Living with persistent insomnia after cancer : a qualitative analysis of impact and management

Objectives To conduct a qualitative exploration of the lived experience of insomnia disorder and its management amongst a sample of mixed‐diagnoses cancer survivors. Methods Twenty‐seven cancer survivors with persistent insomnia were recruited to this qualitative study following completion of treatment for breast (12), prostate (7), colorectal (7), and gynaecological (1) cancers. Eleven males and 16 females (mean age 62 years), who met DSM‐5 criteria for insomnia disorder, contributed to one of four focus group discussions, designed to explore the lived experience of persistent insomnia and its management within cancer care services. Results Poor sleep was a persistently troubling complaint for participants, long after the completion of active cancer treatment. The impact of insomnia was significant for all participants, with six key domains emerging as those most affected: temperament, sociability, physical well‐being, cognitive functioning, relationships, and psychological well‐being. In terms of insomnia management, participants frequently resorted to unfruitful self‐management strategies, due to the lack of professional insomnia expertise within cancer care settings. Three main themes emerged in relation to insomnia management: self‐management, seeking professional intervention, and a lack of focus on sleep. A lack of clinician understanding of the importance of sleep health and the poor availability of evidence‐based insomnia interventions, such as cognitive behavioural therapy for insomnia (CBT‐i), were highlighted as important gaps in cancer care. Conclusions Insomnia was found to have a detrimental and pervasive impact on cancer survivors’ quality of life, which persisted long into survivorship. There is an absence of professional attention to sleep throughout the cancer care trajectory, contributing to its prevalence, persistence, and impact. In order to break this cycle, sleep health should be integrated as a key aspect of cancer treatment and rehabilitation, much like maintaining a healthy diet and appropriate levels of physical activity

Pennsylvania Folklife Vol. 42, No. 3

• Assimilation and Acculturation in a Pennsylvania-German Landscape: The Nisley Family and its Architecture in the Lower Swatara Creek Basin • Charles-Alexandre Lesueur of Paris, Philadelphia, and New Harmony, Indiana • Religious-Geographical History of the Hutterian Brethren in Europe and Russia, 1523-1879https://digitalcommons.ursinus.edu/pafolklifemag/1137/thumbnail.jp

Prelude: the future of structural bamboo

Prelude demonstrates the possibilities for engineered bamboo in structural applications. Our pavilion is composed of a spiral pathway that cantilevers from the base and embodies the function of the Muziekgebouw through a lightweight design that mirrors a musical prelude in structure, concept and form. Inspired by Guastavino´s masonry vaults, the structure evokes the image of a spiral staircase originally constructed from thin tiles, transformed in a novel material with properties distinct from structural masonry. With a growing need for the development of sustainable materials, engineered bamboo combines the benefits of a natural fibre composite with the advantages of a laminated material. Highly renewable, large diameter bamboo used for structural applications is harvested every 4-5 years. Once harvested, the raw material can be processed into strips, which are then laminated into a board product. The processing reduces inherent geometric and mechanical variability of the natural material that currently limit the application of bamboo products. Currently promoted as a decorative material, Prelude is an example of the potential use of engineered bamboo beyond surface applications in architecture

Spatial differences in wind-driven sediment resuspension in a shallow, coastal estuary

Two locations approximately 11 km apart along the axis of the New River Estuary near Jacksonville, NC USA were continuously monitored for eight years. Included in the observations are vertical profiles of turbidity, temperature, salinity, chl-a, dissolved oxygen, pH and water velocity as well as local wind velocity. Differences between the two sites result from a number of factors, including bathymetry, wind strength, direction and fetch, estuarine morphology, tidal currents and sediment properties. The site near the head of the estuary, Morgan Bay, is deeper, experiences generally weaker winds and has less fetch in most directions. Stones Bay, the down-estuary site, is shallower, experiences stronger winds and has longer fetch, particularly in the prevailing wind directions. Current speeds also differ along the estuary with the down-estuary Stones Bay site being more tidal. The observations were used together with a simple wave model to analyze the estuarine turbidity response to different forcing mechanisms. Results suggest that sediments are resuspended primarily by wind-wave generated bottom stress at both locations. While turbidity is generally higher in Stones Bay than in Morgan Bay, turbidity as a function of the local wave-induced bottom stress (including forcing from all directions) is similar at both locations at low stress but diverges at higher stresses. At higher bottom stresses, turbidity in Stones Bay responds primarily to winds from the NE, S and NW while turbidity in Morgan Bay responds primarily to winds from the NW and S. Accounting for sediment resuspension within an approximate spatial advection scale around each of the observation sites, yields a similar turbidity vs bottom stress response curve for the three primary directions in Stones Bay and the S direction in Morgan Bay but a greater turbidity response for winds from the NW in Morgan Bay. In the latter case, waves are crossing the section of the New River Estuary just downstream of the confluence with the New River and are presumably encountering sediments that are more easily resuspended. Average sediment export is down-river with more sediment leaving Stones Bay than Morgan Bay

Dancing in the office: A study of gestures as resistance

Following the art-body-ethics turn in management studies we use dance as an analogy in order to explore how the body can resist organisational control in office work contexts. We argue that in office work gestures can be a site of post-recognition resistance. Drawing on two art videos and on dance studies, we explain that this is operated either through arrest or through flow. In fact aesthetic experiments in gesturing disrupt the work rhythm needed for organisational efficiency and enforced by organisational control. This allows us to contribute primarily to the literature on resistance in organisation studies and relatedly to the growing literature on dance in organisation studies through demonstrating how dance can be a source of resistance

Association between the c.*229C>T polymorphism of the topoisomerase IIb binding protein 1 (TopBP1) gene and breast cancer

Topoisomerase IIb binding protein 1 (TopBP1) is involved in cell survival, DNA replication, DNA damage repair and cell cycle checkpoint control. The biological function of TopBP1 and its close relation with BRCA1 prompted us to investigate whether alterations in the TopBP1 gene can influence the risk of breast cancer. The aim of this study was to examine the association between five polymorphisms (rs185903567, rs116645643, rs115160714, rs116195487, and rs112843513) located in the 30UTR region of the TopBP1 gene and breast cancer risk as well as allele-specific gene expression. Five hundred thirty-four breast cancer patients and 556 population controls were genotyped for these SNPs. Allele-specific Top- BP1 mRNA and protein expressions were determined by using real time PCR and western blotting methods, respectively. Only one SNP (rs115160714) showed an association with breast cancer. Compared to homozygous common allele carriers, heterozygous and homozygous for the T variant had significantly increased risk of breast cancer (adjusted odds ratio = 3.81, 95 % confidence interval: 1.63–8.34, p = 0.001). Mean TopBP1 mRNA and protein expression were higher in the individuals with the CT or TT genotype. There was a significant association between the rs115160714 and tumor grade and stage. Most carriers of minor allele had a high grade (G3) tumors classified as T2-T4N1M0. Our study raises a possibility that a genetic variation of TopBP1 may be implicated in the etiology of breast cancer

Predicting the pore-filling ratio in lumen-impregnated wood

Lumen impregnation, unlike most other wood modification methods, is typically assessed by the pore-filling ratio (PFR) (i.e. the fraction of luminal porosity filled) rather than by weight percentage gain (WPG). During lumen impregnation, the impregnants act on the voids in the wood rather than on the solid mass (e.g. cell walls), but the PFR cannot be measured as conveniently as the WPG during processing. Here, it is demonstrated how the PFR can be calculated directly from the WPG if the bulk density of the untreated wood is known. The relationship between the WPG and bulk density was examined experimentally by applying a pressured impregnation on knot-free specimens from Sitka spruce with a liquid mixture of methacrylate monomers. Based on the validated model, it was possible to further study the effect of different process-related parameters, such as hydraulic pressure, on lumen impregnation. Skeletal density is another key parameter in this model, which directly reflects the amount of inaccessible pores and closed lumens, and can be independently determined by helium pycnometry. The permeability can be qualitatively evaluated by PFR as well as skeletal density. For instance, poor permeability of knotty wood, due to the large extractives content around knots, was reflected by a lower skeletal density and inefficient lumen impregnation (low PFR). Although this model was examined on a laboratory scale, it provides guidance on the precise effect of different parameters on lumen impregnation, thereby improving the fundamental understanding of and enabling better control over the modification of wood by impregnation.We thank the Leverhulme Trust (project: ‘Natural material innovation for sustainable living’) for generous funding. We also thank Prof Paul Dupree, Dr Marta Busse-Wicher, Dr Li Yu from the University of Cambridge, Prof Mark Jones (The Mary Rose Trust), Mr Gervais Sawyer, and Mr George Fereday (London Metropolitan University) for kind discussion and suggestion. We thank Dr Ana Belenguer (University of Cambridge) for the help on metal fillers

Connections of the corticomedial amygdala in the golden hamster. I. Efferents of the “vomeronasal amygdala”

The medial (M) and posteromedial cortical (C3) amygdaloid nuclei and the nucleus of the accessory olfactory tract (NAOT) are disignated the “vomeronasal amygdala” because they are the only components of the amygdala to receive a direct projection from the accessory olfactory bulb (AOB). The efferents of M and C3 were traced after injections of 3 H-proline into the amygdala in male golden hamsters. Frozen sections of the brains were processed for autoradiography. The efferents of the “vomeronasal amygdala” are largely to areas which are primary and secondary terminal areas along the vomeronasal pathway, although the efferents from C3 and M terminate in different layers in these areas than do the projections from the vomeronasal nerve or the AOB. Specifically, C3 projects ipsilaterally to the internal granule cell layer of the AOB, the cellular layer of NAOT, and layer lb of M. Additional fibers from C3 terminate in a retrocommissural component of the bed nucleus of the stria terminalis (BNST) bilaterally, and in the cellular layers of the contralateral C3. The medial nucleus projects to the cellular layer of the ipsilateral NAOT, layer lb of C3, and bilaterally to the medial component of BNST. Projections from M to non-vomeronasal areas terminate in the medial preoptic area-anterior hypothalamic junction, ventromedial nucleus of the hypothalamus, ventral premammillary nucleus and possibly in the ventral subiculum. These results demonstrate reciprocal connections between primary and secondary vomeronasal areas and between the secondary areas themselves. They suggest that M, but not C3, projects to areas outside this vomeronasal network. The medial amygdaloid nucleus is therefore an important link between the vomeronasal organ and areas of the brain not receiving direct vomeronasal input.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50012/1/901970107_ftp.pd