54 research outputs found
How to deal with institutional barriers
Item does not contain fulltextRelatively little is known about why some patients are reluctant to engage in a collaborative discussion with physicians about their choices in health care. To explore this issue further, we conducted six focus-group sessions with forty-eight people in the San Francisco Bay Area. In the focus groups, we found that participants voiced a strong desire to engage in shared decision making about treatment options with their physicians. However, several obstacles inhibit those discussions. These include the fact that even relatively affluent and well-educated patients feel compelled to conform to socially sanctioned roles and defer to physicians during clinical consultations; that physicians can be authoritarian; and that the fear of being categorized as "difficult" prevents patients from participating more fully in their own health care. We argue that physicians may not be aware of a need to create a safe environment for open communication to facilitate shared decision making. Rigorous measures of patient engagement, and of the degree to which health care decisions truly reflect patient preferences, are needed to advance shared decision making in clinical practice.1 mei 201
Recommended from our members
Stability design considerations for mirror support systems in ICF lasers
Some of the major components of laser systems used for Inertial Confinement Fusion (ICF) are the large aperture mirrors which direct the path of the laser. These mirrors are typically supported by systems which consist of mirror mounts, mirror enclosures, superstructures, and foundations. Stability design considerations for the support systems of large aperture mirrors have been developed based on the experience of designing and evaluating similar systems at the Lawrence Livermore National Laboratory (LLNL). Examples of the systems developed at LLNL include Nova, the Petawatt laser, Beamlet, and the National Ignition Facility (NIF). The structural design of support systems of large aperture mirrors has typically been controlled by stability considerations in order for the large laser system to meet its performance requirements for alignment and positioning. This paper will discuss the influence of stability considerations and will provide guidance on the structural design and evaluation of mirror support systems in ICF lasers so that this information can be used on similar systems
Recommended from our members
Design of the Backscatter Spectroscopy System for the Nova Laser Facility
When the laser light is focused onto a target, a number of mechanisms can reflect or scatter the light back through the focus lens. The Backscatter Spectroscopy System (BSS) is a diagnostic that measures the properties of this reflected or scattered light. Just before the main focus lens on each of the ten Nova arms is a KDP crystal array for converting the 1 ..mu..m laser light to shorter harmonic wavelengths. This array rotates approx.10/sup 0/ about the beam axis to select the 351 nm wavelength where most of the experiments are run. The BSS consists of a fused silica plate inserted into one of the beam lines before the KDP array. The reflector plate is shaped like one of the array elements and is aligned with it to minimize the effects of diffraction. The plate is mounted in a mechanism to allow alignment, as well as rotation with the KDP array when the converted wavelength is changed. The plate is mounted 10/sup 0/ off normal so that light can be reflected out of the beam tube. Roughly 4% of target-reflected light reflects off this plate and is transported to an optics table where it is analyzed. To transport the light to the optics table, an alignment insensitive relay lens system is used with a vacuum cell and turning mirrors. The instrumentation on the table includes a 0.5 meter spectrometer with an optical streak camera for time-resolved spectral information, a small photodiode array for intensity data, and a film pack for beam structure and system alignment information. 1 ref., 5 figs
Chemical composition of essential oils and anticholinesterasic activity of Eugenia sulcata Spring ex Mart.
The chemical composition of the essential oils from leaves and stems of Eugenia sulcata Spring ex Mart., obtained by hydrodistillation, was analyzed by GC-MS and quantified by CG-FID. In all, 37 components were identified and sesquiterpenes represented the largest fraction of both oils, in the leaves (58.2 %) and stems (85.3 %). The major constituent found in the essential oil from leaves and stems of E. sulcata was β-caryophyllene, corresponding to 24.6 % and 18.8 %, respectively. The substances α- cubebene (1.1 %), β-copaene (0.5 %), cis-muurola-3,5-diene (0.6 %), cis-muurola-4(14),5-diene (1.3 %), γ- himachalene (2.0 %), epizonarene (0.8 %), trans-calamenene (4.4 %) and trans-cadina-1,4-diene (3.4 %) were identified for the first time as chemical constituents of essential oil from leaves of E. sulcata. To our knowledge, this was the first phytochemical contribution to the essential oil from stems of E. sulcata. It was also performed the acetylcholinesterase inhibitory bioassay of the essential oil from leaves of E. sulcata, which was considered active and exhibited an IC50 value of 4.66 ± 0.48 μg.mL-1.Colegio de Farmacéuticos de la Provincia de Buenos Aire
Cardiovascular effects of the essential oil from leaves of Eugenia sulcata in spontaneously hypertensive rats
ABSTRACT Eugenia sulcata, Spring ex Mart, Myrtaceae, was collected in Restinga de Jurubatiba National Park (RJ, Brazil). Leaves from this species were submitted to hydrodistillation in order to obtain the essential oil. Sesquiterpenes were the main group found (58.2%), and β-caryophyllene was the major constituent (24.6%). Effects of this essential oil on hemodynamic and cardiovascular parameters were evaluated in spontaneously hypertensive rats and Wistar Kyoto rats. The essential oil significantly decreased the systolic (P<0.05) and diastolic (P<0.01) blood pressure in spontaneously hypertensive rats. It was also observed that the essential oil did not interfere with heart rate of rats. The present study reports for the first time the antihypertensive activity of the essential oil extracted from Eugenia sulcata leaves
Comparative study and anticholinesterasic evaluation of essential oils from leaves, stems and flowers of myrciaria floribunda (H.West ex Willd.) O. Berg
Myrciaria floribunda (H.West ex Willd.) O.Berg, Myrtaceae, popularly known as “camboim amarelo”, was collected in Restinga de Jurubatiba (RJ, Brazil). Leaves, stems and flowers were individually submitted to hydrodistillation, affording the respective essential oils. Monoterpenes were the main group of essential oils from leaves (53.9 %) and flowers (55.4 %). Sesquiterpenes were more representative in stems (72.2 %). 1,8-cineole was the major constituent in the essential oil from leaves (38.4 %) and flowers (22.8 %). The major constituent from stems was (2E,6E)-farnesyl acetate (19.9 %). To our knowledge, these are the first contributions for essential oils from stems and flowers of M. floribunda. It was also performed the acetylcholinesterase inhibitory bioassay of the essential oil from stems, flowers and leaves of M.
floribunda. Flowers and leaves oils had an IC50 of 1583 and 681 μg/mL, respectively, being both low to mild values.Colegio de Farmacéuticos de la Provincia de Buenos Aire
Chemical and biological study of essential oils from <i>Eugenia pruniformis</i> Cambess., an endemic species from Brazilian Atlantic Forest
Eugenia pruniformis Cambess. is an endemic species from Brazilian Atlantic Forest. Essential oils from leaves and fruits from this species were obtained by hydrodistillation and analyzed by GCMS/CG-FID. In all, 25 compounds were identified, with predominance of sesquiterpene hydrocarbons in both plant parts. The major compounds were β-caryophyllene, bicyclogermacrene, germacrene D, δ- cadinene and α-copaene. Antioxidant activity was performed for essential oil from leaves using ORAC method, showing value of 0.30 ± 0.06 mmol TE/g. Anticholinesterasic evaluation was also performed for this oil, indicating that it inhibited acetylcholinesterase, showing an IC50 of 1798 μg/mL. These results indicate that this essential oil may be considered as a potential source of substances for Alzheimer’s disease Treatment. To our knowledge, these are the first contributions to biological and phytochemical characterization of E. pruniformis, an almost unexplored species from Brazilian Atlantic Forest.Colegio de Farmacéuticos de la Provincia de Buenos Aire
Recommended from our members
The Advanced Radiographic Capability, A Major Upgrade Of The Computer Controls For The National Ignition Facility*
Recommended from our members
10-kJ Status and 100-kJ Future for NIF PetaWatt Technology
We discuss the status of the NIF ARC, an 8-beam 10-kJ class high-energy petawatt laser, and the future upgrade path of this and similar systems to 100-kJ-class with coherent phasing of multiple apertures
- …