6 research outputs found
The development of an online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making: a usability and pilot study
An online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making was developed. A two-phase usability test was conducted among 12 couples (N = 22; 2 persons participated without their partner) at risk for hereditary cancer and 15 health care providers. Couples and health care providers expressed similar suggestions for improvements, and evaluated the modified decision aid as acceptable, easy to use, and comprehensible. The final decision aid was pilot tested (N = 16) with paired sample t tests comparing main outcomes (decisional conflict, knowledge, realistic expectations regarding the reproductive options and decision self-efficacy) before (T0), immediately (T1) and 2 weeks after (T2) use of the decision aid. Pilot testing indicated decreased decisional conflict scores, increased knowledge, and improved realistic expectations regarding the reproductive options, at T1 and T2. No effect was found for couplesâ decision self-efficacy. The positive findings during usability testing were thus reflected in the pilot study. The decision aid will be further evaluated in a nationwide pretestâposttest study to facilitate implementation in the onco-genetic counselling setting. Ultimately, it is expected that the decision aid will enable end-users to make an informed decision
Reproductive decision-making in the context of hereditary cancer: the effects of an online decision aid on informed decision-making
Individuals having a genetic predisposition to cancer and their partners face challenging decisions regarding their wish to have children. This study aimed to determine the effects of an online decision aid to support couples in making an informed decision regarding their reproductive options. A nationwide pretest-posttest study was conducted in the Netherlands among 131 participants between November 2016 and May 2018. Couples were eligible for participation if one partner had a pathogenic variant predisposing for an autosomal dominant hereditary cancer syndrome. Participants completed a questionnaire before use (T0), and at 3 months (T3) after use of the decision aid to assess the primary outcome measure informed decision-making, and the secondary outcome measures decisional conflict, knowledge, realistic expectations, level of deliberation, and decision self-efficacy. T0âT3 comparisons show an overall positive effect for all outcome measures (all ps < 0.05; knowledge (ES = â 1.05), decisional conflict (ES = 0.99), participantsâ decision self-efficacy (ES = â0.55), level of deliberation (ES = â 0.50), and realistic expectations (ES = â 0.44). Informed decision-making increased over time and 58.0% of the participants made an informed reproductive decision at T3. The online decision aid seems to be an appropriate tool to complement standard reproductive counseling to support our target group in making an informed reproductive decision. Use of the decision aid may lessen the negative psychological impact of decision-making on couplesâ daily life and wellbeing
Modulation instability induced by cross-phase modulation in a dual-wavelength dispersion-managed soliton fiber ring laser
We report on the observation of modulation instability induced by cross-phase
modulation in a dual-wavelength operation dispersion-managed soliton fiber ring
laser with net negative cavity dispersion. The passively mode-locked operation
is achieved by using nonlinear polarization rotation technique. A new type of
dual-wavelength operation, where one is femtosecond pulse and the other is
picosecond pulse operation, is obtained by properly rotating the polarization
controllers. When the dual-wavelength pulses are simultaneously circulating in
the laser ring cavity, a series of stable modulation sidebands appears in the
picosecond pulse spectrum at longer wavelength with lower peak power due to
modulation instability induced by cross-phase modulation between the two lasing
wavelengths. Moreover, the intensities and wavelength shifts of the modulation
sidebands can be tuned by varying the power of the femtosecond pulse or the
lasing central wavelengths of the dual-wavelength pulses. The theoretical
analysis of the modulation instability induced by cross-phase modulation in our
fiber laser is also presented.Comment: 26 pages, 10 figure
Online decision support for persons having a genetic predisposition to cancer and their partners during reproductive decision-making
A nationwide pretestâposttest study was conducted in all clinical genetic centres in the
Netherlands, to evaluate the effects of an online decision aid to support persons who
have a genetic predisposition to cancer and their partners in making an informed decision
regarding reproductive options. Main outcomes (decisional conflict, knowledge, realistic
expectations, level of deliberation, and decision selfâefficacy) were measured before use
(T0), immediately after use (T1), and at 2 weeks (T2) after use of the decision aid. Paired
sample t tests were used to compute differences between the first and subsequent
measurements. T0âT1 and T0âT2 comparisons indicate a significant reduction in mean
decisional conflict scores with stronger effects for participants with high baseline deciâ
sional conflict. Furthermore, use of the decision aid resulted in increased knowledge levels and improved realistic expectations. Level of deliberation only increased for particiâ
pants with lower baseline levels of deliberation. Decision selfâefficacy increased for those
with low baseline scores, whereas those with high baseline scores showed a reduction at
T2. It can be concluded that use of the decision aid resulted in several positive outcomes
indicative of informed decisionâmaking. The decision aid is an appropriate and highly apâ
preciated tool to be used in addition to reproductive counseling
Optical Fiber Soliton Lasers
Experimental and theoretical developments in optical fiber soliton lasers are reviewed. We first review the fundamentals of optical fiber soliton lasers from an experimental viewpoint, including soliton generation and control mechanisms, and highlight the similarities between developments in soliton fiber lasers and soliton transmissions systems. We then review the mathematical theory of soliton lasers based on a master equation description, highlighting some interesting solutions and recent results concerning soliton stability.33 page(s