Deformation analysis of a metropolis from C- to X-band PSI: proof-of-concept with Cosmo-Skymed over Rome, Italy

Stability of monuments and subsidence of residential quarters in Rome (Italy) are depicted based on geospatial analysis of more than 310,000 Persistent Scatterers (PS) obtained from Stanford Method for Persistent Scatterers (StaMPS) processing of 32 COSMO-SkyMed 3m-resolution HH StripMap ascending mode scenes acquired between 21 March 2011 and 10 June 2013. COSMO-SkyMed PS densities and associated displacement velocities are compared with almost 20 years of historical C-band ERS- 1/2, ENVISAT and RADARSAT-1/2 imagery. Accounting for differences in image processing algorithms and satellite acquisition geometries, we assess the feasibility of ground motion monitoring in big cities and metropolitan areas by coupling newly acquired and legacy SAR in full time series. Limitations and operational benefits of the transition from medium resolution C-band to high resolution X-band PS data are discussed, alongside the potential impact on the management of expanding urban environments

In vivo hippocampal subfield volumes in bipolar disorder—A mega-analysis from The Enhancing Neuro Imaging Genetics through Meta-Analysis Bipolar Disorder Working Group

The hippocampus consists of anatomically and functionally distinct subfields that may be differentially involved in the pathophysiology of bipolar disorder (BD). Here we, the Enhancing NeuroImaging Genetics through Meta‐Analysis Bipolar Disorder workinggroup, study hippocampal subfield volumetry in BD. T1‐weighted magnetic resonance imaging scans from 4,698 individuals (BD = 1,472, healthy controls [HC] = 3,226) from 23 sites worldwide were processed with FreeSurfer. We used linear mixed‐effects models and mega‐analysis to investigate differences in hippocampal subfield volumes between BD and HC, followed by analyses of clinical characteristics and medication use. BD showed significantly smaller volumes of the whole hippocampus (Cohen's d = −0.20), cornu ammonis (CA)1 (d = −0.18), CA2/3 (d = −0.11), CA4 (d = −0.19), molecular layer (d = −0.21), granule cell layer of dentate gyrus (d = −0.21), hippocampal tail (d = −0.10), subiculum (d = −0.15), presubiculum (d = −0.18), and hippocampal amygdala transition area (d = −0.17) compared to HC. Lithium users did not show volume differences compared to HC, while non‐users did. Antipsychotics or antiepileptic use was associated with smaller volumes. In this largest study of hippocampal subfields in BD to date, we show widespread reductions in nine of 12 subfields studied. The associations were modulated by medication use and specifically the lack of differences between lithium users and HC supports a possible protective role of lithium in BD

Patient Participation in Pediatric Oncology : Providing Children and Adolescents with Opportunities to Develop Autonomy

There is a longstanding debate surrounding children’s and adolescents participation in their healthcare. Regarding this topic, three central concepts emerge: decision-making capacity, participation, and autonomy. Several legislations across the world (e.g., US, UK, Switzerland) acknowledge that autonomy and the capacity to make decisions do not suddenly appear once a minor patient reaches the age of majority. Yet, there still is much debate with regard to when and how children who are ill can and should be included in, for example, communication and decision-making. Very differing attitudes exist on whether children and adolescents have enough experience and knowledge to make such important and often difficult decisions. Even for parents and healthcare professionals in favour of including minor patients, there remains much insecurity due to a lack of empirical evidence. Decision-making capacity is a concept that is still largely under theorized in pediatric healthcare as most research is carried out on adults. However, it is an important requirement with regard to children’s and adolescents’ ability to transform choices into legally binding decisions. Additionally, it plays a crucial role in children’s overall participation in healthcare since many professional guidelines emphasize the importance of harmonizing the nature and extent of pediatric patients’ participation with their capacities. Empirical research on children’s and adolescents’ participation in healthcare is scarce. Hence, little is known about how they involved in their care, what challenges such practices bring upon the triad of patient, parent, and physician, and how exactly minor patient’s involvement can be adapted to their abilities. Consequently, the aim of the present research is to closely examine the concepts of decision-making capacity and participation in pediatrics using a combination of theoretical and empirical approaches. This doctoral work provides insight into both practical and conceptual aspects of children’s and adolescents’ autonomy in healthcare.

“Chemo-Knights” and “Radio-Robby”

BACKGROUND: Information provision is an important step in enabling pediatric patients to participate in healthcare. Storybooks and patient information brochures represent a channel through which children and adolescents with cancer are informed about their illness. However, the use of such written materials has received little academic attention. OBJECTIVE:The aim of this article was to carry out an exploratory analysis of written information resources for pediatric cancer patients. The potential of these to enhance patient participation will be discussed. METHODS:A convenience sample of 16 written resource materials in English and German were chosen for analysis. Thematic coding was carried out to identify major themes. RESULTS:Subthemes were summarized into 3 main categories: information on diagnosis, treatment, and illness experience. Information was provided on, for example, illness name and etiology, diagnostic and treatment procedures, emotions, and coping strategies. CONCLUSIONS: Storybooks and other written resources on cancer contain a broad array of information and describe illness-related issues to a varying extent. They represent an excellent possibility to ease patient participation in healthcare by providing them with necessary information while also inviting further discussion. IMPLICATIONS FOR PRACTICE:Nurses and other healthcare professionals can use written resource materials to engage in discussions with pediatric patients concerning their illness. Nurses should be aware of the information children and adolescents receive in these materials in order to be able to adequately answer questions that may arise or identify misunderstandings as well as lack of information

End-of-life decision making in pediatrics: literature review on children's and adolescents' participation

Background: Pediatric guidelines recommend that children and adolescents participate in a developmentally appropriate way in end-of-life decision making. Shared decision making in pediatrics is unique because of the triadic relationship of patient, parents, and physician. The involvement of the patient may vary on a continuum from no involvement to being the sole decision maker. However, the effects of child participation have not been thoroughly studied. The aim of this literature review is to identify studies on end-of-life decision making in pediatrics to explore patient participation and to assess the effects of such participation. Methods: Five databases - PubMed, PsycInfo, Medline, CINAHL, and Sociological Abstract - were searched for empirical studies on end-of-life decision making in pediatrics. Selected articles fulfilling the criteria were assessed for type of decision, participants’ characteristics, reports on participation of the minor patient, and outcome. Results: Fifty-seven articles on end-of-life decision making in pediatrics were identified. The majority of papers (n = 43, 75%) investigated parents’ and clinicians’ perspectives, while only 14 articles (25%) included perspectives of children and adolescents. Twenty-two articles (39%) reported some details on various forms of children's participation (e.g., receive information, plan care details, consulted before or after a decision was made). Positive (e.g., respect for patient's preferences) as well as negative (e.g., conflict due to diverging opinions) effects of children's participation in end-of-life decision making were reported. Conclusions: This systematic review highlights the need for research to identify factors that contribute to a favorable participation of minors in decision making processes as well as strategies to solve possible conflicts. More research should take into account the dynamics in the triadic process of decision making and emphasize children and adolescents’ perspectives. A better understanding of how to meaningfully involve children and adolescents in end-of-life decision making could facilitate the practice of patient participation in pediatrics

Relational Capacity: Broadening the Notion of Decision-Making Capacity in Paediatric Healthcare

Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children's position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon the notion of capacity is discussed, followed by an examination of Vygostky's contextualist view on children's development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults' decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties

Dynamics of CL-P1 in ischemia/reperfusion

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Participation in pediatric oncology: views of child and adolescent patients

The aim of the present study is to explore patient's perspectives in pediatric oncology on participation in discussions and decision-making surrounding their cancer diagnosis.; Seventeen patients between 9 and 17 years of age receiving treatment at centers of the Swiss Pediatric Oncology Group were interviewed for this study. Their interview data was analyzed qualitatively to identify themes with regard to participation in medical communication and/or decision-making.; Participants highlighted how their roles in health care discussions varied from direct participation to indirect involvement. Overall, there were fewer accounts of involvement in decision-making than in overall health care discussions. Challenges with regard to completely understanding the information provided and making decisions were identified. Participants also discussed situations when they were not involved in medical communication or decision-making. While they generally valued their participation, the preferred level of involvement oscillated between participants as well as within one and the same child across time.; The complex pattern of participation found in this study calls for a flexible model of involving children and adolescents in health care that accounts for the varying roles and preferences that they manifest. A patient may appreciate active involvement in some decisions while choosing to remain in the background for others. Copyright © 2015 John Wiley & Sons, Ltd

Parents' and patients' experiences with paediatric oncology care in Switzerland--satisfaction and some hurdles

This paper explores parents' and patients' satisfaction with care in Swiss paediatric oncology settings and examines difficulties experienced while undergoing treatment for cancer.; Semistructured interviews were conducted with 19 parents, and with 17 children who were diagnosed with cancer and receiving treatment. During these interviews questions pertaining to communication and decision-making at time of diagnosis and throughout the illness course were asked. In this paper, we examined these interviews using thematic coding to identify themes with regard to satisfaction with care.; Generally, participants reported being very content with the care they received. Aspects that contributed to satisfaction were the friendliness and responsive nature of healthcare staff; helpful communication; and professionals going beyond their duties to care for the family. In spite of mainly being pleased with the care they received, participants underlined several issues that made their experiences at times difficult. These included frequent change of physician or receiving care from another unit, which for them represented lack of continuity of care; language problems; and challenges with reproductive health issues of the child. Additionally, patients suggested several ways to improve hospital stays and thereby patient satisfaction.; Participants reported being very satisfied with care delivered by paediatric oncology units. Nevertheless, they also identified problems that are worth addressing in order to efficiently tend to the needs of patients and families undergoing this difficult experience. Future research is needed to explore how care for children with cancer and their families can be further improved