Application of Symphonology Theory in Patient Decision-Making: Triangulation of Quantitative and Qualitative Methods

This study tested the theory of Symphonology in two ways: 1) by determining if concepts in Symphonology were expressed in the experience of patients involved in health care decision-making, and 2) by testing the effect of an education/counseling intervention based on Symphonology, designed to facilitate decision-making. The study design was a pre-test post-test quasi-experimental design. Demographic and disease-related variables, decision-making role preference and the Bioethical Decision Making Preference Scale for Patients/Families (BDMPSP) (Husted, 2001) were measured prior to the intervention. Demographic variables that were measured included age, gender, race, marital status, years and type of education and time since diagnosis. Verbatim transcripts of semi-structured subject interviews were analyzed. The intervention provided was designed to assist subjects through the decision-making process using Symphonology. After the intervention subjects were again interviewed and they completed a post-test BDMPSP. Subject responses from post-test interviews were triangulated with results of statistical analysis testing the difference between pre and post-intervention BDMPSP scores. Relationships between demographic variables and decision-making role preference and BDMPSP scores were statistically analyzed. The sample consisted of 30 subjects involved in a variety of decisions about health care and treatment during hospitalization in an acute care setting. Median age was 63, 75.7% were female (n = 23) and 53.3% (n = 16) had greater than a high school education. The distribution of decision-making role preferences was 40% active, 53.3% collaborative, and 6.7% passive. There were no significant relationships between demographic variables and decision-making role preference. Qualitative analysis demonstrated that patients expressed all of the concepts of Symphonology in interviews. Statistical analysis of differences in pre and post BDMPSP scores demonstrated that subjects had a more positive experience of being involved in decision-making (p = .02), felt more sufficiency of knowledge (p = .013), less frustration (p = .014) and more powerful (p = .009) after the intervention. Quantitative results were supported by qualitative findings. Findings support the validity of Symphonology theory. The theory can be used to describe the experience of being involved in decision-making and Symphonology has utility as a model for assisting patients through the decision-making process

Studies in vitamin A technic

An application of statistical method to the data of 469 vitamin A feeding tests was made with a view to determining the factors influencing the weight gains of the test animals. The data of this study indicated a possible difference in the reactions of rats fed vitamin A free diets containing different amounts of fat. The data showed also that the quantity of basal diet ingested was the measured variable having the greatest per cent effect upon the weight gains of the animals;An experiment was conducted to test the difference in the reactions during the depletion period of vitamin A test-animals fed diets containing and not containing fat. One hundred twenty-three animals were fed the basal diet containing fat and 60 the fat-free basal diet. The difference in the mean gains in weight was not found to be significant but that between the number of days to depletion was significant. From these data one may conclude that a vitamin A free diet containing fat is preferable to a fat free basal diet as it shortens the time required to deplete the body store of vitamin A;An analysis of the reactions of vitamin A test animals from three different stock colonies revealed significant differences showing that the results of this or any other study could not be applied directly to the animals of any other colony without first testing the homogeneity of the two colonies;Since the food intake was shown to be the factor having the greatest percent effect upon the gains in weight of the test animals, an attempt was made to regulate their gains by controlling this factor. An estimate of the food intake was made by means of a regression equation in which the mean initial weight, mean gain and mean days to depletion were used as the independent variables and mean daily food intake as the dependent variable. Five groups of 20 rats each were fed a quantity of the basal diet estimated by the regression equation. This method of feeding the animals did not result in less variable weight-gains. In analyzing the data to discern reasons for the failure of these 100 animals to react positively to the test it was discovered that the test animals and the 123 animals upon which the regression was based do not belong to the same population even though both groups were offspring of a highly inbred colony of rats. (Abstract shortened by UMI.

A cross cultural study of motor development in the Western Cape

Despite conflicting evidence regarding advanced motor behaviour in black African infants, very few comparative studies have been published. Reliable developmental norms for local populations are essential for the early identification of developmental disabilities. In this study the sample consisted of 681 black and 741 white infants drawn proportionally from the Child Health Care Clinics in the northern areas of greater Cape Town. Babies were sampled in specified age-intervals between the ages of 16 and 1170 days. Variables studied were sex, birth-ranking, weight-percentile at the time of testing, marital status of the mother, parents' education and occupation, family size and family income. The demographic characteristics of the sample were compared with those of the population as a whole, based upon the 1980 census. The testing instruments were the gross and fine motor-adaptive sections of the Denver Developmental Screening Test, supplemented by another 21 items representing reflex reactions or specific components of movement. These supplementary items were pre-tested for inter- and intra-observer reliability. The percentage of children responding to the different tests at different ages was determined by probit analysis or, where more appropriate, by non-parametric logistic regression. Differences between the black and white South African infants were subjected to further statistical analysis, as was the contribution of the different variables to the attainment age. Comparison of the performance of the South African infants with the Denver norms showed that both black and white babies were in advance of the Denver children on the majority of fine motor items. The black infants were also considerably advanced in gross motor behaviour; the white infants less markedly so. In the very few (3) items in which the Denver children excelled, doubts exist regarding either scoring criteria or cultural suitability. Comparative analysis of the two South African samples identified certain consistent developmental trends. The black infants performed better on basic grasping patterns whereas the white infants were advanced in manipulative skills. The black infants were advanced on gross motor behaviour in the first year but were overtaken by the white group on learned gross motor skills in the second and third year, with the exception of items requiring physical strength. Very little correlation could be shown between motor achievement and socio- economic factors. Differences appear to be largely due to child-handling practices and experiential learning, but ethnic characteristics may well play a role in the advanced early gross motor development of the black infant. Heavier infants also performed better in both groups, indicating nutritional influences. The clinical implications of the findings are discussed and recommendations made for implementation and for further research

Hypervelocity Stars. I. The Spectroscopic Survey

We discuss our targeted search for hypervelocity stars (HVSs), stars traveling with velocities so extreme that dynamical ejection from a massive black hole is their only suggested origin. Our survey, now half complete, has successfully identified a total of four probable HVSs plus a number of other unusual objects. Here we report the most recently discovered two HVSs: SDSS J110557.45+093439.5 and possibly SDSS J113312.12+010824, traveling with Galactic rest-frame velocities at least +508+-12 and +418+-10 km/s, respectively. The other late B-type objects in our survey are consistent with a population of post main-sequence stars or blue stragglers in the Galactic halo, with mean metallicity [Fe/H]=-1.3 and velocity dispersion 108+-5 km/s. Interestingly, the velocity distribution shows a tail of objects with large positive velocities that may be a mix of low-velocity HVSs and high-velocity runaway stars. Our survey also includes a number of DA white dwarfs with unusually red colors, possibly extremely low mass objects. Two of our objects are B supergiants in the Leo A dwarf, providing the first spectroscopic evidence for star formation in this dwarf galaxy within the last ~30 Myr.Comment: 10 pages, uses emulateapj, accepted by Ap

Noncontact Diffuse Correlation Tomography of Human Breast Tumor

Our first step to adapt our recently developed noncontact diffuse correlation tomography (ncDCT) system for three-dimensional (3-D) imaging of blood flow distribution in human breast tumors is reported. A commercial 3-D camera was used to obtain breast surface geometry, which was then converted to a solid volume mesh. An ncDCT probe scanned over a region of interest on the mesh surface and the measured boundary data were combined with a finite element framework for 3-D image reconstruction of blood flow distribution. This technique was tested in computer simulations and in vivo human breasts with low-grade carcinoma. Results from computer simulations suggest that relatively high accuracy can be achieved when the entire tumor is within the sensitive region of diffuse light. Image reconstruction with a priori knowledge of the tumor volume and location can significantly improve the accuracy in recovery of tumor blood flow contrasts. In vivo imaging results from two breast carcinomas show higher average blood flow contrasts (5.9- and 10.9-fold) in the tumor regions compared to the surrounding tissues, which are comparable with previous findings using diffuse correlation spectroscopy. The ncDCT system has the potential to image blood flow distributions in soft and vulnerable tissues without distorting tissue hemodynamic

Best Management Practices and Nutrient Reduction: An Integrated Economic-Hydrological Model of the Western Lake Erie Basin

We develop the first spatially integrated economic-hydrological model of the western Lake Erie basin that explicitly links economic models of farmers\u27 field-level Best Management Practice (BMP) adoption choices with the Soil and Water Assessment Tool (SWAT) model to evaluate the cost-effectiveness of nutrient management policies. We quantify the tradeoffs between phosphorus reduction and policy costs and find that a hybrid policy that couples a fertilizer tax with cost-share payments for subsurface placement is the most cost-effective. We also find that economic adoption models can overstate the potential for nutrient reduction by ignoring biophysical complexities and thus demonstrate the importance of coupling economic and biophysical models for efficient policy design

Mutual learning exercise on citizen science initiatives: policy and practice: final report

Over the past decade, great advances have been made in applying innovative participatory and inclusive research practices across a wide range of domains. These have involved increasing numbers of citizens in monitoring, observing, and co-researching societal issues such as climate change impacts on the environment and public health, sustainable mobility, and plastic pollution in rivers and oceans. Important outcomes have been achieved, from fundamental scientific discoveries1 to data that support evidence-informed policy