“I wish I’d told them”: a qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment

<b>Objective</b> To gain insight into patients' experiences of follow-up care after treatment for prostate cancer and identify unmet psychosexual needs.<p></p> <b>Methods</b> Semi-structured interviews were conducted with a purposive sample of 35 patients aged 59-82 from three UK regions. Partners were included in 18 interviews. Data were analyzed using constant comparison. <p></p> <b>Results</b> (1) Psychosexual problems gained importance over time, (2) men felt they were rarely invited to discuss psychosexual side effects within follow-up appointments and lack of rapport with health care professionals made it difficult to raise problems themselves, (3) problems were sometimes concealed or accepted and professionals' attempts to explore potential difficulties were resisted by some, and (4) older patients were too embarrassed to raise psychosexual concerns as they felt they would be considered 'too old' to be worried about the loss of sexual function.<p></p> <b>Conclusion</b> Men with prostate cancer, even the very elderly, have psychosexual issues for variable times after diagnosis. These are not currently always addressed at the appropriate time for the patient.Practice implications Assessments of psychosexual problems should take place throughout the follow-up period, and not only at the time of initial treatment. Further research examining greater willingness or reluctance to engage with psychosexual interventions may be particularly helpful in designing future intervention

Experimental time to burnout of a prototypical ITER divertor plate during a simulated loss of flow accident

Under the sponsorship of the Department of Energy, Office of Utility Technologies, the Energy Storage System Analysis and Development Department at Sandia National Laboratories (SNL) conducted a cost analysis of energy storage systems for electric utility applications. The scope of the study included the analysis of costs for existing and planned battery, SMES, and flywheel energy storage systems. The analysis also identified the potential for cost reduction of key components

A review of the US joining technologies for plasma facing components in the ITER fusion reactor

This paper is a review of the current joining technologies for plasma facing components in the US for the International Thermonuclear Experimental Reactor (ITER) project. Many facilities are involved in this project. Many unique and innovative joining techniques are being considered in the quest to join two candidate armor plate materials (beryllium and tungsten) to a copper base alloy heat sink (CuNiBe, OD copper, CuCrZr). These techniques include brazing and diffusion bonding, compliant layers at the bond interface, and the use of diffusion barrier coatings and diffusion enhancing coatings at the bond interfaces. The development and status of these joining techniques will be detailed in this report

An alternative model of the magnetic cataclysmic variable V1432 Aquilae (=RX J1940.1-1025)

V1432 Aql is currently considered to be an asynchronous AM Her type system, with an orbital period of 12116.3 s and a spin period of 12150 s. I present an alternative model in which V1432 Aql is an intermediate polar with disk overflow or diskless accretion geometry, with a spin period near 4040 s. I argue that published data are insufficient to distinguish between the two models; instead, I provide a series of predictions of the two models that can be tested against future observations.Comment: 10 pages LaTeX including 3 Postscript Figures, to be published in Ap

Electron localization : band-by-band decomposition, and application to oxides

Using a plane wave pseudopotential approach to density functional theory we investigate the electron localization length in various oxides. For this purpose, we first set up a theory of the band-by-band decomposition of this quantity, more complex than the decomposition of the spontaneous polarization (a related concept), because of the interband coupling. We show its interpretation in terms of Wannier functions and clarify the effect of the pseudopotential approximation. We treat the case of different oxides: BaO, $\alpha$-PbO, BaTiO$_3$ and PbTiO$_3$. We also investigate the variation of the localization tensor during the ferroelectric phase transitions of BaTiO$_3$ as well as its relationship with the Born effective charges

Multipole Amplitudes of Pion Photoproduction on Nucleons up to 2GeV within Dispersion Relations and Unitary Isobar Model

Two approaches for analysis of pion photo- and electroproduction on nucleons in the resonance energy region are checked at $Q^2=0$ using the results of GWU(VPI) partial-wave analysis of photoproduction data. The approaches are based on dispersion relations and unitary isobar model. Within dispersion relations good description of photoproduction multipoles is obtained up to $W=1.8 GeV$. Within unitary isobar model, modified with increasing energy by incorporation of Regge poles, and with unified Breit-Wigner parametrization of resonance contributions, good description of photoproduction multipoles is obtained up to $W=2 GeV$.Comment: 23 pages, LaTe

A Pearson-Dirichlet random walk

A constrained diffusive random walk of n steps and a random flight in Rd, which can be expressed in the same terms, were investigated independently in recent papers. The n steps of the walk are identically and independently distributed random vectors of exponential length and uniform orientation. Conditioned on the sum of their lengths being equal to a given value l, closed-form expressions for the distribution of the endpoint of the walk were obtained altogether for any n for d=1, 2, 4 . Uniform distributions of the endpoint inside a ball of radius l were evidenced for a walk of three steps in 2D and of two steps in 4D. The previous walk is generalized by considering step lengths which are distributed over the unit (n-1) simplex according to a Dirichlet distribution whose parameters are all equal to q, a given positive value. The walk and the flight above correspond to q=1. For any d >= 3, there exist, for integer and half-integer values of q, two families of Pearson-Dirichlet walks which share a common property. For any n, the d components of the endpoint are jointly distributed as are the d components of a vector uniformly distributed over the surface of a hypersphere of radius l in a space Rk whose dimension k is an affine function of n for a given d. Five additional walks, with a uniform distribution of the endpoint in the inside of a ball, are found from known finite integrals of products of powers and Bessel functions of the first kind. They include four different walks in R3 and two walks in R4. Pearson-Liouville random walks, obtained by distributing the total lengths of the previous Pearson-Dirichlet walks, are finally discussed.Comment: 33 pages 1 figure, the paper includes the content of a recently submitted work together with additional results and an extended section on Pearson-Liouville random walk

A pilot randomised controlled trial of personalised care after treatment for prostate cancer (TOPCAT-P): nurse-led holistic-needs assessment and individualised psychoeducational intervention: study protocol

INTRODUCTION. Prostate cancer is common and the incidence is increasing, but more men are living longer after diagnosis, and die with their disease rather than of it. Nonetheless, specific and substantial physical, sexual, emotional and mental health problems often lead to a poor quality of life. Urology services increasingly struggle to cope with the demands of follow-up care, and primary care is likely to play the central role in long-term follow-up. The present phase II trial will evaluate the feasibility and acceptability of a nurse-led, person-centred psychoeducational intervention, delivered in community or primary care settings. METHODS AND ANALYSIS. Prostate cancer survivors diagnosed in the past 9-48 months and currently biochemically stable will be identified from hospital records by their treating clinician. Eligible men would have either completed radical treatment, or would be followed up with prostate specific antigen monitoring and symptom reporting. We will recruit 120 patients who will be randomised to receive either an augmented form of usual care, or an additional nurse-led intervention for a period of 36 weeks. Following the health policy in Wales, the intervention is offered by a key worker, is promoting prudent healthcare and is using a holistic needs assessment. Outcome measures will assess physical symptoms, psychological well-being, confidence in managing own health and quality of life. Healthcare service use will be measured over 36 weeks. Feedback interviews with patients and clinicians will further inform the acceptability of the intervention. Recruitment, attrition, questionnaire completion rates and outcome measures variability will be assessed, and results will inform the design of a future phase III trial and accompanying economic evaluation. ETHICS AND DISSEMINATION. Ethics approval was granted by Bangor University and North Wales REC (13/WA/0291). Results will be reported in peer-reviewed publications, at scientific conferences, and directly through national cancer and primary care networks. TRIAL REGISTRATION NUMBER. ISRCTN 34516019