Group-based Tai Chi as therapy for alleviating experiences of social death in people with advanced, incurable disease: an ethnographic study

Advanced, incurable disease is a highly stressful and traumatic life event that can lead to losses of social identity, social connectedness, and losses associated with bodily disintegration. The combination of these losses makes it difficult to remain socially active and sometimes results in experiences of social death. However, few studies have explored the role of group-based hospice activities for mitigating the impact of social death in people with advanced, incurable disease. The aim of this study was to explore the personal and social experiences of participating in hospice-based Tai Chi among people with advanced, incurable disease, including its impact in mitigating experiences of social death. A focused ethnography was used to guide this study. Six months were spent in a local hospice day therapy unit in England collecting data through multiple methods, including 17 semi-structured interviews, 200 hours of participant observation, and informal conversations with 19 participants (15 females; 4 males, aged between 50 and 91). Data were analysed using a thematic framework approach and represented using traditional tales and ethnographic creative non-fictions (CNF). Two main themes were developed: (1) fostering social connections and meaningful support; and (2) the protection of a collective identity. An ethnographic CNF ‘moving and being together’ presents these themes in evocative, engaging, and accessible ways. Study findings demonstrate the value of group-based Tai Chi for mitigating experiences of social death in people with advanced, incurable disease. Ethnographic CNFs are a valuable way to represent lived experiences of illness in palliative and hospice care populations

Giant optical birefringence of semiconductor nanowire metamaterials

Semiconductor nanowires exhibit large polarization anisotropy for the absorption and emission of light, making them ideal building blocks for novel photonic metamaterials. Here, we demonstrate that a high density of aligned nanowires exhibits giant optical birefringence, a collective phenomenon observable uniquely for collections of wires. The nanowire material was grown on gallium phosphide (GaP) (111) in the form of vertically standing GaP nanowires. We obtain the largest optical birefringence to date, with a difference between the in-plane and out-of-plane refractive indices of 0.80 and a relative birefringence of 43%. These values exceed by a factor of 75 the natural birefringence of quartz and a by more than a factor of two the highest values reported so far in other artificial materials. By exploiting the specific crystallographic growth directions of the nanowires on the substrate, we further demonstrate full control over the orientation of the optical birefringence effect in the metamaterial.Comment: 10 pages, 4 figure

SCOPE: a scorecard for osteoporosis in Europe

Summary The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. Introduction The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to draw attention to gaps and inequalities in the provision of primary and secondary prevention of fractures due to osteoporosis. Methods The SCOPE panel reviewed the information available on osteoporosis and the resulting fractures for each of the 27 countries of the European Union (EU27). The information researched covered four domains: background information (e.g. the burden of osteoporosis and fractures), policy framework, service provision and service uptake e.g. the proportion of men and women at high risk that do not receive treatment (the treatment gap). Results There was a marked difference in fracture risk among the EU27. Of concern was the marked heterogeneity in the policy framework, service provision and service uptake for osteoporotic fracture that bore little relation to the fracture burden. For example, despite the wide availability of treatments to prevent fractures, in the majority of the EU27, only a minority of patients at high risk receive treatment for osteoporosis even after their first fracture. The elements of each domain in each country were scored and coded using a traffic light system (red, orange, green) and used to synthesise a scorecard. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. Conclusions The scorecard will enable healthcare professionals and policy makers to assess their country’s general approach to the disease and provide indicators to inform future provision of healthcare

Potential of a cyclone prototype spacer to improve in vitro dry powder delivery

Copyright The Author(s) 2013. This article is published with open access at Springerlink.com. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are creditedPurpose: Low inspiratory force in patients with lung disease is associated with poor deagglomeration and high throat deposition when using dry powder inhalers (DPIs). The potential of two reverse flow cyclone prototypes as spacers for commercial carrierbased DPIs was investigated. Methods: Cyclohaler®, Accuhaler® and Easyhaler® were tested with and without the spacers between 30-60 Lmin-1. Deposition of particles in the next generation impactor and within the devices was determined by high performance liquid chromatography. Results: Reduced induction port deposition of the emitted particles from the cyclones was observed due to the high retention of the drug within the spacers (e.g. salbutamol sulphate (SS): 67.89 ± 6.51 % at 30 Lmin-1 in Cheng 1). Fine particle fractions of aerosol as emitted from the cyclones were substantially higher than the DPIs alone. Moreover, the aerodynamic diameters of particles emitted from the cyclones were halved compared to the DPIs alone (e.g. SS from the Cyclohaler® at 4 kPa: 1.08 ± 0.05 μm vs. 3.00 ± 0.12 μm, with and without Cheng 2, respectively) and unaltered with increased flow rates. Conclusion: This work has shown the potential of employing a cyclone spacer for commercial carrier-based DPIs to improve inhaled drug delivery.Peer reviewe

Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study

Background: Serious inhaler technique errors can impair drug delivery to the lungs. This randomised, crossover, open-label study evaluated the proportion of patients making predefined serious errors with Pulmojet compared with Diskus and Turbohaler dry powder inhalers. Methods: Patients ≥18 years old with asthma and/or COPD who were current users of an inhaler but naïve to the study devices were assigned to inhaler technique assessment on Pulmojet and either Diskus or Turbohaler in a randomised order. Patients inhaled through empty devices after reading the patient information leaflet. If serious errors potentially affecting dose delivery were recorded, they repeated the inhalations after watching a training video. Inhaler technique was assessed by a trained nurse observer and an electronic inhalation profile recorder. Results: Baseline patient characteristics were similar between randomisation arms for the Pulmojet-Diskus (n = 277) and Pulmojet-Turbohaler (n = 144) comparisons. Non-inferiority in the proportions of patients recording no nurse-observed serious errors was demonstrated for both Pulmojet versus Diskus, and Pulmojet versus Turbohaler; therefore, superiority was tested. Patients were significantly less likely to make ≥1 nurse-observed serious errors using Pulmojet compared with Diskus (odds ratio, 0.31; 95 % CI, 0.19–0.51) or Pulmojet compared with Turbohaler (0.23; 0.12–0.44) after reading the patient information leaflet with additional video instruction, if required. Conclusions These results suggest Pulmojet is easier to learn to use correctly than the Turbohaler or Diskus for current inhaler users switching to a new dry powder inhaler

Bragg coherent x-ray diffractive imaging of a single indium phosphide nanowire

Three-dimensional (3D) Bragg coherent x-ray diffractive imaging (CXDI) with a nanofocused beam was applied to quantitatively map the internal strain field of a single indium phosphide nanowire. The quantitative values of the strain were obtained by pre-characterization of the beam profile with transmission ptychography on a test sample. Our measurements revealed the 3D strain distribution in a region of 150 nm below the catalyst Au particle. We observed a slight gradient of the strain in the range of ±0.6% along the [111] growth direction of the nanowire. We also determined the spatial resolution in our measurements to be about 10 nm in the direction perpendicular to the facets of the nanowire. The CXDI measurements were compared with the finite element method simulations and show a good agreement with our experimental results. The proposed approach can become an effective tool for in operando studies of the nanowires

Macrophages promote angiogenesis in human breast tumour spheroids in vivo

An in vivo model has been established to study the role of macrophages in the initiation of angiogenesis by human breast tumour spheroids in vivo. The extent of the angiogenic response induced by T47D spheroids implanted into the dorsal skinfold chamber in nude mice was measured in vivo and compared to that induced by spheroids infiltrated with human macrophages prior to implantation. Our results indicate that the presence of macrophages in spheroids resulted in at least a three-fold upregulation in the release of vascular endothelial growth factor (VEGF) in vitro when compared with spheroids composed only of tumour cells. The angiogenic response measured around the spheroids, 3 days after in vivo implantation, was significantly greater in the spheroids infiltrated with macrophages. The number of vessels increased (macrophages vs no macrophages 34±1.9 vs 26±2.5, P<0.01), were shorter in length (macrophages vs no macrophages 116±4.92 vs 136±6.52, P<0.008) with an increased number of junctions (macrophages vs no macrophages 14±0.93 vs 11±1.25, P<0.025) all parameters indicative of new vessel formation. This is the first study to demonstrate a role for macrophages in the initiation of tumour angiogenesis in vivo

The March 11th, 2011, M 9.0 earthquake offshore Honshu island (Japan): a synthesis of the Tohoku-Oki INGV Team research activities

On March 11th, 2011 (at 05:46:23 UTC) a megaearthquake (M 9.0) occurred near the NE coast of Honshu island ( Japan), originated near the subduction plate boundary between the Pacific and the North America plates. The epicenter has been located at about 130 km East of Sendai city, at a depth of about 32 km. This seismic event has been followed by a devastating tsunami. The location, the geometric parameters, the focal mechanism, are in agreement with the occurrence of the earthquake along the subduction plate boundary. The initial seismological analysis indicated that a surface of about 300 km x 150 km over the fault moved upwards of 30-40 m. The Tohoku-Oki INGV Team has made available a wide and multisciplinary expertise to investigate the different scientific issues concerning the earthquake. Indeed from Seismology to Geomorphology, from Remote Sensing to GPS, from Tsunami to Source Modeling the INGV Team has completed a wide range of analysis, obtaining relevant outcomes that are summarized in this work.Published1-272T. Tettonica attivaN/A or not JCRope