2,390 research outputs found

    The value of a breast care nurse in supporting rural and remote cancer patients in Queensland

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    The role of the Breast Care Nurse in Queensland's Supporting Rural Women with Breast Cancer Project was evaluated by mixed methodology. Through questionnaire and interview patients provided views about the nurse's role under categories of Awareness, Access, Coordination, Information and Psychosocial, Emotional and Practical support. Of the 51 participants 37 resided in rural and remote areas with 18 living between 100 and 500 miles from specialised breast care services. The BCN met with patients at their regular hospital visits and was available by telephone at any time. There was overwhelming agreement among the participants that the timing of contact, ease of accessibility, information provided and support offered were extremely valuable in making their treatment and recovery easier. The vast majority of participants would recommend hospitals with a BCN to their friends. Members of the multidisciplinary care team provided views on Awareness of the BCN, Influence on Care Management, Communication and Patient Outcomes. They recognised the benefits of the BCN to patients and to coordination and liaison of the team. The findings concur with unpublished Australian reports that demonstrate the success of dedicated Breast Care Nurses. The BCN model of care could be used successfully to support other medical conditions

    Quantum Field Theory on Spacetimes with a Compactly Generated Cauchy Horizon

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    We prove two theorems which concern difficulties in the formulation of the quantum theory of a linear scalar field on a spacetime, (M,g_{ab}), with a compactly generated Cauchy horizon. These theorems demonstrate the breakdown of the theory at certain `base points' of the Cauchy horizon, which are defined as `past terminal accumulation points' of the horizon generators. Thus, the theorems may be interpreted as giving support to Hawking's `Chronology Protection Conjecture', according to which the laws of physics prevent one from manufacturing a `time machine'. Specifically, we prove: Theorem 1: There is no extension to (M,g_{ab}) of the usual field algebra on the initial globally hyperbolic region which satisfies the condition of F-locality at any base point. In other words, any extension of the field algebra must, in any globally hyperbolic neighbourhood of any base point, differ from the algebra one would define on that neighbourhood according to the rules for globally hyperbolic spacetimes. Theorem 2: The two-point distribution for any Hadamard state defined on the initial globally hyperbolic region must (when extended to a distributional bisolution of the covariant Klein-Gordon equation on the full spacetime) be singular at every base point x in the sense that the difference between this two point distribution and a local Hadamard distribution cannot be given by a bounded function in any neighbourhood (in MXM) of (x,x). Theorem 2 implies quantities such as the renormalized expectation value of \phi^2 or of the stress-energy tensor are necessarily ill-defined or singular at any base point. The proofs rely on the `Propagation of Singularities' theorems of Duistermaat and H\"ormander.Comment: 37 pages, LaTeX, uses latexsym and amsbsy, no figures; updated version now published in Commun. Math. Phys.; no major revisions from original versio

    Dietary dairy product intake and incident type 2 diabetes: a prospective study using dietary data from a 7-day food diary

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    The consumption of specific dairy types may be beneficial for the prevention of diabetes. Abstract: The aim of this study was to investigate the association between total and types of dairy product intake and risk of developing incident type 2 diabetes, using a food diary. Methods: A nested case-cohort within the EPIC-Norfolk Study was examined, including a random subcohort (n=4,000) and cases of incident diabetes (n=892, including 143 cases in the subcohort) followed-up for 11 years. Diet was assessed using a prospective 7-day food diary. Total dairy intake (g/day) was estimated and categorised into high-fat (≥3.9%) and low-fat (<3.9% fat) dairy, and by subtype into yoghurt, cheese and milk. Combined fermented dairy product intake (yoghurt, cheese, sour cream) was estimated and categorised into high- and low-fat. Prentice-weighted Cox regression HRs were calculated. Results: Total dairy, high-fat dairy, milk, cheese and high-fat fermented dairy product intakes were not associated with the development of incident diabetes. Low-fat dairy intake was inversely associated with diabetes in age- and sex-adjusted analyses (tertile [T] 3 vs T1, HR 0.81 [95% CI 0.66, 0.98]), but further adjustment for anthropometric, dietary and diabetes risk factors attenuated this association. In addition, an inverse association was found between diabetes and low-fat fermented dairy product intake (T3 vs T1, HR 0.76 [95% CI 0.60, 0.99]; ptrend=0.049) and specifically with yoghurt intake (HR 0.72 [95% CI 0.55, 0.95]; ptrend=0.017) in multivariable adjusted analyses. Conclusions/interpretation: Greater low-fat fermented dairy product intake, largely driven by yoghurt intake, was associated with a decreased risk of type 2 diabetes development in prospective analyses. These findings suggest that the consumption of specific dairy types may be beneficial for the prevention of diabetes, highlighting the importance of food group subtypes for public health messages

    Toward systematic control of cybersickness

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    Visually induced motion sickness, or cybersickness, has been well documented in all kinds of vehicular simulators and in many virtual environments. It probably occurs in all virtual environments. Cybersickness has many known determinants, including (a short list) field-of-view, flicker, transport delays, duration of exposure, gender, and susceptibility to motion sickness. Since many of these determinants can be controlled, a major objective in designing virtual environments is to hold cybersickness below a specified level a specified proportion of the time. More than 20 years ago C. W. Simon presented a research strategy based on fractional factorial experiments that was capable in principle of realizing this objective. With one notable exception, however, this strategy was not adopted by the human factors community. The main reason was that implementing Simon\u27s strategy was a major undertaking, very time-consuming, and very costly. In addition, many investigators were not satisfied that Simon had adequately addressed issues of statistical reliability. The present paper proposes a modified Simonian approach to the sate objective (holding cybersickness below specified standards) with some loss in the range of application but a greatly reduced commitment of resources

    Duration and exposure to virtual environments: Sickness curves during and across sessions

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    Although simulator sickness is known to increase with protracted exposure and to diminish with repeated sessions, limited systematic research has been performed in these areas. This study reviewed the few studies with sufficient information available to determine the effect-that exposure duration and repeated exposure have on motion sickness. This evaluation confirmed that longer exposures produce more symptoms and that total sickness subsides over repeated exposures. Additional evaluation was performed to investigate the precise form of this relationship and to determine whether the same form was generalizable across varied simulator environments. The results indicated that exposure duration and repeated exposures are significantly linearly related to sickness outcomes (duration being positively related and repetition negatively related to total sickness). This was true over diverse systems and large subject pools. This result verified the generalizability of-the relationships among sickness, exposure duration, and repeated exposures. Additional research is indicated to determine the optimal length of a single exposure and the optimal intersession interval to facilitate adaptation

    Providing Legal Services for the Poor: A Dilemma and an Opportunity

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    This article serves as a report on the status of pro bono legal services programs in Colorado and the possible options available for attorney participation. It is hoped that this information will assist attorneys in examining their pro bono responsibilities and in seeking creative ways to turn these responsibilities into opportunities. Perhaps as background, the definition of pro bono should first be examined

    Outer Retinal Structure in Best Vitelliform Macular Dystrophy

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    Importance Demonstrating the utility of adaptive optics scanning light ophthalmoscopy (AOSLO) to assess outer retinal structure in Best vitelliform macular dystrophy (BVMD). Objective To characterize outer retinal structure in BVMD using spectral-domain optical coherence tomography (SD-OCT) and AOSLO. Design, Setting, and Participants Prospective, observational case series. Four symptomatic members of a family with BVMD with known BEST1 mutation were recruited at the Advanced Ocular Imaging Program research lab at the Medical College of Wisconsin Eye Institute, Milwaukee. Intervention Thickness of 2 outer retinal layers corresponding to photoreceptor inner and outer segments was measured using SD-OCT. Photoreceptor mosaic AOSLO images within and around visible lesions were obtained, and cone density was assessed in 2 subjects. Main Outcome and Measure Photoreceptor structure. Results Each subject was at a different stage of BVMD, with photoreceptor disruption evident by AOSLO at all stages. When comparing SD-OCT and AOSLO images from the same location, AOSLO images allowed for direct assessment of photoreceptor structure. A variable degree of retained photoreceptors was seen within all lesions. The photoreceptor mosaic immediately adjacent to visible lesions appeared contiguous and was of normal density. Fine hyperreflective structures were visualized by AOSLO, and their anatomical orientation and size were consistent with Henle fibers. Conclusions and Relevance The AOSLO findings indicate that substantial photoreceptor structure persists within active lesions, accounting for good visual acuity in these patients. Despite previous reports of diffuse photoreceptor outer segment abnormalities in BVMD, our data reveal normal photoreceptor structure in areas adjacent to clinical lesions. This study demonstrates the utility of AOSLO for understanding the spectrum of cellular changes that occur in inherited degenerations such as BVMD. Photoreceptors are often significantly affected at various stages of inherited degenerations, and these changes may not be readily apparent with current clinical imaging instrumentation

    Some Properties of Noether Charge and a Proposal for Dynamical Black Hole Entropy

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    We consider a general, classical theory of gravity with arbitrary matter fields in nn dimensions, arising from a diffeomorphism invariant Lagrangian, \bL. We first show that \bL always can be written in a ``manifestly covariant" form. We then show that the symplectic potential current (n1)(n-1)-form, th\th, and the symplectic current (n1)(n-1)-form, \om, for the theory always can be globally defined in a covariant manner. Associated with any infinitesimal diffeomorphism is a Noether current (n1)(n-1)-form, \bJ, and corresponding Noether charge (n2)(n-2)-form, \bQ. We derive a general ``decomposition formula" for \bQ. Using this formula for the Noether charge, we prove that the first law of black hole mechanics holds for arbitrary perturbations of a stationary black hole. (For higher derivative theories, previous arguments had established this law only for stationary perturbations.) Finally, we propose a local, geometrical prescription for the entropy, SdynS_{dyn}, of a dynamical black hole. This prescription agrees with the Noether charge formula for stationary black holes and their perturbations, and is independent of all ambiguities associated with the choices of \bL, th\th, and \bQ. However, the issue of whether this dynamical entropy in general obeys a ``second law" of black hole mechanics remains open. In an appendix, we apply some of our results to theories with a nondynamical metric and also briefly develop the theory of stress-energy pseudotensors.Comment: 30 pages, LaTe
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