The Predictive Roles of Self-efficacy, Illness Perception, and Social Support in Self-care of Patients With Heart Failure

Background: As a chronic disease, heart failure (HF) is a growing problem that not only impacts patients but also their family members and friends. Self-care is the main part of HF treatment. Despite the significance of determining variables involved in self-care, the relationships of self-efficacy, illness perception, and social support with self-care and the predictive roles of these variables in the treatment of HF have not been investigated. Objectives: The present study was aimed at exploring the predictive roles of self-efficacy, illness perception, and social support in self-care of patients with heart failure. Methods: In this predictive correlation study, 149 patients with HF were selected through convenience sampling from Tabriz Research Treatment Centre of Heart in 2016. To collect data, a demographic information questionnaire, self-care behaviour scale, general self-efficacy (GSE), brief illness perception questionnaire (Brief-IPQ), and social support scale were used. To analyse data, SPSS software version 16, descriptive statistics, Pearson correlation coefficient, and multiple stepwise regression analyses were employed. Results: Out of 149 subjects, 102 (68%) participants were male, and 47 (32%) of them were female. The mean and standard deviation of samples’ age were (64.40±10.32) ranging from 37 to 88 years. Most of participants were married (82%). The mean scores were as follows: Self-care (40.66±13.16), self-efficacy (45.81±22.03), illness perception (56.05±18.24), and social support (49.09±6.74). Data analysis demonstrated significant correlations between illness perception and self-care (p<0.001, r=0.649), self-efficacy and self-care (p<0.001, r=-0.678), social support and self-care (p<0.001, r=-0.518), and age and self-care (p<0.001, r=-0.506). The standardized coefficient of illness perception was (β=0.274), social support was (β=-0.237), self-efficacy was (β=-0.230), and age was (β=-0.211). In addition, 56% of self-care variance is explained by age, social support, self-efficacy, and illness perception. Conclusion: All of the investigated variables were found to have a predictive role in self-care. Illness perception was recognized as the most effective factor in predicting self-care. Hence, illness perception can be used to explain 27% of self-care ability of patients with HF

Breast cancer management and outcome according to surgeon's affiliation: a population-based comparison adjusted for patient's selection bias

Background Studies have reported that breast cancer (BC) units could increase the quality of care but none has evaluated the efficacy of alternative options such as private BC networks, which is our study objective. Patients and methods We included all 1404 BC patients operated in the public unit or the private network and recorded at the Geneva Cancer Registry between 2000 and 2005. We compared quality indicators of care between the public BC unit and the private BC network by logistic regression and evaluated the effect of surgeon's affiliation on BC-specific mortality by the Cox model adjusting for the propensity score. Results Both the groups had high care quality scores. For invasive cancer, histological assessment before surgery and axillary lymph node dissection when indicated were less frequent in the public sector (adjusted odds ratio (OR): 0.4, 95% confidence interval (CI) 0.3-0.7, and OR: 0.4, 95% CI 0.2-0.8, respectively), while radiation therapy after breast-conserving surgery was more frequent (OR: 2.5, 95% CI 1.4-4.8). Surgeon affiliation had no substantial effect on BC-specific mortality (adjusted hazard ratio (HR): 0.8, 95% CI 0.5-1.4). Conclusions This study suggests that private BC networks could be an alternative to public BC units with both structures presenting high quality indicators of BC care and similar BC-specific mortalit

Adiabatic Formation of Rydberg Crystals with Chirped Laser Pulses

Ultracold atomic gases have been used extensively in recent years to realize textbook examples of condensed matter phenomena. Recently, phase transitions to ordered structures have been predicted for gases of highly excited, 'frozen' Rydberg atoms. Such Rydberg crystals are a model for dilute metallic solids with tunable lattice parameters, and provide access to a wide variety of fundamental phenomena. We investigate theoretically how such structures can be created in four distinct cold atomic systems, by using tailored laser-excitation in the presence of strong Rydberg-Rydberg interactions. We study in detail the experimental requirements and limitations for these systems, and characterize the basic properties of small crystalline Rydberg structures in one, two and three dimensions.Comment: 23 pages, 10 figures, MPIPKS-ITAMP Tandem Workshop, Cold Rydberg Gases and Ultracold Plasmas (CRYP10), Sept. 6-17, 201

Making a symbolic gesture: a qualitative examination of self-immolation in Iran

Self-immolation is one of the most dramatic methods of committing suicide. Some regions in Iran have a high prevalence of suicide by this method. This study aims to understand and explore the experience of self-immolated women in Iran. Twenty women have interviewed in the burns centers of three different cities immediately the following hospitalization due self-immolation, and the data was analyzed using conventional content analysis. The results were categorized in three main categories: Cultural background and preparing the stage, making a symbolic gesture and events of the day of the incident. Making a symbolic gesture consists of the critical elements of self-immolation, including the presence of significant others, dramatic presentation of misery, bringing an end to misfortune, proof of innocence, creating a sense of compassion or guilt and inspiration from similar cases. The social situation of women in Iran is contributing to self-immolation through feelings of anger and helplessnes

Key-Private Proxy Re-Encryption

Proxy re-encryption (PRE) allows a proxy to convert a ciphertext encrypted under one key into an encryption of the same message under another key. The main idea is to place as little trust and reveal as little information to the proxy as necessary to allow it to perform its translations. At the very least, the proxy should not be able to learn the keys of the participants or the content of the messages it re-encrypts. However, in all prior PRE schemes, it is easy for the proxy to determine between which participants a re-encryption key can transform ciphertexts. This can be a problem in practice. For example, in a secure distributed file system, content owners may want to use the proxy to help re-encrypt sensitive information *without* revealing to the proxy the *identity* of the recipients. In this work, we propose key-private (or anonymous) re-encryption keys as an additional useful property of PRE schemes. We formulate a definition of what it means for a PRE scheme to be secure and key-private. Surprisingly, we show that this property is not captured by prior definitions or achieved by prior schemes, including even the secure *obfuscation* of PRE by Hohenberger, Rothblum, shelat and Vaikuntanathan (TCC 2007). Finally, we propose the first key-private PRE construction and prove its security under a simple extension of the Decisional Bilinear Diffie Hellman assumption and its key-privacy under the Decision Linear assumption in the standard model

A 3-5μ\mum VLT spectroscopic survey of embedded young low mass stars II; OCN−^-

The 4.62$\mu$m (2164.5 cm$^{-1}$) `XCN' band has been detected in the $M$-band spectra of 34 deeply embedded young stellar objects (YSO's), observed with high signal-to-noise and high spectral resolution with the VLT-ISAAC spectrometer, providing the first opportunity to study the solid OCN$^-$ abundance toward a large number of low-mass YSO's. It is shown unequivocally that at least two components, centred at 2165.7 cm$^{-1}$ (FWHM = 26 cm$^{-1}$) and 2175.4 cm$^{-1}$ (FWHM = 15 cm$^{-1}$), underlie the XCN band. Only the 2165.7-component can be ascribed to OCN$^-$, embedded in a strongly hydrogen-bonding, and possibly thermally annealed, ice environment based on laboratory OCN$^-$ spectra. In order to correct for the contribution of the 2175.4-component to the XCN band, a phenomenological decomposition into the 2165.7- and the 2175.4-components is used to fit the full band profile and derive the OCN$^-$ abundance for each line-of-sight. The same analysis is performed for 5 high-mass YSO's taken from the ISO-SWS data archive. Inferred OCN$^-$ abundances are $\leq$ 0.85 % toward low-mass YSO's and $\leq$ 1 % toward high-mass YSO's, except for W33 A. Abundances are found to vary by at least a factor of 10--20 and large source-to-source abundance variations are observed within the same star-forming cloud complex on scales down to 400 AU, indicating that the OCN$^-$ formation mechanism is sensitive to local conditions. The inferred abundances allow quantitatively for photochemical formation of OCN$^-$, but the large abundance variations are not easily explained in this scenario unless local radiation sources or special geometries are invoked. Surface chemistry should therefore be considered as an alternative formation mechanism

Scleral Thickness in Human Eyes

Purpose: To obtain information about scleral thickness in different ocular regions and its associations. Methods: The histomorphometric study included 238 human globes which had been enucleated because of choroidal melanomas or due to secondary angle-closure glaucoma. Using light microscopy, anterior-posterior pupil-optic nerve sections were measured. Results: In the non-axially elongated group (axial length #26 mm), scleral thickness decreased from the limbus (0.5060.11 mm) to the ora serrata (0.4360.14 mm) and the equator (0.4260.15 mm), and then increased to the midpoint between posterior pole and equator (0.6560.15 mm) and to the posterior pole (0.9460.18 mm), from where it decreased to the peri-optic nerve region (0.8660.21 mm) and finally the peripapillary scleral flange (0.3960.09 mm). Scleral thickness was significantly lower in the axially elongated group (axial length.26 mm) than in the non-axially elongated group for measurements taken at and posterior to the equator. Scleral thickness measurements of the posterior pole and of the peripapillary scleral flange were correlated with lamina cribrosa thickness measurements. Scleral thickness measurements at any location of examination were not significantly (all P.0.10) correlated with corneal thickness measurements. Scleral thickness was statistically independent of age, gender and presence of glaucoma. Conclusions: In non-axially elongated eyes, the sclera was thickest at the posterior pole, followed by the peri-optic nerv

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis.

BACKGROUND: Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems. OBJECTIVES: To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. STUDY DESIGN: For effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views. PARTICIPANTS: Children and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months. INTERVENTIONS: Any psychosocial intervention provided in any setting aiming to address the consequences of maltreatment. MAIN OUTCOME MEASURES: Psychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability. METHODS: Young Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible. RESULTS: We identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive-behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) -0.44 (95% CI -4.43 to -1.53)], depression [mean difference -2.83 (95% CI -4.53 to -1.13)] and anxiety [SMD -0.23 (95% CI -0.03 to -0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist-child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself. CONCLUSIONS: It is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions. LIMITATIONS: Studies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses. FUTURE WORK: Studies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes. STUDY REGISTRATION: This study is registered as PROSPERO CRD42013003889. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Imaging Mass Spectrometry: Hype or Hope?

Imaging mass spectrometry is currently receiving a significant amount of attention in the mass spectrometric community. It offers the potential of direct examination of biomolecular patterns from cells and tissue. This makes it a seemingly ideal tool for biomedical diagnostics and molecular histology. It is able to generate beautiful molecular images from a large variety of surfaces, ranging from cancer tissue sections to polished cross sections from old-master paintings. What are the parameters that define and control the implications, challenges, opportunities, and (im)possibilities associated with the application of imaging MS to biomedical tissue studies. Is this just another technological hype or does it really offer the hope to gain new insights in molecular processes in living tissue? In this critical insight this question is addressed through the discussion of a number of aspects of MS imaging technology and sample preparation that strongly determine the outcome of imaging MS experiments