Wellbeing in adults who had a brush with death

Objectives: A Near-Death-Experience can be a lifechanging event initiating deep posttraumatic growth. Yet people can initially be left struggling with the internal changes and feel alienated from their life and social network. This study investigated whether Near-Death-Experiences also have an impact on people’s happiness, and if so, how long it lasts, and what kind of support they receive in making sense of the event. Method: Six semi-structured interviews were conducted with people who had a Near-Death-Experience and the data was subjected to Interpretative Phenomenological Analysis. Results: Five master-themes emerged: Sense of self, Attitude toward life and death, Effects of Near-Death-Experience, Relationship with others, and Experience of happiness. Conclusion: Almost all participants reported feeling less apprehensive towards death and simultaneously found a greater ability to embrace and appreciate life. Some gained new and profound internal insights that manifested in a renewed sense of self, stronger and more pronounced feelings of life purpose, and could reflect on the Near-Death-Experience as a precious gift. The majority of participants experienced a greater degree of happiness that gradually grew over time. This was largely located internally, which freed them from ‘the hedonic treadmill’ of pursuing it in the outside world. Stigma and a lack of awareness still represent a hurdle for connecting with others and accessing support. Clinical and research implications were discussed

A Competence-based Service for Supporting Self-Regulated Learning in Virtual Environments

This  paper  presents  a  conceptual  approach  and  a  Web-based  service  that  aim  at  supporting self-regulated learning in virtual environments. The conceptual approach consists of four  components:  1)  a  self-regulated  learning  model  for  supporting  a  learner-centred  learning  process, 2) a psychological model for facilitating competence-based personalization and knowledge assessment, 3) an open learner model approach for visual interaction and feedback, and 4) a learning analytics approach for capturing relevant learner information required by the other  components.  The  Web-based  service  provides  a  technical  implementation  of  the  conceptual approach, as well as a linkage to existing virtual environments used for learning purposes. The approach and service have been evaluated in user studies in university courses on computer  science  to  demonstrate  the  usefulness  of  the  overall  approach  and  to  get  an  understanding of some limitations

DeWitt Wallace Library Annual Report 2013-2014

Summary of library and media services activities for 2013-201

DeWitt Wallace Library Annual Report 2016-2017

Summary of library and media services activities for 2016-201

DeWitt Wallace Library Annual Report 2014-2015

Summary of library and media services activities for 2014-201

DeWitt Wallace Library Annual Report 2015-2016

Summary of library and media services activities for 2015-201

Clinical use of Whole Genome Sequencing for Mycobacterium tuberculosis

Drug resistant tuberculosis (TB) remains a major challenge to global health and to healthcare in the UK. In 2014, England recorded 6520 cases of TB of which 1.4% were multi-drug resistant (MDR-TB). Extensively drug resistant TB (XDR-TB) occurs at a much lower rate, but the impact on the patient and hospital is severe. Current diagnostic methods such as drug susceptibility testing and targeted molecular tests are slow to return or examine only a limited number of target regions respectively. Faster, more comprehensive diagnostics will enable earlier use of the most appropriate drug regimen thus improving patient outcome and reducing overall healthcare costs. Whole genome sequencing has been shown to provide a rapid and comprehensive view of the genotype of the organism and thus enable reliable prediction of the drug susceptibility phenotype within a clinically relevant time frame. In addition it provides the highest resolution when investigating transmission events in possible outbreak scenarios. However, robust software and database tools need to be developed for the full potential to be realized in this specialized area of medicine

Direct susceptibility testing for multi drug resistant tuberculosis: A meta-analysis

<p>Abstract</p> <p>Background</p> <p>One of the challenges facing the tuberculosis (TB) control programmes in resource-limited settings is lack of rapid techniques for detection of drug resistant TB, particularly multi drug resistant tuberculosis (MDR TB). Results obtained with the conventional indirect susceptibility testing methods come too late to influence a timely decision on patient management. More rapid tests directly applied on sputum samples are needed. This study compared the sensitivity, specificity and time to results of four direct drug susceptibility testing tests with the conventional indirect testing for detection of resistance to rifampicin and isoniazid in <it>M. tuberculosis</it>. The four direct tests included two in-house phenotypic assays – Nitrate Reductase Assay (NRA) and Microscopic Observation Drug Susceptibility (MODS), and two commercially available tests – Genotype^®MTBDR and Genotype^®MTBDR<it>plus </it>(Hain Life Sciences, Nehren, Germany).</p> <p>Methods</p> <p>A literature review and meta-analysis of study reports was performed. The Meta-Disc software was used to analyse the reports and tests for sensitivity, specificity, and area under the summary receiver operating characteristic (sROC) curves. Heterogeneity in accuracy estimates was tested with the Spearman correlation coefficient and Chi-square.</p> <p>Results</p> <p>Eighteen direct DST reports were analysed: NRA – 4, MODS- 6, Genotype MTBDR^®– 3 and Genotype^®MTBDR<it>plus </it>– 5. The pooled sensitivity and specificity for detection of resistance to rifampicin were 99% and 100% with NRA, 96% and 96% with MODS, 99% and 98% with Genotype^®MTBDR, and 99% and 99% with the new Genotype^®MTBDR<it>plus</it>, respectively. For isoniazid it was 94% and 100% for NRA, 92% and 96% for MODS, 71% and 100% for Genotype^®MTBDR, and 96% and 100% with the Genotype^®MTBDR<it>plus</it>, respectively. The area under the summary receiver operating characteristic (sROC) curves was in ranges of 0.98 to 1.00 for all the four tests. Molecular tests were completed in 1 – 2 days and also the phenotypic assays were much more rapid than conventional testing.</p> <p>Conclusion</p> <p>Direct testing of rifampicin and isoniazid resistance in <it>M. tuberculosis </it>was found to be highly sensitive and specific, and allows prompt detection of MDR TB.</p

Use of a Molecular Diagnostic Test in AFB Smear Positive Tuberculosis Suspects Greatly Reduces Time to Detection of Multidrug Resistant Tuberculosis

Background: The WHO has recommended the implementation of rapid diagnostic tests to detect and help combat M/XDR tuberculosis (TB). There are limited data on the performance and impact of these tests in field settings. Methods: The performance of the commercially available Genotype MTBDRplus molecular assay was compared to conventional methods including AFB smear, culture and drug susceptibility testing (DST) using both an absolute concentration method on Löwenstein-Jensen media and broth-based method using the MGIT 960 system. Sputum specimens were obtained from TB suspects in the country of Georgia who received care through the National TB Program. Results: Among 500 AFB smear-positive sputum specimens, 458 (91.6%) had both a positive sputum culture for Mycobacterium tuberculosis and a valid MTBDRplus assay result. The MTBDRplus assay detected isoniazid (INH) resistanc

Mycobacterium tuberculosis Complex Lineage 3 as Causative Agent of Pulmonary Tuberculosis, Eastern Sudan1.

Pathogen-based factors associated with tuberculosis (TB) in eastern Sudan are not well defined. We investigated genetic diversity, drug resistance, and possible transmission clusters of Mycobacterium tuberculosis complex (MTBC) strains by using a genomic epidemiology approach. We collected 383 sputum specimens at 3 hospitals in 2014 and 2016 from patients with symptoms suggestive of TB; of these, 171 grew MTBC strains. Whole-genome sequencing could be performed on 166 MTBC strains; phylogenetic classification revealed that most (73.4%; n = 122) belonged to lineage 3 (L3). Genome-based cluster analysis showed that 76 strains (45.9%) were grouped into 29 molecular clusters, comprising 2-8 strains/patients. Of the strains investigated, 9.0% (15/166) were multidrug resistant (MDR); 10 MDR MTBC strains were linked to 1 large MDR transmission network. Our findings indicate that L3 strains are the main causative agent of TB in eastern Sudan; MDR TB is caused mainly by transmission of MDR L3 strains