Exploring aspects of physiotherapy care valued by breast cancer patients

OBJECTIVE: To explore the reported value of physiotherapy care received by patients who had accessed a Specialist Breast Care Physiotherapy Service. DESIGN: Exploratory qualitative study using in-depth interviews to explore aspects of physiotherapy care valued by breast cancer patients. Thematic network analysis was used to interpret the data and bring together the different experiences of the participants and identify common themes. SETTING: Physiotherapy Department at a NHS Foundation Trust Teaching Hospital. PARTICIPANTS: Nineteen participants were recruited and three were selected to take part in the in-depth interviews. All participants had received physiotherapy care from a Specialist Breast Care Physiotherapy Service and had been discharged within the last six months. RESULTS: Participants valued a patient-centred holistic approach to care and access to a Specialist Service with an experienced clinician. In particular the importance of the therapeutic alliance and the value of psychological, emotional and educational support emerged, with the participants feeling empowered in their recovery. CONCLUSION AND CLINICAL IMPLICATIONS: Participants reported an overall positive experience of their physiotherapy care. This study supports the need for service providers to evaluate their current physiotherapy provision and subsequently develop Specialised Services to meet the physiotherapy needs of breast cancer patients throughout all stages of their treatment pathway from the delivery of pre-operative care through to post-treatment follow-up

Classical antiparticles

We review how antiparticles may be introduced in classical relativistic mechanics, and emphasize that many of their paradoxical properties can be more transparently understood in the classical than in the quantum domain.Comment: 14 pages, standard LaTeX, no figures, no macros. To be published in the American Journal of Physics. Ref [1] is archived here as hep-ph/950341

Does size matter? The impact of a small but targeted cleaning training intervention within a paediatric ward

Background: Cleaning is a critical tool for infection prevention and control, and is a key intervention for preventing healthcare associated infections (HCAIs) and controlling intermediate transmission routes between patient and environment. This study sought to identify potential areas of weakness in clinical surface cleaning, and assess the effectiveness of a staff group specific training intervention. Observations: One-hundred hours of audit observations in a paediatric cardiac intensive care unit (CICU) assessed surface cleaning technique of healthcare staff within bedspaces. Cleaning was assessed with a 5-component bundle, with each cleaning opportunity scored out of five. Training Intervention: Fifty hours of audit observations before and after a training intervention tested the efficacy of a staff group specific education intervention. The intervention was developed and implemented for 69% of nurses and 100% of cleaners. Results: One hundred and eighteen cleaning opportunities were observed before training, and scored an average of 2.4. One hundred and twenty-one cleaning opportunities were observed after training and scored an average 3.0. On average, before training, each cleaning opportunity by nurses and cleaners fulfilled 2.4 and 2.5, respectively, of the 5 bundle components. Following training, this improved to 3.3 and 2.9 respectively. There was a statistically significant improvement in bundle scores for nurses (P=.004) and cleaners (P=.0003). Conclusions: Surface wipe methods were inconsistent between all staff groups. The education based intervention resulted in a small improvement in most of the cleaning components. This study has identified how a small but targeted cleaning training intervention can have a significant (P= <.0001) impact on cleaning bundle compliance for both nurses and cleaners

Buried treasure—marine turtles do not ‘disguise’ or ‘camouflage’ their nests but avoid them and create a decoy trail

After laying their eggs and refilling the egg chamber, sea turtles scatter sand extensively around the nest site. This is presumed to camouflage the nest, or optimize local conditions for egg development, but a consensus on its function is lacking. We quantified activity and mapped the movements of hawksbill (Eretmochelys imbricata) and leatherback (Dermochelys coriacea) turtles during sand-scattering. For leatherbacks, we also recorded activity at each sand-scattering position. For hawksbills, we recorded breathing rates during nesting as an indicator of metabolic investment and compared with published values for leatherbacks. Temporal and inferred metabolic investment in sand-scattering was substantial for both species. Neither species remained near the nest while sand-scattering, instead moving to several other positions to scatter sand, changing direction each time, progressively displacing themselves from the nest site. Movement patterns were highly diverse between individuals, but activity at each sand-scattering position changed little between completion of egg chamber refilling and return to the sea. Our findings are inconsistent with sand-scattering being to directly camouflage the nest, or primarily for modifying the nest-proximal environment. Instead, they are consistent with the construction of a series of dispersed decoy nests that may reduce the discovery of nests by predators

Experiences of disabled women during pregnancy, childbirth and early parenting services: implications for occupational therapy

The aim of this study was to understand the experiences of women with physical and sensory disability during their interaction with maternity services. The study was funded by a national charity whose previous research identified that disabled women had more negative experiences than non-disabled women (Birthrights, 2013). This paper specifically discusses implications for occupational therapy. Two-phase, inter-professional mixed methods research was used involving online surveys in phase 1 and narrative interviews in phase 2. Recruitment was through disability and parenting networks and social media. Survey data were analysed descriptively and open questions were themed. Phase 2 telephone interviews were audio recorded, transcribed verbatim and analysed thematically. Although overall satisfaction with care was scored highly in phase 1, negative experiences were described. Key challenges included a lack of continuity of carer; women feeling that they were not being listened to; feeling they were treated less favourably because of disability; and 56% feeling that maternity care providers did not have appropriate attitudes to disability. Interview themes echoed these, when women described implications of not being listened to, including that their judgement about their own bodies was ignored or undermined. The research revealed that occupational therapists did little to support women during this time. While some occupational therapy input was described, this focused on equipment provision. Minimal support with the occupations of parenting was described. The results suggest a clear need for interprofessional working and the need for occupational therapists to liaise between midwifery staff and disabled women

Pharmacological properties of rutin and its potential uses for Alzheimer’s disease.

Rutin, a flavonoid with a wide range of biological activities, has a long history of use in nutritional supplements owing to its action against oxidative stress, inflammation, and hyperglycemia. Because of its pharmacological properties such as antioxidant, antiapoptosis, antiinflammation, rutin is proposed to treat Alzheimer’s disease (AD). AD is a complex, multi-factorial neurodegenerative disease, and is characterized by neuronal atrophy of brain tissue. One of the pathological hallmarks of AD is the aggregation of soluble β amyloid (Aβ) into fibrillary deposits. Aβ aggregation induces neurotoxicity, oxidative stress and neuro-inflammation. In this review, we discussed the preclinical evidence on the antioxidant, antiapoptosis and anti-inflammatory proprieties of rutin, and the application of rutin in AD preclinical models. Rutin, delivered via oral and intraperitoneal routes, has been shown to functionally modify the cognitive and behavioural symptoms of AD in vivo due to its ability to cross the blood-brain barrier and act as both an antioxidant and an anti-inflammatory agent in the brain. Rutin attenuates oxidative stress, decreases the production of nitric oxide (NO) and proinflammatory cytokine and inhibits Aβ aggregation and cytotoxicity. Further studies to improve its bioavailability and investigations into its protective activities in AD would provide a concrete foundation for the use of rutin in clinical trials

Lithospheric Structure and Tectonic Processes Constrained by Microearthquake Activity at the Central Ultraslow-Spreading Southwest Indian Ridge (49.2° to 50.8°E)

Beneath ultra‐slow spreading ridges, the oceanic lithosphere remains poorly understood. Using recordings from a temporary array of ocean bottom seismometers, we here report a ~17‐days‐long microearthquake study on two segments (27 and 28) of the ultra‐slow spreading Southwest Indian Ridge (49.2° to 50.8° E). A total of 214 locatable microearthquakes are recorded; seismic activity appears to be concentrated within the west median valley at segment 28 and adjacent nontransform discontinuities (NTDs). Earthquakes reach a maximum depth of ~20 km beneath the seafloor, and they mainly occur in the mantle, implying a cold and thick brittle lithosphere. The relatively uniform brittle/ductile boundary beneath segment 28 suggests that there is no focused melting in this region. The majority of earthquakes are located below the Moho interface, and a 5‐km‐thick aseismic zone is present beneath segment 28 and adjacent NTDs. At the Dragon Flag hydrothermal vent field along segment 28, the presence of a detachment fault has been inferred from geomorphic features and seismic tomography. Our seismicity data show that this detachment fault deeply penetrates into the mantle with a steeply dipping (~65°) interface, and it appears to rotate to a lower angle in the upper crust, with ~55° of rollover. There is a virtual seismic gap beneath magmatic segment 27, which may be connected to the presence of an axial magma chamber beneath the spreading centre as well as focused melting; in this scenario, the increased magma supply produces a broad, elevated temperature environment which suppresses earthquake generation

On the origin of seismic anisotropy in the shallow crust of the Northern Volcanic Zone, Iceland

Title: Authors: Conor Andrew Bacon, Jessica Helen Johnson, Robert Stephen White, Nicholas Rawlinson Journal: Journal of Geophysical Research: Solid Earth Plain Language Summary Iceland is well known for its earthquakes and volcanoes, which have helped to produce an awe-inspiring primordial landscape over the last 20 million years or so. The emergence of Iceland in the North Atlantic Ocean can be attributed to the interaction of the Mid-Atlantic Ridge, where new oceanic crust forms by rifting between the North American and Eurasian plates, and a rising conduit of hot mantle from deep in the Earth, known as a mantle plume. The confluence of these two phenomena has produced excessive melting of mantle rocks, with the resultant melt accreted and cooled to form the Icelandic crust. We investigate how extensional stresses related to the divergence of the two tectonic plates have influenced the upper 3–4 km of the crust around Askja volcano, in the deep interior of Iceland. To do so, we exploit information contained in recordings of earthquakes from the neighborhood of Askja, which suggests that cracks formed parallel to the Mid-Atlantic Ridge, which permeate the upper crust, gradually close with depth. This relationship between the regional stress field associated with rifting and brittle deformation in the uppermost crust breaks down around Askja itself, where magmatic processes likely cause local changes in the stress field. Abstract The Icelandic crust is a product of its unique tectonic setting, where the interaction of an ascending mantle plume and the Mid-Atlantic Ridge has caused elevated mantle melting, with the melt accreted and cooled in the crust to form an oceanic plateau. We investigate the strength and orientation of seismic anisotropy in the upper crust of the Northern Volcanic Zone using local earthquake shear-wave splitting, with a view to understanding how the contemporary stress field may influence sub-wavelength structure and processes. This is achieved using a data set comprising urn:x-wiley:21699313:media:jgrb55395:jgrb55395-math-000150,000 earthquakes located in the top 10 km of the crust, recorded by up to 70 stations over a 9 year period. We find that anisotropy is largely confined to the top 3–4 km of the crust, with an average delay time of 0.10 ± 0.05 s, and an average orientation of the fast axis of anisotropy of N014°E ± 27°, which is perpendicular to the spreading direction of the Eurasian and North American plates (N106°E). These results are consistent with the presence of rift-parallel cracks that gradually close with depth, the preferential opening of which is controlled by the regional stress field. Lateral variations in the strength of shear wave anisotropy (SWA) reveal that regions with the highest concentrations of earthquakes have the highest SWA values (∼10%), which reflects the presence of significant brittle deformation. Disruption of the orientation of the fast axis of anisotropy around Askja volcano can be related to local stress changes caused by underlying magmatic processes