Navigating cancer using online communities: a grounded theory of survivor and family experiences

Purpose: People affected by cancer often have unmet emotional and social support needs. Online cancer communities are a convenient channel for connecting cancer survivors, allowing them to support one another. However, it is unclear whether online community use makes a meaningful contribution to cancer survivorship, as little previous research has examined the experience of using contemporary cancer communities. We aimed to explore the experiences of visitors to online cancer communities. Methods: Twenty-three in-depth interviews were conducted with online cancer community visitors, including cancer survivors (n = 18), family members (n = 2), and individuals who were both a survivor and family member (n = 3). Interviews were analysed using a grounded theory approach. Results: A theory developed explaining how individuals ‘navigated’ the experience of cancer using online cancer communities. Online advice and information led participants on a ‘journey to become informed’. Online friendships normalised survivorship and cast participants on a ‘journey to recreate identity’. Participants navigated a ‘journey through different worlds’ as they discovered relevant and hidden communities. Conclusions: This theory highlights virtual paths people affected by cancer can take to self-manage their experience of the disease. Online community experiences can be improved by promoting online evaluation skills and signposting visitors to bereavement support. Implications for cancer survivors: Cancer survivors can benefit through both lurking and posting in online communities. However, individuals risk becoming distressed when they befriend individuals who may soon die. Additionally, people affected by rarer cancers can struggle to find shared experiences online and may need to look elsewhere for support

Preliminary Canopy Removal Experiments in Algal Dominated Communities Low on the Shore and in the Shallow Subtidal on the Isle of Man

The algal dominated communities immediately above and below the low-water spring level on a moderately exposed Manx shore were investigated by canopy removal experiments. Fucus serratus, Laminaria digitata and L. hyperborea were removed. Competition was shown to be important in determining the zonation of L. digitata and the distribution along the wave exposure gradient of other species such as Alaria esculenta, Desmarestia aculeata and D. viridis, and L. saccharina. Many species of algal epiphytes were early colonizers of canopy removal areas suggesting that competition from canopy algae usually restricts them to an epiphytic habit. The results indicate that interactions between macrophytes are much more important than grazing in structuring these communities

Modelling and control of a water jet cutting probe for flexible surgical robot

Surgical removal of cancerous tissue from the spine is limited by the inability of hand held drills and cutting tools to reach small crevices present in complex bones such as the spinal column, especially on the anterior side. In addition, the high speed rotating mechanisms used presently are subject to stability issues when manoeuvring around tortuous bone forms. We report on the design and experimental testing of a novel flexible robotic surgical system which addresses these issues. The robot consists of a flexible probe, a water jet cutting system, and a haptic feedback controller. The water jet cutting system consists of a flexible end effector capable of bending around the anterior of the spinal column for tissue removal. A new experimental method of controlling the depth of water jet cut is described. The haptic feedback controller is based on a constraint set approach to define 3D boundaries, based on five key types of constraints. Experimental outcomes of measuring the depth of water jet cut were combined with haptic regional constraints with the aim of improving the safety of surgical procedures. The reliability, accuracy and performance of the prototype robot were tested in a mock surgical procedure on the lower lumbar vertebrae. Results show promise for the implementation of water jet cutting for robotic surgical spinal procedures

Endovascular repair or open repair for ruptured abdominal aortic aneurysm: a Cochrane systematic review

OBJECTIVES: Emergency endovascular aneurysm repair (eEVAR) may improve outcomes for patients with ruptured abdominal aortic aneurysm (RAAA). The study aim was to compare the outcomes for eEVAR with conventional open surgical repair for the treatment of RAAA. SETTING: A systematic review of relevant publications was performed. Randomised controlled trials (RCTs) comparing eEVAR with open surgical repair for RAAA were included. PARTICIPANTS: 3 RCTs were included, with a total of 761 patients with RAAA. INTERVENTIONS: Meta-analysis was performed with fixed-effects models with ORs and 95% CIs for dichotomous data and mean differences with 95% CIs for continuous data. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was short-term mortality. Secondary outcome measures included aneurysm-specific and general complication rates, quality of life and economic analysis. RESULTS: Overall risk of bias was low. There was no difference between the 2 interventions on 30-day (or in-hospital) mortality, OR 0.91 (95% CI 0.67 to 1.22; p=0.52). 30-day complications included myocardial infarction, stroke, composite cardiac complications, renal complications, severe bowel ischaemia, spinal cord ischaemia, reoperation, amputation and respiratory failure. Reporting was incomplete, and no robust conclusion was drawn. For complication outcomes that did include at least 2 studies in the meta-analysis, there was no clear evidence to support a difference between eEVAR and open repair. Longer term outcomes and cost per patient were evaluated in only a single study, thus precluding definite conclusions. CONCLUSIONS: Outcomes between eEVAR and open repair, specifically 30-day mortality, are similar. However, further high-quality trials are required, as the paucity of data currently limits the conclusions

Arts on prescription for community‐dwelling older people with a range of health and wellness needs

Published evidence for the role of participatory art in supporting health and well‐being is growing. The Arts on Prescription model is one vehicle by which participatory art can be delivered. Much of the focus of Arts on Prescription has been on the provision of creative activities for people with mental health needs. This Arts on Prescription program, however, targeted community‐dwelling older people with a wide range of health and wellness needs. Older people were referred to the program by their healthcare practitioner. Professional artists led courses in visual arts, photography, dance and movement, drama, singing, or music. Classes were held weekly for 8–10 weeks, with six to eight participants per class, and culminated with a showing of work or a performance. Program evaluation involved pre‐ and postcourse questionnaires, and focus groups and individual interviews. Evaluation data on 127 participants aged 65 years and older were available for analysis. We found that Arts on Prescription had a positive impact on participants. Quantitative findings revealed a statistically significant improvement in the Warwick–Edinburgh Mental Well‐being Scale(WEMWBS) as well as a statistically significant increase in the level of self‐reported creativity and frequency of creative activities. Qualitative findings indicated that the program provided challenging artistic activities which created a sense of purpose and direction, enabled personal growth and achievement, and empowered participants, in a setting which fostered the development of meaningful relationships with others. This evaluation adds to the evidence base in support of Arts on Prescription by expanding the application of the model to older people with a diverse range of health and wellness needs

Investigation of the thermoelectric response in conducting polymers doped by solid-state diffusion

The thermoelectric effect is a physical phenomenon which intricately relates the thermal energy of charge carriers to their charge transport. Understanding the mechanism of this interaction in different systems lies at the heart of inventing novel materials which can revolutionize thermoelectric power gener- ation technology. Despite a recent surge of interest in organic thermoelectric materials, the community has had difficulties in formulating the charge trans- port mechanism in the presence of a significant degree of disorder. Here, we analyze the thermoelectric properties of various conducting polymers doped by a solid-state diffusion of dopant molecules based on a transport model with a power-law energy-dependence of transport function. A fine control of the degree of doping via post-doping annealing provides an accurate empirical evidence of a strong energy dependence of the carrier mobility in the conducting polymers. A superior thermoelectric power factor of conducting polymers doped by solid-state diffusion to that of other doping methods can be attributed to a resulting higher intrinsic mobility and higher free carrier concentration.The research leading to these results has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013) / ERC grant agreement n 610115. Keehoon Kang thanks the for financial support from Samsung Scholarship Foundation and the National Creative Research Laboratory program (Grant No. 2012026372) through the National Research Foundation of Korea, funded by the Korean Ministry of Science and ICT. K.B. acknowledges funding by the German Research Foundation (BR 4869/1-1)

Evaluations of land cover risk factors for canine leptospirosis: 94 cases (2002–2009)

Associations of land cover/land use variables and the presence of dogs in urban vs. rural address locations were evaluated retrospectively as potential risk factors for canine leptospirosis in Kansas and Nebraska using Geographic Information Systems (GIS). The sample included 94 dogs positive for leptospirosis predominantly based on a positive polymerase chain reaction test for leptospires in urine, isolation of leptospires on urine culture, a single reciprocal serum titer of 12,800 or greater, or a four-fold rise in reciprocal serum titers over a 2–4 weeks period; and 185 dogs negative for leptospirosis based on a negative polymerase chain reaction test and reciprocal serum titers less than 400. Land cover features from 2001 National Land Cover Dataset and 2001 Kansas Gap Analysis Program datasets around geocoded addresses of case/control locations were extracted using 2500 m buffers, and the presence of dogs’ address locations within urban vs. rural areas were estimated in GIS. Multivariate logistic models were used to determine the risk of different land cover variables and address locations to dogs. Medium intensity urban areas (OR = 1.805, 95% C.I. = 1.396, 2.334), urban areas in general (OR = 2.021, 95% C.I. = 1.360, 3.003), and having urban address locations (OR = 3.732, 95% C.I. = 1.935, 7.196 entire study region), were significant risk factors for canine leptospirosis. Dogs regardless of age, sex and breed that live in urban areas are at higher risk of leptospirosis and vaccination should be considered

In-service Initial Teacher Education in the Learning and Skills Sector in England: Integrating Course and Workplace Learning

The aim of the paper is to advance understanding of in-service learning and skills sector trainee teachers’ learning and propose ways of improving their learning. A conceptual framework is developed by extending Billett’s (International Journal of Educational Research 47:232–240, 2008) conceptualisation of workplace learning, as a relationally interdependent process between the opportunities workplaces afford for activities and interactions and how individuals engage with these, to a third base of participation, the affordances of the initial teacher education course. Hager and Hodkinson’s (British Educational Research Journal 35:619–638, 2009) metaphor of ‘learning as becoming’ is used to conceptualise the ways trainees reconstruct learning in a continuous transactional process of boundary crossing between course and workplace. The findings of six longitudinal case studies of trainees’ development, and evidence from other studies, illustrate the complex interrelationships between LSS workplace affordances, course affordances and trainee characteristics and the ways in which trainees reconstruct learning in each setting. The experience of teaching and interacting with learners, interactions with colleagues, and access to workplace resources and training are important workplace affordances for learning. However, some trainees have limited access to these affordances. Teaching observations, course activities and experiences as a learner are significant course affordances. Trainees’ beliefs, prior experiences and dispositions vary and significantly influence their engagement with course and workplace affordances. It is proposed that better integration of course and workplace learning through guided participation in an intentional workplace curriculum and attention to the ways trainees choose to engage with this, together with the use of practical theorising has the potential to improve trainee learning

Defective Hand1 phosphoregulation uncovers essential roles for Hand1 in limb morphogenesis

The morphogenesis of the vertebrate limbs is a complex process in which cell signaling and transcriptional regulation coordinate diverse structural adaptations in diverse species. In this study, we examine the consequences of altering Hand1 dimer choice regulation within developing vertebrate limbs. Although Hand1 deletion via the limb-specific Prrx1-Cre reveals a non-essential role for Hand1 in mouse limb morphogenesis, altering Hand1 phosphoregulation, and consequently Hand1 dimerization affinities, results in a severe truncation of proximal-anterior limb elements. Molecular analysis reveals a non-cell-autonomous mechanism that causes widespread cell death within the embryonic limb bud. In addition, we observe changes in proximal-anterior gene regulation, including a reduction in the expression of Irx3, Irx5, Gli3 and Alx4, all of which are upregulated in Hand2 limb conditional knockouts. A reduction of Hand2 and Shh gene dosage improves the integrity of anterior limb structures, validating the importance of the Twist-family bHLH dimer pool in limb morphogenesis., Summary: Altering Hand1 phosphoregulation, and consequently Hand1 dimerization affinities, results in a severe truncation of anterior-proximal limb elements in mice