Barriers to mental health service use among distressed family caregivers of lung cancer patients

Although family caregivers of patients with lung and other cancers show high rates of psychological distress, they underuse mental health services. This qualitative study aimed to identify barriers to mental health service use among 21 distressed family caregivers of lung cancer patients. Caregivers had not received mental health services during the patient's initial months of care at a comprehensive cancer centre in New York City. Thematic analysis of interview data was framed by Andersen's model of health service use and Corrigan's stigma theory. Results of our analysis expand Andersen's model by providing a description of need variables (e.g. psychiatric symptoms), enabling factors (e.g. finances), and psychosocial factors associated with caregivers' non-use of mental health services. Regarding psychosocial factors, caregivers expressed negative perceptions of mental health professionals and a desire for independent management of emotional concerns. Additionally, caregivers perceived a conflict between mental health service use and the caregiving role (e.g. prioritising the patient's needs). Although caregivers denied stigma associated with service use, their anticipated negative self-perceptions if they were to use services suggest that stigma may have influenced their decision to not seek services. Findings suggest that interventions to improve caregivers' uptake of mental health services should address perceived barriers

Development of an antimicrobial blended white LED system containing pulsed 405-nm LEDs for decontamination applications

This study details the design, build and testing of a prototype antimicrobial blended white light unit containing pulsed red, yellow, green and 405nm LEDs. With a push for alternative methods of disinfection, optical methods have become a topic of interest. Ultra-violet (UV) light is widely known for its antimicrobial properties however; 405nm light has demonstrated significant antimicrobial properties against many common hospital acquired pathogens. In this study, a pulsed, blended, white-light prototype with a high content of 405 nm antimicrobial light, was designed, built and tested. Antimicrobial efficacy testing of the prototype was conducted using Staphylococcus aureus and Pseudomonas. aeruginosa, two bacteria which are common causes of hospital acquired infections. These were exposure to 3 different light outputs from the prototype and the surviving bacteria enumerated. Results showed that the mixed light output provided a much better CRI and light output under which to work. Also, the light output containing 405 nm light provided an antimicrobial effect, with decontamination of 103 CFUml-1 populations of both bacterial species. The other light content (red, yellow, green) had no beneficial or adverse effects on the antimicrobial properties of the 405nm light. The results suggest that with further development, it could be possible to produce an antimicrobial blended white light containing pulsed 405nm light that could supplement or even replace standard white lighting in certain environments

Efficacy of Pulsed 405-nm LEDs for antimicrobial photodynamic inactivation : effects of intensity, frequency, and duty cycle

Objective: This study investigates possible advantages in pulsed over continuous 405-nm LED-light for bacterial inactivation and energy efficiency. Background: Alternative non-antibiotic methods of disinfection and infection control have become of significant interest. Recent studies have demonstrated the application of systems using 405-nm light-emitting diodes for continuous disinfection of the clinical environment, and also for potential treatment of contaminated wounds. Methods: Liquid suspensions of 103 CFU/ml populations of Staphylococcus aureus were subject to pulsed 405-nm light of different frequencies, duty cycles and intensities, and for different lengths of time. Results: Pulsed exposures with the same average irradiance of 16 mWcm2 and varying duty cycle (25%, 50%, 75%), showed very similar performance compared with continuous exposures, with 95-98% reduction of S. aureus achieved for all duty cycles. The pulsing frequency was varied in intervals from 100 Hz - 10 kHz and appeared to have little effect on antimicrobial efficacy. However, when comparing pulsed with continuous exposure, an improvement in inactivation per unit optical energy was achieved, with results showing an increase of approximately 83% in optical efficiency. Conclusions: These results suggest that under pulsed conditions a lower energy consumption and lower perceived brightness could be achieved, thus potentially providing improved operating conditions for medical/infection-control applications without compromising antimicrobial efficacy

Warped Higgsless Models with IR--Brane Kinetic Terms

We examine a warped Higgsless $SU(2)_L\times SU(2)_R\times U(1)_{B-L}$ model in 5--$d$ with IR(TeV)--brane kinetic terms. It is shown that adding a brane term for the $U(1)_{B-L}$ gauge field does not affect the scale ($\sim 2-3$ TeV) where perturbative unitarity in $W_L^+ W_L^- \to W_L^+ W_L^-$ is violated. This term could, however, enhance the agreement of the model with the precision electroweak data. In contrast, the inclusion of a kinetic term corresponding to the $SU(2)_D$ custodial symmetry of the theory delays the unitarity violation in $W_L^\pm$ scattering to energy scales of $\sim 6-7$ TeV for a significant fraction of the parameter space. This is about a factor of 4 improvement compared to the corresponding scale of unitarity violation in the Standard Model without a Higgs. We also show that null searches for extra gauge bosons at the Tevatron and for contact interactions at LEP II place non-trivial bounds on the size of the IR-brane terms.Comment: 23 pages, 8 figure

Randomly Evolving Idiotypic Networks: Structural Properties and Architecture

We consider a minimalistic dynamic model of the idiotypic network of B-lymphocytes. A network node represents a population of B-lymphocytes of the same specificity (idiotype), which is encoded by a bitstring. The links of the network connect nodes with complementary and nearly complementary bitstrings, allowing for a few mismatches. A node is occupied if a lymphocyte clone of the corresponding idiotype exists, otherwise it is empty. There is a continuous influx of new B-lymphocytes of random idiotype from the bone marrow. B-lymphocytes are stimulated by cross-linking their receptors with complementary structures. If there are too many complementary structures, steric hindrance prevents cross-linking. Stimulated cells proliferate and secrete antibodies of the same idiotype as their receptors, unstimulated lymphocytes die. Depending on few parameters, the autonomous system evolves randomly towards patterns of highly organized architecture, where the nodes can be classified into groups according to their statistical properties. We observe and describe analytically the building principles of these patterns, which allow to calculate number and size of the node groups and the number of links between them. The architecture of all patterns observed so far in simulations can be explained this way. A tool for real-time pattern identification is proposed.Comment: 19 pages, 15 figures, 4 table

Spontaneous symmetry breaking: exact results for a biased random walk model of an exclusion process

It has been recently suggested that a totally asymmetric exclusion process with two species on an open chain could exhibit spontaneous symmetry breaking in some range of the parameters defining its dynamics. The symmetry breaking is manifested by the existence of a phase in which the densities of the two species are not equal. In order to provide a more rigorous basis to these observations we consider the limit of the process when the rate at which particles leave the system goes to zero. In this limit the process reduces to a biased random walk in the positive quarter plane, with specific boundary conditions. The stationary probability measure of the position of the walker in the plane is shown to be concentrated around two symmetrically located points, one on each axis, corresponding to the fact that the system is typically in one of the two states of broken symmetry in the exclusion process. We compute the average time for the walker to traverse the quarter plane from one axis to the other, which corresponds to the average time separating two flips between states of broken symmetry in the exclusion process. This time is shown to diverge exponentially with the size of the chain.Comment: 42 page

Vegetation and peat characteristics of restiad bogs on Chatham Island (Rekohu), New Zealand

Restiad bogs dominated by Sporadanthus traversii on Chatham Island, New Zealand, were sampled to correlate vegetation patterns and peat properties, and to compare with restiad systems dominated by Sporadanthus ferrugineus and Empodisma minus in the Waikato region, North Island, New Zealand. Classification and ordination resulted in five groups that reflected a disturbance gradient. The largest S. traversii group, which comprised plots from central, relatively intact bogs, had the lowest levels of total nitrogen (mean 1.20 mg cm-3), total phosphorus (mean 0.057 mg cm-3), total potassium (mean 0.083 mg cm-3), and available phosphorus (mean 18.6 μg cm-3). Modification by drainage, stock, and fires resulted in a decline of S. traversii and an increase of Gleichenia dicarpa fern cover, together with elevated peat nutrient levels and higher bulk density. Compared with peat dominated by Sporadanthus ferrugineus or Empodisma minus in relatively unmodified Waikato restiad bogs, Chatham Island peat under S. traversii has significantly higher total potassium, total nitrogen, available phosphorus, bulk density, and von Post decomposition indices, and significantly lower pH. Sporadanthus traversii and Empodisma minus have similar ecological roles in restiad bog development, occupying a relatively wide nutrient range, and regenerating readily from seed after fire. Despite differences in root morphology, S. traversii and E. minus are the major peat formers in raised restiad bogs on Chatham Island and in Waikato, respectively, and could be regarded as ecological equivalents

Wage losses in the year after breast cancer: Extent and determinants among Canadian women

This article is available open access through the publisher’s website at the link below. © The Author 2008.Background - Wage losses after breast cancer may result in considerable financial burden. Their assessment is made more urgent because more women now participate in the workforce and because breast cancer is managed using multiple treatment modalities that could lead to long work absences. We evaluated wage losses, their determinants, and the associations between wage losses and changes for the worse in the family's financial situation among Canadian women over the first 12 months after diagnosis of early breast cancer. Methods - We conducted a prospective cohort study among women with breast cancer from eight hospitals throughout the province of Quebec. Information that permitted the calculation of wage losses and information on potential determinants of wage losses were collected by three pretested telephone interviews conducted over the year following the start of treatment. Information on medical characteristics was obtained from medical records. The main outcome was the proportion of annual wages lost because of breast cancer. Multivariable analysis of variance using the general linear model was used to identify personal, medical, and employment characteristics associated with the proportion of wages lost. All statistical tests were two-sided. Results - Among 962 eligible breast cancer patients, 800 completed all three interviews. Of these, 459 had a paying job during the month before diagnosis. On average, these working women lost 27% of their projected usual annual wages (median = 19%) after compensation received had been taken into account. Multivariable analysis showed that a higher percentage of lost wages was statistically significantly associated with a lower level of education (Ptrend = .0018), living 50 km or more from the hospital where surgery was performed (P = .070), lower social support (P = .012), having invasive disease (P = .086), receipt of chemotherapy (P < .001), self-employment (P < .001), shorter tenure in the job (Ptrend < .001), and part-time work (P < .001). Conclusion - Wage losses and their effects on financial situation constitute an important adverse consequence of breast cancer in Canada.The Canadian Breast Cancer Research Alliance, Canadian Institutes of Health Research, and Fondation de l’Université Laval

Motional Squashed States

We show that by using a feedback loop it is possible to reduce the fluctuations in one quadrature of the vibrational degree of freedom of a trapped ion below the quantum limit. The stationary state is not a proper squeezed state, but rather a ``squashed'' state, since the uncertainty in the orthogonal quadrature, which is larger than the standard quantum limit, is unaffected by the feedback action.Comment: 8 pages, 2 figures, to appear in the special Issue "Quantum Correlations and Fluctuations" of J. Opt.