Development of a Standard Test Scenario to Evaluate the Effectiveness of Portable Fire Extinguishers on Lithium-ion Battery Fires

Many sources of fuel are present aboard current spacecraft, with one especially hazardous source of stored energy: lithium ion batteries. Lithium ion batteries are a very hazardous form of fuel due to their self-sustaining combustion once ignited, for example, by an external heat source. Batteries can become extremely energetic fire sources due to their high density electrochemical energy content that may, under duress, be violently converted to thermal energy and fire in the form of a thermal runaway. Currently, lithium ion batteries are the preferred types of batteries aboard international spacecraft and therefore are routinely installed, collectively forming a potentially devastating fire threat to a spacecraft and its crew. Currently NASA is developing a fine water mist portable fire extinguisher for future use on international spacecraft. As its development ensues, a need for the standard evaluation of various types of fire extinguishers against this potential threat is required to provide an unbiased means of comparing between fire extinguisher technologies and ranking them based on performance

Educating Future Nursing Scientists: Recommendations for Integrating Omics Content in PhD Programs

Preparing the next generation of nursing scientists to conduct high-impact, competitive, sustainable, innovative, and interdisciplinary programs of research requires that the curricula for PhD programs keep pace with emerging areas of knowledge and health care/biomedical science. A field of inquiry that holds great potential to influence our understanding of the underlying biology and mechanisms of health and disease is omics. For the purpose of this article, omics refers to genomics, transcriptomics, proteomics, epigenomics, exposomics, microbiomics, and metabolomics. Traditionally, most PhD programs in schools of nursing do not incorporate this content into their core curricula. As part of the Council for the Advancement of Nursing Science\u27s Idea Festival for Nursing Science Education, a work group charged with addressing omics preparation for the next generation of nursing scientists was convened. The purpose of this article is to describe key findings and recommendations from the work group that unanimously and enthusiastically support the incorporation of omics content into the curricula of PhD programs in nursing. The work group also calls to action faculty in schools of nursing to develop strategies to enable students needing immersion in omics science and methods to execute their research goals

Cost-Consequence Analysis Alongside a Randomised Controlled Trial of Hospital Versus Telephone Follow-Up after Treatment for Endometrial Cancer

Background Regular outpatient follow-up programmes are usually offered to patients following treatment for gynaecological and other cancers. Despite the substantial resources involved in providing these programmes, there is evidence that routine follow-up programmes do not affect survival or the likelihood of detecting recurrence and may not meet patient needs. Alternative follow-up modalities may offer the same outcomes at lower cost. We examined the costs of using telephone-based routine follow-up of women treated for endometrial cancer undertaken by specialist gynaecology oncology nurses in comparison to routine hospital-based follow-up. Methods The ENDCAT trial randomised 259 women at five centres in the north west of England with a known diagnosis of Stage I endometrial cancer who had completed primary treatment on a 1:1 basis to receive either standard hospital outpatient follow-up or a telephone follow-up intervention administered by specialist nurses. A cost-consequence analysis was undertaken in which we compared costs to the health system and to individuals with the trial’s co-primary outcomes of psychological morbidity and participant satisfaction with information received. Results Psychological morbidity, psychosocial needs, patient satisfaction and quality of life did not differ between arms. Patients randomised to telephone follow-up underwent more and longer consultations. There was no difference in total health service mean per patient costs at 6 months (mean difference £8, 95% percentile confidence interval: − £147 to £141) or 12 months (mean difference: − £77, 95% percentile confidence interval: − £334 to £154). Estimated return journey costs per patient for hospital consultations were £11.47. Productivity costs were approximately twice as high under hospital follow-up. Conclusion Telephone follow-up was estimated to be cost-neutral for the NHS and may free up clinic time for other patients. There was some evidence that telephone follow-up may be more efficient for patients and wider society, and is not associated with additional psychological morbidity, lower patient satisfaction or reduced quality of life

The Sustained Effects of CBT Training on Therapist Competence and Patient Outcomes

The continued effectiveness of in-service psychological therapy training requires evaluation. This study assessed therapist competence and patient clinical outcome during cognitive behaviour therapy training and 12+ months post-training. Trainee competence was assessed using audio-recorded sessions rated on the Cognitive Therapy Scale Revised at the beginning (n = 33) and end of training (n = 45), and at least 12 months post-training (n = 45). Pre-to-posttreatment clinical outcome for trainees’ patients during the course (n = 360) and post-training (n = 360) was evaluated using standardised self-report measures. The relationship between therapist competence and patient outcomes was explored. Trainees achieved competence during training (100%, n = 45) and largely maintained competence post-training (84%, n = 38). Patients demonstrated pre-to-posttreatment effect sizes between 1.38 and 1.89 and reliable improvement exceeding 80% during and after training. Competence was not significantly associated with patient outcome. Trainees predominantly maintained competence and achieved good clinical outcomes post-training. Structured training and continued use of regular supervision possibly supported retention of competence

Oxygen Concentration Flammability Thresholds of Selected Aerospace Materials Considered for the Constellation Program

Materials selection for spacecraft is based on an upward flammability test conducted in a quiescent environment in the highest expected oxygen concentration environment. The test conditions and its pass/fail test logic do not provide sufficient quantitative materials flammability information for an advanced space exploration program. A modified approach has been suggested determination of materials self-extinguishment limits. The flammability threshold information will allow NASA to identify materials with increased flammability risk from oxygen concentration and total pressure changes, minimize potential impacts, and allow for development of sound requirements for new spacecraft and extraterrestrial landers and habitats. This paper provides data on oxygen concentration self-extinguishment limits under quiescent conditions for selected materials considered for the Constellation Program

Telephone follow-up after treatment for endometrial cancer: A qualitative study of patients' and clinical nurse specialists' experiences in the ENDCAT trial

Purpose: Endometrial cancer is the sixth most common female cancer worldwide. There is little evidence that routine hospital surveillance increases survival or decreases morbidity following treatment. Gynaecology Oncology clinical nurse specialists (CNSs) are ideally placed to provide the care, information and support to enable women with a gynaecological cancer to self-manage and live well. A multi-centre randomised controlled trial (RCT) compared hospital follow-up (HFU) with telephone follow-up (TFU) by CNSs. The structured telephone intervention focused on information provision to meet patients psychosocial and information needs. This study aimed to explore the views of women who had received TFU and the CNS's who had delivered the service. Method: A qualitative study to complement the RCT using semi-structured interviews was conducted. Twentyfive patients were randomly selected from participants in the TFU arm stratified by study site. Seven CNSs were interviewed. Results: Patient and CNS regarded TFU positively; Three themes emerged from the patient interviews; Convenient Care, Discrete Personalised Care, Confidence and Reassurance. Themes arising from the CNS interviews were Patient Centred Care, Holistic Care and, Confidence and Skills. Patients found that TFU with CNS's was convenient and enabled discussion of issues and information provision at time-points relevant to them. The CNS's found the structured format of TFU enabled them to utilise their skills and knowledge to identify and meet patients holistic needs. Conclusions: Alternative models of care such as TFU provided by CNSs provides the care, information and support to enable women treated for endometrial cancer to self-manage and live well

Exploring the acceptability and feasibility of patient initiated follow up for women treated for stage I endometrial cancer

Purpose There is a strong shift away from hospital-based approaches to follow-up after active treatment for cancer with supported self-management being promoted as an approach to long term recovery. We aimed to determine the acceptability and feasibility of patient-initiated follow-up (PIFU), supported by a self-management approach, for patients treated for Stage I endometrial cancer. Methods A mixed methods study was undertaken. Participants were asked to forego hospital outpatient follow-up appointments, supported by a self-management approach. Outcome measures included satisfaction with information and service, psychological morbidity, quality of life and preferences for follow-up. Qualitative interviews were carried out with study participants to determine their views on follow-up in general and PIFU in particular. Results We recruited 17 patients. High levels of satisfaction were evident with no physical or psychological detriment. Self-management was a favoured option. Participants questioned the value of hospital follow-up and were willing to engage in self-management if they knew who to contact if they had a problem and were aware of the signs and symptoms of recurrence. However, uptake to the study was low and further work is needed to explore if recruitment to a randomised controlled trial (RCT) is a viable option. Conclusions Alternative approaches to hospital-based follow-up need to demonstrate that patients feel supported, knowing what symptoms to report and to whom. This study shows acceptability of a supported self-management approach but raises some concerns about the feasibility of recruitment to a future RCT

Endometrial cancer patients’ preferences for follow-up after treatment: A cross-sectional survey

Purpose Alternatives to hospital follow-up (HFU) following treatment for cancer have been advocated. Telephone follow-up (TFU) and patient-initiated follow-up are being implemented but it is unclear if these approaches will meet the preferences and needs of patients. This study aimed to explore the preferences of endometrial cancer patients and their levels of satisfaction with HFU and nurse-led TFU. Methods A cross-sectional survey design was utilised and a questionnaire was administered to 236 patients who had participated in a randomised controlled trial comparing HFU with TFU for women diagnosed with Stage I endometrial cancer (ENDCAT trial). Results 211 (89.4%) patients returned the questionnaire; 105 in the TFU group and 106 in the HFU group. The TFU group were more likely to indicate that appointments were on time (p < 0.001) and were more likely to report that their appointments were thorough (p = 0.011). Participants tended to prefer what was familiar to them. Those in the HFU group tended to prefer hospital-based appointments while the TFU group tended to prefer appointments with a clinical nurse specialist, regardless of locality. Conclusions To provide patient centred follow-up services we need to ensure that patient preferences are taken into account and understand that patients may come to prefer what they have experienced. Patient initiated approaches may become standard and preferred practice but TFU remains a high-quality alternative to HFU and may provide an effective transition between HFU and patient-initiated approaches