Patient Satisfaction in a One-Stop Haematuria clinic and Urology Outpatients: A Comparison of Clinics

One-stop clinics have shown to improve the patient experience in early diagnosis of potentially life threatening conditions, although this service is less evident in Urology, where morbidity and mortality resulting from bladder cancers are increasing. This study will discuss whether or not one-stop haematuria clinics improve patient satisfaction. A survey analysis comparing patient satisfaction for a one-stop haematuria clinic and a traditional outpatient service was developed, based around the ‘Determinants and Components’ theory. A convenience sample of 102 haematuria patients attending either the one-stop clinic (Route A) or an outpatient clinic within the Urology service (Route B), at an assigned National Health Service hospital, were invited to complete a ‘patient satisfaction’ questionnaire. Data were compared between clinic routes according to the patient satisfaction themes of: Time and Availability, Quality of Care, Environment, Accessibility and Convenience and Global Satisfaction. Response rate was 51%; with overall positive patient satisfaction levels for both clinics. Route A patients were most satisfied with Quality of Care; however, reported problems relating to prior information provision and appointment co-ordination. For Route B, Availability and Time was a primary source of both satisfaction and dissatisfaction, receiving contradictory qualitative and quantitative responses respectively. Both groups rated Environment and Accessibility and Convenience highly overall, yet these were not a primary determinant of satisfaction. The majority of haematuria patients (82%), expressed a preference to attend a one-stop clinic over several outpatient appointments. Practical recommendations for related service improvements are offered

Aggregating multiple body sensors for analysis in sports

Real time monitoring of the wellness of sportspersons, during their sporting activity and training, is important in order to maximise performance during the sporting event itself and during training, as well as being important for the health of the sportsperson overall. We have combined a suite of common, off-the-shelf sensors with specialist body sensing technology we are developing ourselves and constructed a software system for recording, analysing and presenting sensed data gathered from a single player during a sporting activity, a football match. We gather readings for heart rate, galvanic skin response, motion, heat flux, respiration, and location (GPS) using on-body sensors, while simultaneously tracking player activity using a combination of a playercam video and pitch-wide video recording. We have aggregated all this sensed data into a single overview of player performance and activity which can be reviewed, post-event. We are currently working on integrating other non-invasive methods for real-time on-body monitoring of sweat electrolytes and pH via a textile-based sweat sampling and analysis platform. Our work is heading in two directions; firstly from post-event data aggregation to real-time monitoring, and secondly, to convert raw sensor readings into performance indicators that are meaningful to practitioners in the field

Assessing the Risk of Metals and Their Mixtures in the Antarctic Nearshore Marine Environment with Diffusive Gradients in Thin-Films

© 2019 American Chemical Society. Robust environmental assessments and contaminant monitoring in Antarctic near-shore marine environments need new techniques to overcome challenges presented by a highly dynamic environment. This study outlines an approach for contaminant monitoring and risk assessment in Antarctic marine conditions using diffusive gradients in thin-films (DGT) coupled to regionally specific ecotoxicology data and environmental quality standards. This is demonstrated in a field study where DGT samplers were deployed in the near-shore marine environment of East Antarctica around the operational Casey station and the abandoned Wilkes station to measure the time-averaged biologically available fraction of metal contaminants. The incorporation of DGT-labile concentrations to reference toxicity mixture models for three Antarctic organisms predicted low toxic effects (<5% effect to the growth or development of each organism). The comparison of metal concentrations to the Australian and New Zealand default water quality guideline values (WQGVs) showed no marine site exceeding the WQGVs for 95% species protection. However, all sites exceeded the 99% WQGVs due to copper concentrations that are likely of geogenic origin (i.e., not from anthropogenic sources). This study provides evidence supporting the use of the DGT technique to monitor contaminants and assess their environmental risk in the near-shore marine environment of Antarctica

Sliding contact problems involving inhomogeneous materials comprising a coating-transition layer-substrate and a rigid punch

This paper proposes a semi-analytical model for the two-dimensional contact problem involving a multi-layered elastic solid loaded normally and tangentially by a rigid punch. The solid is comprised of a homogeneous coating and substrate joined together by a graded elastic transition layer whose material properties exhibit an exponential dependence on the vertical coordinate. By applying the Fourier transform to the governing boundary value problem, we formulate analytic expressions for the stresses and displacements induced by the application of line forces acting both normally and tangentially at the origin. The superposition principle is then used to generalise these expressions to the case of distributed normal and tangential tractions acting on the solid surface. A pair of coupled integral equations are further derived for the parabolic stamp problem which are easily solved using collocation methods. The primary aim of this paper is to provide insight into the likely behaviour of graded materials under the combined effects of surface pressure and shear stress. In this study, the assumption of Coulomb friction is invoked and the effects of material gradation, coating/interlayer thickness and friction coefficient upon the contact footprint and sub-surface stress field are investigated in great detail. The results we obtain suggest that the thickness of the transition layer as well as the combined thickness of the coating and transition layer have a significant effect on the maximum sub-surface stress attained through contact. This indicates that small changes in the composition of the coating can lead to significant differences in material behaviour. We additionally find that an increase in the amount of friction present in the contact can cause dramatic changes in the pattern of the stress field and can give rise to a much larger maximum stress. This effect can be offset somewhat under certain conditions by changing the thickness of the transition layer. To the best of the authors belief, this work represents the first attempt made to characterise the effects of friction on the sub-surface stress field within a graded elastic material

Mechanisms of Skyrmion and Skyrmion Crystal Formation from the Conical Phase

Real-space topological magnetic structures such as skyrmions and merons are promising candidates for information storage and transport. However, the microscopic mechanisms that control their formation and evolution are still unclear. Here, using in situ Lorentz transmission electron microscopy, we demonstrate that skyrmion crystals (SkXs) can nucleate, grow, and evolve from the conical phase in the same ways that real nanocrystals form from vapors or solutions. More intriguingly, individual skyrmions can also “reproduce” by division in a mitosis-like process that allows them to annihilate SkX lattice imperfections, which is not available to crystals made of mass-conserving particles. Combined string method and micromagnetic calculations show that competition between repulsive and attractive interactions between skyrmions governs particle-like SkX growth, but nonconservative SkX growth appears to be defect mediated. Our results provide insights toward manipulating magnetic topological states by applying established crystal growth theory, adapted to account for the new process of skyrmion mitosis

Correlation of Gleason Scores with Diffusion-Weighted Imaging Findings of Prostate Cancer

The purpose of our study was to compare the apparent diffusion coefficient (ADC) derived from diffusion-weighted imaging (DWI) of prostate cancer (PCa) patients with three classes of pathological Gleason scores (GS). Patients whose GS met these criteria (GS 3 + 3, GS 3 + 4, and GS 4 + 3) were included in this study. The DWI was performed using b values of 0, 50, and 400 s/mm2 in 44 patients using an endorectal coil on a 1.5T MRI scanner. The apparent diffusion coefficient (ADC) values were calculated from the DWI data of patients with three different Gleason scores. In patients with a high-grade Gleason score (4 + 3), the ADC values were lower in the peripheral gland tissue, pathologically determined as tumor compared to low grade (3 + 3 and 3 + 4). The mean and standard deviation of the ADC values for patients with GS 3 + 3, GS 3 + 4, and GS 4 + 3 were 1.135 ± 0.119, 0.976 ± 0.103 and 0.831 ± 0.087 mm2/sec. The ADC values were statistically significant (P < 0.05) between the three different scores with a trend of decreasing ADC values with increasing Gleason scores by one-way ANOVA method. This study shows that the DWI-derived ADC values may help differentiate aggressive from low-grade PCa

The role of mentorship in protege performance

The role of mentorship on protege performance is a matter of importance to academic, business, and governmental organizations. While the benefits of mentorship for proteges, mentors and their organizations are apparent, the extent to which proteges mimic their mentors' career choices and acquire their mentorship skills is unclear. Here, we investigate one aspect of mentor emulation by studying mentorship fecundity---the number of proteges a mentor trains---with data from the Mathematics Genealogy Project, which tracks the mentorship record of thousands of mathematicians over several centuries. We demonstrate that fecundity among academic mathematicians is correlated with other measures of academic success. We also find that the average fecundity of mentors remains stable over 60 years of recorded mentorship. We further uncover three significant correlations in mentorship fecundity. First, mentors with small mentorship fecundity train proteges that go on to have a 37% larger than expected mentorship fecundity. Second, in the first third of their career, mentors with large fecundity train proteges that go on to have a 29% larger than expected fecundity. Finally, in the last third of their career, mentors with large fecundity train proteges that go on to have a 31% smaller than expected fecundity.Comment: 23 pages double-spaced, 4 figure