10,657 research outputs found
Widespread occurrence of Mycobacterium tuberculosis DNA from 18th-19th century Hungarians
A large number (265) of burials from 1731-1838 were discovered in sealed crypts of the Dominican Church, Vac, Hungary in 1994. Many bodies were naturally mummified, so that both soft tissues and bones were available. Contemporary archives enabled the determination of age at death, and the identification of family groups. In some cases, symptoms before death were described and, occasionally, occupation. Initial radiological examination of a small number of individuals had indicated calcified lung lesions and demonstrable acid-fast bacteria suggestive of tuberculosis infection. Tuberculosis was endemic in 18th-19th century Europe, so human remains should contain detectable Mycobacterium tuberculosis complex (MTB) DNA, enabling comparisons with modern isolates. Therefore, a comprehensive examination of 168 individuals for the presence of MTB DNA was undertaken. Specific DNA amplification methods for MTB showed that 55% of individuals were positive and that the incidence varied according to age at death and sampling site in the body. Radiographs were obtained from 27 individuals and revealed an association between gross pathology and the presence of MTB DNA. There was an inverse relationship between PCR positivity and MTB target sequence size. In some cases, the preservation of MTB DNA was excellent, and several target gene sequences could be detected from the same sample. This information, combined with MTB DNA sequencing data and molecular typing techniques, will enable us to study the past epidemiology of TB infection, and extends the timeframe for studying changes in molecular fingerprints. Am J Phys Anthropol 120:144-152, 2003. (C) 2003 Wiley-Liss, Inc
Neurologists' lived experiences of communicating the diagnosis of a motor neurodegenerative condition: an interpretative phenomenological analysis
BACKGROUND
Receiving the diagnosis of a motor neurodegenerative condition (MNDC) can be a life-changing experience. Although several studies of individuals' experiences have indicated dissatisfaction with aspects of how an MNDC diagnosis was communicated, few studies have addressed doctors' experiences of breaking bad news for these conditions, especially from a qualitative perspective. This study explored UK neurologists' lived experience of delivering an MNDC diagnosis.
METHODS
Interpretative phenomenological analysis was used as the overarching method. Eight consultant neurologists working with patients with MNDCs took part in individual, semi-structured interviews.
RESULTS
Two themes were constructed from the data: 'Meeting patients' emotional and information needs at diagnosis: a balancing act between disease, patient and organization-related factors', and 'Empathy makes the job harder: the emotional impact and uncovered vulnerabilities associated with breaking bad news'. Breaking the news of an MNDC diagnosis was challenging for participants, both in terms of achieving a patient-centred approach and in terms of dealing with their own emotions during the process.
CONCLUSIONS
Based on the study's findings an attempt to explain sub-optimal diagnostic experiences documented in patient studies was made and how organizational changes can support neurologists with this demanding clinical task was discussed
Neurologists' current practice and perspectives on communicating the diagnosis of a motor neurodegenerative condition: a UK survey
Background
The communication of a life-changing diagnosis can be a difficult task for doctors with potential long-term effects on patient outcomes. Although several studies have addressed the experiences of individuals with motor neurodegenerative diseases in receiving this diagnosis, a significant research gap exists regarding professionals’ perspectives, especially in the UK. This study aimed to assess UK neurologists’ current practice and perspectives on delivering the diagnosis of a motor neurodegenerative disease, explore different aspects of the process and detail the potential challenges professionals might face.
Methods
We conducted an anonymised online survey with 44 questions, grouped into four sections; basic demographic information, current practice, the experience of breaking bad news and education and training needs.
Results
Forty-nine professionals completed the survey. Overall, participants seemed to meet the setting-related standards of good practice; however, they also acknowledged the difficulty of this aspect of their clinical work, with about half of participants (46.5%) reporting moderate levels of stress while breaking bad news. Patients’ relatives were not always included in diagnostic consultations and participants were more reluctant to promote a sense of optimism to patients with poorer prognosis. Although professionals reported spending a mean of around 30–40 min for the communication of these diagnoses, a significant proportion of participants (21–39%) reported significantly shorter consultation times, highlighting organisational issues related to lack of capacity. Finally, the majority of participants (75.5%) reported not following any specific guidelines or protocols but indicated their interest in receiving further training in breaking bad news (78.5%).
Conclusions
This was the first UK survey to address neurologists’ practice and experiences in communicating these diagnoses. Although meeting basic standards of good practice was reported by most professionals, we identified several areas of improvement. These included spending enough time to deliver the diagnosis appropriately, including patients’ relatives as a standard, promoting a sense of hope and responding to professionals’ training needs regarding breaking bad news
Evidence for nodal superconductivity in LaFePO
In several iron-arsenide superconductors there is strong evidence for a fully
gapped superconducting state consistent with either a conventional s-wave
symmetry or an unusual state where there the gap changes sign between
the electron and hole Fermi surface sheets. Here we report measurements of the
penetration depth in very clean samples of the related
iron-phosphide superconductor, LaFePO, at temperatures down to 100 mK.
We find that varies almost perfectly linearly with strongly
suggesting the presence of gap nodes in this compound. Taken together with
other data, this suggests the gap function may not be generic to all pnictide
superconductors
Observations of Reconnection Flows in a Flare on the Solar Disk
Magnetic reconnection is a well-accepted part of the theory of solar eruptive
events, though the evidence is still circumstantial. Intrinsic to the
reconnection picture of a solar eruptive event, particularly in the standard
model for two-ribbon flares ("CSHKP" model), are an advective flow of
magnetized plasma into the reconnection region, expansion of field above the
reconnection region as a flux rope erupts, retraction of heated
post-reconnection loops, and downflows of cooling plasma along those loops. We
report on a unique set of SDO/AIA imaging and Hinode/EIS spectroscopic
observations of the disk flare SOL2016-03-23T03:54 in which all four flows are
present simultaneously. This includes spectroscopic evidence for a plasma
upflow in association with large-scale expanding closed inflow field. The
reconnection inflows are symmetric, and consistent with fast reconnection, and
the post-reconnection loops show a clear cooling and deceleration as they
retract. Observations of coronal reconnection flows are still rare, and most
events are observed at the solar limb, obscured by complex foregrounds, making
their relationship to the flare ribbons, cusp field and arcades formed in the
lower atmosphere difficult to interpret. The disk location and favorable
perspective of this event have removed these ambiguities giving a clear picture
of the reconnection dynamics.Comment: 9 pages, 5 figures, and 1 table. Accepted for publication in ApJ
RC J1148+0455 identification: gravitational lens or group of galaxies ?
The structure of the radio source RC B1146+052 of the ``Cold'' catalogue is
investigated by data of the MIT-GB-VLA survey at 4850 MHz. This source belongs
to the steep spectrum radio sources subsample of the RC catalogue. Its spectral
index is = -1.04. The optical image of this source obtained with 6m
telescope is analysed. The radio source center is situated in a group of 8
galaxies of about 24 in the R-filter. The possible explanations of the
complex structure of radio components are considered.Comment: 6 pages, 5 figures, uses psfig.sty. This was the poster as presented
on Gamow Memorial Internat. Conference GMIC'99 "Early Universe: Cosmological
Problems and Instrumental Technologies" in St.Petersburg, 23-27 Aug., 1999.
Submitted to Proceedings to be published in A&A Transaction
Three dimensionality of pulsed second-sound waves in He II
Three dimensionality of 3D pulsed second sound wave in He II emitted from a
finite size heater is experimentally investigated and theoretically studied
based on two-fluid model in this study. The detailed propagation of 3D pulsed
second sound wave is presented and reasonable agreement between the
experimental and theoretical results is obtained. Heater size has a big
influence on the profile of 3D second sound wave. The counterflow between the
superfluid and normal fluid components becomes inverse in the rarefaction of 3D
second sound wave. The amplitude of rarefaction decreases due to the
interaction between second sound wave and quantized vortices, which explains
the experimental results about second sound wave near [Phys. Rev. Lett. 73,
2480 (1994)]. The accumulation of dense quantized vortices in the vicinity of
heater surface leads to the formation of a thermal boundary layer, and further
increase of heating duration results in the occurrence of boiling phenomena.
PACS numbers: 67.40.Pm 43.25.+y 67.40.BzComment: 30 pages, 9 figures. Physical Review B, Accepte
Healthcare professionals’ involvement in breaking bad news to newly diagnosed patients with motor neurodegenerative conditions: a qualitative study
Purpose
Research on breaking bad news (BBN) in healthcare has mostly focused on the doctor-patient interaction during a single consultation. However, it has been increasingly recognised that BBN is a wider process that also involves other healthcare professionals. This qualitative study explored non-medical1 healthcare professionals’ involvement in BBN to newly diagnosed patients with motor neurodegenerative conditions in the UK.
Materials and methods
19 healthcare professionals working with people with motor neurone disease, multiple sclerosis, Parkinson’s disease or Huntington’s disease took part in individual, semi-structured interviews which were analysed using thematic analysis.
Results
Four themes were constructed: dealing with the diagnostic aftermath, unpacking the diagnosis, breaking bad news as a balancing act and empowering patients to regain control over their health and lives. Participants reported being broadly involved in BBN by supporting patients with negative diagnostic experiences, re-iterating diagnostic information and helping patients understand the impact of their condition. The challenges of effectively breaking bad news and how these difficult conversations could help empower patients were also emphasised.
Conclusions
BBN was a critical and challenging aspect of healthcare professionals’ clinical work with newly diagnosed patients with motor neurodegenerative conditions. Besides providing information, BBN was perceived as a way to educate patients, encourage them to make decisions and prepare for the future
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