341 research outputs found
Exploring women's sensory experiences of undergoing colposcopy and related procedures: implications for preparatory sensory information provision
INTRODUCTION: Some women experience distress during colposcopy examinations which is partly related to women's fear, or experience, of pain during the procedure. However, little is known about women's sensory experiences of colposcopy (other than pain) or what might impact on these experiences. The aim of this study was to explore women's sensory experiences of colposcopy and related procedures and identify factors which influenced negative sensory experiences. METHODS: In-depth interviews were conducted with 23 women who had undergone, for the first time, a colposcopy (some with related procedures, including punch biopsies and loop excision) as part of follow-up for abnormal cervical cytology. Interviews were analysed thematically using the Framework Approach to organise the data and identify emerging higher-order themes. RESULTS: Women described a range of sensory experiences including pain or discomfort, cramping, stinging and cold sensations (due to the application of acetic acid to the cervix). Four key themes emerged as important aspects of the overall sensory experience: levels of pain, treatment-specific sensations, anaesthetic-specific sensations and solution-specific sensations. Factors that may influence women having a negative sensory experience were sensory expectations of the procedure(s) and lack of preparatory sensory information. DISCUSSION: Our study provides unique in-depth insight into women's sensory experiences of colposcopy and related procedures and suggests women require more preparatory sensory information. The issues identified as contributing to women having a negative sensory experience may help inform the development of pre-colposcopy information which may better prepare women with abnormal cervical cytology for follow-up examinations
Pay progression in routinised service sector work: navigating the internal labour market in a fast food multinational company
The United Kingdom's widespread use of low‐skill, low‐paid employment has been well documented. It has been argued internal labour markets (ILMs) benefit such workers, affording them with opportunities for progression. Relatively little is known, however, about the impact of ILMs on entry level workers undertaking routinised service sector work. Drawing on qualitative data, this article explores the prospects on offer in a market leading, fast food multinational company. Potential enabling features include on‐the‐job training, a transparent and integrated pay structure and a professed culture of progression. Occupational movements to positions above the low‐pay threshold are, however, relatively rare. We conjecture this contradiction is the result of the business context in which the firm operates. The findings suggest that in sectors where price leadership strategies dominate, escape from low pay is likely to be exceptional, even within large organisations featuring some of the classic characteristics of ‘pure’ or strong ILMs
Trends in, and predictors of, anxiety and specific worries following colposcopy: a 12-month longitudinal study
Objective
Little is known about which women are at greatest risk of adverse psychological after-effects following colposcopy. This study examined time trends in, and identified predictors of, anxiety and specific worries over 12 months.
Methods
Women attending two hospital-based colposcopy clinics for abnormal cervical cytology were invited to complete psychosocial questionnaires at 4, 8 and 12 months following colposcopy. General anxiety and screening-specific worries (about cervical cancer, having sex and future fertility) were measured. Generalised estimating equations were used to assess associations between socio-demographic, lifestyle and clinical variables and risk of psychological outcomes.
Results
Of 584 women initially recruited, 429, 343 and 303 completed questionnaires at 4, 8 and 12 months, respectively. Screening-specific worries declined significantly over time but were still relatively high at 12 months: 23%, 39% and 18% for worries about cervical cancer, fertility and having sex, respectively. Anxiety remained stable (20%) over time. Risks of cervical cancer worry and anxiety were both almost double in women without private health insurance (cervical cancer worry: OR = 1.80, 95% CI 1.25–2.61; anxiety: OR = 1.84, 95% CI 1.20–2.84). Younger women (<40 years) had higher risk of fertility worries. Non-Irish women had higher risk of anxiety (OR = 2.13, 95% CI 1.13–4.01).
Conclusions
Screening-specific worries declined over time but anxiety remained stable. Notable proportions of women still reported adverse outcomes 12 months following colposcopy, with predictors varying between outcomes. Women in socio-demographically vulnerable groups were at greatest risk of adverse psychological outcomes. This information could inform development of interventions to alleviate psychological distress post-colposcopy. Copyright © 2015 John Wiley & Sons, Ltd
Leveraging SN Ia spectroscopic similarity to improve the measurement of
Recent studies suggest spectroscopic differences explain a fraction of the
variation in Type Ia supernova (SN Ia) luminosities after light-curve/color
standardization. In this work, (i) we empirically characterize the variations
of standardized SN Ia luminosities, and (ii) we use a spectroscopically
inferred parameter, SIP, to improve the precision of SNe Ia along the distance
ladder and the determination of the Hubble constant (). First, we show
that the \texttt{Pantheon+} covariance model modestly overestimates the
uncertainty of standardized magnitudes by %, in the parameter space
used by the Team to measure ; accounting for this alone
yields km s Mpc. Furthermore, accounting
for spectroscopic similarity between SNe~Ia on the distance ladder reduces
their relative scatter to mag per object (compared to
mag previously). Combining these two findings in the model of SN covariance, we
find an overall 14% reduction (to km s Mpc) of the
uncertainty in the Hubble constant and a modest increase in its value.
Including a budget for systematic uncertainties itemized by Riess et al.
(2022a), we report an updated local Hubble constant with %
uncertainty, km s Mpc. We conclude that
spectroscopic differences among photometrically standardized SNe Ia do not
explain the ``Hubble tension." Rather, accounting for such differences
increases its significance, as the discrepancy against CDM calibrated
by the 2018 measurement rises to 5.7.Comment: 28 pages, 15 figures, accepted to JCA
A Comprehensive Measurement of the Local Value of the Hubble Constant with 1 km/s/Mpc Uncertainty from the Hubble Space Telescope and the SH0ES Team
We report observations from HST of Cepheids in the hosts of 42 SNe Ia used to
calibrate the Hubble constant (H0). These include all suitable SNe Ia in the
last 40 years at z1000 orbits, more than doubling the
sample whose size limits the precision of H0. The Cepheids are calibrated
geometrically from Gaia EDR3 parallaxes, masers in N4258 (here tripling that
Cepheid sample), and DEBs in the LMC. The Cepheids were measured with the same
WFC3 instrument and filters (F555W, F814W, F160W) to negate zeropoint errors.
We present multiple verifications of Cepheid photometry and tests of
background determinations that show measurements are accurate in the presence
of crowding. The SNe calibrate the mag-z relation from the new Pantheon+
compilation, accounting here for covariance between all SN data, with host
properties and SN surveys matched to negate differences. We decrease the
uncertainty in H0 to 1 km/s/Mpc with systematics. We present a comprehensive
set of ~70 analysis variants to explore the sensitivity of H0 to selections of
anchors, SN surveys, z range, variations in the analysis of dust, metallicity,
form of the P-L relation, SN color, flows, sample bifurcations, and
simultaneous measurement of H(z).
Our baseline result from the Cepheid-SN sample is H0=73.04+-1.04 km/s/Mpc,
which includes systematics and lies near the median of all analysis variants.
We demonstrate consistency with measures from HST of the TRGB between SN hosts
and NGC 4258 with Cepheids and together these yield 72.53+-0.99. Including
high-z SN Ia we find H0=73.30+-1.04 with q0=-0.51+-0.024. We find a 5-sigma
difference with H0 predicted by Planck+LCDM, with no indication this arises
from measurement errors or analysis variations considered to date. The source
of this now long-standing discrepancy between direct and cosmological routes to
determining the Hubble constant remains unknown.Comment: 67 pages, 31 figures, replaced to match ApJ accepted version (March
2022), Table 6 distances included here, long form of photometry tables,
fitting code, compact form of data, available from Github page,
https://pantheonplussh0es.github.i
Understanding Women's Differing Experiences of Distress after Colposcopy: A Qualitative Interview Study.
BACKGROUND: Women who have an abnormal cervical cytology test may be referred for a colposcopy. Accumulating evidence suggests some women may experience distress after colposcopy. This exploratory study examined women's differing experiences of post-colposcopy distress with the aim of identifying factors that are predictive of, or protective against, distress. METHODS: We carried out semistructured, qualitative interviews with 23 women who had undergone colposcopies. Interviews were transcribed verbatim, coded, and analyzed thematically. The Framework Approach was used to summarize and organize the data and identify emerging higher order themes. RESULTS: Two forms of post-colposcopy distress emerged: 1) short term and 2) long term. Short-term distress was experienced immediately after the colposcopy and in the days afterward, and was usually related to the physical experience of the colposcopy. Long-term distress typically persisted over time and was related to concerns about fertility, cervical cancer, and sexual intercourse. The drivers of short-term and long-term distress differed. Factors related to short-term distress were feeling unprepared for the procedure, having a negative experience of the procedure, and attending the clinic alone. Factors related to long-term distress were future intentions to have (more) children, having physical after-effects of the procedure that impacted on the woman's life, and being under on-going clinic surveillance. Absence of these factors (e.g., being accompanied to the clinic) was protective against short- and long-term distress. CONCLUSIONS: Colposcopy can lead to short- and long-term post-procedural distress for some women. We identified a range of factors, some potentially modifiable, that seem to influence the chances of experiencing distress. These results may inform the development of strategies or interventions aimed at preventing or minimizing distress after colposcopy and related procedures
Renin inhibition by substituted piperidines: A novel paradigm for the inhibition of monomeric aspartic proteinases?
BackgroundThe aspartic proteinase renin catalyses the first and rate-limiting step in the conversion of angiotensinogen to the hormone angiotensin II, and therefore plays an important physiological role in the regulation of blood pressure. Numerous potent peptidomimetic inhibitors of this important drug target have been developed, but none of these compounds have progressed past clinical phase II trials. Limited oral bioavailability or excessive production costs have prevented these inhibitors from becoming new antihypertensive drugs. We were interested in developing new nonpeptidomimetic renin inhibitors.ResultsHigh-throughput screening of the Roche compound library identified a simple 3,4-disubstituted piperidine lead compound. We determined the crystal structures of recombinant human renin complexed with two representatives of this new class. Binding of these substituted piperidine derivatives is accompanied by major induced-fit adaptations around the enzyme's active site.ConclusionsThe efficient optimisation of the piperidine inhibitors was facilitated by structural analysis of the renin active site in two renin-inhibitor complexes (some of the piperidine derivatives have picomolar affinities for renin). These structural changes provide the basis for a novel paradigm for inhibition of monomeric aspartic proteinases
The Viscous Nonlinear Dynamics of Twist and Writhe
Exploiting the "natural" frame of space curves, we formulate an intrinsic
dynamics of twisted elastic filaments in viscous fluids. A pair of coupled
nonlinear equations describing the temporal evolution of the filament's complex
curvature and twist density embodies the dynamic interplay of twist and writhe.
These are used to illustrate a novel nonlinear phenomenon: ``geometric
untwisting" of open filaments, whereby twisting strains relax through a
transient writhing instability without performing axial rotation. This may
explain certain experimentally observed motions of fibers of the bacterium B.
subtilis [N.H. Mendelson, et al., J. Bacteriol. 177, 7060 (1995)].Comment: 9 pages, 4 figure
Morphological Instabilities in a growing Yeast Colony: Experiment and Theory
We study the growth of colonies of the yeast Pichia membranaefaciens on
agarose film. The growth conditions are controlled in a setup where nutrients
are supplied through an agarose film suspended over a solution of nutrients. As
the thickness of the agarose film is varied, the morphology of the front of the
colony changes. The growth of the front is modeled by coupling it to a
diffusive field of inhibitory metabolites. Qualitative agreement with
experiments suggests that such a coupling is responsible for the observed
instability of the front.Comment: RevTex, 4 pages and 3 figure
Quantum resonances and decoherence for delta-kicked atoms
The quantum resonances occurring with delta-kicked atoms when the kicking
period is an integer multiple of the half-Talbot time are analyzed in detail.
Exact results about the momentum distribution at exact resonance are
established, both in the case of totally coherent dynamics and in the case when
decoherence is induced by Spontaneous Emission. A description of the dynamics
when the kicking period is close to, but not exactly at resonance, is derived
by means of a quasi-classical approximation where the detuning from exact
resonance plays the role of the Planck constant. In this way scaling laws
describing the shape of the resonant peaks are obtained. Such analytical
results are supported by extensive numerical simulations, and explain some
recent surprising experimental observations.Comment: 51 pages, 13 figures; KEYWORDS: quantum chaos, decoherence, kicked
rotor, dynamical localization, atom optics; submitted to Nonlinearit
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