Midwives’ perceived barriers in communicating about depression with ethnic minority clients

Objective: This study aimed to assess the most influential barriers midwives perceive in communicating about depression-related symptoms with ethnic minority clients. Methods: In-depth interviews were held with midwives (N = 8) and Moroccan-Dutch women (N = 6) suffering from perinatal depression to identify the most salient communication barriers. Subsequently, an online survey among midwives (N = 60) assessing their perceived barriers and the occurrence of these barriers in practice was administered. Composite scores using the QUOTE methodology were calculated to determine influential barriers. Results: Three types of barriers emerged from the interviews. Educational-related barriers, client-related barriers and midwife-related barriers. Results of the survey showed that the most influential barriers were educational-related barriers (e.g. lack of culturally sensitive depression screening instruments) and client-related barriers (e.g. cultural taboo about talking about depression). Conclusion: Culturally sensitive screening instruments for depression and patient education materials should be developed to mitigate the educational-related barriers to communicating about depression. Patient education materials should also target the clients’ social environment (e.g. husbands) to help break the cultural taboo about depression. Practice implications: Based on this study's results, communication strategies to empower both midwives and ethnic minority clients with depression can be developed in a collaborative approach

Hardware/Software Co-design Applied to Reed-Solomon Decoding for the DMB Standard

This paper addresses the implementation of Reed- Solomon decoding for battery-powered wireless devices. The scope of this paper is constrained by the Digital Media Broadcasting (DMB). The most critical element of the Reed-Solomon algorithm is implemented on two different reconfigurable hardware architectures: an FPGA and a coarse-grained architecture: the Montium, The remaining parts are executed on an ARM processor. The results of this research show that a co-design of the ARM together with an FPGA or a Montium leads to a substantial decrease in energy consumption. The energy consumption of syndrome calculation of the Reed- Solomon decoding algorithm is estimated for an FPGA and a Montium by means of simulations. The Montium proves to be more efficient

The relationship between small-scale nursing home care for people with dementia and staff's perceived job characteristics

Background: Over the past few decades, new care models that are more resident-oriented and directed toward small-scale and homelike environments have been developed worldwide. The impact of these care models on the quality of life of residents has been studied. However, little research has been conducted to gain insight into how these new care models influence healthcare staff's work environment. This study focuses on the consequences of small-scale care on staff's perceived job characteristics. Methods: Data were derived from a sample of 136 Dutch living arrangements providing nursing home care for people with dementia (2008/2009), in which 1,327 residents and 1,147 staff participated. The relationship between two indicators of small-scale care (small-scale care characteristics and total number of residents with dementia in facility) and staff's job characteristics (job demands, decision authority, coworker and supervisor support) were studied with multilevel regression analyses. All analyses were adjusted for staff, resident, and living arrangement characteristics when needed. Results: Both indicators of small-scale care were associated with job demands; staff perceived less time and work pressure as more characteristics of small-scale care were integrated and the facility had less residents with dementia in total. Only one indicator was associated with decision authority. As more characteristics of small-scale care were integrated, staff's perceived decision authority was higher. No relationship was found with coworker and supervisor social support. Conclusions: Knowing that job demands and decision authority are important predictors of job appraisal and well-being, our findings show that small-scale care could have a beneficial impact on healthcare staff's work environment. Copyright © International Psychogeriatric Association 2014

Richting nieuwe bedrijfssystemen : ondernemers en onderzoekers in gesprek over innovatie

In dit rapport hebben ondernemers en onderzoekers gezamenlijk een beeld geschetst van toekomstige ontwikkelingen in bedrijfssystemen in Nederland en per regio. Daarvoor is eerst inzicht gegeven in toekomstige trends, trendbreuken, maatschappelijke randvoorwaarden en verwachte internationale concurrentiepositie. Het rapport sluit af met een aantal innovatieopgaven en suggesties van de wijze waarop dit innovatieproces kan worden aangepakt. In this report, agricultural entrepreneurs and researchers collaborate to paint a picture of future developments in farming systems in the Netherlands and the country's four regions. To do this, the report first offers insight into future trends, breaks against trends, societal limiting conditions and the expected international competitiveness. The report concludes with a number of innovation problems and suggestions on the way in which to approach this innovation process

Navitoclax Most Promising BH3 Mimetic for Combination Therapy in Hodgkin Lymphoma

The treatment of young patients with Hodgkin lymphoma (HL) is often successful but a significant proportion of patients suffers from late toxicity. In the current era there are new opportunities for less toxic and more targeted treatment options. In this respect, the anti-apoptotic pathway is an attractive target since Hodgkin tumor cells abundantly express components of this pathway. We measured the effect of BH3 mimetics that interfere with anti-apoptotic proteins in cell lines, also in combination with the standard of care chemotherapeutic doxorubicin and the recently discovered preclinically active tamoxifen. Several anti-apoptotic BCL-2 family proteins were expressed in each case (n = 84) and in HL cell lines (n = 5). Cell lines were checked for sensitivity to BH3 mimetics by BH3 profiling and metabolic assays and monotherapy was only partially successful. Doxorubicin was synergistic with a BCL-XL inhibitor and BCL2/XL/W inhibitor navitoclax. Tamoxifen that targets the estrogen receptor β present in the mitochondria of the cell lines, could induce cell death, and was synergistic with several BH3 mimetics including/as well as navitoclax. In conclusion, targeting the anti-apoptotic pathway by the triple inhibitor navitoclax in combination with doxorubicin or tamoxifen is a promising treatment strategy in HL

Herpes simplex virus type 1 and normal protein permeability in the lungs of critically ill patients: a case for low pathogenicity?

INTRODUCTION: The pathogenicity of late respiratory infections with herpes simplex virus type 1 (HSV-1) in the critically ill is unclear. METHODS: In four critically ill patients with persistent pulmonary infiltrates of unknown origin and isolation of HSV-1 from tracheal aspirate or bronchoalveolar lavage fluid, at 7 (1-11) days after start of mechanical ventilatory support, a pulmonary leak index (PLI) for 67Gallium (67Ga)-transferrin (upper limit of normal 14.1 x 10(-3)/min) was measured. RESULTS: The PLI ranged between 7.5 and 14.0 x 10(-3)/min in the study patients. Two patients received a course of acyclovir and all survived. CONCLUSIONS: The normal capillary permeability observed in the lungs argues against pathogenicity of HSV-1 in the critically ill, and favors that isolation of the virus reflects reactivation in the course of serious illness and immunodepresssion, rather than primary or superimposed infection in the lungs

Совершенствование инструмента с учётом особенностей бурения различными способами

In the article the special features of the main methods of slits and boreholes drilling in the mountain rocks of different strengths with the hard–alloy and artificial diamond instrument are shown. The process of instrument wearing out during rotary drilling with strokes is examined, as well as the cases of implementing of hard–alloys elements with supporting of implementing of hard–alloys elements with supporting of their self–rotating. The advantages and disadvantages of each of above – mentioned methods of drilling are shown as well as the ways of the further improvement for each method