"Trust me...": Psychological and behavioral predictors of perceived physician empathy

A sociocognitive model of distal and proximal predictors of empathic judgments was tested among 100 physicians. The authors hypothesized that physician perceived control would affect empathy ratings via physician communication style. Specifically, physicians with high perceived control would use more open communication and be rated as more empathic. Physicians with low perceived control would use a controlling communication style and be rated as less empathic. Physicians completed a medical attribution questionnaire prior to a structured patient consultation exercise, during which patients and assessors rated physician empathy. The exercise was audiotaped, transcribed, and content analyzed for verbal behaviors. Support was found for the hypotheses; however, patients, but not medical assessors, associated empathy with reassurance and provision of medical information

Stress distribution in masonry infills connected with stiff and flexible interface

Masonry infills are largely used in RC structures for various purposes, and in seismic zones, they are also preferred for providing earthquake resistant systems. However, due to the rigid connection between infills and RC frames, these systems are vulnerable when large deformations are demanded. Cyclic loads that are occurring during seismic excitations cause stress concentration level to increase, particularly in frame-infill contact zones. As a result of stress increment, infill panels get weaker in terms of both in-plane and out-of-plane resistance. These drawbacks cause loss of lives and properties, thus affecting governments and societies adversely. In order to overcome this obstacle, an innovative solution is proposed which uses flexible polymers (Polyurethane PM) as joint elements for protecting the structural elements. The research is focused on numerical analyses of three types of frames with masonry infills, which are excited through both in-plane and out-of-plane directions by different earthquake records. Infill walls are connected to the frames in three manners: stiffly (classical approach), with flexible joints at 3-boundaries and with flexible joints at 4-boundaries. Differences in calculated stress distribution as well as some other linear and non-linear results are presented and discussed. The primary results give promising outcomes that this new method might be used in seismic zones for protecting structures

Heart failure following cancer treatment: characteristics, survival and mortality of a linked health data analysis

Background: Cardiotoxicity resulting in heart failure is a devastating complication of cancer therapy. A patient may survive cancer only to develop heart failure (HF), which has a higher mortality rate than some cancers. Aim: This study aimed to describe the characteristics and outcomes of HF in patients with blood or breast cancer after chemotherapy treatment. Methods: Queensland Cancer Registry, Death Registry and Hospital Administration records were linked (1996–2009). Patients were categorised as those with an index HF admission (that occurred after cancer diagnosis) and those without an index HF admission (non-HF). Results: A total of 15 987 patients was included, and 1062 (6.6%) had an index HF admission. Median age of HF patients was 67 years (interquartile range 58–75) versus 54 years (interquartile range 44–64) for non-HF patients. More men than women developed HF (48.6% vs 29.5%), and a greater proportion in the HF group had haematological cancer (83.1%) compared with breast cancer (16.9%). After covariate adjustment, HF patients had increased mortality risk compared with non-HF patients (hazard ratios 1.67 (95% confidence interval, 1.54–1.81)), and 47% of the index HF admission occurred within 1 year from cancer diagnosis and 70% within 3 years. Conclusion: Cancer treatment may place patients at a greater risk of developing HF. The onset of HF occurred soon after chemotherapy, and those who developed HF had a greater mortality risk

Heart failure following blood cancer therapy in pediatric and adult populations

Aim: The link between chemotherapy treatment and cardiotoxicity is well established, particularly for adults with blood cancers. However, it is less clear for children. This analysis aimed to compare the trajectory and mortality of children and adults who received chemotherapy for blood cancers and were subsequently hospitalised for heart failure. Methods: Linked data from the Queensland Cancer Registry, Death Registry and Hospital Administration records for initial chemotherapy and later heart failure were reviewed (1996-2009). Of all identified blood cancer patients (N=23,434); 8,339 received chemotherapy, including 817 children (aged ≤18 years at time of cancer diagnosis) and 7,522 adults. Time-varying Cox proportional hazards regression models were used to compare the characteristics and survival between the two groups. Results: Of those who were subsequently hospitalised for heart failure, 70% of children and 46% of adults had the index admission within 12 months of their cancer diagnosis. Of these, 53% of the pediatric heart failure population and 71% of the adult heart failure population died within the study period. Following adjustment for age, sex and chemotherapy admissions, children with heart failure had an increased mortality risk compared to their non-heart failure counterparts, a difference which was much greater than that between the adult groups. Conclusion: The impact of heart failure on children previously treated for blood cancer is more severe than for adults, with earlier morbidity and greater mortality. Improved strategies are needed for the prevention and management of cardiotoxicity in this population

A clock network for geodesy and fundamental science

Leveraging the unrivaled performance of optical clocks in applications in fundamental physics beyond the standard model, in geo-sciences, and in astronomy requires comparing the frequency of distant optical clocks truthfully. Meeting this requirement, we report on the first comparison and agreement of fully independent optical clocks separated by 700 km being only limited by the uncertainties of the clocks themselves. This is achieved by a phase-coherent optical frequency transfer via a 1415 km long telecom fiber link that enables substantially better precision than classical means of frequency transfer. The fractional precision in comparing the optical clocks of three parts in $10^{17}$ was reached after only 1000 s averaging time, which is already 10 times better and more than four orders of magnitude faster than with any other existing frequency transfer method. The capability of performing high resolution international clock comparisons paves the way for a redefinition of the unit of time and an all-optical dissemination of the SI-second.Comment: 14 pages, 3 figures, 1 tabl

Healthy living after cancer: a dissemination and implementation study evaluating a telephone-delivered healthy lifestyle program for cancer survivors

Background: Given evidence shows physical activity, a healthful diet and weight management can improve cancer outcomes and reduce chronic disease risk, the major cancer organisations and health authorities have endorsed related guidelines for cancer survivors. Despite these, and a growing evidence base on effective lifestyle interventions, there is limited uptake into survivorship care. Methods/Design: Healthy Living after Cancer (HLaC) is a national dissemination and implementation study that will evaluate the integration of an evidence-based lifestyle intervention for cancer survivors into an existing telephone cancer information and support service delivered by Australian state-based Cancer Councils. Eligible participants (adults having completed cancer treatment with curative intent) will receive 12 health coaching calls over 6 months from Cancer Council nurses/allied health professionals targeting national guidelines for physical activity, healthy eating and weight control. Using the RE-AIM evaluation framework, primary outcomes are service-level indicators of program reach, adoption, implementation/costs and maintenance, with secondary (effectiveness) outcomes of patient-reported anthropometric, behavioural and psychosocial variables collected at pre- and post-program completion. The total participant accrual target across four participating Cancer Councils is 900 over 3 years. Discussion: The national scope of the project and broad inclusion of cancer survivors, alongside evaluation of service-level indicators, associated costs and patient-reported outcomes, will provide the necessary practice-based evidence needed to inform future allocation of resources to support healthy living among cancer survivors.Elizabeth G. Eakin, Sandra C. Hayes, Marion R. Haas, Marina M. Reeves, Janette L. Vardy, Frances Boyle, Janet E. Hiller, Gita D. Mishra, Ana D. Goode, Michael Jefford, Bogda Koczwara, Christobel M. Saunders, Wendy Demark-Wahnefried, Kerry S. Courneya, Kathryn H. Schmitz, Afaf Girgis, Kate White, Kathy Chapman, Anna G. Boltong, Katherine Lane, Sandy McKiernan, Lesley Millar, Lorna O, Brien, Greg Sharplin, Polly Baldwin and Erin L. Robso