Voices emerging from the shadows : Radiologic practitioners’ experiences of challenging conversations

Objective Traditionally, radiologists have practiced their profession behind the scenes. Today, radiologic practitioners face mounting expectations to communicate more directly with patients. However, their experiences with patient communication are not well understood. The aim of this study was to describe the challenges of radiologic practitioners when communicating with patients. Methods Twelve day-long interprofessional communication skills workshops for radiologic clinicians were held at Boston Children\u2019s Hospital. Prior to each workshop, participants were asked to write narratives describing experiences with difficult radiologic conversations that they found particularly challenging or satisfying. The narratives were transcribed and analyzed through thematic content analysis by two researchers. Results Radiologists, radiology trainees, technologists, nurses, and medical interpreters completed 92 narratives. The most challenging aspects of healthcare conversations included: Conveying Serious News (n = 44/92; 48%); Expanded Scope of Radiologic Practice (n = 37/92; 40%); Inexperience and Gaps in Education (n = 15/92; 16%); Clinical Uncertainty (n = 14/92; 15%); and Interprofessional Teamwork (n = 9/92; 10%). Conclusion Radiologic clinicians face substantial communicative challenges focused on conveying serious, unexpected and uncertain diagnoses amid practical challenges and limited educational opportunities. Practice implications Innovative educational curricula that address these challenges may enhance radiologic practitioners\u2019 success in adopting patient-centered communication

Integrated optical directional coupler biosensor

We present measurements on biomolecular binding reactions, using a new type of integrated optical biosensor based on a planar directional coupler structure. The device is fabricated by Ag+-Na+ ion-exchange in glass and definition of the sensing region is achieved by use of transparent fluoropolymer isolation layers formed by thermal evaporation. The suitability of the sensor for application to the detection of environmental pollutants is considered

Experiences of health care transition voiced by young adults with type 1 diabetes: a qualitative study

Objective: This qualitative study aimed to explore the experience of transition from pediatric to adult diabetes care reported by posttransition emerging adults with type 1 diabetes (T1D), with a focus on preparation for the actual transfer in care. Methods: Twenty-six T1D emerging adults (mean age 26.2±2.5 years) receiving adult diabetes care at a single center participated in five focus groups stratified by two levels of current glycemic control. A multidisciplinary team coded transcripts and conducted thematic analysis. Results: Four key themes on the process of transfer to adult care emerged from a thematic analysis: 1) nonpurposeful transition (patients reported a lack of transition preparation by pediatric providers for the transfer to adult diabetes care); 2) vulnerability in the college years (patients conveyed periods of loss to follow-up during college and described health risks and diabetes management challenges specific to the college years that were inadequately addressed by pediatric or adult providers); 3) unexpected differences between pediatric and adult health care systems (patients were surprised by the different feel of adult diabetes care, especially with regards to an increased focus on diabetes complications); and 4) patients’ wish list for improving the transition process (patients recommended enhanced pediatric transition counseling, implementation of adult clinic orientation programs, and peer support for transitioning patients). Conclusion: Our findings identify modifiable deficiencies in the T1D transition process and underscore the importance of a planned transition with enhanced preparation by pediatric clinics as well as developmentally tailored patient orientation in the adult clinic setting

Secondary user relations in emerging mobile computing environments

Mobile technologies are enabling access to information in diverse environ.ments, and are exposing a wider group of individuals to said technology. Therefore, this paper proposes that a wider view of user relations than is usually considered in information systems research is required. Specifically, we examine the potential effects of emerging mobile technologies on end-­‐user relations with a focus on the ‘secondary user’, those who are not intended to interact directly with the technology but are intended consumers of the technology’s output. For illustration, we draw on a study of a U.K. regional Fire and Rescue Service and deconstruct mobile technology use at Fire Service incidents. Our findings provide insights, which suggest that, because of the nature of mobile technologies and their context of use, secondary user relations in such emerging mobile environments are important and need further exploration

Reservoir characterization of the Ordovician Red River Formation in southwest Williston Basin Bowman County, ND and Harding County, SD

This topical report is a compilation of characterizations by different disciplines of the Red River Formation in the southwest portion of the Williston Basin and the oil reservoirs which it contains in an area which straddles the state line between North Dakota and South Dakota. Goals of the report are to increase understanding of the reservoir rocks, oil-in-place, heterogeneity, and methods for improved recovery. The report is divided by discipline into five major sections: (1) geology, (2) petrography-petrophysical, (3) engineering, (4) case studies and (5) geophysical. Interwoven in these sections are results from demonstration wells which were drilled or selected for special testing to evaluate important concepts for field development and enhanced recovery. The Red River study area has been successfully explored with two-dimensional (2D) seismic. Improved reservoir characterization utilizing 3-dimensional (3D) and has been investigated for identification of structural and stratigraphic reservoir compartments. These seismic characterization tools are integrated with geological and engineering studies. Targeted drilling from predictions using 3D seismic for porosity development were successful in developing significant reserves at close distances to old wells. Short-lateral and horizontal drilling technologies were tested for improved completion efficiency. Lateral completions should improve economics for both primary and secondary recovery where low permeability is a problem and higher density drilling is limited by drilling cost. Low water injectivity and widely spaced wells have restricted the application of waterflooding in the past. Water injection tests were performed in both a vertical and a horizontal well. Data from these tests were used to predict long-term injection and oil recovery

Unlocking the role of a genital herpesvirus, otarine herpesvirus 1, in California sea lion cervical cancer

This research was funded by the Geoffrey Hughes Research Fellowship and The Marine Mammal Center.Urogenital carcinoma in California sea lions (Zalophus californianus) is the most common cancer of marine mammals. Primary tumors occur in the cervix, vagina, penis, or prepuce and aggressively metastasize resulting in death. This cancer has been strongly associated with a sexually transmitted herpesvirus, otarine herpesvirus 1 (OtHV1), but the virus has been detected in genital tracts of sea lions without cancer and a causative link has not been established. To determine if OtHV1 has a role in causing urogenital carcinoma we sequenced the viral genome, quantified viral load from cervical tissue from sea lions with (n = 95) and without (n = 163) urogenital carcinoma, and measured viral mRNA expression using in situ mRNA hybridization (Basescope®) to quantify and identify the location of OtHV1 mRNA expression. Of the 95 sea lions diagnosed with urogenital carcinoma, 100% were qPCR positive for OtHV1, and 36% of the sea lions with a normal cervix were positive for the virus. The non-cancer OtHV1 positive cases had significantly lower viral loads in their cervix compared to the cervices from sea lions with urogenital carcinoma. The OtHV1 genome had several genes similar to the known oncogenes, and RNA in situ hybridization demonstrated high OtHV1 mRNA expression within the carcinoma lesions but not in normal cervical epithelium. The high viral loads, high mRNA expression of OtHV1 in the cervical tumors, and the presence of suspected OtHV1 oncogenes support the hypothesis that OtHV1 plays a significant role in the development of sea lion urogenital carcinoma.Publisher PDFPeer reviewe

Between overt and covert research: concealment and disclosure in an ethnographic study of commercial hospitality

This article examines the ways in which problems of concealment emerged in an ethnographic study of a suburban bar and considers how disclosure of the research aims, the recruitment of informants, and elicitation of information was negotiated throughout the fieldwork. The case study demonstrates how the social context and the relationships with specific informants determined overtness or covertness in the research. It is argued that the existing literature on covert research and covert methods provides an inappropriate frame of reference with which to understand concealment in fieldwork. The article illustrates why concealment is sometimes necessary, and often unavoidable, and concludes that the criticisms leveled against covert methods should not stop the fieldworker from engaging in research that involves covertness

A weighting method to improve habitat association analysis: tested on British carabids

Analysis of species’ habitat associations is important for biodiversity conservation and spatial ecology. The original phi coefficient of association is a simple method that gives both positive and negative associations of individual species with habitats. The method originates in assessing the association of plant species with habitats, sampled by quadrats. Using this method for mobile animals creates problems as records often have imprecise locations, and would require either using only records related to a single habitat or arbitrarily choosing a single habitat to assign. We propose and test a new weighted version of the index that retains more records, which improves association estimates and allows assessment of more species. It weights habitats that lie within the area covered by the species record with their certainty level, in our case study, the proportion of the grid cell covered by that habitat. We used carabid beetle data from the National Biodiversity Network atlas and CEH Land Cover Map 2015 across Great Britain to compare the original method with the weighted version. We used presence‐only data, assigning species absences using a threshold based on the number of other species found at a location, and conducted a sensitivity analysis of this threshold. Qualitative descriptions of habitat associations were used as independent validation data. The weighted index allowed the analysis of 52 additional species (19% more) and gave results with as few as 50 records. For the species we could analyse using both indices, the weighted index explained 70% of the qualitative validation data compared to 68% for the original, indicating no accuracy loss. The weighted phi coefficient of association provides an improved method for habitat analysis giving information on preferred and avoided habitats for mobile species that have limited records, and can be used in modelling and analysis that directs conservation policy and practice