The Stress-Buffering Model of Social Support in Post-Acute Brain Injury Rehabilitation

Currently, 3.2-5.3 million Americans (1.1-1.7%) live with long-term disability resulting from acquired brain injury (ABI). Despite two to three million more being treated yearly for milder injuries and released without further services, those with enduring problems often require ongoing rehabilitation and support. The immediate and long-term costs of ABI are substantial, as are the burdens associated with lifelong sequelae. A clear understanding of prognostic indicators—only some of which have been identified—could assist in reducing these costs and burdens. Social support, which has been linked with physical health and function in populations across the world, is one likely indicator. Family stress, which may influence the availability of social support and which has been independently linked to functional outcomes in various populations, is another. Somewhat surprisingly, the relationship of either with functional outcomes in ABI has yet to be firmly established. Framed by the Stress-Buffering Model of social support, this study examined the extent to which family stress predicts physical function following ABI and whether and how social support moderates this relationship. Data for this study was obtained from a national brain injury database (OutcomeInfo). OutcomeInfo houses demographic, injury, medical, service, and administrative information, as well as ratings and scores from the Mayo-Portland Adaptability Inventory—Fourth Edition (MPAI-4). The MPAI-4 is a questionnaire designed for use in post-acute rehabilitation and support programs, intended to allow facilities to track outcomes and changes throughout treatment. Bivariate Pearson and partial correlation were used in this study to gather preliminary information about the Stress-Buffering Model’s applicability within these post-acute services. Bivariate Pearson correlations revealed no significant relationships between family stress or friend support and physical function. Partial correlations revealed no significant relationships when controlling for several personal and contextual variables both individually and concurrently. This study had several limitations, and results should not be generalized at this point. Despite the lack of significant results, this study presents a coherent conceptual framework within which to examine these relationships further and provides a research design upon which future investigators may build

Free and Open-Source Automated 3-D Microscope

International audienceOpen-source technology not only has facilitated the expansion of the greater research community, but by lowering costs it has encouraged innovation and customizable design. The field of automated microscopy has continued to be a challenge in accessibility due the expense and inflexible, non-interchangeable stages. This paper presents a low-cost, open source microscope 3-D stage. A RepRap 3-D printer was converted to an optical microscope equipped with a customized, 3-D printed holder for a USB microscope. Precision measurements were determined to have an average error of 10 μm at the maximum speed and 27 μm at the minimum recorded speed. Accuracy tests yielded an error of 0.15%. The machine is a true 3-D stage and thus able to operate with USB microscopes or conventional desktop microscopes. It is larger than all commercial alternatives, and is thus capable of high depth images over unprecedented areas and complex geometries. The repeatibility is below 2-D microscope stages, but testing shows that it is adequate for the majority of scientific applications. The open source microscope stage costs less than 3% to 9% of the closest proprietary commercial stages. This extreme affordability vastly improves accessibility for 3-D microscopy throughout the world

Impact of DIY home manufacturing with 3D printing on the toy and game market

The 2020 toy and game market is projected to be US$135 billion. To determine if 3D printing could affect these markets if consumers offset purchases by 3D printing free designs, this study investigates the 100 most popular downloaded designs at MyMiniFactory in a month. Savings are quantified for using a Lulzbot Mini 3D printer and three filament types: commercial filament, pellet-extruded filament, and post-consumer waste converted to filament with a recyclebot. Case studies probed the quality of: (1) six common complex toys; (2) Lego blocks; and (3) the customizability of open source board games. All filaments analyzed saved the user over 75$60 million/year in offset purchases. The most common savings fell by 40%–90% in total savings, which came with the ability to make novel toys and games. The results of this study show consumers can generate higher value items for less money using the open source distributed manufacturing paradigm. It appears clear that consumer do-it-yourself (DIY) manufacturing is set to have a significant impact on the toy and game markets in the future

Could 79 people solarize the U.S. electric grid?

Although wealth inequality has many established negatives, this study investigates a potential positive, unprecedented wealth concentration makes it possible for solutions to large and seemingly intractable problems to be deployed by convincing a relatively small number of individuals to invest. In order to probe this potential outcome of inequality, this study quantifies the number of people necessary to radically reduce the greenhouse gas emissions responsible for global climate destabilization from the U.S. electric grid, which is one of the largest sources of emissions. Specifically, this study determined that 1544 GW of solar photovoltaic (PV) technology must be deployed to eliminate the use of fossil fuels on the U.S. electric grid, if PV is conservatively deployed as a function of population density. The results showed that only 79 American multi-billionaires would need to invest in PV. This investment would still leave each investor with a billion dollars of liquid assets as well as substantial long-term profits from PV. The analysis also concluded that 79 people is a conservative upper estimate of those that would need to be convinced of the usefulness of moving to a solar U.S. grid and that this estimate is likely to decrease further in the future

Impact of DIY Home Manufacturing with 3D Printing on the Toy and Game Market

International audienceThe 2020 toy and game market is projected to be US$135 billion.To determine if 3D printing could affect these markets if consumers offset purchases by 3D printing free designs, this study investigates the 100 most popular downloaded designs at MyMiniFactory in a month. Savings are quantified for using a Lulzbot Mini 3D printer and three filament types: commercial filament, pellet-extruded filament, and post-consumer waste converted to filament with a recyclebot. Case studies probed the quality of: (1) six common complex toys; (2) Lego blocks; and (3) the customizability of open source board games. All filaments analyzed saved the user over 75$60 million/year in offset purchases. The most common savings fell by 40%–90% in total savings, which came with the ability to make novel toys and games. The results of this study show consumers can generate higher value items for less money using the open source distributed manufacturing paradigm. It appears clear that consumer do-it-yourself (DIY) manufacturing is set to have a significant impact on the toy and game markets in the future

Exporting values: conditionality, democracy and the European neighbourhood

In recent years the European Union has begun to emerge as an important regional and global 'soft' power. The corner stone of its new role is the promotion of democracy and European values. In the past decade the borders of the EU have become increasingly unstable. In an attempt promote a stable and prosperous region the EU has developed the European Neighourhood Policy (ENP). However, an examination of the strategies and concepts present in this policy bring up questions surrounding its validity as a democracy promotion tool. In this thesis I will argue that the ENP will be insufficient as a democracy promotion tool because it fails to provide the necessary conditionality or reciprocity. I will argue that this lack of conditionality is a result of differing preferences among member states as well as EU economic and strategic protectionism. Finally, I will argue that without proper conditionality the ENP cannot succeed given the current political conditions in the ENP states

Pain relief for women undergoing oocyte retrieval for assisted reproduction

Peer reviewedPublisher PD

The Experience and Management of Medical Uncertainty in Telomere Biology Disorders

Background: Telomere biology disorders (TBDs) are rare, cancer-predisposing, genetic conditions with wide phenotypic spectrums and ages of onset creating a burden of medical uncertainty. No research addresses medical uncertainty in this context. Methods: Study 1 is a qualitative thematic analysis of telephone interviews to explore medical uncertainty sources, issues, and management strategies of patients with TBDs and their caregivers. Study 2 is a mixed methods content analysis of TBD-related social media posts to assess types of medical uncertainty discussed online in the TBD community. Study 3 used the same methods as Study 1 to explore motivations for and perceived benefits and barriers to the use of online support resources. Results: Individuals with TBDs and their caregivers experience chronic or recurrent uncertainty, with a range of interrelated, dynamic, sources, issues, and management strategies. Scientific uncertainty included diagnostic and prognostic ambiguity and limited clinician knowledge of TBDs. Practical uncertainty focused on logistics of maintaining care teams across medical disciplines. Personal uncertainty encompassed self-identity, life goals, and relationship expectations post-diagnosis. Scientific, practical, and personal issues of uncertainty were interrelated: limited scientific knowledge of TBDs gave rise to practical and personal issues, which created psychosocial burdens including anxiety and barriers to relationship formation and health decision-making. Individuals with TBDs and their caregivers reported multiple evolving management strategies which included information-seeking and sharing, organizing aspects of uncertainty, stress-relief techniques, and connecting with peer support. In study 2, TBD social media posts included information exchange regarding diagnostic and prognostic uncertainty. Overall, post creators were white, female, parents of patients with TBDs. Study 3 revealed that most participants engaged in online support but expressed contradictory feelings about online resources. Perceived barriers included distrust of online platforms and lack of targeted resources. Conclusions: Medical uncertainty is a burden for patients with TBDs and their caregivers, but uncertainty sources and issues may change over time, impacting the utility of different management strategies. The intractability, continuity, variety, and fluctuation of medical uncertainty throughout the illness experience creates barriers to management peculiar to TBDs and may limit the effectiveness of uncertainty-management approaches developed in other rare and high-risk disease contexts.Doctor of Philosoph