426 research outputs found

    Translation to practice: a randomised controlled study of an evidenced based booklet targeted at breast care nurses in the United Kingdom

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    BACKGROUND: In the United Kingdom (UK), it was documented that a problem of knowledge transfer existed within the speciality of breast-cancer care, thus depriving patients of receiving optimal care. Despite increasingly robust research evidence indicating recommendation of whole body exercise for people affected by breast cancer, commensurate changes to practice were not noted amongst breast-care nurses (BCNs). AIM: To evaluate the effect of a targeted booklet, Exercise and Breast Cancer: A Booklet for Breast-Care Nurses, on changes in knowledge, reported practice, and attitudes of BCNs in the UK. METHOD: A prospective, experimental approach was used for designing a pre- and post-test randomised controlled study. Comparisons of knowledge, reported practice, and attitudes based on responses to a questionnaire were made at two time-points in two groups of BCNs (control and experimental). The unit of randomisation and analysis was hospital clusters of BCNs. The sample comprised 92 nurses from 62 hospitals. Analysis consisted of descriptive statistics and clustered regression techniques: clustered logistic regression for knowledge items, clustered linear regression for knowledge scores, ologit for attitude and reported practice items, and clustered multiple regression for paired and multiple variable analysis. RESULTS: A statistically significant increase in knowledge and changes in reported practice and attitudes were found. Robust variables affecting knowledge acquisition were: promotion of health, promotion of exercise, and understanding how exercise can reduce cancer-related fatigue. DISCUSSION: The study has shown that evidence-based printed material, such as an information booklet, can be used as an effective research dissemination method when developed for needs, values, and context of a target audience. CONCLUSIONS: This practical approach to research dissemination could be replicated and applied to other groups of nurses.</p

    Primordial nucleosynthesis with a varying fine structure constant: An improved estimate

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    We compute primordial light-element abundances for cases with fine structure constant alpha different from the present value, including many sources of alpha dependence neglected in previous calculations. Specifically, we consider contributions arising from Coulomb barrier penetration, photon coupling to nuclear currents, and the electromagnetic components of nuclear masses. We find the primordial abundances to depend more weakly on alpha than previously estimated, by up to a factor of 2 in the case of ^7Li. We discuss the constraints on variations in alpha from the individual abundance measurements and the uncertainties affecting these constraints. While the present best measurements of primordial D/H, ^4He/H, and ^7Li/H may be reconciled pairwise by adjusting alpha and the universal baryon density, no value of alpha allows all three to be accommodated simultaneously without consideration of systematic error. The combination of measured abundances with observations of acoustic peaks in the cosmic microwave background favors no change in alpha within the uncertainties.Comment: Phys. Rev. D accepted version; minor changes in response to refere

    Kaon-Nucleon Scattering Amplitudes and Z^*-Enhancements from Quark Born Diagrams

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    We derive closed form kaon-nucleon scattering amplitudes using the ``quark Born diagram" formalism, which describes the scattering as a single interaction (here the OGE spin-spin term) followed by quark line rearrangement. The low energy I=0 and I=1 S-wave KN phase shifts are in reasonably good agreement with experiment given conventional quark model parameters. For klab>0.7k_{lab}> 0.7 Gev however the I=1 elastic phase shift is larger than predicted by Gaussian wavefunctions, and we suggest possible reasons for this discrepancy. Equivalent low energy KN potentials for S-wave scattering are also derived. Finally we consider OGE forces in the related channels KΔ\Delta, K^*N and KΔ^*\Delta, and determine which have attractive interactions and might therefore exhibit strong threshold enhancements or ``Z^*-molecule" meson-baryon bound states. We find that the minimum-spin, minimum-isospin channels and two additional KΔ^*\Delta channels are most conducive to the formation of bound states. Related interesting topics for future experimental and theoretical studies of KN interactions are also discussed.Comment: 34 pages, figures available from the authors, revte

    Longitudinal measures of RNA expression and disease activity in FSHD muscle biopsies

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    Advances in understanding the pathophysiology of facioscapulohumeral dystrophy (FSHD) have led to the discovery of candidate therapeutics, and it is important to identify markers of disease activity to inform clinical trial design. For drugs that inhibit DUX4 expression, measuring DUX4 or DUX4-target gene expression might be an interim measure of drug activity; however, only a subset of FHSD muscle biopsies shows evidence of DUX4 expression. Our prior study showed that MRI T2-STIR-positive muscles had a higher probability of showing DUX4 expression than muscles with normal MRI characteristics. In the current study, we performed a 1-year follow-up assessment of the same muscle with repeat MRI and muscle biopsy. There was little change in MRI characteristics over the 1-year period and, similar to the initial evaluation, MRI T2-STIR-postive muscles had a higher expression of DUX4-regulated genes, as well as genes associated with inflammation, extracellular matrix and cell cycle. Compared to the initial evaluation, overall the level of expression in these gene categories remained stable over the 1-year period; however, there was some variability for each individual muscle biopsied. The pooled data from both the initial and 1-year follow-up evaluations identified several FSHD subgroups based on gene expression, as well as a set of genes-composed of DUX4-target genes, inflammatory and immune genes and cell cycle control genes-that distinguished all of the FSHD samples from the controls. These candidate markers of disease activity need to be replicated in independent datasets and, if validated, may provide useful measures of disease progression and response to therapy.Functional Genomics of Muscle, Nerve and Brain Disorder

    Equations for the estimation of strong ground motions from shallow crustal earthquakes using data from Europe and the Middle East : vertical peak ground acceleration and spectral acceleration

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    This article presents equations for the estimation of vertical strong ground motions caused by shallow crustal earthquakes with magnitudes M w 5 and distance to the surface projection of the fault less than 100km. These equations were derived by weighted regression analysis, used to remove observed magnitude-dependent variance, on a set of 595 strong-motion records recorded in Europe and the Middle East. Coefficients are included to model the effect of local site effects and faulting mechanism on the observed ground motions. The equations include coefficients to model the observed magnitude-dependent decay rate. The main findings of this study are that: short-period ground motions from small and moderate magnitude earthquakes decay faster than the commonly assumed 1/r, the average effect of differing faulting mechanisms is similar to that observed for horizontal motions and is not large and corresponds to factors between 0.7 (normal and odd) and 1.4 (thrust) with respect to strike-slip motions and that the average long-period amplification caused by soft soil deposits is about 2.1 over those on rock sites

    Effect of atrial fibrillation on endovascular thrombectomy for acute ischemic stroke. A meta-analysis of individual patient data from six randomised trials: Results from the HERMES collaboration

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    Background: Atrial fibrillation is an important risk factor for ischemic stroke, and is associated with an increased risk of poor outcome after ischemic stroke. Endovascular thrombectomy is safe and effective in acute ischemic stroke patients with large vessel occlusion of the anterior circulation. This meta-analysis aims to investigate whether there is an interaction between atrial fibrillation and treatment effect of endovascular thrombectomy, and secondarily whether atrial fibrillation is associated with worse outcome in patients with ischemic stroke due to large vessel occlusion. Methods: Individual patient data were from six of the recent randomised clinical trials (MR CLEAN, EXTEND-IA, REVASCAT, SWIFT PRIME, ESCAPE, PISTE) in which endovascular thrombectomy plus standard care was compared to standard care alone. Primary outcome measure was the shift on the modified Rankin scale (mRS) at 90 days. Secondary outcomes were functional independence (mRS 0–2) at 90 days, National Institutes of Health Stroke Scale score at 24 h, symptomatic intracranial hemorrhage and mortality at 90 days. The primary effect parameter was the adjusted common odds ratio, estimated with ordinal logistic regression (shift analysis); treatment effect modification of atrial fibrillation was assessed with a multiplicative interaction term. Results: Among 1351 patients, 447 p

    Measurement of the diffractive structure function in deep inelastic scattering at HERA

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    This paper presents an analysis of the inclusive properties of diffractive deep inelastic scattering events produced in epep interactions at HERA. The events are characterised by a rapidity gap between the outgoing proton system and the remaining hadronic system. Inclusive distributions are presented and compared with Monte Carlo models for diffractive processes. The data are consistent with models where the pomeron structure function has a hard and a soft contribution. The diffractive structure function is measured as a function of \xpom, the momentum fraction lost by the proton, of β\beta, the momentum fraction of the struck quark with respect to \xpom, and of Q2Q^2. The \xpom dependence is consistent with the form \xpoma where a = 1.30 ± 0.08 (stat)  0.14+ 0.08 (sys)a~=~1.30~\pm~0.08~(stat)~^{+~0.08}_{-~0.14}~(sys) in all bins of β\beta and Q2Q^2. In the measured Q2Q^2 range, the diffractive structure function approximately scales with Q2Q^2 at fixed β\beta. In an Ingelman-Schlein type model, where commonly used pomeron flux factor normalisations are assumed, it is found that the quarks within the pomeron do not saturate the momentum sum rule.Comment: 36 pages, latex, 11 figures appended as uuencoded fil
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