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Patients' experiences of transitioning between different renal replacement therapy modalities : a qualitative study

BACKGROUND: Different kidney replacement therapy modalities are available to manage end-stage kidney disease, such as home-based dialysis, in-center hemodialysis, and kidney transplantation. Although transitioning between modalities is common, data on how patients experience these transitions are scarce. This study explores patients' perspectives of transitioning from a home-based to an in-center modality. METHODS: Patients transitioning from peritoneal dialysis to in-center hemodialysis were purposively selected. Semi-structured interviews were performed, digitally recorded, and transcribed verbatim. Data analysis, consistent with Charmaz' constructivist approach of grounded theory was performed. RESULTS: Fifteen patients (10 males; mean age 62 years) participated. The conditions of the transitioning process impacted the participants' experiences, resulting in divergent experiences and associated emotions. Some participants experienced a loss of control due to the therapy-related changes. Some felt tied down and having lost independence, whereas others stated they regained control as they felt relieved from responsibility. This paradox of control was related to the patient having or not having (1) experienced a fit of hemodialysis with their personal lifestyle, (2) a frame of reference, (3) higher care requirements, (4) insight into the underlying reasons for transitioning, and (5) trust in the healthcare providers. CONCLUSIONS: Care teams need to offer opportunities to elicit patients' knowledge and fears, dispel myths, forge connections with other patients, and visit the dialysis unit before transition to alleviate anxiety. Interventions that facilitate a sense of control should be grounded in the meaning that the disorder has for the person and how it impacts their sense of self

Toward Specification-Guided Active Mars Exploration for Cooperative Robot Teams

As a step towards achieving autonomy in space exploration missions, we consider a cooperative robotics system consisting of a copter and a rover. The goal of the copter is to explore an unknown environment so as to maximize knowledge about a science mission expressed in linear temporal logic that is to be executed by the rover. We model environmental uncertainty as a belief space Markov decision process and formulate the problem as a two-step stochastic dynamic program that we solve in a way that leverages the decomposed nature of the overall system. We demonstrate in simulations that the robot team makes intelligent decisions in the face of uncertainty

Electro-optic routing of photons from single quantum dots in photonic integrated circuits

Recent breakthroughs in solid-state photonic quantum technologies enable generating and detecting single photons with near-unity efficiency as required for a range of photonic quantum technologies. The lack of methods to simultaneously generate and control photons within the same chip, however, has formed a main obstacle to achieving efficient multi-qubit gates and to harness the advantages of chip-scale quantum photonics. Here we propose and demonstrate an integrated voltage-controlled phase shifter based on the electro-optic effect in suspended photonic waveguides with embedded quantum emitters. The phase control allows building a compact Mach-Zehnder interferometer with two orthogonal arms, taking advantage of the anisotropic electro-optic response in gallium arsenide. Photons emitted by single self-assembled quantum dots can be actively routed into the two outputs of the interferometer. These results, together with the observed sub-microsecond response time, constitute a significant step towards chip-scale single-photon-source de-multiplexing, fiber-loop boson sampling, and linear optical quantum computing.Comment: 7 pages, 4 figues + supplementary informatio

Educational differences in the validity of self-reported physical activity

BACKGROUND: The assessment of physical activity for surveillance or population based studies is usually done with self-report questionnaires. However, bias in self-reported physical activity may be greater in lower educated than in higher educated populations. The aim of the present study is to describe educational differences in the validity of self-reported physical activity. METHODS: We included 196 healthy adults (age 57 ± 15.4, of whom 17 % low, 24 % medium and 59 % high educated). Criterion validity of an adapted International Physical Activity Questionnaire was assessed against the ActiGraph GT3X+ accelerometer. RESULTS: While criterion validity of self-reported physical activity was low to moderate in the total sample (Spearman rho ranged from 0.16 to 0.27, depending on the variables used), the validity in lower educated respondents was poor (-0.07 to 0.05). CONCLUSIONS: The results confirm the hypothesis that self-report physical activity questionnaires are less valid in lower educated populations

The Distance to NGC 4993: The Host Galaxy of the Gravitational-wave Event GW170817

The historic detection of gravitational waves from a binary neutron star merger (GW170817) and its electromagnetic counterpart led to the first accurate (sub-arcsecond) localization of a gravitational-wave event. The transient was found to be $\sim$10" from the nucleus of the S0 galaxy NGC 4993. We report here the luminosity distance to this galaxy using two independent methods. (1) Based on our MUSE/VLT measurement of the heliocentric redshift ($z_{\rm helio}=0.009783\pm0.000023$) we infer the systemic recession velocity of the NGC 4993 group of galaxies in the cosmic microwave background (CMB) frame to be $v_{\rm CMB}=3231 \pm 53$ km s$^{-1}$. Using constrained cosmological simulations we estimate the line-of-sight peculiar velocity to be $v_{\rm pec}=307 \pm 230$ km s$^{-1}$, resulting in a cosmic velocity of $v_{\rm cosmic}=2924 \pm 236$ km s$^{-1}$ ($z_{\rm cosmic}=0.00980\pm 0.00079$) and a distance of $D_z=40.4\pm 3.4$ Mpc assuming a local Hubble constant of $H_0=73.24\pm 1.74$ km s$^{-1}$ Mpc$^{-1}$. (2) Using Hubble Space Telescope measurements of the effective radius (15.5" $\pm$ 1.5") and contained intensity and MUSE/VLT measurements of the velocity dispersion, we place NGC 4993 on the Fundamental Plane (FP) of E and S0 galaxies. Comparing to a frame of 10 clusters containing 226 galaxies, this yields a distance estimate of $D_{\rm FP}=44.0\pm 7.5$ Mpc. The combined redshift and FP distance is $D_{\rm NGC 4993}= 41.0\pm 3.1$ Mpc. This 'electromagnetic' distance estimate is consistent with the independent measurement of the distance to GW170817 as obtained from the gravitational-wave signal ($D_{\rm GW}= 43.8^{+2.9}_{-6.9}$ Mpc) and confirms that GW170817 occurred in NGC 4993.Comment: 9 pages, 5 figure

Implikasi Kedudukan Gubernur Daerah Istimewa YOGYAKARTA Terhadap Demokratisasi Dan Efektivitas Pemerintahan Daerah Istimewa YOGYAKARTA

Governor multiple appointments by Sri Sultan Hamengku as King of Kasultanan is one ofDaerah Istimewa Yogyakarta's privileges. In one side, Daerah Istimewa Yogyakarta is able toimplement the democracy in daily lives. But in other side, the absences of elections as oneelement of the democracy, bring out the questions about governmental process which isdemocratic and effective in Daerah Istimewa Yogyakarta. Courteous attitude owned by thepeople and legislative institution causing minimum control system for executive institution. Atthe end, we need to find formula of the implication dualism Governor positions by King ofKasultanan towards democratic and government effectiveness in Daerah Istimewa Yogyakarta