The specter of cancer: Exploring secondary trauma for health professionals providing cancer support and counseling

Health professionals are vulnerable to occupational stress and tend to report high levels of secondary trauma and burnout; this is especially so for those working in “high-death” contexts such as cancer support and palliative care. In this study, 38 health professionals (psychologists, social workers, pastoral carers/chaplains, nurses, group facilitators, and a medical practitioner) who provide grief support and counseling in cancer and palliative care each participated in a semistructured interview. Qualitatively, a grounded theory analysis revealed four themes: (a) the role of health professionals in supporting people who are experiencing grief and loss issues in the context of cancer, (b) ways of working with patients with cancer and their families, (c) the unique qualities of cancer-related loss and grief experiences, and (d) the emotional demands of the work and associated self-care. The provision of psychological services in the context of cancer is colored by the specter of cancer, an unseen yet real phenomenon that contributes to secondary trauma and burnout. The participants’ reported secondary trauma has serious repercussions for their well-being and may compromise the care they provide. The findings have implications for the retention and well-being of personnel who provide psychosocial care in cancer and the quality and delivery of services for people with cancer and their families

Applications and Challenges of Real-time Mobile DNA Analysis

The DNA sequencing is the process of identifying the exact order of nucleotides within a given DNA molecule. The new portable and relatively inexpensive DNA sequencers, such as Oxford Nanopore MinION, have the potential to move DNA sequencing outside of laboratory, leading to faster and more accessible DNA-based diagnostics. However, portable DNA sequencing and analysis are challenging for mobile systems, owing to high data throughputs and computationally intensive processing performed in environments with unreliable connectivity and power. In this paper, we provide an analysis of the challenges that mobile systems and mobile computing must address to maximize the potential of portable DNA sequencing, and in situ DNA analysis. We explain the DNA sequencing process and highlight the main differences between traditional and portable DNA sequencing in the context of the actual and envisioned applications. We look at the identified challenges from the perspective of both algorithms and systems design, showing the need for careful co-design

Elementary Teachers\u27 and Principals\u27 Concerns in the Implementation of Inclusion in a South Texas School District

This study addressed the in depth concerns that elementary regular education teachers, elementary special education teachers, and campus administrators in one South Texas school district have for the use or non-use of inclusionary practices as a means of educating students with special needs. These concerns that teachers and campus administrators have can influence the practice of inclusion. The purpose of this mixed methods study was to: (a) identify the levels of concern of elementary regular and special education teachers in one South Texas school district concerning the implementation of inclusion; (b) identify the levels of concern of campus administrators in one inclusive South Texas school district concerning the implementation of inclusion; (c) explore in depth the levels of concern of elementary regular education teachers who have students with disabilities integrated in their classrooms, and elementary special education teachers who are integrated into the regular education classroom concerning the implementation of inclusion; (d) explore in depth the levels of concern of campus administrators who do and do not utilize inclusionary practices in their respective campuses. While identifying levels of concern of teachers and campus leadership, this study attempted to address those concerns to determine what perceptual suggestions could improve the education of special education students that are and are not participating in inclusion as a method of education

Evaluation of an Unfractioned Heparin Pharmacy Dosing Protocol for the Treatment of Venous Thromboembolism in Nonobese, Obese, and Severely Obese Patients

Background: Despite large interpatient variability in dose response, heparin is utilized for treatment of venous thromboembolism (VTE). Current data on the optimal heparin dosing in obese patients are conflicting. Objective: The objective was to evaluate the time and dose required to achieve a therapeutic activated partial thromboplastin time (aPTT) in nonobese, obese, and severely obese patients using a pharmacist-directed heparin dosing protocol. Methods: This was a retrospective cohort study in a single-center community hospital inpatient setting. Adult patients receiving heparin for VTE treatment from July 1, 2013, to July 31, 2015, were evaluated. Patients were categorized into 3 groups: nonobese (BMI \u3c 30 kg/m2), obese (BMI = 30-39.9 kg/m2), and severely obese (BMI ≥ 40 kg/m2). Data on height, weight, initial bolus dose, initial infusion rate, time to therapeutic aPTT, and therapeutic infusion rate were collected. Dosing body weight (DBW) was utilized for patients 20% over their ideal body weight (IBW). The primary outcome was time to therapeutic aPTT. Results: Analysis included 298 patients. Median times to therapeutic aPTT (hours:minutes) in the nonobese, obese, and severely obese were 15:00 (interquartile range [IQR] = 8:05-23:21), 15:40 (IQR = 9:22-25:10), and 15:22 (IQR = 7.54-23:40), respectively (P = 0.506). There was no difference in bleeding among the nonobese (14%), obese (13.9%), or severely obese groups (7.9%; P = 0.453). No adverse thrombotic events occurred during hospitalization. Conclusion: Using a DBW for heparin dosing in patients 20% over their IBW resulted in similar times to therapeutic aPTT and adverse events in the nonobese, obese, and severely obese

Intake of Fermented Vegetables and Inflammatory Markers in Women: A Pilot and Feasibility Clinical Study

The aim of this pilot study was to examine the feasibility and effect of consumption of fermented vegetables on blood markers of inflammation in women. A total of 34 women were randomized into one of three groups: fermented vegetable (Group A, n=11), non-fermented vegetable (Group B, n=13), and control (Group C, n=10). Participants in the vegetable groups were provided ½ cup of vegetables/day for six weeks, while the control group was asked to maintain their regular diet. Blood samples were collected before and after the intervention for measurement of inflammatory markers. Blood pressure, body composition, dietary intake, side effects and compliance to the intervention were assessed. Thirty-one participants completed the study. The majority of the participants were white (71%). Compliance to the interventions was 79.8% in group A and 86.5% in group B. Approximately 2.9 kg and 3.2 kg of cabbage and/or pickles per person were consumed by groups A and B, respectively, over an average of 41 days. Side effects were reported by groups A and B in 21.1% and 34.1% of the time, respectively. Median age was 35 years, body mass index, 24.1 kg/m2, and blood pressure, 114/75 mmHg. At the end of the intervention, median changes and interquartile ranges of the inflammatory markers in groups A, B, and C, respectively were: C-reactive protein: -26.8 (251), -14.2 (194), and -32.0 (545) ng/mL; tumor necrosis factor-alpha: -0.21 (0.46), -0.20 (1.50), and +0.14 (3.33) ng/mL, and lipopolysaccharide binding protein: +2.15 (7.2), -2.40 (2.4), and +0.31 (6.3) ng/mL

Inner Planetary System Gap Complexity is a Predictor of Outer Giant Planets

The connection between inner small planets and outer giant planets is crucial to our understanding of planet formation across a wide range of orbital separations. While Kepler provided a plethora of compact multi-planet systems at short separations ($\lesssim 1$ AU), relatively little is known about the occurrence of giant companions at larger separations and how they impact the architectures of the inner systems. Here, we use the catalog of systems from the Kepler Giant Planet Search (KGPS) to study how the architectures of the inner transiting planets correlate with the presence of outer giant planets. We find that for systems with at least three small transiting planets, the distribution of inner-system gap complexity ($\mathcal{C}$), a measure of the deviation from uniform spacings, appears to differ ($p \lesssim 0.02$) between those with an outer giant planet ($50 M_\oplus \leq M_p\sin{i} \leq 13 M_{\rm Jup}$) and those without any outer giants. All four inner systems (with 3+ transiting planets) with outer giant(s) have a higher gap complexity ($\mathcal{C} > 0.32$) than 79% (19/24) of the inner systems without any outer giants (median $\mathcal{C} \simeq 0.06$). This suggests that one can predict the occurrence of outer giant companions by selecting multi-transiting systems with highly irregular spacings. We do not find any correlation between outer giant occurrence and the size (similarity or ordering) patterns of the inner planets. The larger gap complexities of inner systems with an outer giant hints that massive external planets play an important role in the formation and/or disruption of the inner systems.Comment: Published in AJ. 16 pages, 6 figures, 1 tabl

Physico-electrochemical Characterization of Pluripotent Stem Cells during Self-Renewal or Differentiation by a Multi-modal Monitoring System.

Monitoring pluripotent stem cell behaviors (self-renewal and differentiation to specific lineages/phenotypes) is critical for a fundamental understanding of stem cell biology and their translational applications. In this study, a multi-modal stem cell monitoring system was developed to quantitatively characterize physico-electrochemical changes of the cells in real time, in relation to cellular activities during self-renewal or lineage-specific differentiation, in a non-destructive, label-free manner. The system was validated by measuring physical (mass) and electrochemical (impedance) changes in human induced pluripotent stem cells undergoing self-renewal, or subjected to mesendodermal or ectodermal differentiation, and correlating them to morphological (size, shape) and biochemical changes (gene/protein expression). An equivalent circuit model was used to further dissect the electrochemical (resistive and capacitive) contributions of distinctive cellular features. Overall, the combination of the physico-electrochemical measurements and electrical circuit modeling collectively offers a means to longitudinally quantify the states of stem cell self-renewal and differentiation

Perfusion bioreactor culture of human adipose-derived stromal cells on decellularized adipose tissue scaffolds enhances in vivo adipose tissue regeneration

Tissue-engineering approaches hold promise to address the need in plastic and reconstructive surgery for new therapies that promote stable adipose tissue regeneration. Previous studies have demonstrated the potential of combining decellularized adipose tissue (DAT) scaffolds with adipose-derived stromal cells (ASCs) for volume augmentation applications. With the goal of enhancing in vivo angiogenesis and adipogenesis, this study evaluated the effects of culturing human ASCs on DAT scaffolds within a perfusion bioreactor. Using this system, the impact of both dynamic culture and hypoxic preconditioning were explored in vitro and in vivo. Initial studies compared the effects of 14 days of culture within the perfusion bioreactor under hypoxia (2% O2) or normoxia (~20% O2) on human ASC expansion and expression of hypoxia inducible factor-1 alpha (HIF-1α) in vitro relative to static cultured controls. The findings indicated that culturing within the bioreactor under hypoxia significantly increased ASC proliferation on the DAT, with a higher cell density observed in the scaffold periphery. Subsequent characterization in a subcutaneous implant model in athymic nude mice revealed that in vivo angiogenesis and adipogenesis were markedly enhanced when the ASCs were cultured on the DAT within the perfusion bioreactor under hypoxia for 14 days prior to implantation relative to the other culture conditions, as well as freshly seeded and unseeded DAT control groups. Overall, dynamic culture within the perfusion bioreactor system under hypoxia represents a promising approach for preconditioning ASCs on DAT scaffolds to enhance their capacity to stimulate angiogenesis and host-derived adipose tissue regeneration