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

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

First application of Markov chain Monte Carlo-based Bayesian data analysis to the Doppler-shift attenuation method

Motivated primarily by the large uncertainties in the thermonuclear rate of the 30P(p,γ)31S reaction that limit our understanding of classical novae, we carried out lifetime measurements of 31S excited states using the Doppler Shift Lifetimes (DSL2) facility at the TRIUMF Isotope Separator and Accelerator (ISAC-II) facility. The 31S excited states were populated by the 3He(32S,α)31S reaction. The deexcitation γ rays were detected by a clover-type high-purity germanium detector in coincidence with the α particles detected by a silicon detector telescope. We have applied modern Markov chain Monte Carlo-based Bayesian statistical techniques to perform lineshape analyses of Doppler-shift attenuation method γ-ray data for the first time. We have determined the lifetimes of the two lowest-lying 31S excited states. First experimental upper limits on the lifetimes of four higher-lying states have been obtained. The experimental results were compared to shell-model calculations using five universal sd-shell Hamiltonians. Evidence for γ rays originating from the astrophysically important Jπ=3/2+, 260-keV 30P(p,γ)31S resonance with an excitation energy of Ex=6390.2(7) keV in 31S has also been observed, although strong constraints on the lifetime will require better statistics

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

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

Soybean Management for Seed Composition: The Perspective of U.S. Farmers

The soybean [Glycine max (L.) Merr.] compositional quality is mainly provided by the seed concentration of protein and oil. These traits are critical for sustaining global use, and although there is demand for high protein soybean, no mechanism to differentiate production is in place. At the opposite end of the supply chain, farmers are remunerated on a mass basis without having any incentive regarding seed composition. This study evaluated farmers\u27 perspectives and knowledge on soybean quality and their propensity to adopt quality improvement technologies. Farmers from the main U.S. producing regions (n = 271) were investigated with a self-administrated survey containing 21 questions during 2020 and 2021. Our results show that 84% are unaware of the current protein and oil levels from their own production. A small portion (1.4%) make management decisions (e.g., choice of genotypes or monitor quality) based on the implications on seed quality. However, practices already in place are likely to enhance the quality of seed, namely N nutrition (via rhizobia [12.9%] or fertilizer [5.9%]) and late-season crop protection (17.1%). If farmers are financially rewarded by US$0.50 per bushel, a mindset change may occur. Based on these results, we concluded that shifts in the U.S. production system targeting protein or oil markets are possible, and the constraints are mainly related to on-farm management. However, the challenges for improving the U.S. soybean competitiveness in global or niche markets also rely upon other segments of the production chain, specifically breeders, technology suppliers, and logistical structure

The voices of youth in envisioning positive futures for nature and people

The unpredictable Anthropocene poses the challenge of imagining a radically different, equitable and sustainable world. Looking 100 years ahead is not easy, and especially as millennials, it appears quite bleak. This paper is the outcome of a visioning exercise carried out in a 2-day workshop, attended by 33 young early career professionals under the auspices of IPBES. The process used Nature Futures Framework in an adapted visioning method from the Seeds of Good Anthropocene project. Four groups envisioned more desirable future worlds; where humanity has organised itself, the economy, politics and technology, to achieve improved nature-human well-being. The four visions had differing conceptualisations of this future. However, there were interesting commonalities in their leverage points for transformative change, including an emphasis on community, fundamentally different economic systems based on sharing and technological solutions to foster sustainability and human-nature connectedness. Debates included questioning the possibility of maintaining local biocultural diversity with increased connectivity globally and the prominence of technology for sustainability outcomes. These visions are the first step towards a wider galvanisation of youth visions for a brighter future, which is often missing in the arena where it can be taken seriously, to trigger more transformative pathways towards meeting global goals