Insights into the impact of clinical encounters gained from personal accounts of living with advanced cancer.

Aim To describe the impact of interactions with health care professionals revealed by people’s accounts of living and dying with cancer; to explore reasons for the observed effects; and thus, to consider the implications for practice. Background The importance of practitioner–patient interactions is enshrined within professional values. However, our understanding of how and why the consultation impacts on outcomes remains underdeveloped. Stories recounted by people living and dying with cancer offer important insights into illness experience, including the impact of contact with health services, framed within the context of the wider social setting in which people live their lives. From our recent study of distress in primary palliative care patients, we describe how people’s accounts revealed both therapeutic and noxious effects of such encounters, and discuss reasons for the observed effects. Method A qualitative study with a purposive sample of 19 primary palliative care patients: (8 men, 11 at high risk of depression). In-depth interviews were analysed using the iterative thematic analysis described by Lieblich. Findings Living with cancer can be an exhausting process. Maintaining continuity of everyday life was the norm, and dependent on a dynamic process of balancing threats and supports to people’s emotional well-being. Interactions with health care professionals were therapeutic when they provided emotional, or narrative, support. Threats arose when the patient’s perception of the professional’s account of their illness experience was at odds with the person’s own sense of their core self and what was important to them. Our findings highlight the need for a framework in which clinicians may legitimately utilize different illness models to deliver a personalized, patient-centred assessment of need and care. The work provides testable hypotheses supporting development of understanding of therapeutic impact of the consultation

Dislocation Engineering in Novel Nanowire Structures

Leveraging defects is a cornerstone of materials science, and has become increasingly important from bulk to nanostructured materials. We use molecular dynamics simulations to explore the limits of defect engineering by harnessing individual dislocations in nanoscale metallic specimens and utilizing their intrinsic behavior for application in mechanical dampening. We study arrow-shaped, single crystal copper nanowires designed to trap and control the dynamics of dislocations under uniaxial loading. We characterize how nanowire cross-section and stacking-fault energy of the material affects the ability to trap partial or full dislocations. Cyclic loading simulations show that the periodic motion of the dislocations leads to mechanical dissipation even at frequencies up to 2x10^10 Hz, orders of magnitude higher than the current state of the art

Scattering Parameter Measurements of the Long Wavelength Array Antenna and Front End Electronics

We present recent 2-port vector network analyzer (VNA) measurements of the complete set of scattering parameters for the antenna used within the Long Wavelength Array (LWA) and the associated front end electronics (FEEs). Full scattering parameter measurements of the antenna yield not only the reflection coefficient for each polarization, S11 and S22, but also the coupling between polarizations, S12 and S21. These had been previously modeled using simulations, but direct measurements had not been obtained until now. The measurements are used to derive a frequency dependent impedance mismatch factor (IMF) which represents the fraction of power that is passed through the antenna-FEE interface and not reflected due to a mismatch between the impedance of the antenna and the impedance of the FEE. We also present results from a two antenna experiment where each antenna is hooked up to a separate port on the VNA. This allows for cross-antenna coupling to be measured for all four possible polarization combinations. Finally, we apply the newly measured IMF and FEE forward gain corrections to LWA data to investigate how well they remove instrumental effects.Comment: 16 pages, 12 figures, Accepted for publication in Publications of the Astronomical Society of the Pacifi

Impairment of Cycling Capacity in the Heat in Well-Trained Endurance Athletes After High-Intensity Short-Term Heat Acclimation

Purpose: to investigate the effects of short-term, high-intensity interval-training (HIIT) heat acclimation (HA). Methods: male cyclists/triathletes were assigned into either an HA (n = 13) or a comparison (COMP, n = 10) group. HA completed 3 cycling heat stress tests (HSTs) to exhaustion (60% Wmax; HST1, pre-HA; HST2, post-HA; HST3, 7 d post-HA). HA consisted of 30-min bouts of HIIT cycling (6 min at 50% Wmax, then 12 × 1-min 100%-Wmax bouts with 1-min rests between bouts) on 5 consecutive days. COMP completed HST1 and HST2 only. HST and HA trials were conducted in 35°C/50% relative humidity. Cycling capacity and physiological and perceptual data were recorded. Results: cycling capacity was impaired after HIIT HA (77.2 [34.2] min vs 56.2 [24.4] min, P = .03) and did not return to baseline after 7 d of no HA (59.2 [37.4] min). Capacity in HST1 and HST2 was similar in COMP (43.5 [8.3] min vs 46.8 [15.7] min, P = .54). HIIT HA lowered resting rectal (37.0°C [0.3°C] vs 36.8°C [0.2°C], P = .05) and body temperature (36.0°C [0.3°C] vs 35.8°C [0.3°C], P = .03) in HST2 compared with HST1 and lowered mean skin temperature (35.4°C [0.5°C] vs 35.1°C [0.3°C], P = .02) and perceived strain on day 5 compared with day 1 of HA. All other data were unaffected. Conclusions: cycling capacity was impaired in the heat after 5 d of consecutive HIIT HA despite some heat adaptation. Based on data, this approach is not recommended for athletes preparing to compete in the heat; however, it is possible that it may be beneficial if a state of overreaching is avoided