219 research outputs found
How outpatient palliative care teleconsultation facilitates empathic patient-professional relationships: a qualitative study
Rapportage LTO FAB II 2008 : Functionele Agro Biodiversiteit
Doel van het LTO FAB II project is een gebruiksklaar FAB concept te ontwikkelen voor een aantal ziekten en plagen in een aantal gewassen die op eenvoudige wijze door telers benut kan worden en voor de toepasser kostenneutraal zijn. Uitgangspunt in het FAB project is een evenwichtige balans tussen de 3 P’s (People, planet én profit). Het toetsen van wetenschappelijke inzichten en het genereren van nieuwe voor de praktijk toepasbare kennis is de centrale taak van dit project. Daarbij daagt FAB de wetenschap uit en worden innovaties uitgeprobeerd. In deze rapportage zijn de resultaten en conclusies verwoord voor de deelprojecten omgeving, bovengronds (akkerranden en scouting) en bodem tijdens het seizoen 200
Realizing better doctor-patient dialogue about choices in palliative care and early phase clinical trial participation: towards an online value clarification tool (OnVaCT)
Realizing better doctor-patient dialogue about choices in palliative care and early phase clinical trial participation: towards an online value clarification tool (OnVaCT)
Background: Patients with advanced cancer for whom standard systemic treatment is no longer available may be
offered participation in early phase clinical trials. In the decision making process, both medical-technical information
and patient values and preferences are important. Since patients report decisional conflict after deciding on
participation in these trials, improving the decision making process is essential. We aim to develop and evaluate an
Online Value Clarification Tool (OnVaCT) to assist patients in clarifying their values around this end-of-life decision.
This improved sharing of values is hypothesized to support medical oncologists in tailoring their information to
individual patients’ needs and, consequently, to support patients in taking decisions in line with their values and
reduce decisional conflict.
Methods: In the first part, patients’ values and preferences and medical oncologists’ views hereupon will be
explored in interviews and focus groups to build a first prototype OnVaCT using digital communication (serious
gaming). Next, we will test feasibility during think aloud sessions, to deliver a ready-to-implement OnVaCT. In the
second part, the OnVaCT, with accompanied training module, will be evaluated in a pre-test (12–18 months before
implementation) post-test (12–18 months after implementation) study in three major Dutch cancer centres. We will
include 276 patients (> 18 years) with advanced cancer for whom standard systemic therapy is no longer available,
and who are referred for participation in early phase clinical trials. The first consultation will be recorded to analyse
patient-physician communication regarding the discussion of patients’ values and the decision making process.
Three weeks afterwards, decisional conflict will be measured.
Discussion: This project aims to support the discussion of patient values when considering participation in early
phase clinical trials. By including patients before their first appointment with the medical oncologist and record
Vortex Motion Noise in Micrometre-Sized Thin Films of the Amorphous Nb0.7Ge0.3 Weak-Pinning Superconductor
We report high-resolution measurements of voltage (V) noise in the mixed
state of micrometre-sized thin films of amorphous Nb0.7Ge0.3, which is a good
representative of weak-pinning superconductors. There is a remarkable
difference between the noise below and above the irreversibility field Birr.
Below Birr, in the presence of measurable pinning, the noise at small applied
currents resembles shot noise, and in the regime of flux flow at larger
currents decreases with increasing voltage due to a progressive ordering of the
vortex motion. At magnetic fields B between Birr and the upper critical field
Bc2 flux flow is present already at vanishingly small currents. In this regime
the noise scales with (1-B/Bc2)^2 V^2 and has a frequency (f) spectrum of 1/f
type. We interpret this noise in terms of the properties of strongly driven
depinned vortex systems at high vortex density.Comment: 8 pages, 5 figures, version accepted for publication in PR
Automated reasoning on feature models
Software Product Line (SPL) Engineering has proved to be an effective method for software production. However, in the SPL community it is well recognized that variability in SPLs is increasing by the thousands. Hence, an automatic support is needed to deal with variability in SPL. Most of the current proposals for automatic reasoning on SPL are not devised to cope with extra– functional features. In this paper we introduce a proposal to model and reason on an SPL using constraint programming. We take into account functional and extra–functional features, improve current proposals and present a running, yet feasible implementation
Stem cell factor receptor (c-KIT) codon 816 mutations predict development of bilateral testicular germ-cell tumors
Testicular germ-cell tumors (TGCTs) of adolescents and adults originate
from intratubular germ cell neoplasia (ITGCN), which is composed of the
malignant counterparts of embryonal germ cells. ITGCN cells are
characterized, among others, by the presence of stem cell factor receptor
c-KIT. Once established, ITGCN will always progress to invasiveness.
Approximately 2.5-5% of patients with a TGCT will develop bilateral
disease and require complete castration, resulting in infertility, a need
for lifelong androgen replacement, and psychological stress. To date, the
only way to predict a contralateral tumor is surgical biopsy of the
contralateral testis to demonstrate ITGCN. We did a retrospective study of
224 unilateral and 61 proven bilateral TGCTs (from 46 patients, in three
independently collected series in Europe) for the presence of activating
c-KIT codon 816 mutations. A c-KIT codon 816 mutation was found in three
unilateral TGCT (1.3%), and in 57 bilateral TGCTs (93%; P < 0.0001). In
the two wild-type bilateral tumors for which ITGCN was available, the
preinvasive cells contained the mutation. The mutations were somatic in
origin and identical in both tumors. We conclude that somatic activating
codon 816 c-KIT mutations are associated with development of bilateral
TGCT. Detection of c-KIT codon 816 mutations in unilateral TGCT identifies
patients at risk for bilateral disease. These patients may undergo
tailored treatment to prevent the development of bilateral disease, with
retention of testicular hormonal function
Rapportage FAB 2006 : Functionele Agro Biodiversiteit
Dit LTO project over functionele agrobiodiversiteit is mede gefinancierd door LNV, VROM, Hoofdproductschap Akkerbouw, Productschap Tuinbouw en Rabobank. Het bevat tekstbijdragen vanuit LEI, PRI, PPO, NIOO en DLV Plant. Het onderzoek betreft: akkerranden met bloemstroken, bodemfauana van die akkeranden, bladluizen in aardappelen, graan en spruitkool, wittelkoolvlieg en rupsen op spruitkool. Afsluitend een bedrijfseconomische bijdrag
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