Satisfaction and quality of life in women who undergo breast surgery: a qualitative study to develop conceptual model

Background: In cosmetic and reconstructive breast surgery, measurement of patient-reported outcomes has become increasingly important to research efforts and clinical care. We aimed to describe how breast conditions and breast surgery impact on patient satisfaction and quality of life. Methods: We conducted qualitative, in-depth interviews with 48 women who had undergone either breast reduction (n = 15), breast augmentation (n = 12), or breast reconstruction (n = 21) surgery in order to begin to build a theoretical understanding of patient satisfaction and quality of life in breast surgery patients. Interviews were audio-taped, transcribed verbatim and analyzed thematically. Results: The patient interviews revealed that breast conditions and breast surgery impact women in the following six main areas: satisfaction with breasts; satisfaction with overall outcome; psychosocial well-being; sexual well-being; physical well-being; and satisfaction with the process of care. We used these six themes to form the basis of a conceptual framework of patient satisfaction and quality of life in women who undergo breast surgery. Conclusion: Our conceptual framework establishes the main issues of concern for breast surgery patients. This new framework can be used to help develop local guidelines for future clinical assessment, management and measurement, establish the validity of the current management strategies, and develop evidence-based guidance for the development of new patient reported outcome measures for future outcomes research

The temporary marketing organization

Increasingly, marketing activity is carried out within temporary organizations, where teams are assembled to complete a specific task within a predetermined timeframe. Such organizations are uniquely suited to promoting various marketing outcomes but are not well understood. From a practical standpoint, their inherent characteristics create organizational challenges which, if not appropriately managed, can compromise performance. Drawing on agency theory and research on embedded ties, we conceptualize these challenges in terms of particular selection and enforcement problems. We identify three different forms of temporary marketing organizations that vary in their selection and enforcement qualities. Next, we develop a conceptual framework which shows the selection and enforcement implications of a temporary organization’s task, timeline and team composition. We also show how selection and enforcement mechanisms have portable qualities and can be “imported” to a given temporary organization, either from a prior temporary organization or from a larger permanent one

Class reconstruction driven adversarial domain adaptation for hyperspectral image classification

We address the problem of cross-domain classification of hyperspectral image (HSI) pairs under the notion of unsupervised domain adaptation (UDA). The UDA problem aims at classifying the test samples of a target domain by exploiting the labeled training samples from a related but different source domain. In this respect, the use of adversarial training driven domain classifiers is popular which seeks to learn a shared feature space for both the domains. However, such a formalism apparently fails to ensure the (i) discriminativeness, and (ii) non-redundancy of the learned space. In general, the feature space learned by domain classifier does not convey any meaningful insight regarding the data. On the other hand, we are interested in constraining the space which is deemed to be simultaneously discriminative and reconstructive at the class-scale. In particular, the reconstructive constraint enables the learning of category-specific meaningful feature abstractions and UDA in such a latent space is expected to better associate the domains. On the other hand, we consider an orthogonality constraint to ensure non-redundancy of the learned space. Experimental results obtained on benchmark HSI datasets (Botswana and Pavia) confirm the efficacy of the proposal approach

The development of a computer-based product definition for artillery products

Any company that is involved in manufacturing, must be able to tell the exact difference between any two products of the same family. This is necessary to enable such a company to support these products during the total life cycle, and becomes possible if the product definition is kept under configuration control. Traditionally, paper copies of all the specifications and drawings etc., were kept under configuration and the real electronic source information was not. The objective of this system is to maintain the electronic source data for every product. This system enables the product developers to access the total product definition from a Windows based personal computer. The genuine source data is available, not only paper copies. At the same time , the logistic, functional and manufacturing definitions can be accessed in a user friendly way

Effect on cardiovascular disease risk factors of interventions to alter consultations between practitioners and patients with type 2 diabetes: A systematic review and meta-analysis of trials in primary care

$\textbf{Objective:}$ To examine the effect on cardiovascular (CVD) risk factors of interventions to alter consultations between practitioners and patients with type 2 diabetes. $\textbf{Search Strategy:}$ Electronic and manual citation searching to identify relevant randomized controlled trials (RCTs). $\textbf{Inclusion Criteria:}$ RCTs that compared usual care to interventions to alter consultations between practitioners and patients. The population was adults aged over 18 years with type 2 diabetes. Trials were set in primary care. $\textbf{Data extraction and synthesis:}$ We recorded if explicit theory-based interventions were used, how consultations were measured to determine whether interventions had an effect on these and calculated weighted mean differences for CVD risk factors including glycated haemoglobin (HbA$_{1c}$), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C). $\textbf{Results:}$ We included seven RCTs with a total of 2277 patients with type 2 diabetes. A range of measures of the consultation was reported, and underlying theory to explain intervention processes was generally undeveloped and poorly applied. There were no overall effects on CVD risk factors; however, trials were heterogeneous. Subgroup analysis suggested some benefit among studies in which interventions demonstrated impact on consultations; statistically significant reductions in HbA$_{1c}$ levels (weighted mean difference, −0.53%; 95% CI: [−0.77, −0.28]; $P$<.0001; $I^{2}$ =46%). $\textbf{Conclusions:}$ Evidence of effect on CVD risk factors from interventions to alter consultations between practitioners and patients with type 2 diabetes was heterogeneous and inconclusive. This could be explained by variable impact of interventions on consultations. More research is required that includes robust measures of the consultations and better development of theory to elucidate mechanisms.HDM was an Academic Clinical Fellow, Andrew Cooper is funded by the University of Cambridge MRC Epidemiology Unit (grant code: MC_UU_12015/4), SJG is an NIHR Senior Investigator. The primary care unit is a member of the National Institute for Health Research (NIHR) School for Primary Care Research and supported by NIHR Research funds. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health

Effect of social media in improving knowledge among patients having fixed appliance orthodontic treatment: A single-center randomized controlled trial

Research has shown that orthodontic patients are more likely to retain information presented in an audiovisual format. However, there has been little research on the effectiveness of audiovisual information provided through different routes such as the Internet. This parallel-group randomized controlled trial assessed whether provision of audiovisual information on the YouTube (Google, San Bruno, Calif) Web site to orthodontic patients undergoing fixed appliance treatment results in improved patient knowledge when compared with conventional methods of information provision. The effects of sex and ethnicity were also investigated

Reprogramming bone progenitor identity and potency through control of collagen density and oxygen tension

The biophysical microenvironment of the cell is being increasingly used to control cell signaling and to direct cell function. Herein, engineered 3D tuneable biomimetic scaffolds are used to control the cell microenvironment of Adipose-derived Mesenchymal Stromal Cells (AMSC), which exhibit a collagen density-specific profile for early and late stage bone cell lineage status. Cell potency was enhanced when AMSCs were cultured within low collagen density environments in hypoxic conditions. A transitional culture containing varied collagen densities in hypoxic conditions directed differential cell fate responses. The early skeletal progenitor identity (PDPN+CD146−CD73+CD164+) was rescued in the cells which migrated into low collagen density gels, with cells continuously exposed to the high collagen density gels displaying a transitioned bone-cartilage-stromal phenotype (PDPN+CD146+CD73−CD164-). This study uncovers the significant contributions of the physical and physiological cell environment and highlights a chemically independent methodology for reprogramming and isolating skeletal progenitor cells from an adipose-derived cell population

The Developmental Mismatch in Structural Brain Maturation during Adolescence

Regions of the human brain develop at different rates across the first two decades of life, with some maturing before others. It has been hypothesized that a mismatch in the timing of maturation between subcortical regions (involved in affect and reward processing) and prefrontal regions (involved in cognitive control) underlies the increase in risk-taking and sensation-seeking behaviors observed during adolescence. Most support for this 'dual systems' hypothesis relies on cross-sectional data, and it is not known whether this pattern is present at an individual level. The current study utilizes longitudinal structural magnetic resonance imaging (MRI) data to describe the developmental trajectories of regions associated with risk-taking and sensation-seeking behaviors, namely, the amygdala, nucleus accumbens (NAcc) and prefrontal cortex (PFC). Structural trajectories of gray matter volumes were analyzed using FreeSurfer in 33 participants aged 7-30 years, each of whom had at least three high-quality MRI scans spanning three developmental periods: late childhood, adolescence and early adulthood (total 152 scans). The majority of individuals in our sample showed relatively earlier maturation in the amygdala and/or NAcc compared to the PFC, providing evidence for a mismatch in the timing of structural maturation between these structures. We then related individual developmental trajectories to retrospectively assessed self-reported risk-taking and sensation-seeking behaviors during adolescence in a subsample of 24 participants. Analysis of this smaller sample failed to find a relationship between the presence of a mismatch in brain maturation and risk-taking and sensation-seeking behaviors during adolescence. Taken together, it appears that the developmental mismatch in structural brain maturation is present in neurotypically developing individuals. This pattern of development did not directly relate to self-reported behaviors at an individual level in our sample, highlighting the need for prospective studies combining anatomical and behavioral measures. © 2014 S. Karger AG, Basel

KCNQ/M currents in sensory neurons: Significance for pain therapy

Neuronal hyperexcitability is a feature of epilepsy and both inflammatory and neuropathic pain. M currents [I-K(M)] play a key role in regulating neuronal excitability, and mutations in neuronal KCNQ2/3 subunits, the molecular correlates of I-K(M), have previously been linked to benign familial neonatal epilepsy. Here, we demonstrate that KCNQ/M channels are also present in nociceptive sensory systems. I-K(M) was identified, on the basis of biophysical and pharmacological properties, in cultured neurons isolated from dorsal root ganglia (DRGs) from 17-d-old rats. Currents were inhibited by the M-channel blockers linopirdine (IC50, 2.1 muM) and XE991 (IC50, 0.26 muM) and enhanced by retigabine (10 muM). The expression of neuronal KCNQ subunits in DRG neurons was confirmed using reverse transcription-PCR and single-cell PCR analysis and by immunofluorescence. Retigabine, applied to the dorsal spinal cord, inhibited C and Adelta fiber-mediated responses of dorsal horn neurons evoked by natural or electrical afferent stimulation and the progressive "windup" discharge with repetitive stimulation in normal rats and in rats subjected to spinal nerve ligation. Retigabine also inhibited responses to intrapaw application of carrageenan in a rat model of chronic pain; this was reversed by XE991. It is suggested that I-K(M) plays a key role in controlling the excitability of nociceptors and may represent a novel analgesic target