1,674 research outputs found
The role of recovered envelope cues in the identification of temporal-fine-structure speech for hearing-impaired listeners
Narrowband speech can be separated into fast temporal cues [temporal fine structure (TFS)], and slow amplitude modulations (envelope). Speech processed to contain only TFS leads to envelope recovery through cochlear filtering, which has been suggested to account for TFS-speech intelligibility for normal-hearing listeners. Hearing-impaired listeners have deficits with TFS-speech identification, but the contribution of recovered-envelope cues to these deficits is unknown. This was assessed for hearing-impaired listeners by measuring identification of disyllables processed to contain TFS or recovered-envelope cues. Hearing-impaired listeners performed worse than normal-hearing listeners, but TFS-speech intelligibility was accounted for by recovered-envelope cues for both groups.National Institutes of Health (U.S.) (Grant R43 DC013006)National Institutes of Health (U.S.) (Grant R01 DC00117
Physiciansâ views on the role of relatives in euthanasia and physician-assisted suicide decision-making:a mixed-methods study among physicians in the Netherlands
Background: Relatives have no formal position in the practice of euthanasia and physician-assisted suicide (EAS) according to Dutch legislation. However, research shows that physicians often involve relatives in EAS decision-making. It remains unclear why physicians do (not) want to involve relatives. Therefore, we examined how many physicians in the Netherlands involve relatives in EAS decision-making and explored reasons for (not) involving relatives and what involvement entails. Methods: In a mixed-methods study, 746 physicians (33% response rate) completed a questionnaire, and 20 were interviewed. The questionnaire included two statements on relativesâ involvement in EAS decision-making. Descriptive statistics were used, and multivariable logistic regression analyses to explore characteristics associated with involving relatives. In subsequent interviews, we explored physiciansâ views on involving relatives in EAS decision-making. Interviews were thematically analysed. Results:The majority of physicians want to know relativesâ opinions about an EAS request (80%); a smaller group also takes these opinions into account in EAS decision-making (35%). Physicians who had ever received an explicit EAS request were more likely to want to know opinions and clinical specialists and elderly care physicians were more likely to take these opinions into account. In interviews, physicians mentioned several reasons for involving relatives: e.g. to give relatives space and help them in their acceptance, to tailor support, to be able to perform EAS in harmony, and to mediate in case of conflicting views. Furthermore, physicians explained that relativesâ opinions can influence the decision-making process but cannot be a decisive factor. If relatives oppose the EAS request, physicians find the process more difficult and try to mediate between patients and relatives by investigating relativesâ objections and providing appropriate information. Reasons for not taking relativesâ opinions into account include not wanting to undermine patient autonomy and protecting relatives from a potential burdensome decision. Conclusions: Although physicians know that relatives have no formal role, involving relatives in EAS decision-making is common practice in the Netherlands. Physicians consider this important as relatives need to continue with their lives and may need bereavement support. Additionally, physicians want to perform EAS in harmony with everyone involved. However, relativesâ opinions are not decisive.</p
Physiciansâ views on the role of relatives in euthanasia and physician-assisted suicide decision-making:a mixed-methods study among physicians in the Netherlands
Background: Relatives have no formal position in the practice of euthanasia and physician-assisted suicide (EAS) according to Dutch legislation. However, research shows that physicians often involve relatives in EAS decision-making. It remains unclear why physicians do (not) want to involve relatives. Therefore, we examined how many physicians in the Netherlands involve relatives in EAS decision-making and explored reasons for (not) involving relatives and what involvement entails. Methods: In a mixed-methods study, 746 physicians (33% response rate) completed a questionnaire, and 20 were interviewed. The questionnaire included two statements on relativesâ involvement in EAS decision-making. Descriptive statistics were used, and multivariable logistic regression analyses to explore characteristics associated with involving relatives. In subsequent interviews, we explored physiciansâ views on involving relatives in EAS decision-making. Interviews were thematically analysed. Results:The majority of physicians want to know relativesâ opinions about an EAS request (80%); a smaller group also takes these opinions into account in EAS decision-making (35%). Physicians who had ever received an explicit EAS request were more likely to want to know opinions and clinical specialists and elderly care physicians were more likely to take these opinions into account. In interviews, physicians mentioned several reasons for involving relatives: e.g. to give relatives space and help them in their acceptance, to tailor support, to be able to perform EAS in harmony, and to mediate in case of conflicting views. Furthermore, physicians explained that relativesâ opinions can influence the decision-making process but cannot be a decisive factor. If relatives oppose the EAS request, physicians find the process more difficult and try to mediate between patients and relatives by investigating relativesâ objections and providing appropriate information. Reasons for not taking relativesâ opinions into account include not wanting to undermine patient autonomy and protecting relatives from a potential burdensome decision. Conclusions: Although physicians know that relatives have no formal role, involving relatives in EAS decision-making is common practice in the Netherlands. Physicians consider this important as relatives need to continue with their lives and may need bereavement support. Additionally, physicians want to perform EAS in harmony with everyone involved. However, relativesâ opinions are not decisive.</p
Casimir-Polder interaction between an atom and a small magnetodielectric sphere
On the basis of macroscopic quantum electrodynamics and point-scattering
techniques, we derive a closed expression for the Casimir-Polder force between
a ground-state atom and a small magnetodielectric sphere in an arbitrary
environment. In order to allow for the presence of both bodies and media,
local-field corrections are taken into account. Our results are compared with
the known van der Waals force between two ground-state atoms. To continuously
interpolate between the two extreme cases of a single atom and a macroscopic
sphere, we also derive the force between an atom and a sphere of variable
radius that is embedded in an Onsager local-field cavity. Numerical examples
illustrate the theory.Comment: 9 pages, 4 figures, minor addition
Local-field correction to one- and two-atom van der Waals interactions
Based on macroscopic quantum electrodynamics in linearly and causally
responding media, we study the local-field corrected van der Waals potentials
and forces for unpolarized ground-state atoms placed within a magnetoelectric
medium of arbitrary size and shape. We start from general expressions for the
van der Waals potentials in terms of the (classical) Green tensor of the
electromagnetic field and the atomic polarizability and incorporate the
local-field correction by means of the real-cavity model. In this context,
special emphasis is given to the decomposition of the Green tensor into a
medium part multiplied by a global local-field correction factor and, in the
single-atom case, a part that only depends on the cavity characteristics. The
result is used to derive general formulas for the local-field corrected van der
Waals potentials and forces. As an application, we calculate the van der Waals
potential between two ground-state atoms placed within magnetoelectric bulk
material.Comment: 9 pages, 2 figures, corrections according to erratu
Self-regulated learning in the clinical context:A systematic review
OBJECTIVES: Research has suggested beneficial effects of self-regulated learning (SRL) for medical students' and residents' workplace-based learning. Ideally, learners go through a cyclic process of setting learning goals, choosing learning strategies and assessing progress towards goals. A clear overview of medical students' and residents' successful key strategies, influential factors and effective interventions to stimulate SRL in the workplace is missing. This systematic review aims to provide an overview of and a theoretical base for effective SRL strategies of medical students and residents for their learning in the clinical context.METHODS: This systematic review was conducted according to the guidelines of the Association for Medical Education in Europe. We systematically searched PubMed, EMBASE, Web of Science, PsycINFO, ERIC and the Cochrane Library from January 1992 to July 2016. Qualitative and quantitative studies were included. Two reviewers independently performed the review process and assessed the methodological quality of included studies. A total of 3341 publications were initially identified and 18 were included in the review.RESULTS: We found diversity in the use of SRL strategies by medical students and residents, which is linked to individual (goal setting), contextual (time pressure, patient care and supervision) and social (supervisors and peers) factors. Three types of intervention were identified (coaching, learning plans and supportive tools). However, all interventions focused on goal setting and monitoring and none on supporting self-evaluation.CONCLUSIONS: Self-regulated learning in the clinical environment is a complex process that results from an interaction between person and context. Future research should focus on unravelling the process of SRL in the clinical context and specifically on how medical students and residents assess their progress towards goals.</p
Awareness of dying: it needs words
Purpose: The purpose of this research is to study to what extent dying patients are aware of the imminence of death, whether such awareness is associated with patient characteristics, symptoms and acceptance of dying, and whether medical records and nurses' and family caregivers' views on patients' awareness of dying agree. Methods: Nurses and family caregivers of 475 deceased patients from three different care settings in the southwest Netherlands were requested to fill out questionnaires. The two groups were asked whether a patient had been aware of the imminence of death. Also, medical records were screened for statements indicating that the patient had been informed of the imminence of death. Results: Nurses completed questionnaires about 472 patients, family caregivers about 280 patients (response 59%). According to the medical records, 51% of patients had been aware of the imminence of death; according to nurses, 58%; according to family caregivers, 62%. Patients who, according to their family caregiver, had been aware of the imminence of death were significantly more often in peace with dying and felt more often that life had been worth living. Inter-rater agreement on patients' awareness of dying was fair (Cohen's kappa = 0.23-0.31). Conclusions: Being aware of dying is associated with acceptance of dying, which supports the idea that open communication in the dying phase can contribute to the quality of the dying process. However, views on whether or not patients are aware of the imminence of death diverge between different caregivers. This suggests that communication in the dying phase of patients is open for improvement
Solar neutrino detection in a large volume double-phase liquid argon experiment
Precision measurements of solar neutrinos emitted by specific nuclear
reaction chains in the Sun are of great interest for developing an improved
understanding of star formation and evolution. Given the expected neutrino
fluxes and known detection reactions, such measurements require detectors
capable of collecting neutrino-electron scattering data in exposures on the
order of 1 ktonne yr, with good energy resolution and extremely low background.
Two-phase liquid argon time projection chambers (LAr TPCs) are under
development for direct Dark Matter WIMP searches, which possess very large
sensitive mass, high scintillation light yield, good energy resolution, and
good spatial resolution in all three cartesian directions. While enabling Dark
Matter searches with sensitivity extending to the "neutrino floor" (given by
the rate of nuclear recoil events from solar neutrino coherent scattering),
such detectors could also enable precision measurements of solar neutrino
fluxes using the neutrino-electron elastic scattering events. Modeling results
are presented for the cosmogenic and radiogenic backgrounds affecting solar
neutrino detection in a 300 tonne (100 tonne fiducial) LAr TPC operating at
LNGS depth (3,800 meters of water equivalent). The results show that such a
detector could measure the CNO neutrino rate with ~15% precision, and
significantly improve the precision of the 7Be and pep neutrino rates compared
to the currently available results from the Borexino organic liquid
scintillator detector.Comment: 21 pages, 7 figures, 6 table
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