Pediatric Oncology Palliative Care: Experiences of General Practitioners and Bereaved Parents

Objective: This qualitative study set in the West Midlands region of the United Kingdom, aimed to examine the role of the general practitioner (GP) in children's oncology palliative care from the perspective of GPs who had cared for a child with cancer receiving palliative care at home and bereaved parents. Methods: One-to-one semi-structured interviews were undertaken with 18 GPs and 11 bereaved parents following the death. A grounded theory data analysis was undertaken; identifying generated themes through chronological comparative data analysis. Results: Similarity in GP and parent viewpoints was found, the GPs role seen as one of providing medication and support. Time pressures GPs faced influenced their level of engagement with the family during palliative and bereavement care and their ability to address their identified learning deficits. Lack of familiarity with the family, coupled with an acknowledgment that it was a rare and could be a frightening experience, also influenced their level of interaction. There was no consistency in GP practice nor evidence of practice being guided by local or national policies. Parents lack of clarity of their GPs role resulted in missed opportunities for support. Conclusions: Time pressures influence GP working practices. Enhanced communication and collaboration between the GP and regional childhood cancer centre may help address identified GP challenges, such as learning deficits, and promote more time-efficient working practices through role clarity. Parents need greater awareness of their GP's wide-ranging role; one that transcends palliative care incorporating bereavement support and on-going medical care for family member

Slicing Strategies for the Generalised Type-2 Mamdani Fuzzy Inferencing System

The final publication is available at Springer via http://dx.doi.org/[insert DOI]".As a three-dimensional object, there are a number of ways of slicing a generalised type-2 fuzzy set. In the context of the Mamdani Fuzzy Inferencing System, this paper concerns three accepted slicing strategies, the vertical slice, the wavy slice, and the horizontal slice or alpha -plane. Two ways of de ning the generalised type-2 fuzzy set, vertical slices and wavy slices, are presented. Fuzzi cation and inferencing is presented in terms of vertical slices. After that, the application of all three slicing strategies to defuzzi cation is described, and their strengths and weaknesses assessed

Direct Correlation between Diffusion of Loxosceles reclusa Venom and Extent of Dermal Inflammation

Objectives: Envenomation by Loxosceles species (brown recluse) spiders results in large dermal inflammatory lesions. Venom-induced dermal inflammation occurs indirectly via soluble mediators of inflammation. This study aimed to explore whether the anatomic extent of dermonecrotic arachnidism is due to the cascade of soluble proinflammatory mediators elicited by venom deposited at the bite site, or due to diffusion of the venom per se. Methods: Three New Zealand white rabbits received intradermal L. reclusa venom (3-Μg) injections in the flank. At the time of maximum dermal inflammation (24 hr), paired 4-mm dermal biopsies were obtained in 2-cm intervals extending 0 to 12 cm from the inoculation site. Normal dermal tissue was obtained from the opposite flank to serve as a negative control. One biopsy sample from each interval was homogenized and assayed for myeloperoxidase (MPO) activity and for the presence of venom via an enzyme immunoassay (EIA). The other paired dermal biopsy was sectioned, and examined for the presence of polymorphonuclear neutrophils (PMNs) by microscopy. Lesional areas were measured using digital images imported into imaging software. Results: Mean ± SD lesional diameter 24 hours post inoculation measured 9.18 ± 0.64 cm. Venom was detected in biopsies 0 to 10 cm from the injection site. As expected, the highest venom concentrations were measured at the inoculation site (4.28 ± 3.9 ng/4 mm). In addition, PMNs and MPO were detected up to 8 and 10 cm from the inoculation site, respectively. Neither PMNs nor MPO was detected in tissue absent of venom (kappa = 0.88, p < 0.001). Conclusions: Loxosceles venom diffuses from the envenomation site. The extent of dermal inflammation mirrors the extent of Loxosceles venom diffusion. This observation implies that the venom itself defines the extent and magnitude of tissue injury following Loxosceles envenomation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74825/1/j.1553-2712.2001.tb02107.x.pd

Predictors of drinking and functional outcomes for men and women following inpatient alcohol treatment

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106952/1/ajad12098.pd

Draft Genome Sequence Of The Biosurfactant-producing Bacterium Gordonia Amicalis Strain Ccma-559, Isolated From Petroleum-impacted Sediment.

Gordonia amicalis strain CCMA-559 was isolated from an oil-contaminated mangrove swamp and shown to produce biosurfactants. This strain is a strict aerobe that readily degrades an array of carbon sources, including N-acetylglucosamine, cellobiose, Tween 80, and 4-hydroxybenzoic acid, and, like other G. amicalis strains, likely desulfurizes dibenzothiophene.

The Broken Dream of Pervasive Sentient Ambient Calm Invisible Ubiquitous Computing

Date of Acceptance: 15/12/2014We dreamt of technology becoming invisible, for our wants and needs to be primary and the tools we use for making them a reality to become like a genie, a snap of the fingers and ta daa, everything is realised. What went wrong? Was this always an impossible dream? How did we end up with this fetishised obsession with mobile phones? How did we end up with technology tearing apart our sense of experience and replacing it with 'Likes'. No one meant this to happen, not even US Corporates, they just wanted to own us, not diminish our sense of existing and interacting within the real world. In this paper we consider how tools took over, and how the dream of ubiquitous (or whatever its called) computing was destroyed. We rally rebellious forces and consider how we might fight back, and whether we should even bother trying.Postprin

Microwave and Millimeter Wave Techniques

Contains reports on two research projects.Joint Services Electronics Program (Contract DAAG29-78-C-0020)National Science Foundation (Grant AST77-26896