Index matching between passive and active tellurite glasses for use in microstructured fiber lasers: Erbium doped lanthanum-tellurite glass

Active and passive variants of La-containing tellurite glasses have been developed with matched refractive indices. The consequences of adding lanthanum to the glass was studied through measurements of the crystallization stability, glass viscosity and the loss of unstructured fibers. Doping the glass with erbium allowed for any spectroscopic changes to be observed through measurements of the absorption and energy level lifetimes. The fluorescence emission spectra were measured at 1.5 microm and, to the best of our knowledge, for the first time in tellurite glass at 2.7 microm.Michael R. Oermann, Heike Ebendorff-Heidepriem, Yahua Li, Tze-Cheung Foo, and Tanya M. Monrohttp://www.opticsinfobase.org/abstract.cfm?URI=oe-17-18-1557

Effect of an audiovisual message for tetanus booster vaccination broadcast in the waiting room

<p>Abstract</p> <p>Background</p> <p>General practitioners (GPs) often lack time and resources to invest in health education; audiovisual messages broadcast in the waiting room may be a useful educational tool. This work was designed to assess the effect of a message inviting patients to ask for a tetanus booster vaccination.</p> <p>Methods</p> <p>A quasi experimental study was conducted in a Belgian medical practice consisting of 6 GPs and 4 waiting rooms (total: 20,000 contacts/year). A tetanus booster vaccination audiovisual message was continuously broadcast for 6 months in 2 randomly selected waiting rooms (intervention group - 3 GPs) while the other 2 waiting rooms remained unequipped (control group - 3 GPs). At the end of the 6-month period, the number of vaccine adult-doses delivered by local pharmacies in response to GPs' prescriptions was recorded. As a reference, the same data were also collected retrospectively for the general practice during the same 6-month period of the previous year.</p> <p>Results</p> <p>During the 6-month reference period where no audiovisual message was broadcast in the 4 waiting rooms, the number of prescriptions presented for tetanus vaccines was respectively 52 (0.44%) in the intervention group and 33 (0.38%) in the control group (p = 0.50). By contrast, during the 6-month study period, the number of prescriptions differed between the two groups (p < 0.0001), rising significantly to 91 (0.79%) in the intervention group (p = 0.0005) while remaining constant in the control group (0.38% vs 0.39%; p = 0.90).</p> <p>Conclusions</p> <p>Broadcasting an audiovisual health education message in the GPs' waiting room was associated with a significant increase in the number of adult tetanus booster vaccination prescriptions delivered by local pharmacies.</p

A social role for churches and cultural demarcation:how German MEPs represent religion in the European Parliament

This study deals with the question of how German members of the European Parliament (MEPs) represent the German model of religion–state relations at the European level. Based on a survey and interviews with German MEPs as well as a content-analysis of German MEPs’ speeches, motions and parliamentary questions during the seventh term of the European Parliament (EP), our study demonstrates that this model is represented in three dimensions. First, German MEPs reflect the close cooperation between the churches and the state in Germany, primarily on social issues, through largely church- and religion-friendly attitudes and relatively frequent contacts with religious interest-groups. Second, by referring to religious freedoms and minorities primarily outside the EU and by placing Islam in considerably more critical contexts than Christianity, German MEPs create a cultural demarcation line between Islam and Christianity through their parliamentary activities, which is similar to, though less politicised than, cultural boundaries often produced in public debates in Germany. Third, our study illustrates similar patterns of religious affiliation and subjective religiosity among German parliamentarians in both the EP and the national Parliament, which to some degree also reflect societal trends in Germany. Yet our data also suggest that European political elites are more religious than the average German population. If the presence of religion in terms of religious interest-groups and arguments is included, the EP appears to be more secularist than the German Parliament

Developing a class solution for Prostate Stereotactic Ablative Body Radiotherapy (SABR) using Volumetric Modulated Arc Therapy (VMAT)

Background and purpose To develop a class solution for prostate Stereotactic Ablative Radiotherapy (SABR) using Volumetric Modulated Arc Therapy (VMAT). Materials and methods Seven datasets were used to compare plans using one 360° arc (1FA), one 210° arc (1PA), two full arcs and two partial arcs. Subsequently using 1PA, fifteen datasets were compared using (i) 6 mm CTV–PTV margins, (ii) 8 mm CTV–PTV margins and (iii) including the proximal SV within the CTV. Monaco™ 3.2 (Elekta™) was used for planning with the Agility™ MLC system (Elekta™). Results Highly conformal plans were produced using all four arc arrangements. Compared to 1FA, 1PA resulted in significantly reduced rectal doses, and monitor units and estimated delivery times were reduced in six of seven cases. Using 6 mm CTV–PTV margins, planning constraints were met for all fifteen datasets. Using 8 mm margins required relaxation of the uppermost bladder constraint in three cases to achieve adequate coverage, and, compared to 6 mm margins, rectal and bladder doses significantly increased. Including the proximal SV required relaxation of the uppermost bladder and rectal constraints in two cases, and rectal and bladder doses significantly increased. Conclusions Prostate SABR VMAT is optimal using 1PA. 6 mm CTV–PTV margins, compatible with daily fiducial-based IGRT, are consistently feasible in terms of target objectives and OAR constraints

Critical Thinking in Nursing Education: Literature Review

The need for critical thinking in nursing has been accentuated in response to the rapidly changing health care environment. Nurses must think critically to provide effective care whilst coping with the expansion in role associated with the complexities of current health care systems. This literature review will present a history of inquiry into critical thinking and research to support the conclusion that critical thinking is necessary not only in the clinical practice setting, but also as an integral component of nursing education programs to promote the development of nurses’ critical thinking abilities. The aims of this paper are: (a) to review the literature on critical thinking; (b) to examine the dimensions of critical thinking; (c) to investigate the various critical thinking strategies for their appropriateness to enhance critical thinking in nurses, and; (d) to examine issues relating to evaluation of critical thinking skills in nursing.</ul

An 18-month study of the safety and efficacy of repeated courses of inhaled aztreonam lysine in cystic fibrosis

Chronic airway infection with Pseudomonas aeruginosa (PA) causes morbidity and mortality in patients with cystic fibrosis (CF). Additional anti-PA therapies are needed to improve health status and health-related quality of life. AIR-CF3 was an international 18-month, open-label study to evaluate the safety and efficacy of repeated courses of aztreonam for inhalation solution (AZLI, now marketed as Cayston®) in patients aged ≥6 years with CF and PA infection who previously participated in one of two Phase 3 studies: AIR-CF1 or AIR-CF2. Patients received up to nine courses (28 days on/28 days off) of 75 mg AZLI two (BID) or three times daily (TID) based on randomization in the previous trials. 274 patients, mean age 28.5 years (range: 8–74 years), participated. Mean treatment adherence was high (92.0% BID group, 88.0% TID group). Hospitalization rates were low and adverse events were consistent with CF With each course of AZLI, FEV1 and scores on the Cystic Fibrosis Questionnaire-Revised Respiratory Symptomscale improved and bacterial density in sputum was reduced. Benefits waned in the 28 days off therapy, but weight gain was sustained over the 18months. There were no sustained decreases in PA susceptibility. A dose response was observed; AZLI TID-treated patients demonstrated greater improvements in lung function and respiratory symptoms over 18 months. Repeated intermittent 28-day courses of AZLI treatment were well tolerated. Clinical benefits in pulmonary function, health-related quality of life, and weight were observed with each course of therapy. AZLI is a safe and effective new therapy in patients with CF and PA airway infection

Writing Toward Readers\u27 Better Health: A Case Study Examining the Development of Online Health Information

Each year, more people search the Internet for health information. Through a case study conducted at a prominent health information company, I will show that technical communicators are well suited to contribute to the development of online health information. Like other technical communicators, online health information developers must make rhetorical choices based on audience needs, function within specific social contexts, and work through challenges of writing, editing, and project management

Energy level decay and excited state absorption processes in erbium-doped tellurite glass

The fundamental excited state decay processes relating to the 4I11/2 → 4I13/2 transition in singly Er3+-doped tellurite (TZNL) glass have been investigated in detail using time-resolved fluorescence spectroscopy. Selective laser excitation of the 4I11/2 energy level at 970 nm and selective laser excitation of the 4I13/2 energy level at 1485 nm has established that energy transfer upconversion by way of a dipole-dipole interaction between two excited erbium ions in the 4I13/2 level populates the 4I11/2 upper laser level of the 3 m transition. This upconversion has been analyzed for Er2O3 concentrations between 0.5 mol. and 2.2 mol. . The 4I13/2 and 4I11/2 energy levels emit luminescence with peaks located at 1532 nm and 2734 nm, respectively, with radiative decay efficiencies of 65 and 6.8 for the higher (2.2 mol. ) concentration sample. The low 2.7 m emission efficiency is due to the non-radiative decay bridging the 4I11/2 → 4I13/2 transition and energy transfer to the OH- groups in the glass. Excited state absorption was observed to occur from the 4I13/2 and 4I11/2 levels with peak absorptions occurring at 1550 nm and 971 nm, respectively. The decay time of the 4I11/2 excited state decreased with an increase in the Er3+ concentration, which related to energy transfer to OH- ions that had a measured concentration of 6.6 1018 cm-3. Results from numerical simulations showed that a population inversion is reached at a threshold pumping intensity of ∼80 kW cm-2 for a cw laser pump at 976 nm if [Er3+] ≥ 1.2 × 1021 cm-3 (or [Er 2O3] ≥ 2.65 mol. ) without OH- impurities being present. © 2011 American Institute of Physics.Laércio Gomes, Michael Oermann, Heike Ebendorff-Heidepriem, David Ottaway, Tanya Monro, André Felipe Henriques Librantz and Stuart D. Jackso

A treatment evaluator tool to monitor the real-world effectiveness of inhaled aztreonam lysine in cystic fibrosis

Background: Studies are required that evaluate real-world outcomes of inhaled aztreonam lysine in patients with cystic fibrosis (CF). Methods: Our treatment-evaluator tool assessed the effectiveness of inhaled aztreonam in routine practice in 117 CF patients across four time periods (6–12 (P2) and 0–6 months (P1) pre-initiation, and 0–6 (T1) and 6–12 months (T2) post-initiation). Outcomes were: changes in %-predicted forced expiratory volume in 1 s (FEV1), body-mass index (BMI), hospitalisation days and intravenous antibiotic usage. Results: Median FEV1% predicted for each 6-month period was 38.9%, 34.6%, 37.1% and 36.5%; median change was − 2.0% between P2 and P1, increasing to + 0.6% (p &lt; 0.001) between P1 and T1. Annualised hospital bed-days was reduced (p = 0.05) post-initiation, as was intravenous antibiotics days (p = 0.001). BMI increased over 6 months post-initiation (p ≤ 0.001). Conclusions: In patients with CF in routine practice, inhaled aztreonam lysine is associated with improved lung function and weight, and reduced hospitalisation and intravenous antibiotic use

CyberKnife for hilar lung tumors: report of clinical response and toxicity

<p>Abstract</p> <p>Objective</p> <p>To report clinical efficacy and toxicity of fractionated CyberKnife radiosurgery for the treatment of hilar lung tumors.</p> <p>Methods</p> <p>Patients presenting with primary and metastatic hilar lung tumors, treated using the CyberKnife system with Synchrony fiducial tracking technology, were retrospectively reviewed. Hilar location was defined as abutting or invading a mainstem bronchus. Fiducial markers were implanted by conventional bronchoscopy within or adjacent to tumors to serve as targeting references. A prescribed dose of 30 to 40 Gy to the gross tumor volume (GTV) was delivered in 5 fractions. Clinical examination and PET/CT imaging were performed at 3 to 6-month follow-up intervals.</p> <p>Results</p> <p>Twenty patients were accrued over a 4 year period. Three had primary hilar lung tumors and 17 had hilar lung metastases. The median GTV was 73 cc (range 23-324 cc). The median dose to the GTV was 35 Gy (range, 30 - 40 Gy), delivered in 5 fractions over 5 to 8 days (median, 6 days). The resulting mean maximum point doses delivered to the esophagus and mainstem bronchus were 25 Gy (range, 11 - 39 Gy) and 42 Gy (range, 30 - 49 Gy), respectively. Of the 17 evaluable patients with 3 - 6 month follow-up, 4 patients had a partial response and 13 patients had stable disease. AAT t a median follow-up of 10 months, the 1-year Kaplan-Meier local control and overall survival estimates were 63% and 54%, respectively. Toxicities included one patient experiencing grade II radiation esophagitis and one patient experiencing grade III radiation pneumonitis. One patient with gross endobronchial tumor within the mainstem bronchus developed a bronchial fistula and died after receiving a maximum bronchus dose of 49 Gy.</p> <p>Conclusion</p> <p>CyberKnife radiosurgery is an effective palliative treatment option for hilar lung tumors, but local control is poor at one year. Maximum point doses to critical structures may be used as a guide for limiting toxicities. Preliminary results suggest that dose escalation alone is unlikely to enhance the therapeutic ratio of hilar lung tumors and novel approaches, such as further defining the patient population or employing the use of radiation sensitizers, should be investigated.</p