Trekstock RENEW: evaluation of a 12-week exercise referral programme for young adult cancer survivors delivered by a cancer charity.

PURPOSE: To evaluate the uptake and effect of RENEW, a 12-week exercise referral programme for young adult cancer survivors delivered by Trekstock, a UK-based cancer charity. METHODS: The RENEW programme provides one-to-one individually tailored support from a level-4 cancer-rehabilitation-qualified gym instructor, free gym membership and access to information resources online. Objective and self-report data on cardiorespiratory function, strength, body composition, fatigue, sleep quality and general health-related quality of life (HRQoL) was collected from participants before the programme (week 0), immediately after (week 12) and 1 month later (week 16). RESULTS: Forty-eight young adults (83% female; mean age, 29 years) with a history of cancer took part within the 12-week programme and completed the evaluation measures. Physical activity (PA) levels significantly increased following the programme and remained raised at follow-up. Improvements in physical function were significant: peak expiratory flow (mean change, 30.96, p = 0.003), sit-and-reach test (mean change, 6.55 ± 4.54, p < 0.0001), and 6-mine-walk test (mean change, 0.12 ± 0.04, p < 0.0001). No significant changes in BMI, weight or muscle mass were observed. Improvements in fatigue, sleep and HRQoL were observed across the programme and at follow-up (mean change, weeks 0-16; 8.04 ± 1.49 p < 0.01; 1.05 ± 0.49 p < 0.05; and - 0.9 ± 0.46 p = 0.051, respectively). Changes in self-efficacy to exercise and motivations to exercise were not observed at 12 weeks or at follow-up. CONCLUSIONS: Results suggest that the RENEW exercise referral programme has a positive impact upon some domains of physical function and well-being among young adult cancer survivors. IMPLICATION FOR CANCER SURVIVORS: Exercise referral programmes delivered by charity organisations are one means by which PA behaviour change support may be widely disseminated to young adult cancer survivors. Health professionals and charitable bodies specialising in the care of young adults with cancer should look to address factors which prevent engagement and uptake of 'real-world' PA interventions such as the RENEW programme

Evolutionary -Laplacian with convection and reaction under dynamic boundary condition

Möten med palliativa cancerpatienter utgör en del av allmänsjuksköterskans yrkesområde. Osäkerhet som leder till svårigheter att bemöta dessa patienter finns hos sjuksköterskor och sjuksköterskestudenter. Syftet var att undersöka vilka tankar, känslor och prioriteringar som var viktiga för den palliativa cancerpatienten samt vad som utmärkte en god relation till sjuksköterskan. En systematisk litteraturstudie enligt Goodmans sju steg genomfördes modifierat. I resultatet framkommer att patienter känner rädsla för att bli en börda och upplever osäkerhet samt ett kroppsligt förfall. Patienternas prioriteringar handlade om symtomkontroll, bevarandet av värdighet, det dagliga livet samt relationen till anhöriga. Att sjuksköterskan såg och tillgodosåg patientens behov samt hjälpte och skyddade patienten ingav tillit och hopp vilket stärkte relationen och kommunikationen.Encounters with palliative cancer patients are a part of the nursing profession. Uncertainty that leads to difficulties to respond to these patients exists in both nurses and nursing students. The aim was to explore which thoughts, feelings and priorities were important for the palliative cancer patient and features important for a good relationship with the nurse. A systematic literature review after Goodman´s seven steps was carried out with modifications. Emerging in the result was patient´s thoughts about fear of becoming a burden, feelings of insecurity and a bodily decay. Patient´s priorities concerned symptom control, preservation of dignity, daily life and the relationship with relatives. Nurses who saw and met patient´s needs and also helped and protected them gave trust and hope which strengthened the relationship and communication

Leader Behaviors as Mediators of the Leader Characteristics - Follower Satisfaction Relationship

This is the author accepted manuscript. The final version is available from SAGE Publications via the DOI in this record.This study examined two potential mediators through which leaders transmit their position power into an effectiveness outcome. Drawing upon recent work integrating trait, situational, and behavioral theories of leadership effectiveness, we hypothesized and tested a model specifying that the interactive effects of leader position power and leader political skill on follower satisfaction would be mediated by followers’ perceptions of leaders’ initiating structure and consideration behaviors. Specifically, this model indicates that leaders who are both in powerful positions and politically skilled are perceived to initiate more structure and demonstrate more consideration for their followers than their nonpolitically skilled counterparts, which, in turn, positively impacts followers’ satisfaction (i.e., an indication of subjective leadership effectiveness). Utilizing 190 leaders and 476 followers, we found support for the hypothesized model. Contributions to various literatures, strengths, limitations, and practical implications are discussed

Quantum ergodicity for graphs related to interval maps

We prove quantum ergodicity for a family of graphs that are obtained from ergodic one-dimensional maps of an interval using a procedure introduced by Pakonski et al (J. Phys. A, v. 34, 9303-9317 (2001)). As observables we take the L^2 functions on the interval. The proof is based on the periodic orbit expansion of a majorant of the quantum variance. Specifically, given a one-dimensional, Lebesgue-measure-preserving map of an interval, we consider an increasingly refined sequence of partitions of the interval. To this sequence we associate a sequence of graphs, whose directed edges correspond to elements of the partitions and on which the classical dynamics approximates the Perron-Frobenius operator corresponding to the map. We show that, except possibly for subsequences of density 0, the eigenstates of the quantum graphs equidistribute in the limit of large graphs. For a smaller class of observables we also show that the Egorov property, a correspondence between classical and quantum evolution in the semiclassical limit, holds for the quantum graphs in question.Comment: 20 pages, 1 figur

Migration Routes of New World Sanderlings (Calidris alba)

We color-marked Sanderlings (Calidris alba Pallas) at 19 locations in 6 countries in the New World and coordinated a network of volunteers to locate banded individuals in migration over a five-year period. The observers reported 252 independent sightings of birds in countries different from the country of banding. Sanderlings that migrate north to the Arctic from Chile and Peru travel principally through the central corridor (Texas and northward) of the United States and Canada; smaller numbers follow the Pacific coast. A few migrate north from the Pacific coast of South America along the Atlantic coast of the United States. Southbound from the Arctic to coastal Chile and Peru, many individuals switch eastward to stopovers on the Atlantic coast, including birds that migrated north along the U.S. Pacific coast. Sanderlings banded in Brazil during the nonbreeding period appear only on the U.S. Atlantic coast in migration. Our results emphasize the individual nature of migration. We found considerable heterogeneity in migratory behavior among individuals that spend the nonbreeding season together on the same beaches. Individuals from widely separated nonbreeding sites often shared similar pathways. In this species and perhaps in others, no simple single migratory route connects breeding with nonbreeding regions

"I couldn't do this with opposition from my colleagues": A qualitative study of physicians' experiences as clinical tutors

<p>Abstract</p> <p>Background</p> <p>Clinical contact in the early curriculum and workplace learning with active tutorship are important parts of modern medical education. In a previously published study, we found that medical students' tutors experienced a heavier workload, less reasonable demands and less encouragement, than students. The aim of this interview study was to further illuminate physicians' experiences as clinical tutors.</p> <p>Methods</p> <p>Twelve tutors in the Early Professional Contact course were interviewed. In the explorative interviews, they were asked to reflect upon their experiences of working as tutors in this course. Systematic text condensation was used as the analysis method.</p> <p>Results</p> <p>In the analysis, five main themes of physicians' experiences as clinical tutors in the medical education emerged: <it>(a) Pleasure and stimulation</it>. Informants appreciated tutorship and meeting both students and fellow tutors, <it>(b) Disappointment and stagnation</it>. Occasionally, tutors were frustrated and expressed negative feelings, <it>(c) Demands and duty</it>. Informants articulated an ambition to give students their best; a desire to provide better medical education but also a duty to meet demands of the course management, <it>(d) Impact of workplace relations</it>. Tutoring was made easier when the clinic's management provided active support and colleagues accepted students at the clinic, and <it>(e) Multitasking difficulties</it>. Combining several duties with those of a tutorship was often reported as difficult.</p> <p>Conclusions</p> <p>It is important that tutors' tasks are given adequate time, support and preparation. Accordingly, it appears highly important to avoid multitasking and too heavy a workload among tutors in order to facilitate tutoring. A crucial factor is acceptance and active organizational support from the clinic's management. This implies that tutoring by workplace learning in medical education should play an integrated and accepted role in the healthcare system.</p

VLTI-MATISSE chromatic aperture-synthesis imaging of η Carinae\u27s stellar wind across the Br α line: Periastron passage observations in February 2020

Context. Eta Carinae is a highly eccentric, massive binary system (semimajor axis ~15.5 au) with powerful stellar winds and a phase-dependent wind-wind collision (WWC) zone. The primary star, η Car A, is a luminous blue variable (LBV); the secondary, η Car B, is a Wolf-Rayet or O star with a faster but less dense wind. Aperture-synthesis imaging allows us to study the mass loss from the enigmatic LBV η Car. Understanding LBVs is a crucial step toward improving our knowledge about massive stars and their evolution. Aims. Our aim is to study the intensity distribution and kinematics of η Car\u27s WWC zone. Methods. Using the VLTI-MATISSE mid-infrared interferometry instrument, we perform Brα imaging of η Car\u27s distorted wind. Results. We present the first VLTI-MATISSE aperture-synthesis images of η Car A\u27s stellar windin several spectral channels distributed across the Brα 4.052 μm line (spectral resolving power R ~ 960). Our observations were performed close to periastron passage in February 2020 (orbital phase ~ 14.0022). The reconstructed iso-velocity images show the dependence of the primary stellar wind on wavelength or line-of-sight (LOS) velocity with a spatial resolution of 6 mas (~14 au). The radius of the faintest outer wind regions is ~26 mas (~60 au). At several negative LOS velocities, the primary stellar wind is less extended to the northwest than in other directions. This asymmetry is most likely caused by the WWC. Therefore, we see both the velocity field of the undisturbed primary wind and the WWC cavity. In continuum spectral channels, the primary star wind is more compact than in line channels. A fit of the observed continuum visibilities with the visibilities of a stellar wind CMFGEN model (CMFGEN is an atmosphere code developed to model the spectra of a variety of objects) provides a full width at half maximum fit diameter of the primary stellar wind of 2.84 ± 0.06 mas (6.54 ± 0.14 au). We comparethe derived intensity distributions with the CMFGEN stellar wind model and hydrodynamic WWC models

Low exposure long-baseline neutrino oscillation sensitivity of the DUNE experiment

The Deep Underground Neutrino Experiment (DUNE) will produce world-leading neutrino oscillation measurements over the lifetime of the experiment. In this work, we explore DUNE\u27s sensitivity to observe charge-parity violation (CPV) in the neutrino sector, and to resolve the mass ordering, for exposures of up to 100 kiloton-megawatt-calendar years (kt-MW-CY), where calendar years include an assumption of 57% accelerator uptime based on past accelerator performance at Fermilab. The analysis includes detailed uncertainties on the flux prediction, the neutrino interaction model, and detector effects. We demonstrate that DUNE will be able to unambiguously resolve the neutrino mass ordering at a 4σ (5σ) level with a 66 (100) kt-MW-CY far detector exposure, and has the ability to make strong statements at significantly shorter exposures depending on the true value of other oscillation parameters, with a median sensitivity of 3σ for almost all true δCP values after only 24 kt-MW-CY. We also show that DUNE has the potential to make a robust measurement of CPV at a 3σ level with a 100 kt-MW-CY exposure for the maximally CP-violating values δCP=±π/2. Additionally, the dependence of DUNE\u27s sensitivity on the exposure taken in neutrino-enhanced and antineutrino-enhanced running is discussed. An equal fraction of exposure taken in each beam mode is found to be close to optimal when considered over the entire space of interest

Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin burn propagation into surrounding cold fuel, enabling the possibility of high energy gain. While scientific breakeven (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion

Machine Learning-Driven Multiscale Modeling: Bridging the Scales with a Next-Generation Simulation Infrastructure

Interdependence across time and length scales is common in biology, where atomic interactions can impact larger-scale phenomenon. Such dependence is especially true for a well-known cancer signaling pathway, where the membrane-bound RAS protein binds an effector protein called RAF. To capture the driving forces that bring RAS and RAF (represented as two domains, RBD and CRD) together on the plasma membrane, simulations with the ability to calculate atomic detail while having long time and large length- scales are needed. The Multiscale Machine-Learned Modeling Infrastructure (MuMMI) is able to resolve RAS/RAF protein-membrane interactions that identify specific lipid-protein fingerprints that enhance protein orientations viable for effector binding. MuMMI is a fully automated, ensemble-based multiscale approach connecting three resolution scales: (1) the coarsest scale is a continuum model able to simulate milliseconds of time for a 1 μm2 membrane, (2) the middle scale is a coarse-grained (CG) Martini bead model to explore protein-lipid interactions, and (3) the finest scale is an all-atom (AA) model capturing specific interactions between lipids and proteins. MuMMI dynamically couples adjacent scales in a pairwise manner using machine learning (ML). The dynamic coupling allows for better sampling of the refined scale from the adjacent coarse scale (forward) and on-the-fly feedback to improve the fidelity of the coarser scale from the adjacent refined scale (backward). MuMMI operates efficiently at any scale, from a few compute nodes to the largest supercomputers in the world, and is generalizable to simulate different systems. As computing resources continue to increase and multiscale methods continue to advance, fully automated multiscale simulations (like MuMMI) will be commonly used to address complex science questions