Rapid Inventory of Earthquake Damage (RIED)

The 25 January 1999 Quindío earthquake in Colombia was a major disaster for the coffee-growing region in Colombia. Most of the damage occurred in the city of Armenia and surrounding villages. Damage due to earthquakes is strongly related to topographic and subsurface geotechnical conditions underneath structures and houses. The RIED project used aerial photographs to obtain a rapid inventory of the earthquake damage right after the seismic event. This inventory was subsequently used to identify any existing relation with subsurface- and topographic conditions. Hazard zonation maps were made on the basis of seismic response analysis of a three-dimensional model of the subsurface that has been created in the GIS. Also indicative zonation maps were created outlining potential areas where topographic amplification may occur. These seismic zonation maps delineate those areas that are most likely affected by subsurface and topographic resonance effects during a future and similar earthquake. The maps have been presented to the city planning authorities of Armenia so that reconstruction of the damaged areas can be carried out in such a way that high risk areas will be avoided or that structures and houses will be built according to the standards for high seismic risk areas

Cancer through black eyes - The views of UK based black men towards cancer: A constructivist grounded theory study

Purpose: Little is known about black African (BA) and black African-Caribbean (BAC) men's views towards cancer; yet culture and acculturation can contribute to the way in which people understand, explain and develop their attitudes towards cancer. Hence, cancer prevention and early detection strategies may not be sensitive to United Kingdom (UK)-based black men's views, affecting their awareness of risk factors and early detection services. This study explored the views of UK-based BA and BAC men towards cancer. Method: In collaboration with black community organisations based in four major cities in the UK, 25 participants were recruited using convenience and theoretical sampling methods. Data were collected using 33 semi-structured interviews, and analysed using grounded theory analytic procedures. Results: One core category (cancer through black eyes) and seven sub-categories emerged; ‘cultural views’, ‘religious beliefs’, ‘avoiding Babylon’, ‘alienation’, ‘suspicious mind’, ‘advertisements and information influence very little’, and ‘gap in service provision (bridging the gap)’. Participants' views towards cancer were linked to socially constructed perspectives, linked with cultural and religious beliefs, and shaped by what being a black male means in society. Risk factors such as smoking and obesity had different meanings and symbolisation through black eyes. There were macro- and micro-level similarities and differences between BA and BAC men. Conclusions: Cancer services and related public-health campaigns aimed at black men need to understand cancer through black eyes. Public health campaigns based solely on the clinical meaning of cancer are incongruent with black men's understandings of cancer, and therefore ineffective at reducing health inequality

Development and evaluation of the Dignity Talk question framework for palliative patients and their families: A mixed-methods study

Background: Effective patient–family communication can reduce patients’ psychosocial distress and relieve family members’ current suffering and their subsequent grief. However, terminally ill patients and their family members often experience great difficulty in communicating their true feelings, concerns, and needs to each other. Aim: To develop a novel means of facilitating meaningful conversations for palliative patients and family members, coined Dignity Talk, explore anticipated benefits and challenges of using Dignity Talk, and solicit suggestions for protocol improvement. Design: A convergent parallel mixed-methods design. Dignity Talk, a self-administered question list, was designed to prompt end-of-life conversations, adapted from the Dignity Therapy question framework. Participants were surveyed to evaluate the Dignity Talk question framework. Data were analyzed using qualitative and quantitative methods. Setting/participants: A total of 20 palliative patients, 20 family members, and 34 healthcare providers were recruited from two inpatient palliative care units in Winnipeg, Canada. Results: Most Dignity Talk questions were endorsed by the majority of patients and families (>70%). Dignity Talk was revised to be convenient and flexible to use, broadly accessible, clearly stated, and sensitively worded. Participants felt Dignity Talk would be valuable in promoting conversations, enhancing family connections and relationships, enhancing patient sense of value and dignity, promoting effective interaction, and attending to unfinished business. Participants suggested that patients and family members be given latitude to respond only to questions that are meaningful to them and within their emotional capacity to broach. Conclusion: Dignity Talk may provide a gentle means of facilitating important end-of-life conversations

Development of a Robot-Based Multi-Directional Dynamic Fiber Winding Process for Additive Manufacturing Using Shotcrete 3D Printing

The research described in this paper is dedicated to the use of continuous fibers as reinforcement for additive manufacturing, particularly using Shotcrete. Composites and in particular fiber reinforced polymers (FRP) are increasingly present in concrete reinforcement. Their corrosion resistance, high tensile strength, low weight, and high flexibility offer an interesting alternative to conventional steel reinforcement, especially with respect to their use in Concrete 3D Printing. This paper presents an initial development of a dynamic robot-based manufacturing process for FRP concrete reinforcement as an innovative way to increase shape freedom and efficiency in concrete construction. The focus here is on prefabricated fiber reinforcement, which is concreted in a subsequent additive process to produce load-bearing components. After the presentation of the fabrication concept for the integration of FRP reinforcement and the state of the art, a requirements analysis regarding the mechanical bonding behavior in concrete is carried out. This is followed by a description of the development of a dynamic fiber winding process and its integration into an automated production system for individualized fiber reinforcement. Next, initial tests for the automated application of concrete by means of Shotcrete 3D Printing are carried out. In addition, an outlook describes further technical development steps and provides an outline of advanced manufacturing concepts for additive concrete manufacturing with integrated fiber reinforcement

Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences

Background: Compassion is considered an essential element in quality patient care. One of the conceptual challenges in healthcare literature is that compassion is often confused with sympathy and empathy. Studies comparing and contrasting patients’ perspectives of sympathy, empathy, and compassion are largely absent. Aim: The aim of this study was to investigate advanced cancer patients’ understandings, experiences, and preferences of “sympathy,” “empathy,” and “compassion” in order to develop conceptual clarity for future research and to inform clinical practice. Design: Data were collected via semi-structured interviews and then independently analyzed by the research team using the three stages and principles of Straussian grounded theory. Setting/participants: Data were collected from 53 advanced cancer inpatients in a large urban hospital. Results: Constructs of sympathy, empathy, and compassion contain distinct themes and sub-themes. Sympathy was described as an unwanted, pity-based response to a distressing situation, characterized by a lack of understanding and self-preservation of the observer. Empathy was experienced as an affective response that acknowledges and attempts to understand individual’s suffering through emotional resonance. Compassion enhanced the key facets of empathy while adding distinct features of being motivated by love, the altruistic role of the responder, action, and small, supererogatory acts of kindness. Patients reported that unlike sympathy, empathy and compassion were beneficial, with compassion being the most preferred and impactful. Conclusion: Although sympathy, empathy, and compassion are used interchangeably and frequently conflated in healthcare literature, patients distinguish and experience them uniquely. Understanding patients’ perspectives is important and can guide practice, policy reform, and future research

Measuring recall of medical information in non-English-speaking people with cancer: A methodology

Background Many patients who require an interpreter have difficulty remembering information from their medical consultations. Memory aids such as consultation audio-recordings may be of benefit to these patients. However, there is no established means of measuring patients’ memory of medical information. Objectives This study aimed to develop a method for eliciting and coding recall of medical information in non-English-speaking patients. Design This method, called Patient-Interpreter-Clinician coding (PICcode), was developed in the context of a phase II trial conducted in two outpatient oncology clinics in Melbourne, Australia, and was refined iteratively through consultation with an expert panel and piloting. Between-coder differences in early versions of the coding system were resolved through discussion and consensus resulting in refinements to PICcode. Results The final version of PICcode involved transcribing, translating and coding of audio-recorded consultations and semi-structured interviews (SSI). The SSIs were designed to elicit patients’ free-recall of medical information. Every unit of medical information in the consultation was identified and categorized in a coding tree. SSIs were coded to identify the extent to which information was recalled from the consultation. Discussion The iterative changes involved in developing PICcode assisted in clarifying precise details of the process and produced a widely applicable coding system. PICcode is the most comprehensively described method of determining the amount of information that patients who use an interpreter recall from their medical consultations. PICcode can be adapted for English-speaking patients and other healthcare populations

Pretreatment with a 55-kDa Tumor Necrosis Factor Receptor-Immunoglobulin Fusion Protein Attenuates Activation of Coagulation, but not of Fibrinolysis, during Lethal Bacteremia in Baboons

Baboons (Papio anubis) receiving a lethal intravenous infusion with live Escherichia coli were pretreated with either a 55-kDa tumor necrosis factor (TNF) receptor-IgG fusion protein (TNFR55:IgG) (n = 4, 4.6 mg/kg) or placebo (n = 4). Neutralization of TNF activity in TNFR55:IgG-treated animals was associated with a complete prevention of mortality and a strong attenuation of coagulation activation as reflected by the plasma concentrations of thrombin-antithrombin III complexes (P < .05). Activation of fibrinolysis was not influenced by TNFR55:IgG (plasma tissue-type plasminogen activator and plasmin-a2-antiplasmin complexes), whereas TNFR55:IgG did inhibit the release of plasminogen activator inhibitor type I (P < .05). Furthermore, TNFR55:IgG inhibited neutrophil degranulation (plasma levels of elastase-α1-antitrypsin complexes, P < .05) and modestly reduced release of secretory phospholipase A2. These data suggest that endogenous TNF contributes to activation of coagulation, but not to stimulation of fibrinolysis, during severe bacteremi

Decreased Bone Mineral Density in Adults Born with Very Low Birth Weight: A Cohort Study

Petteri Hovi and colleagues evaluate skeletal health in 144 adults born preterm with very low birth weight and show that as adults these individuals have significantly lower bone mineral density than do their term-born peers