76 research outputs found

    The Role of Trust in Social Entrepreneurship: A Case Study of Global Brigades

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    This article aims to begin filling this gap by utilizing a specific social entrepreneurship initiative to illustrate the role of trust in social entrepreneurship efforts

    An Avoidable Cognitive Error in Chest Radiography

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    Teaching Point: Awareness in radiology reporting of cognitive errors such as the alliterative bias can help minimize the delay to diagnosis and accelerate adequate patient care

    Reject Analysis in Digital Radiography and Computed Tomography: A Belgian Imaging Department Case Study

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    Objective: Reject analysis is usually performed in digital radiography (DR) for quality assurance. Data for computed tomography (CT) rejects remains sparse. The aim of this study is to help provide a straightforward benchmark for reject analysis of both DR and CT. Materials and methods: This retrospective observational study included 107,277 DR and 20,659 CT during 18 months in a tertiary care center. Rejected acquisitions were retrieved by Dose Archiving and Communication System (DACS). The DR and CT reject analysis included reject rates, reasons for rejection and supplementary radiation dose associated with these rejects. Results: 8,904 rejected DR and 514 rejected CT were retrieved. The DR reject rate was 8.3% whereas the CT reject rate was 2.5%. The cumulative effective dose (ED) of DR rejects was 377.3 mSv while the cumulative ED of CT rejects was 1267.4 mSv. The major reason for rejects was positioning for both DR (61%) and CT (44%). Conclusion: This study helps constitute a simple reproducible method to analyze both DR and CT rejects simultaneously. Although CT rejects are less often monitored than DR rejects, the radiation dose associated with CT rejects is much higher, which emphasizes the need to systematically monitor both DR and CT rejects. Investigating the reasons and the most frequently rejected examinations gives an opportunity for improvement of imaging techniques in cooperation with technologists

    Practical implementation of the comprehensive geriatric assessment to optimise care for older adults with cancer

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    Whilst cancer remains a very serious health problem at any stage, cancer combined with increasing age creates an even more challenging situation for health care providers [...

    Urbanization affects oak-pathogen interactions across spatial scales

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    The world is rapidly urbanizing, thereby transforming natural landscapes and changing the abundance and distribution of organisms. However, insights into the effects of urbanization on species interactions, and plant-pathogen interactions in particular, are lacking. We investigated the effects of urbanization on powdery mildew infection on Quercus robur at continental and within-city scales. At the continental scale, we compared infection levels between urban and rural areas of different-sized cities in Europe, and investigated whether plant traits, climatic variables and CO2 emissions mediated the effect of urbanization on infection levels. Within one large city (Stockholm, Sweden), we further explored whether local habitat features and spatial connectivity influenced infection levels during multiple years. At the continental scale, infection severity was consistently higher on trees in urban than rural areas, with some indication that temperature mediated this effect. Within Stockholm city, temperature had no effect, while local accumulation of leaf litter negatively affected powdery mildew incidence in one out of three years, and more connected trees had lower infection levels. This study is the first to describe the effects of urbanization on plant-pathogen interactions both within and among cities, and to uncover the potential mechanisms behind the observed patterns at each scale.Peer reviewe

    Oncologic Home-Hospitalization Delivers a High-Quality and Patient-Centered Alternative to Standard Ambulatory Care: Results of a Randomized-Controlled Equivalence Trial

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    PURPOSE- Given the increasing burden of cancer on patients, health care providers, and payers, the shift of certain outpatient procedures to the patients' homes (further indicated as oncologic home-hospitalization [OHH]) might be a high-quality, patient-centered, and cost-effective alternative to standard ambulatory cancer care (SOC). METHODS- A randomized-controlled trial was conducted to evaluate the quality of a locally implemented model for OHH (n = 74) compared with SOC (n = 74). The model for OHH consisted of home administration of certain subcutaneous cancer drugs (full OHH) and home nursing assessments before ambulatory systemic cancer therapy (partial OHH). Quality was evaluated based on patient-reported quality of life (QoL) and related end points; service use and cost data; safety data; patient-reported satisfaction and preferences; and model efficiency. An equivalence design was used for primary end point analysis. Participants were followed during 12 weeks of systemic cancer treatment. RESULTS- This trial demonstrated equivalence of both models (OHH v SOC) in terms of patient-reported QoL (95% CI not exceeding the equivalence margin of 10%). Full OHH resulted in significantly less hospital visits (mean of 5.6 ± 3.0 v 13.2 ± 4.6; P = .011). Partial OHH reduced waiting times for therapy administration at the day care unit with 45% per visit (2 hours 36 minutes ± 1 hour 4 minutes v 4 hours ± 1 hour 4 minutes; P < .001). No safety issues were detected. Of the intervention group, 88% reported to be highly satisfied with the OHH model, and 77% reported a positive impact on their QoL. At study end, 60% of both study arms preferred OHH above SOC. CONCLUSION- The shift of particular procedures from the outpatient clinic to the patients' homes offers a high-quality and patient-centered alternative for a large proportion of patients with cancer. Further research is needed to evaluate potential cost-efficiency

    Impacts of urbanization on insect herbivory and plant defences in oak trees

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    Systematic comparisons of species interactions in urban versus rural environments can improve our understanding of shifts in ecological processes due to urbanization. However, such studies are relatively uncommon and the mechanisms driving urbanization effects on species interactions (e.g. between plants and insect herbivores) remain elusive. Here we investigated the effects of urbanization on leaf herbivory by insect chewers and miners associated with the English oak Quercus robur by sampling trees in rural and urban areas throughout most of the latitudinal distribution of this species. In performing these comparisons, we also controlled for the size of the urban areas (18 cities) and gathered data on CO emissions. In addition, we assessed whether urbanization affected leaf chemical defences (phenolic compounds) and nutritional traits (phosphorus and nitrogen), and whether such changes correlated with herbivory levels. Urbanization significantly reduced leaf chewer damage but did not affect leaf miners. In addition, we found that leaves from urban locations had lower levels of chemical defences (condensed and hydrolysable tannins) and higher levels of nutrients (nitrogen and phosphorus) compared to leaves in rural locations. The magnitude of urbanization effects on herbivory and leaf defences was not contingent upon city size. Importantly, while the effects of urbanization on chemical defences were associated with CO emissions, changes in leaf chewer damage were not associated with either leaf traits or CO levels. These results suggest that effects of urbanization on herbivory occur through mechanisms other than changes in the plant traits measured here. Overall, our simultaneous assessment of insect herbivory, plant traits and abiotic correlates advances our understanding of the main drivers of urbanization effects on plant–herbivore interactions.This research was financially supported by a Spanish National Research Grant (AGL2015-70748-R), a Regional Government of Galicia Grant (IN607D 2016/001) and the Ramón y Cajal Research Programme (RYC-2013-13230).Peer reviewe

    A randomised wait-list controlled trial to evaluate Emotional Freedom Techniques for self-reported cancer-related cognitive impairment in cancer survivors (EMOTICON)

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    Background Cancer-related cognitive impairment (CRCI) is a prevalent source of comprised quality of life in cancer survivors. This study evaluated the efficacy of Emotional Freedom Techniques (EFT) on self-reported CRCI (sr-CRCI). Methods In this prospective multicentre randomised wait-list controlled study (ClinicalTrials.gov Identifier: NCT02771028), eligible cancer survivors had completed curative treatment, were 18 years or older and screened positive for sr-CRCI with ≥ 43 on the Cognitive Failures Questionnaire (CFQ). Participants were randomised to the immediate treatment group (ITG) or wait-list control (WLC) group, based on age (< or ≥ 65 years), gender, treatment (chemotherapy or not), and centre. The ITG started to apply EFT after inclusion and performed this for 16 weeks. The WLC group could only start the application of EFT after 8 weeks of waiting. Evaluations took place at baseline (T0), 8 weeks (T1) and 16 weeks (T2). The primary outcome was the proportion of patients with sr-CRCI according to the CFQ score. Findings Between October 2016 and March 2020, 121 patients were recruited with CFQ ≥ 43 indicating sr-CRCI. At T1, the number of patients scoring positive on the CFQ was significantly reduced in the ITG compared to the WLC group (40.8% vs. 87.3% respectively; p<0.01). For the WLC group, a reduction in CFQ scores was observed at T2, comparable to the effect of the ITG at T1. Linear mixed model analyses indicated a statistically significant reduction in the CFQ score, distress, depressive symptoms, fatigue and also an improvement in quality of life. Interpretation This study provides evidence for the application of EFT for sr-CRCI in cancer survivors and suggests that EFT may be useful for other symptoms in cancer survivors

    Acupuncture as a Complementary Therapy for Cancer Care: Acceptability and Preferences of Patients and Informal Caregivers

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    Background: Acupuncture can effectively manage cancer-related side effects, for both patients undergoing treatment and for cancer survivors. It may also be effective in managing physiological and psychological symptoms common among informal caregivers of cancer patients. Objectives: The aim of this survey was to explore the acceptability and preferences of cancer patients, cancer survivors, and their informal caregivers in relation to acupuncture. Methods: The survey was conducted from 20th November to 27th November 2018. The questionnaire was developed to explore acceptability and preferences, including motivation, symptoms to be addressed, and practical issues (location, cost, etc.), in relation to acupuncture. Results: The survey response rate was 94.5% in cancer patients and cancer survivors and 100% in caregivers. Acceptability of acupuncture was 34.5% (n = 40/116) and 48.0% (n = 26/54) in cancer patients and caregivers, respectively. About 52.5% (n = 21/40) of patients preferred to undergo acupuncture at the day center clinic, whereas caregivers had no specific preference. Patients and cancer survivors would use acupuncture for symptoms of fatigue (60%), listlessness (57.5%), and pain (47.5%). Informal caregivers expressed an interest in using acupuncture for their pain, stress, and sleeping difficulties 48.0% (n = 26/54). Conclusion: Cancer patients, cancer survivors, and informal caregivers would accept acupuncture as a complementary therapy. This openness and preference to acupuncture provide the foundations for this complementary therapy to be incorporated into holistic and supportive cancer care, both for patients and those supporting them

    Impacts of urbanization on insect herbivory and plant defences in oak trees

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    Systematic comparisons of species interactions in urban versus rural environments can improve our understanding of shifts in ecological processes due to urbanization. However, such studies are relatively uncommon and the mechanisms driving urbanization effects on species interactions (e.g. between plants and insect herbivores) remain elusive. Here we investigated the effects of urbanization on leaf herbivory by insect chewers and miners associated with the English oak Quercus robur by sampling trees in rural and urban areas throughout most of the latitudinal distribution of this species. In performing these comparisons, we also controlled for the size of the urban areas (18 cities) and gathered data on CO 2 emissions. In addition, we assessed whether urbanization affected leaf chemical defences (phenolic compounds) and nutritional traits (phosphorus and nitrogen), and whether such changes correlated with herbivory levels. Urbanization significantly reduced leaf chewer damage but did not affect leaf miners. In addition, we found that leaves from urban locations had lower levels of chemical defences (condensed and hydrolysable tannins) and higher levels of nutrients (nitrogen and phosphorus) compared to leaves in rural locations. The magnitude of urbanization effects on herbivory and leaf defences was not contingent upon city size. Importantly, while the effects of urbanization on chemical defences were associated with CO 2 emissions, changes in leaf chewer damage were not associated with either leaf traits or CO 2 levels. These results suggest that effects of urbanization on herbivory occur through mechanisms other than changes in the plant traits measured here. Overall, our simultaneous assessment of insect herbivory, plant traits and abiotic correlates advances our understanding of the main drivers of urbanization effects on plant–herbivore interactions.info:eu-repo/semantics/acceptedVersio
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