A qualitative exploration of experiences of gender identity and gender questioning among adults with Klinefelter syndrome/XXY

People with Klinefelter syndrome (KS/XXY) may be at higher risk of gender dysphoria than the general population and gender diversity needs greater recognition and consideration in services for people affected. This study aimed to give systematic insights into experiences of gender diversity among people with KS/XXY, which could inform more person-centred care for people with KS/XXY and contribute to practical guidance for healthcare professionals. We conducted individual, semi-structured interviews with 11 adults with diagnosed KS/XXY. The verbatim interview transcripts were analysed using experiential reflexive thematic analysis, which identified four themes: 1) Experience of gender, which described participants’ experiences of exploring and negotiating their gender identity; 2) Navigating expectations, which described how participants’ gender uncertainty was associated with confusion, isolation and shame, and how fears about other people’s reactions caused participants to keep their gender identity secret; 3) Testosterone assumptions, which described how participants needed more discussion and counselling before testosterone replacement therapy, and how some benefited from treatment with alternative hormones to testosterone; and 4) A different approach, which described participants’ experiences of care at gender identity clinics. The findings give new insights into the gender identity journeys of people with KS/XXY, from early attempts to understand and make sense of gender, through dealing with social pressures, the development of gender identities more congruent with feelings, and experiences with hormone replacement therapy. The practice implications include that there should be improved consideration of gender identity in care for KS/XXY, better psychological support for those affected by gender diversity, and more consideration given to alternatives to testosterone-based therapies. Future research could explore the experiences of gender identity among different groups of people with KS/XXY, the development of gender identity over time, the effects of testosterone replacement therapy on gender identity, and health care providers’ knowledge and attitudes about gender identity and KS/XXY

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

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

Ultra-short pulses in linear and nonlinear media

We consider the evolution of ultra-short optical pulses in linear and nonlinear media. For the linear case, we first show that the initial-boundary value problem for Maxwell's equations in which a pulse is injected into a quiescent medium at the left endpoint can be approximated by a linear wave equation which can then be further reduced to the linear short-pulse equation. A rigorous proof is given that the solution of the short pulse equation stays close to the solutions of the original wave equation over the time scales expected from the multiple scales derivation of the short pulse equation. For the nonlinear case we compare the predictions of the traditional nonlinear Schr\"odinger equation (NLSE) approximation which those of the short pulse equation (SPE). We show that both equations can be derived from Maxwell's equations using the renormalization group method, thus bringing out the contrasting scales. The numerical comparison of both equations to Maxwell's equations shows clearly that as the pulse length shortens, the NLSE approximation becomes steadily less accurate while the short pulse equation provides a better and better approximation

The effect of melt viscosity on thermal efficiency for single screw extrusion of HDPE

YesIn this work, a highly instrumented single screw extruder has been used to study the effect of polymer rheology on the thermal efficiency of the extrusion process. Three different molecular weight grades of high density polyethylene (HDPE) were extruded at a range of conditions. Three geometries of extruder screws were used at several set temperatures and screw rotation speeds. The extruder was equipped with real-time quantification of energy consumption; thermal dynamics of the process were examined using thermocouple grid sensors at the entrance to the die. Results showed that polymer rheology had a significant effect on process energy consumption and thermal homogeneity of the melt. Highest specific energy consumption and poorest homogeneity was observed for the highest viscosity grade of HDPE. Extruder screw geometry, set extrusion temperature and screw rotation speed were also found to have a direct effect on energy consumption and melt consistency. In particular, specific energy consumption was lower using a barrier flighted screw compared to single flighted screws at the same set conditions. These results highlight the complex nature of extrusion thermal dynamics and provide evidence that rheological properties of the polymer can significantly influence the thermal efficiency of the process. (C) 2014 The Authors. Published by Elsevier B.V. All rights reserved

Investigation of transition frequencies of two acoustically coupled bubbles using a direct numerical simulation technique

The theoretical results regarding the ``transition frequencies'' of two acoustically interacting bubbles have been verified numerically. The theory provided by Ida [Phys. Lett. A 297 (2002) 210] predicted the existence of three transition frequencies per bubble, each of which has the phase difference of $\pi /2$ between a bubble's pulsation and the external sound field, while previous theories predicted only two natural frequencies which cause such phase shifts. Namely, two of the three transition frequencies correspond to the natural frequencies, while the remaining does not. In a subsequent paper [M. Ida, Phys. Rev. E 67 (2003) 056617], it was shown theoretically that transition frequencies other than the natural frequencies may cause the sign reversal of the secondary Bjerknes force acting between pulsating bubbles. In the present study, we employ a direct numerical simulation technique that uses the compressible Navier-Stokes equations with a surface-tension term as the governing equations to investigate the transition frequencies of two coupled bubbles by observing their pulsation amplitudes and directions of translational motion, both of which change as the driving frequency changes. The numerical results reproduce the recent theoretical predictions, validating the existence of the transition frequencies not corresponding to the natural frequency.Comment: 18 pages, 8 figures, in pres

MINERVA - A Multi-Modal Radiation Treatment Planning System

Recently, research efforts have begun to examine the combination of BNCT with external beam photon radiotherapy (Barth et al. 2004). In order to properly prepare treatment plans for patients being treated with combinations of radiation modalities, appropriate planning tools must be available. To facilitiate this, researchers at the Idaho National Engineering and Environmental Laboratory (INEEL)and Montana State University (MSU) have undertaken development of a fully multi-modal radiation treatment planning system