THE LIVED EXPERIENCES OF PARENTS WITH CHRONIC SORROW WHO ARE CARING FOR CHILDREN WITH A CHRONIC MEDICAL CONDITION

Caring for the millions of children living with a chronic medical condition creates multiple parental burdens. Parents whose children have a diagnosis of a chronic medical condition may experience an ongoing, unresolved grief or sadness phenomenon known as chronic sorrow. This may impact parental ability to manage their child’s health care needs and may lead to negative health outcomes for the parent caregiver, affected child, and the family. The aim of this interpretive phenomenological study was to understand the nature and meaning of the lived experiences of parents with chronic sorrow who are caring for a child with a chronic medical condition. A cohort of parent participants whose children have various chronic medical diagnoses was included to determine similarities as well as unique and diverse experiences of chronic sorrow. Data were collected through semi-structured interviews and analyzed for common themes. Demographic data, field notes and a reflexivity journal were important components of data analysis. Demographic data was analyzed using SPSS version 19 software. Six themes captured the nature and meaning of chronic sorrow for twelve participants and overarching truth of life goes on represented the six themes. Implications included early recognition of persons at risk and those who have chronic sorrow, development and testing of assessment tools, inclusion of fathers and children in future research, and inclusion of chronic sorrow content in curricula across the disciplines of healthcare

Topographic and stochastic influences on pāhoehoe lava lobe emplacement

A detailed understanding of pāhoehoe emplacement is necessary for developing accurate models of flow field development, assessing hazards, and interpreting the significance of lava morphology on Earth and other planetary surfaces. Active pāhoehoe lobes on Kīlauea Volcano, Hawai'i, were examined on 21–26 February 2006 using oblique time series stereo-photogrammetry and differential global positioning system measurements. During this time, the local discharge rate for peripheral lava lobes was generally constant at 0.0061±0.0019 m3/s, but the areal coverage rate of the lobes exhibited a periodic increase every 4.13±0.64 min. This periodicity is attributed to the time required for the pressure within the liquid lava core to exceed the cooling-induced strength of its margins. The pāhoehoe flow advanced through a series of down-slope and cross-slope breakouts, which began as ∼0.2-m-thick units (i.e., toes) that coalesced and inflated to become approximately meter-thick lobes. The lobes were thickest above the lowest points of the initial topography and above shallow to reverse-facing slopes, defined relative to the local flow direction. The flow path was typically controlled by high-standing topography, with the zone directly adjacent to the final lobe margin having an average relief that was a few centimeters higher than the lava-inundated region. This suggests that toe-scale topography can, at least temporarily, exert strong controls on pāhoehoe flow paths by impeding the lateral spreading of the lobe. Observed cycles of enhanced areal spreading and inflated lobe morphology are also explored using a model that considers the statistical likelihood of sequential breakouts from active flow margins and the effects of topographic barriers

Diffusion MRI fiber tractography of the brain

The ability of fiber tractography to delineate non-invasively the white matter fiber pathways of the brain raises possibilities for clinical applications and offers enormous potential for neuroscience. In the last decade, fiber tracking has become the method of choice to investigate quantitative MRI parameters in specific bundles of white matter. For neurosurgeons, it is quickly becoming an invaluable tool for the planning of surgery, allowing for visualization and localization of important white matter pathways before and even during surgery. Fiber tracking has also claimed a central role in the field of “connectomics,” a technique that builds and studies comprehensive maps of the complex network of connections within the brain, and to which significant resources have been allocated worldwide. Despite its unique abilities and exciting applications, fiber tracking is not without controversy, in particular when it comes to its interpretation. As neuroscientists are eager to study the brain's connectivity, the quantification of tractography-derived “connection strengths” between distant brain regions is becoming increasingly popular. However, this practice is often frowned upon by fiber-tracking experts. In light of this controversy, this paper provides an overview of the key concepts of tractography, the technical considerations at play, and the different types of tractography algorithm, as well as the common misconceptions and mistakes that surround them. We also highlight the ongoing challenges related to fiber tracking. While recent methodological developments have vastly increased the biological accuracy of fiber tractograms, one should be aware that, even with state-of-the-art techniques, many issues that severely bias the resulting structural “connectomes” remain unresolved