The development of a ‘flexible learning’ strategy for design and technology

Traditional approaches towards the teaching and learning of design and technology are becoming more difficult to sustain and the need to consider alternative strategies is becoming more urgent. A number of factors have contributed to the need to consider strategies intended to be more flexible and accommodating : worsening staff / student ratios; the need to provide an increasingly wide range of technological information at the relevant point of design development; a belief that design students and teachers are entitled to relevant technological knowledge in a form which is appropriate to their needs. This paper describes the selection, development and evaluation of trial materials which aim to support individual student learning in design and technology. The initial student groups were identified as first year industrial design and technology undergraduates and A/AS-level design and technology students. This target is continually widening, however, and might also include teachers who wish to develop their own technological capability through INSET

Health-related quality of life outcomes among breast cancer survivors

Background: Data from a nationwide sample of US breast cancer survivors were used to examine associations between patient characteristics (breast cancer clinical features, prognostic factors, and treatments) and health-related quality of life (HRQOL). Associations between postdiagnosis HRQOL and mortality were then evaluated. Methods: The authors identified female breast cancer survivors (n = 2453) from the Sister Study or Two Sister Study who were at least 1 year from breast cancer diagnosis and who had responded to a survivorship survey in 2012. HRQOL was assessed with the Patient-Reported Outcomes Measurement Information System (PROMIS) Global 10 measures. Multivariable linear regression was used to assess predictors associated with HRQOL. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between HRQOL and all-cause mortality. Results: HRQOL, assessed an average of 4.9 years after the cancer diagnosis (standard deviation of 1.9 years), was negatively associated with a higher cancer stage at diagnosis; a higher comorbidity score at the survey; experience of surgical complications; dissatisfaction with breast surgery; and experience of any recent recurrence, metastasis, or secondary malignancy. Since the completion of the survey, there were 85 deaths (3.5%) during a mean follow-up of 4 years (standard deviation of 0.5 years). In multivariate models, decreases in PROMIS physical T scores and mental T scores were associated with increased mortality (HR for physical T scores, 1.08; 95% CI, 1.05-1.11; HR for mental T scores, 1.03; 95% CI, 1.01-1.06). Conclusions: Prognostic and cancer treatment–related factors affect HRQOL in breast cancer survivors and may inform targeted survivorship care. PROMIS global health measures may offer additional insights into patients' well-being and mortality risk. Lay Summary: Findings from a study suggest that prognostic and cancer treatment–related factors affect health-related quality of life (HRQOL) in breast cancer survivors and that poor HRQOL may increase the mortality risk. The evaluation of HRQOL is important because it may hold potential as a tool for optimizing survivorship care

Research in Extracorporeal Life Support: A Call to Action

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Correlation functions and emission time sequence of light charged particles from projectile-like fragment source in E/A = 44 and 77 MeV 40Ar + 27Al collisions

Two-particle correlation functions, involving protons, deuterons, tritons, and alpha-particles, have been measured at very forward angles (0.7 deg < theta_lab < 7 deg), in order to study projectile-like fragment (PLF) emission in E/A = 44 and 77 MeV 40Ar + 27Al collisions. Peaks, originating from resonance decays, are larger at E/A = 44 than at 77 MeV. This reflects the larger relative importance of independently emitted light particles, as compared to two-particle decay from unstable fragments, at the higher beam energy. The time sequence of the light charged particles, emitted from the PLF, has been deduced from particle-velocity-gated correlation functions (discarding the contribution from resonance decays). Alpha-particles are found to have an average emission time shorter than protons but longer than tritons and deuterons.Comment: 18 pages, 5 figures, submitted to Nuclear Physics

Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy

Background: Contralateral prophylactic mastectomy (CPM) rates have been increasing in the US, and although high levels of satisfaction with CPM have been reported, few studies have evaluated the long-term effects on body image, comparing CPM with breast-conserving surgery (BCS) and unilateral mastectomy (UM). Methods: We analyzed responses from a survey of women with both a personal and family history of breast cancer who were enrolled in the Sister Study (n = 1176). Among women who underwent mastectomy, we examined satisfaction with the mastectomy decision, as well as variation in the use of reconstruction and experience of complications. Five survey items, evaluated individually and as a summed total score, were used to compare body image across surgery types (BCS, UM without reconstruction, CPM without reconstruction, UM with reconstruction, and CPM with reconstruction). Results: Participants were, on average, 3.6 years post-diagnosis at the time of survey (standard deviation 1.7). The majority of women (97% of CPM, 89% of UM) were satisfied with their mastectomy decision. Reconstruction was more common after CPM than after UM (70 vs. 47%), as were complications (28 vs. 19%). Body image scores were significantly worse among women who underwent CPM than among women who underwent BCS, with the lowest scores among women who underwent CPM without reconstruction. Conclusions: In our sample, most women were highly satisfied with their mastectomy decision, including those who elected to undergo CPM. However, body image was lower among those who underwent CPM than among those who underwent BCS. Our findings may inform decisions among women considering various courses of surgical treatment

Fertility-related experiences after breast cancer diagnosis in the Sister and Two Sister Studies

Background: Commonly used chemotherapies can be toxic to the ovaries. To the authors’ knowledge, the majority of studies evaluating receipt of fertility counseling for women in their reproductive years have been performed in specific settings, thereby limiting generalizability. Methods: A nationwide sample of US women diagnosed with breast cancer before age 45 years completed a survey assessing the prevalence of fertility counseling. Age-adjusted log-binomial regression was used to estimate prevalence ratios (PRs) and 95% CIs for fertility counseling. Results: Among 432 survivors diagnosed between 2004 and 2011, 288 (67%) had not discussed the effects of treatment on fertility with a health care provider before or during treatment. Fertility discussion was associated with younger age (PR, 3.49 [95% CI, 2.66-4.58] for aged <35 years vs ≥40 years) and lower parity (PR, 1.81 [95% CI, 1.29-2.53] for parity 1 vs 2). Approximately 20% of respondents reported that they were interested in future fertility (87 of 432 respondents) at the time of their diagnosis, but not all of these individuals (66 of 87 respondents) received counseling regarding the impact of treatment on their fertility, and few (8 of 87 respondents) used fertility preservation strategies. Among 68 women with a fertility interest who provided reasons for not taking steps to preserve fertility, reasons cited included concern for an adverse impact on cancer treatment (56%), lack of knowledge (26%), decision to not have a child (24%), and cost (18%). Conclusions: Across multiple treatment settings, the majority of women of reproductive age who are diagnosed with breast cancer did not discuss fertility with a health care provider or use fertility preservation strategies. Discussing the potential impact of cancer treatment on future fertility is an important aspect of patient education

Generation of Large-Scale Vorticity in a Homogeneous Turbulence with a Mean Velocity Shear

An effect of a mean velocity shear on a turbulence and on the effective force which is determined by the gradient of Reynolds stresses is studied. Generation of a mean vorticity in a homogeneous incompressible turbulent flow with an imposed mean velocity shear due to an excitation of a large-scale instability is found. The instability is caused by a combined effect of the large-scale shear motions (''skew-induced" deflection of equilibrium mean vorticity) and ''Reynolds stress-induced" generation of perturbations of mean vorticity. Spatial characteristics, such as the minimum size of the growing perturbations and the size of perturbations with the maximum growth rate, are determined. This instability and the dynamics of the mean vorticity are associated with the Prandtl's turbulent secondary flows. This instability is similar to the mean-field magnetic dynamo instability. Astrophysical applications of the obtained results are discussed.Comment: 8 pages, 3 figures, REVTEX4, submitted to Phys. Rev.

Sward structure of marandu palisadegrass subjected to continuous stocking and nitrogen-induced rhythms of growth

Acceleration of the growth rhythm of plants using nitrogen fertiliser alters the rates of physiological processes like growth and senescence and may cause significant changes in sward structure, interfering with plant and animal responses. The objective of this experiment was to evaluate sward structure of marandu palisadegrass (Brachiaria brizantha) maintained at 30 cm under continuous stocking and subjected to contrasting rhythms of growth from January 2007 to April 2008. These were generated using or not nitrogen fertiliser, and comprised four experimental treatments as follows: control (non-fertilised), 150, 300 and 450 kg ha-1 of N. Acceleration of the growth rhythm of plants was associated with increases in leaf and stem bulk density, and resulted in larger LAI and total bulk density on swards subjected to faster (fertilised with 300 and 450 kg ha-1 of N) than those subjected to slower rhythms of growth (non-fertilised or fertilised with 150 kg ha-1 of N). Variations in dead material bulk density were associated with seasonal variations in climatic conditions, and were not influenced by growth rhythms. During autumn/winter and early spring (dry period of the year) swards subjected to faster, relative to those subjected to slower rhythms of growth, had larger proportion of leaves on the top horizons. On the other hand, sward structure did not vary among rhythms of growth at times of the year when there was no limitation in the availability of climatic growth factors (late spring and summer), indicating that when control of the grazing process is efficient, changes in sward structure are basically a function of seasonal variations in climatic growth conditions and phenological state of plants.A aceleração do ritmo de crescimento das plantas por meio da adubação nitrogenada altera a velocidade dos processos fisiológicos, atuando sobre o crescimento e a senescência, podendo refletir-se em alterações importantes sobre a estrutura do dossel. Avaliou-se a estrutura do dossel forrageiro de pastos de capim-marandu (Brachiaria brizantha) mantidos a 30 cm de altura por meio de lotação contínua e submetidos a ritmos de crescimento contrastantes de janeiro de 2007 a abril de 2008. Os distintos ritmos de crescimento foram criados por meio da utilização de adubação nitrogenada, segundo os tratamentos: sem adubação (controle), 150, 300 e 450 kg ha-1 de N. A aceleração do ritmo de crescimento dos pastos resultou em aumentos de densidade volumétrica de folhas e de colmos, refletindo em maior IAF e densidade volumétrica total em pastos submetidos aos ritmos de crescimento mais acelerados (adubados com 300 e 450 kg ha-1 de N) relativamente àqueles submetidos a ritmos de crescimento mais lentos (pastos não adubados e/ou adubados com 150 kg ha-1 de N). Variações em densidade volumétrica do material morto estiveram associadas a flutuações estacionais das condições climáticas, e não foram influenciadas pelos ritmos de crescimento avaliados. Na época da seca (outono/inverno e início de primavera), os pastos submetidos aos ritmos de crescimento mais acelerados apresentaram maior proporção de folhas no horizonte superior do dossel. Por outro lado, a estrutura do dossel não variou entre os ritmos de crescimento nas épocas de maior disponibilidade de fatores de crescimento (final de primavera e verão), indicando que quando o controle do processo de pastejo é feito de maneira eficiente, mudanças em estrutura são função basicamente de variações estacionais em condições climáticas e estádio fenológico das plantas

Factors associated with breast MRI use among women with a family history of breast cancer

Although annual breast magnetic resonance imaging (MRI) is recommended for women at high risk for breast cancer as an adjunct to screening mammography, breast MRI use remains low. We examined factors associated with breast MRI use in a cohort of women with a family history of breast cancer but no personal cancer history. Study participants came from the Sister Study cohort, a nationwide, prospective study of women with at least 1 sister who had been diagnosed with breast cancer but who themselves had not ever had breast cancer (n = 17 894). Participants were surveyed on breast cancer beliefs, cancer worry, breast MRI use, provider communication, and genetic counseling and testing. Logistic regression was used to assess factors associated with having a breast MRI overall and for those at high risk. Breast MRI was reported by 16.1% and was more common among younger women and those with higher incomes. After adjustment for demographics, ever use of breast MRI was associated with actual and perceived risk. Odds ratios (OR) were 12.29 (95% CI, 8.85-17.06), 2.48 (95% CI, 2.27-2.71), and 2.50 (95% CI, 2.09-2.99) for positive BRCA1/2 test, lifetime breast cancer risk ≥ 20%, and being told by a health care provider of higher risk, respectively. Women who believed they had much higher risk than others or had higher level of worry were twice as likely to have had breast MRI; OR = 2.23 (95% CI, 1.82-2.75) and OR = 1.76 (95% CI, 1.52-2.04). Patterns were similar among women at high risk. Breast cancer risk, provider communication, and personal beliefs were determinants of breast MRI use. To support shared decisions about the use of breast MRI, women could benefit from improved understanding of the chances of getting breast cancer and increased quality of provider communications