Deformation analysis of a metropolis from C- to X-band PSI: proof-of-concept with Cosmo-Skymed over Rome, Italy

Stability of monuments and subsidence of residential quarters in Rome (Italy) are depicted based on geospatial analysis of more than 310,000 Persistent Scatterers (PS) obtained from Stanford Method for Persistent Scatterers (StaMPS) processing of 32 COSMO-SkyMed 3m-resolution HH StripMap ascending mode scenes acquired between 21 March 2011 and 10 June 2013. COSMO-SkyMed PS densities and associated displacement velocities are compared with almost 20 years of historical C-band ERS- 1/2, ENVISAT and RADARSAT-1/2 imagery. Accounting for differences in image processing algorithms and satellite acquisition geometries, we assess the feasibility of ground motion monitoring in big cities and metropolitan areas by coupling newly acquired and legacy SAR in full time series. Limitations and operational benefits of the transition from medium resolution C-band to high resolution X-band PS data are discussed, alongside the potential impact on the management of expanding urban environments

The vulnerability of the individual benefit argument

In "Shared Vulnerabilities in Research" the author argues that research conferring no direct benefit and conducted with a vulnerable group of subjects cannot be morally justified on the grounds that the beneficiaries of that research share the subjects' vulnerability. While we agree that the paper's central argument is valid, we challenge the assumption that one (A) suffers for the benefit of another (B). The author erroneously extracts A from his group (of vulnerable subjects). Consequently, any opportunities or benefits that may come to the group will exclude A. Ultimately, we conclude that it does make a moral difference whether the beneficiaries share the research subjects' vulnerability

End-of-life decision making in pediatrics: literature review on children's and adolescents' participation

Background: Pediatric guidelines recommend that children and adolescents participate in a developmentally appropriate way in end-of-life decision making. Shared decision making in pediatrics is unique because of the triadic relationship of patient, parents, and physician. The involvement of the patient may vary on a continuum from no involvement to being the sole decision maker. However, the effects of child participation have not been thoroughly studied. The aim of this literature review is to identify studies on end-of-life decision making in pediatrics to explore patient participation and to assess the effects of such participation. Methods: Five databases - PubMed, PsycInfo, Medline, CINAHL, and Sociological Abstract - were searched for empirical studies on end-of-life decision making in pediatrics. Selected articles fulfilling the criteria were assessed for type of decision, participants’ characteristics, reports on participation of the minor patient, and outcome. Results: Fifty-seven articles on end-of-life decision making in pediatrics were identified. The majority of papers (n = 43, 75%) investigated parents’ and clinicians’ perspectives, while only 14 articles (25%) included perspectives of children and adolescents. Twenty-two articles (39%) reported some details on various forms of children's participation (e.g., receive information, plan care details, consulted before or after a decision was made). Positive (e.g., respect for patient's preferences) as well as negative (e.g., conflict due to diverging opinions) effects of children's participation in end-of-life decision making were reported. Conclusions: This systematic review highlights the need for research to identify factors that contribute to a favorable participation of minors in decision making processes as well as strategies to solve possible conflicts. More research should take into account the dynamics in the triadic process of decision making and emphasize children and adolescents’ perspectives. A better understanding of how to meaningfully involve children and adolescents in end-of-life decision making could facilitate the practice of patient participation in pediatrics

Cancer care in Romania: challenges and pitfalls of children's and adolescents' multifaceted involvement

Communication about diagnosis and medical treatment for children suffering from life-threatening illnesses is complex. It is a primary step in involving underage patients and families in care and lays the foundation for obtaining parental permission and patient assent for treatment. In practice child participation in care is often difficult to obtain due to patients' different and sometimes fluctuating preferences, but also parents' protective strategies. Physicians may be susceptible to parental wishes to limit information and feel uncomfortable discussing issues related to uncertainty of cure with patients. A qualitative study in Romanian paediatric oncology units was conducted to explore children's involvement from the perspectives of parents and oncologists. Interviews with participants discussed 18 patient cases. Data were transcribed and thematic analysis was used to interpret and mine patients' involvement during treatment. Different facets of patient participation were identified: restricting, widening and enhancing involvement. A fourth category, unintentional involvement, occurred for all patients due to children's observations during long-term hospitalisations and access to Internet. Uncertainty overarched parental attitudes regarding the extent to which children should be included. Physicians usually complied with parental wishes to limit involvement, but together with parents involved patients at least in a practical way. Adults' protective attitude may backfire, as adolescents' online searches often expose patients to worse-case scenarios. Further research should acknowledge the hazards of restricted diagnosis disclosure and develop clinician tools to support families in communicating with patients. This should be paralleled by physician efforts to elicit patients' needs regarding participation

Decision making in pediatric oncology: Views of parents and physicians in two European countries

Decision making is a highly complex task when providing care for seriously ill children. Physicians, parents, and children face many challenges when identifying and selecting from available treatment options

Parents' and patients' experiences with paediatric oncology care in Switzerland--satisfaction and some hurdles

This paper explores parents' and patients' satisfaction with care in Swiss paediatric oncology settings and examines difficulties experienced while undergoing treatment for cancer.; Semistructured interviews were conducted with 19 parents, and with 17 children who were diagnosed with cancer and receiving treatment. During these interviews questions pertaining to communication and decision-making at time of diagnosis and throughout the illness course were asked. In this paper, we examined these interviews using thematic coding to identify themes with regard to satisfaction with care.; Generally, participants reported being very content with the care they received. Aspects that contributed to satisfaction were the friendliness and responsive nature of healthcare staff; helpful communication; and professionals going beyond their duties to care for the family. In spite of mainly being pleased with the care they received, participants underlined several issues that made their experiences at times difficult. These included frequent change of physician or receiving care from another unit, which for them represented lack of continuity of care; language problems; and challenges with reproductive health issues of the child. Additionally, patients suggested several ways to improve hospital stays and thereby patient satisfaction.; Participants reported being very satisfied with care delivered by paediatric oncology units. Nevertheless, they also identified problems that are worth addressing in order to efficiently tend to the needs of patients and families undergoing this difficult experience. Future research is needed to explore how care for children with cancer and their families can be further improved

Participation in pediatric oncology: views of child and adolescent patients

The aim of the present study is to explore patient's perspectives in pediatric oncology on participation in discussions and decision-making surrounding their cancer diagnosis.; Seventeen patients between 9 and 17 years of age receiving treatment at centers of the Swiss Pediatric Oncology Group were interviewed for this study. Their interview data was analyzed qualitatively to identify themes with regard to participation in medical communication and/or decision-making.; Participants highlighted how their roles in health care discussions varied from direct participation to indirect involvement. Overall, there were fewer accounts of involvement in decision-making than in overall health care discussions. Challenges with regard to completely understanding the information provided and making decisions were identified. Participants also discussed situations when they were not involved in medical communication or decision-making. While they generally valued their participation, the preferred level of involvement oscillated between participants as well as within one and the same child across time.; The complex pattern of participation found in this study calls for a flexible model of involving children and adolescents in health care that accounts for the varying roles and preferences that they manifest. A patient may appreciate active involvement in some decisions while choosing to remain in the background for others. Copyright © 2015 John Wiley & Sons, Ltd

Dynamics of CL-P1 in ischemia/reperfusion

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