100 research outputs found
Variation in reported experience of involvement in cancer treatment decision making: Evidence from the National Cancer Patient Experience Survey
This is the final version. Available on open access from Springer Nature via the DOI in this recordBackground: Exploring variation in patients' experiences of involvement in treatment decision making can identify groups needing extra support, such as additional consultation time, when considering treatment options. Methods: We analysed data from the 2010 English National Cancer Patient Experience Survey, a national survey of all patients attending hospitals in England for cancer treatment over a 3-month period, to examine how experience of involvement in decisions about treatment varied between patients with 38 different primary cancers using logistic regression. We analysed responses from 41 411 patients to a single question examining patient experience of involvement in treatment decision making. We calculated unadjusted odds ratios of reporting the most positive experience between patients of different sociodemographic and tumour characteristics and explored the effects of adjusting for age, gender, ethnicity, deprivation, cancer type and hospital of treatment.Results:Of the 41 441 respondents, 29 776 (72%) reported positive experiences of decision-making involvement. Younger patients reported substantially less positive experiences of involvement in decision making (adjusted OR=0.49 16-24 vs 65-74; P<0.001), as did ethnic minorities (adjusted ORs=0.52, 0.62 and 0.73 for Black, Chinese and Asian vs White patients, respectively; P<0.001). Experience varied considerably between patients with different cancers (e.g., OR=0.52 for anal and 1.37 for melanoma vs colon cancer; P<0.001), with ovarian, myeloma, bladder and rectal cancer patients reporting substantially worse experiences compared with other patients with gynaecological, haematological, urological and colorectal cancers, respectively. Clustering of different patient groups within hospitals with outlying performance report scores could not account for observed differences. Conclusion: Efforts to improve involvement in treatment decision making can focus on those who report the worst experience, in particular younger patients, ethnic minorities and patients with rectal, ovarian, multiple myeloma and bladder cancer. Β© 2013 Cancer Research UK. All rights reserved.National Institute for Health Research (NIHR
Accuracy of routinely recorded ethnic group information compared with self-reported ethnicity: Evidence from the English Cancer Patient Experience survey
This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordData sharing statement No additional data are available.Objective: To describe the accuracy of ethnicity coding in contemporary National Health Service (NHS) hospital records compared with the 'gold standard' of self-reported ethnicity. Design: Secondary analysis of data from a crosssectional survey (2011). Setting: All NHS hospitals in England providing cancer treatment. Participants: 58 721 patients with cancer for whom ethnicity information (Office for National Statistics 2001 16-group classification) was available from self-reports (considered to represent the 'gold standard') and their hospital record. Methods: We calculated the sensitivity and positive predictive value (PPV) of hospital record ethnicity. Further, we used a logistic regression model to explore independent predictors of discordance between recorded and self-reported ethnicity. Results: Overall, 4.9% (4.7-5.1%) of people had their self-reported ethnic group incorrectly recorded in their hospital records. Recorded White British ethnicity had high sensitivity (97.8% (97.7-98.0%)) and PPV (98.1% (98.0-98.2%)) for self-reported White British ethnicity. Recorded ethnicity information for the 15 other ethnic groups was substantially less accurate with 41.2% (39.7-42.7%) incorrect. Recorded 'Mixed' ethnicity had low sensitivity (12-31%) and PPVs (12- 42%). Recorded 'Indian', 'Chinese', 'Black-Caribbean' and 'Black African' ethnic groups had intermediate levels of sensitivity (65-80%) and PPV (80-89%, respectively). In multivariable analysis, belonging to an ethnic minority group was the only independent predictor of discordant ethnicity information. There was strong evidence that the degree of discordance of ethnicity information varied substantially between different hospitals (p<0.0001). Discussion: Current levels of accuracy of ethnicity information in NHS hospital records support valid profiling of White/non-White ethnic differences. However, profiling of ethnic differences in process or outcome measures for specific minority groups may contain a substantial and variable degree of misclassification error. These considerations should be taken into account when interpreting ethnic variation audits based on routine data and inform initiatives aimed at improving the accuracy of ethnicity information in hospital records. Copyright Β© 2013 BMJ Publishing Group. All rights reserved.National Institute for Health Research (NIHR
The Pattern Of Neurological Manifestations Of Tuberculosis Among Adult Sudanese Patients
Objective: To study the pattern of neurological manifestations of
tuberculosis among adult Sudanese tuberculous patients seen at El-Shaab
Teaching Hospital (Sudan).
Methods: This study was performed on 179 Sudanese patients with tuberculosis admitted at El-Shaab Teaching Hospital during the period from May 2005 to January 2006.
Demographic and clinical data were obtained. Investigations including CXR, sputum for acid
alcohol fast bacilli [AAFB], Mantoux test, complete haemogram were done. Screening for HIV, NC Study, EMG, CT, MRI of the brain or spinal cord were performed when indicated.
Results: Fifty seven out of 179 tuberculous patients had neurological complications. 22 presented with Pott\'s paraplegia, 18 with peripheral neuropathy, six had tubercloma, three with tuberculous meningitis, three had quadriplegia, two had hemiplegia, two had proximal myopathy and one had multiple cranial nerves palsies
CONCULSION: The study revealed high incidence of Potts paraplegia and peripheral neuropathy, this is most probably due to late presentation. Keywords: Pott\'s paraplegia, peripheral neuropathy, tubercloma, tuberculous meningitis, quadriplegia, hemiplegia, proximal myopathy Sudan Journal of Medical Sciences Vol. 3 (3) 2008: pp. 221-22
The Greening of Electricity Production in Palestine Through the Implementation of National Energy Strategies for Wiehe Development
Π Π΄Π°Π½Π½ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΏΠΎΠ΄ΡΠ΅ΡΠΊΠΈΠ²Π°Π΅ΡΡΡ, ΡΡΠΎ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌΠΈ Π²ΠΎΠ·ΠΎΠ±Π½ΠΎΠ²Π»ΡΠ΅ΠΌΡΠΌΠΈ ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠ°ΠΌΠΈ ΡΠ½Π΅ΡΠ³ΠΈΠΈ Π² ΠΠ°Π»Π΅ΡΡΠΈΠ½Π΅ ΡΠ²Π»ΡΡΡΡΡ ΡΠΎΠ»Π½Π΅ΡΠ½Π°Ρ ΡΠ½Π΅ΡΠ³ΠΈΡ, ΡΠ½Π΅ΡΠ³ΠΈΡ Π²Π΅ΡΡΠ° ΠΈ Π±ΠΈΠΎΠΌΠ°ΡΡΠ°, ΠΏΠΎΡΡΠΎΠΌΡ ΡΠ½Π΅ΡΠ³Π΅ΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΡ ΠΎΡ ΡΠΎΡΠ΅Π΄Π½ΠΈΡ
ΡΡΡΠ°Π½ ΠΌΠΎΠΆΠ΅Ρ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠ½ΠΈΠ·ΠΈΡΡΡΡ, Π΅ΡΠ»ΠΈ ΠΠ°Π»Π΅ΡΡΠΈΠ½Π° Π±ΡΠ΄Π΅Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ ΠΈΠΌΠ΅ΡΡΠΈΠ΅ΡΡ Π²ΠΎΠ·ΠΎΠ±Π½ΠΎΠ²Π»ΡΠ΅ΠΌΡΠ΅ ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠΈ ΡΠ½Π΅ΡΠ³ΠΈΠΈ. ΠΠΎΠ·ΠΎΠ±Π½ΠΎΠ²Π»ΡΠ΅ΠΌΡΠ΅ ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠΈ ΡΠ½Π΅ΡΠ³ΠΈΠΈ Π² ΠΠ°Π»Π΅ΡΡΠΈΠ½Π΅ ΠΎΡΠΊΡΡΠ²Π°ΡΡ Π½ΠΎΠ²ΡΠ΅ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Ρ Π΄Π»Ρ ΡΠ½Π΅ΡΠ³Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΅ΠΊΡΠΎΡΠ°, ΡΡΠΎΠ±Ρ ΠΏΠΎΠ΄ΡΠΎΠ»ΠΊΠ½ΡΡΡ ΠΏΡΠ°ΠΊΡΠΈΠΊΡ ΠΊ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΠΌΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ.This study highlights that the main renewable energy sources in Palestine are solar energy, wind energy and biomass, thereby the energy dependence on neighbouring countries may significantly decrease, when Palestine uses the available renewable energy sources. The renewable energies in Palestine open new perspectives for energy sector in order to prompt practices for sustainable development
Accuracy of routinely recorded ethnic group information compared with self-reported ethnicity: evidence from the English Cancer Patient Experience survey.
OBJECTIVE: To describe the accuracy of ethnicity coding in contemporary National Health Service (NHS) hospital records compared with the 'gold standard' of self-reported ethnicity. DESIGN: Secondary analysis of data from a cross-sectional survey (2011). SETTING: All NHS hospitals in England providing cancer treatment. PARTICIPANTS: 58 721 patients with cancer for whom ethnicity information (Office for National Statistics 2001 16-group classification) was available from self-reports (considered to represent the 'gold standard') and their hospital record. METHODS: We calculated the sensitivity and positive predictive value (PPV) of hospital record ethnicity. Further, we used a logistic regression model to explore independent predictors of discordance between recorded and self-reported ethnicity. RESULTS: Overall, 4.9% (4.7-5.1%) of people had their self-reported ethnic group incorrectly recorded in their hospital records. Recorded White British ethnicity had high sensitivity (97.8% (97.7-98.0%)) and PPV (98.1% (98.0-98.2%)) for self-reported White British ethnicity. Recorded ethnicity information for the 15 other ethnic groups was substantially less accurate with 41.2% (39.7-42.7%) incorrect. Recorded 'Mixed' ethnicity had low sensitivity (12-31%) and PPVs (12-42%). Recorded 'Indian', 'Chinese', 'Black-Caribbean' and 'Black African' ethnic groups had intermediate levels of sensitivity (65-80%) and PPV (80-89%, respectively). In multivariable analysis, belonging to an ethnic minority group was the only independent predictor of discordant ethnicity information. There was strong evidence that the degree of discordance of ethnicity information varied substantially between different hospitals (p<0.0001). DISCUSSION: Current levels of accuracy of ethnicity information in NHS hospital records support valid profiling of White/non-White ethnic differences. However, profiling of ethnic differences in process or outcome measures for specific minority groups may contain a substantial and variable degree of misclassification error. These considerations should be taken into account when interpreting ethnic variation audits based on routine data and inform initiatives aimed at improving the accuracy of ethnicity information in hospital records
The Effects of Thermal Procedure on Transformation Temperature, Crystal Structure and Microstructure of Cu-Al-Co Shape Memory Alloy
The purpose of this study is to investigate the effects of different thermal procedures of the Cu-Al-Co shape memory alloy on its crystal structure, transformation temperature and microstructure. The alloys were subjected to a heat treatment and then cooling was applied at four different conditions. After the thermal process, XRD, DSC, optical microscopy and micro-hardness measurements were carried out. The experimental studies showed that crystal structure, microstructure and transformation temperature of Cu-Al-Co alloy were changed from the cooling conditions
Type of RNA Packed in VLPs Impacts IgG Class Switching-Implications for an Influenza Vaccine Design
Nucleic acid packed within virus-like particles (VLPs) is shown to shape the immune response and to induce stronger B cell responses in different immunisation models. Here, using a VLP displaying the highly conserved extracellular domain of the M2 protein (M2e) from the influenza viruses as an antigen, we demonstrate that the type of RNA packaged into VLPs can alter the quality of the induced humoral response. By comparing prokaryotic RNA (pRNA), eukaryotic RNA (eRNA) and transfer RNA (tRNA), we find that pRNA induces the most protective IgG subclasses using a murine influenza model. We provide evidence that this process is predominantly dependent on endosomal Toll-like receptor (TLR7), and rule out a role for cytoplasmic mitochondrial antiviral signalling protein (MAVS) and its upstream retinoic acid-inducible gene-I-like receptors (RIG-I). Our findings provide considerations for the rational design of VLP-based vaccines and the immunomodulation exerted by TLR7 ligands packaged within the particles. Based on this work, we conclude that VLPs packing prokaryotic RNA must be preferred whenever a response dominated by IgG2 is desired, while eukaryotic RNA should be employed in order to induce a response dominated by IgG1
Compressive Response of Polycrystalline NiCoMnGa High-Temperature Meta-magnetic Shape Memory Alloys
The effects of the addition of quaternary element, Co, to polycrystalline NiMnGa alloys on their magnetic and shape memory properties have been investigated. NiCoMnGa polycrystalline alloys have been found to demonstrate good shape memory and superelasticity behavior under compression at temperatures greater than 100 Β°C with about 3% transformation strain and low-temperature hysteresis. It is also possible to train the material to demonstrate a large two-way shape memory effect
Infrared fiber based on AgCl-AgBr and AgBr-TlI crystals to transfer thermal radiation in pulsed
The our research objective is to study IR energy transfer in pulsed and continuous mode through optical fibers produced from crystals of silver halide and a monovalent thallium solid solutions. It is assumed that the transfer of infrared radiation in the pulsed mode will significantly reduce losses. We designed the experimental setup, determined its operational parameters, and obtained the dependence of the detector's received radiation on the frequency of the pulses of thermal radiation. As a research subjects we used two different fibers compositions namely AgCl0.25Br0.75 and Ag0.95Tl0.05Br0.95I0.05. Β© Published under licence by IOP Publishing Ltd.Council on grants of the President of the Russian Federation: SP-2455.2018.1The research has been supported by the grants of President of the Russian Federation SP-2455.2018.1
Thermal Conductivity Measurement of Infrared Optical Fibers Based on Silver Halide Solid Solution Crystals
The aim of the study is to measure the thermal conductivity of silver halide light guides based on crystals of the AgCl-AgBr system used in PSD production technologies. The conductivity temperature coefficient of the samples under study were determined by the laser flash method using the LFA 467 (Hyper Flash) installation. We studied mono- and polycrystalline samples of solid solutions with the composition AgCl0,25AgBr0,75 in the temperature range 298β523 K. The thermal conductivity of the investigated materials was then calculated using literature data on density and heat capacity. The thermal conductivity coefficient ranges from 0.80Β±0,04 to 0.53Β±0,03 (W/mΒ·K), depending on the microstructure of the sample. Β© 2021 Institute of Physics Publishing. All rights reserved.The research has been supported by the grants of President of the Russian Federation, MD-5324.2021.4
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