Living with multiple myeloma: A focus group study of unmet needs and preferences for survivorship care

Purpose: To describe the unmet informational, psychological, emotional, social, practical, and physical needs and preferences for posttreatment survivorship care of individuals living with multiple myeloma to inform the development of relevant, personcentered, survivorship services. Methods: An exploratory, descriptive study using 2 focus groups with 14 participants, 6 to 49 months postdiagnosis. Results: Thematic analysis revealed 7 key themes: information needs, experience with health-care professionals, coping with side effects, communicating with family and friends, dealing with emotions, support needs, and living with the chronicity of myeloma. Participants described key characteristics of survivorship care relevant to their needs and indicated they would like a more whole of person approach to follow-up when the main treatment phases had completed. Conclusion: Participants in this study described unmet needs across a breadth of domains that varied over time. The development of flexible, person-centered approaches to comprehensive survivorship care is needed to address the considerable quality-of-life issues experienced by people living with multiple myeloma. Nurse-led care may offer 1 viable model to deliver enhanced patient experience—providing the vital “link” that people described as missing from their survivorship care

Impact of sand organic carbon and climatic changes on the population density and morphometric characters of Emerita asiatica in the East Coast of Southern India

240-244A population density of Emerita asiatica in relation to sand organic carbon in the Nemmeli beach, East coast, Kanchipuram District of Tamil Nadu was studied. Specimens were collected once in a fortnight from April 2017 to March 2018 by hand picking method in the intertidal region of Nemmeli beach. The total sand organic carbon level was recorded once in a fortnight. The population presented a smaller incidence of males in relation to females (48.66:51.34); however, in May 2017 an inverse pattern occurred (73:27). Ovigerous females were present in all samples with greater frequencies in October and November 2017 whereas, the highest juveniles were present in May and September 2017. The variation noted in a population of Emerita asiatica showed there is a relationship to sand organic carbon fluctuations; it can be determined that the sand organic carbon fluctuations have an influence on the population density of this species in Nemmeli beach. Hence, the rather stable sand organic carbon throughout the year and moderate changes in the sand may well be conducive to population biology of Emerita asiatica

The cancer nurse coordinator service in Western Australia: Perspectives of specialist cancer nurse coordinators

Objective: In Western Australia the cancer nurse coordinator (CNC) role is unique, state wide and situated in nursing. It requires the domains of clinical expert, resource consultant, educator, change agent, researcher and advocate to facilitate seamless coordination of care for patients across metropolitan, rural and remote geographical areas of Western Australia. This study examined the role, function and impact of CNCs from the perspective of coordinators themselves. Design: Prospective two-phase mixed method study. This paper reports data from the Self Report Activity Questionnaire in Phase one. Setting: The state-wide Western Australian Cancer Nurse Coordinator Service. Subjects: Metropolitan and rural CNCs (n=18) who had worked in the role for at least six months. Results: Overall, CNCs spent 70% of time in clinical consultation and 41% of CNCs reported having an educational role. Most CNCs (71%) noted that at least half of their patients had complex psychosocial needs at referral. Key role-related activities related to direct nursing care and patient education were performed most frequently on a daily basis. Tasks related to care management planning, patient advocacy and multidisciplinary clinical care were performed weekly. Strategic, team communication and professional development activities were performed less frequently. Conclusion: Diversity of the CNC role was demonstrated with findings showing that CNCs fulfilled the core components of the specialist cancer nurse. Given the clear need to provide consistent support to cancer patients in an increasingly individualised and integrated manner, we consider the CNC role a fundamental element of quality cancer care

Impact of sand organic carbon and climatic changes on the population density and morphometric characters of Emerita asiatica in the East Coast of Southern India

A population density of Emerita asiatica in relation to sand organic carbon in the Nemmeli beach, East coast, Kanchipuram District of Tamil Nadu was studied. Specimens were collected once in a fortnight from April 2017 to March 2018 by hand picking method in the intertidal region of Nemmeli beach. The total sand organic carbon level was recorded once in a fortnight. The population presented a smaller incidence of males in relation to females (48.66:51.34); however, in May 2017 an inverse pattern occurred (73:27). Ovigerous females were present in all samples with greater frequencies in October and November 2017 whereas, the highest juveniles were present in May and September 2017. The variation noted in a population of Emerita asiatica showed there is a relationship to sand organic carbon fluctuations; it can be determined that the sand organic carbon fluctuations have an influence on the population density of this species in Nemmeli beach. Hence, the rather stable sand organic carbon throughout the year and moderate changes in the sand may well be conducive to population biology of Emerita asiatica

Analog IC test and product engineering curriculum for Malaysia microelectronics industry

Production test is a significant driver of semiconductor manufacturing cost. Parallel with the advances of semiconductor fabrication, the need for a pool of talented product and test engineers is significantly increasing. This paper describes the academia-industries collaboration effort in developing an analogue electronic test and product engineering to boost-up technical competencies of electronic engineering graduates particularly in microelectronic major. The program has been successfully conducted at Universiti Putra Malaysia with strong support from Texas Instruments and Teradyne

Calorie Restriction in Adulthood Reduces Hepatic Disorders Induced by Transient Postnatal Overfeeding in Mice.

Impaired early nutrition influences the risk of developing metabolic disorders in later life. We observed that transient postnatal overfeeding (OF) in mice induces long-term hepatic alterations, characterized by microsteatosis, fibrosis associated with oxidative stress (OS), and stress-induced premature senescence (SIPS). In this study, we investigated whether such changes can be reversed by moderate calorie restriction (CR). C57BL/6 male mice pups were maintained during lactation in litters adjusted to nine pups in the normal feeding (NF) group and three pups in the transient postnatal OF group. At six months of age, adult mice from the NF and OF groups were randomly assigned to an ad libitum diet or CR (daily energy supply reduced by 20%) for one month. In each group, at the age of seven months, analysis of liver structure, liver markers of OS (superoxide anion, antioxidant defenses), and SIPS (lipofuscin, p53, p21, p16, pRb/Rb, Acp53, sirtuin-1) were performed. CR in the OF group reduced microsteatosis, decreased levels of superoxide anion, and increased protein expression of catalase and superoxide dismutase. Moreover, CR decreased lipofuscin staining, p21, p53, Acp53, and p16 but increased pRb/Rb and sirtuin-1 protein expression. CR did not affect the NF group. These results suggest that CR reduces hepatic disorders induced by OF

Postinfective bowel dysfunction following Campylobacter enteritis is characterised by reduced microbiota diversity and impaired microbiota recovery

Objectives Persistent bowel dysfunction following gastroenteritis (postinfectious (PI)-BD) is well recognised, but the associated changes in microbiota remain unclear. Our aim was to define these changes after gastroenteritis caused by a single organism, Campylobacter jejuni, examining the dynamic changes in the microbiota and the impact of antibiotics. Design A single-centre cohort study of 155 patients infected with Campylobacter jejuni. Features of the initial illness as well as current bowel symptoms and the intestinal microbiota composition were recorded soon after infection (visit 1, 80 days later (visits 2 and 3). Microbiota were assessed using 16S rRNA sequencing. Results PI-BD was found in 22 of the 99 patients who completed the trial. The cases reported significantly looser stools, with more somatic and gastrointestinal symptoms. Microbiota were assessed in 22 cases who had significantly lower diversity and altered microbiota composition compared with the 44 age-matched and sex-matched controls. Moreover 60 days after infection, cases showed a significantly lower abundance of 23 taxa including phylum Firmicutes, particularly in the order Clostridiales and the family Ruminoccocaceae, increased Proteobacteria abundance and increased levels of Fusobacteria and Gammaproteobacteria. The microbiota changes were linked with diet; higher fibre consumption being associated with lower levels of Gammaproteobacteria. Conclusion The microbiota of PI-BD patients appeared more disturbed by the initial infection compared with the microbiota of those who recovered. The prebiotic effect of high fibre diets may inhibit some of the disturbances seen in PI-BD.Peer reviewe

Numerical Investigation into the Effect of Splats and Pores on the Thermal Fracture of Air Plasma-Sprayed Thermal Barrier Coatings

The effect of splat interfaces on the fracture behavior of air plasma-sprayed thermal barrier coatings (APS-TBC) is analyzed using finite element modeling involving cohesive elements. A multiscale approach is adopted in which the explicitly resolved top coat microstructural features are embedded in a larger domain. Within the computational cell, splat interfaces are modeled as being located on a sinusoidal interface in combination with a random distribution of pores. Parametric studies are conducted for different splat interface waviness, spacing, pore volume fraction and fracture properties of the splat interface. The results are quantified in terms of crack nucleation temperature and total microcrack length. It is found that the amount of cracking in TBCs actually decreases with increased porosity up to a critical volume fraction. In contrast, the presence of splats is always detrimental to the TBC performance. This detrimental effect is reduced for the splat interfaces with high waviness and spacing compared to those with low waviness and spacing. The crack initiation temperature was found to be linearly dependent on the normal fracture properties of the splat interface. Insights derived from the numerical results aid in engineering the microstructure of practical TBC systems for improved resistance against thermal fracture

Conserved superenergy currents

We exploit once again the analogy between the energy-momentum tensor and the so-called ``superenergy'' tensors in order to build conserved currents in the presence of Killing vectors. First of all, we derive the divergence-free property of the gravitational superenergy currents under very general circumstances, even if the superenergy tensor is not divergence-free itself. The associated conserved quantities are explicitly computed for the Reissner-Nordstrom and Schwarzschild solutions. The remaining cases, when the above currents are not conserved, lead to the possibility of an interchange of some superenergy quantities between the gravitational and other physical fields in such a manner that the total, mixed, current may be conserved. Actually, this possibility has been recently proved to hold for the Einstein-Klein-Gordon system of field equations. By using an adequate family of known exact solutions, we present explicit and completely non-obvious examples of such mixed conserved currents.Comment: LaTeX, 19 pages; improved version adding new content to the second section and some minor correction