530 research outputs found

    Coping Strategies of Jordanian Adolescents With Cancer: An Interpretive Phenomenological Analysis Study

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    Interpretive phenomenological analysis methodology was used to explore coping strategies used by hospitalized Jordanian adolescents with cancer. In-depth face-to-face interviews were conducted with 10 Jordanian adolescents, aged 13 to18 years, who were receiving chemotherapy for cancer. During treatment, participants were confronted with physical, psychosocial, and emotional distresses resulting from the disease process, the treatment, and its associated side-effects. To cope with the impact of their illness, participants utilized 4 coping strategies: "Strengthening spiritual convictions," "Being optimistic and rebuilding hope," "Enhancing appearance," and "Finding self again." The findings of this study can assist health team members to promote positive psychological care to Arab Muslim adolescents with cancer in a supportive and therapeutic treatment environment

    Generating Individual Patient Preferences for the Treatment of Osteoarthritis Using Adaptive Choice-Based Conjoint (ACBC) Analysis.

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    INTRODUCTION: To explore how adaptive choice-based conjoint (ACBC) analysis could contribute to shared decision-making in the treatment of individual patients with osteoarthritis (OA). METHODS: In-depth case study of three individuals randomly selected from patients with OA participating in an ACBC analysis exercise. Eleven members of a research users' group participated in developing an ACBC task on medication preferences for OA. Individual medication priorities are illustrated by the detailed analysis of ACBC output from three randomly selected patients from the main sample. RESULTS: The case study analysis illustrates individual preferences. Participant 1's priority was avoidance of the four high-risk side effects of medication, which accounted for 90% of the importance of all attributes, while the remaining attributes (expected benefit; way of taking medication; frequency; availability) accounted only for 10% of the total influence. Participant 3 was similar to participant 1 but would accept a high risk of one of the side effects if the medication were available by prescription. In contrast, participant 2's priority was the avoidance of Internet purchase of medication; this attribute (availability) accounted for 52% of the importance of all attributes. CONCLUSIONS: Individual patients have preferences that likely lead to different medication choices. ACBC has the potential as a tool for physicians to identify individual patient preferences as a practical basis for concordant prescribing for OA in clinical practice. Future research needs to establish whether accurate knowledge of individual patient preferences for treatment attributes and levels translates into concordant behavior in clinical practice

    Modelling and Analysis of Stage-Structured Population Model with State-Dependent Maturation Delay and Harvesting

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    In 1992, Aiello, Freedman and Wu proposed a mathematical model of certain marine population in which the time from birth to maturity is directly related to the number of individuals present. In this paper we derive an alternative model where the immature birth rate is taken to be a non-monotone birth function in the kind seen in other frequently studied population model, the death rate for the matures is taken to be a general function, and with harvesting of the mature and immature populations. We study the dynamics of our model analytically, and we present results on positivity and boundedness. We also carry out a linearised analysis on the equilibria, which is algebraically very complicated in the case of the non-trivial equilibrium. We prove that the zero steady state is globally asymptotically stable in the situation when the positive equilibrium does not exist

    What went wrong? The flawed concept of cerebrospinal venous insufficiency

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    In 2006, Zamboni reintroduced the concept that chronic impaired venous outflow of the central nervous system is associated with multiple sclerosis (MS), coining the term of chronic cerebrospinal venous insufficiency ('CCSVI'). The diagnosis of 'CCSVI' is based on sonographic criteria, which he found exclusively fulfilled in MS. The concept proposes that chronic venous outflow failure is associated with venous reflux and congestion and leads to iron deposition, thereby inducing neuroinflammation and degeneration. The revival of this concept has generated major interest in media and patient groups, mainly driven by the hope that endovascular treatment of 'CCSVI' could alleviate MS. Many investigators tried to replicate Zamboni's results with duplex sonography, magnetic resonance imaging, and catheter angiography. The data obtained here do generally not support the 'CCSVI' concept. Moreover, there are no methodologically adequate studies to prove or disprove beneficial effects of endovascular treatment in MS. This review not only gives a comprehensive overview of the methodological flaws and pathophysiologic implausibility of the 'CCSVI' concept, but also summarizes the multimodality diagnostic validation studies and open-label trials of endovascular treatment. In our view, there is currently no basis to diagnose or treat 'CCSVI' in the care of MS patients, outside of the setting of scientific research

    Trends in prevalence, mortality, and disability-adjusted life-years relating to chronic obstructive pulmonary disease in Europe: an observational study of the global burden of disease database, 2001-2019

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    Introduction Chronic Obstructive Pulmonary Disease (COPD) is associated with significant mortality and well-defined aetiological factors. Previous reports indicate that mortality from COPD is falling worldwide. This study aims to assess the burden of COPD using prevalence, mortality, and disability-adjusted life years (DALYs) between 2001 and 2019 in 28 European countries (the European Union and the United Kingdom). Methods We extracted COPD data from the Global Burden of Disease database based on the International Classification of Diseases versions 10 (J41, 42, 43, 44 and 47). Age-standardised prevalence rates (ASPRs), age-standardised mortality rates (ASMRs), and DALYs were analysed for European countries by sex for each year (2001–2019) and reported per 100,000 population. We used Joinpoint regression analysis to quantify changing trends in the burden of COPD. Results In 2019, the median ASPR across Europe was 3230/100,000 for males and 2202/100,000 for females. Between 2001 and 2019, the median percentage change in ASPR was − 9.7% for males and 4.3% for females. 23/28 countries demonstrated a decrease in ASPRs in males, and 11/28 demonstrated a decrease in females. The median percentage change in ASMR between 2001 and 2019 was − 27.5% for males and − 10.4% for females. 25/28 and 19/28 countries demonstrated a decrease in ASMR in males and females, respectively. Conclusion In the EU between 2001 and 2019 COPD prevalence has overall increased in females but continues to decrease in males and in some countries, female prevalence now exceeds that of males. COPD mortality in the EU has decreased overall between 2001 and 2019; however, this decrease is not universal, particularly in females, and therefore remains a substantial source of amenable mortality

    Taphonomic and zooarchaeological investigations at the middle Pleistocene site of Ti's al Ghadah, western Nefud Desert, Saudi Arabia

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    In recent years, the Arabian Peninsula has emerged as a key region for elucidating hominin and faunal evolution and dispersals between Africa and Eurasia. Central to this research is the middle Pleistocene site of Ti's al Ghadah (TAG) which has yielded a diverse and abundant fossil faunal assemblage and the earliest chronometrically dated evidence for hominins in this part of the world. Here, we present the first detailed taphonomic study of the large Unit 5 fossil assemblage from the site. We aim to assess which actor/s were responsible for the accumulation of the assemblage and evaluate evidence that might be consistent with the accumulation of fauna by hominins. We also describe, for the first time, fossils and lithic artefacts from stratigraphic horizons not previously considered, providing taphonomic insights into their accumulation. The taphonomic work shows that the Unit 5 faunal assemblage was accumulated by ambush predators, likely large felids and hominins, in a lake side environment, and that carcasses were subsequently scavenged by more durophagus carnivores such as hyenas and canids. Less can be reliably said regarding the newly described fossil assemblages given their poor preservation and significant wind abrasion, but large carnivores again appear to have played a role, and hominins probably played a role in the accumulation of at least one of these. This study provides the first detail insights into the interplay between hominins, carnivores, and herbivores in Arabia, and suggests that watering holes have been a focus on the Arabian landscape for resources since the middle Pleistocene

    Trends of HIV-related cancer mortality between 2001 and 2018: an observational analysis

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    The burden of AIDS-defining cancers has remained relatively steady for the past two decades, whilst the burden of non-AIDS-defining cancer has increased. Here, we conduct a study to describe mortality trends attributed to HIV-associated cancers in 31 countries. We extracted HIV-related cancer mortality data from 2001 to 2018 from the World Health Organization Mortality Database. We computed age-standardized death rates (ASDRs) per 100,000 population using the World Standard Population. Data were visualized using Locally Weighted Scatterplot Smoothing (LOWESS). Data for females were available for 25 countries. Overall, there has been a decrease in mortality attributed to HIV-associated cancers among most of the countries. In total, 18 out of 31 countries (58.0%) and 14 out of 25 countries (56.0%) showed decreases in male and female mortality, respectively. An increasing mortality trend was observed in many developing countries, such as Malaysia and Thailand, and some developed countries, such as the United Kingdom. Malaysia had the greatest increase in male mortality (+495.0%), and Canada had the greatest decrease (-88.5%). Thailand had the greatest increase in female mortality (+540.0%), and Germany had the greatest decrease (-86.0%). At the endpoint year, South Africa had the highest ASDRs for both males (16.8/100,000) and females (19.2/100,000). The lowest was in Japan for males (0.07/100,000) and Egypt for females (0.028/100,000)

    Information security: Listening to the perspective of organisational insiders

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    Aligned with the strategy-as-practice research tradition, this article investigates how organisational insiders understand and perceive their surrounding information security practices, how they interpret them, and how they turn such interpretations into strategic actions. The study takes a qualitative case study approach, and participants are employees at the Research & Development department of a multinational original brand manufacturer. The article makes an important contribution to organisational information security management. It addresses the behaviour of organisational insiders – a group whose role in the prevention, response and mitigation of information security incidents is critical. The article identifies a set of organisational insiders’ perceived components of effective information security practices (organisational mission statement; common understanding of information security; awareness of threats; knowledge of information security incidents, routines and policy; relationships between employees; circulation of stories; role of punishment provisions; and training), based on which more successful information security strategies can be developed

    Epidemiological Impact of SARS-CoV-2 Vaccination: Mathematical Modeling Analyses.

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    This study aims to inform SARS-CoV-2 vaccine development/licensure/decision-making/implementation, using mathematical modeling, by determining key preferred vaccine product characteristics and associated population-level impacts of a vaccine eliciting long-term protection. A prophylactic vaccine with efficacy against acquisition (VES) ≥70% can eliminate the infection. A vaccine with VES <70% may still control the infection if it reduces infectiousness or infection duration among those vaccinated who acquire the infection, if it is supplemented with <20% reduction in contact rate, or if it is complemented with herd-immunity. At VES of 50%, the number of vaccinated persons needed to avert one infection is 2.4, and the number is 25.5 to avert one severe disease case, 33.2 to avert one critical disease case, and 65.1 to avert one death. The probability of a major outbreak is zero at VES ≥70% regardless of the number of virus introductions. However, an increase in social contact rate among those vaccinated (behavior compensation) can undermine vaccine impact. In addition to the reduction in infection acquisition, developers should assess the natural history and disease progression outcomes when evaluating vaccine impact
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