime, and have been shown to be sperm limited under both laboratory and field conditions. Here we ask whether receiving an additional mating alleviates sperm limitation in wild females. In our experiment one group of females received a single additional mating, while a control group received an interrupted, and therefore unsuccessful, mating. Females that received an additional mating did not lay more fertilised eggs in total, nor did they lay proportionately more fertilised eggs. Female fertility declined significantly through time, demonstrating that females were sperm limited. However, receipt of an additional mating did not significantly alter the rate of this decline.Conclusions/Significance: Our data suggest that the fertility consequences of a single additional mating were small. We discuss this effect (or lack thereof), and suggest that it is likely to be attributed to small ejaculate size, a high proportion of failed copulations, and the presence of X-linked meiotic drive in this species

Risk Factors and Immunity in a Nationally Representative Population following the 2009 Influenza A(H1N1) Pandemic

Understanding immunity, incidence and risk factors of the 2009 influenza A(H1N1) pandemic (2009 H1N1) through a national seroprevalence study is necessary for informing public health interventions and disease modelling.We collected 1687 serum samples and individual risk factor data between November-2009 to March-2010, three months after the end of the 2009 H1N1 wave in New Zealand. Participants were randomly sampled from selected general practices countrywide and hospitals in the Auckland region. Baseline immunity was measured from 521 sera collected during 2004 to April-2009. Haemagglutination inhibition (HI) antibody titres of ≥1∶40 against 2009 H1N1 were considered seroprotective as well as seropositive. The overall community seroprevalence was 26.7% (CI:22.6–29.4). The seroprevalence varied across age and ethnicity. Children aged 5–19 years had the highest seroprevalence (46.7%;CI:38.3–55.0), a significant increase from the baseline (14%;CI:7.2–20.8). Older adults aged ≥60 had no significant difference in seroprevalence between the serosurvey (24.8%;CI:18.7–30.9) and baseline (22.6%;CI:15.3–30.0). Pacific peoples had the highest seroprevalence (49.5%;CI:35.1–64.0). There was no significant difference in seroprevalence between both primary (29.6%;CI:22.6–36.5) and secondary healthcare workers (25.3%;CI:20.8–29.8) and community participants. No significant regional variation was observed. Multivariate analysis indicated age as the most important risk factor followed by ethnicity. Previous seasonal influenza vaccination was associated with higher HI titres. Approximately 45.2% of seropositive individuals reported no symptoms.Based on age and ethnicity standardisation to the New Zealand Population, about 29.5% of New Zealanders had antibody titers at a level consistent with immunity to 2009 H1N1. Around 18.3% of New Zealanders were infected with the virus during the first wave including about one child in every three. Older people were protected due to pre-existing immunity. Age was the most important factor associated with infection followed by ethnicity. Healthcare workers did not appear to have an increased risk of infection compared with the general population

Three-dimensional CFD simulations with large displacement of the geometries using a connectivity-change moving mesh approach

This paper deals with three-dimensional (3D) numerical simulations involving 3D moving geometries with large displacements on unstructured meshes. Such simulations are of great value to industry, but remain very time-consuming. A robust moving mesh algorithm coupling an elasticity-like mesh deformation solution and mesh optimizations was proposed in previous works, which removes the need for global remeshing when performing large displacements. The optimizations, and in particular generalized edge/face swapping, preserve the initial quality of the mesh throughout the simulation. We propose to integrate an Arbitrary Lagrangian Eulerian compressible flow solver into this process to demonstrate its capabilities in a full CFD computation context. This solver relies on a local enforcement of the discrete geometric conservation law to preserve the order of accuracy of the time integration. The displacement of the geometries is either imposed, or driven by fluid–structure interaction (FSI). In the latter case, the six degrees of freedom approach for rigid bodies is considered. Finally, several 3D imposed-motion and FSI examples are given to validate the proposed approach, both in academic and industrial configurations

Complex-Distance Potential Theory and Hyperbolic Equations

An extension of potential theory in R^n is obtained by continuing the Euclidean distance function holomorphically to C^n. The resulting Newtonian potential is generated by an extended source distribution D(z) in C^n whose restriction to R^n is the delta function. This provides a natural model for extended particles in physics. In C^n, interpreted as complex spacetime, D(z) acts as a propagator generating solutions of the wave equation from their initial values. This gives a new connection between elliptic and hyperbolic equations that does not assume analyticity of the Cauchy data. Generalized to Clifford analysis, it induces a similar connection between solutions of elliptic and hyperbolic Dirac equations. There is a natural application to the time-dependent, inhomogeneous Dirac and Maxwell equations, and the `electromagnetic wavelets' introduced previously are an example.Comment: 25 pages, submited to Proceedings of 5th Intern. Conf. on Clifford Algebras, Ixtapa, June 24 - July 4, 199