A blended electronic illness management and recovery program for people with severe mental illness : qualitative process evaluation alongside a randomized controlled trial

Background: We conducted a trial to test the electronic Illness Management and Recovery (e-IMR) intervention to provide conclusions on the potential efficacy of eHealth for people with severe mental illness (SMI). In the e-IMR intervention, we used the standard IMR program content and methodology and combined face-to-face sessions with internet-based strategies on the constructed e-IMR internet platform. During the trial, the e-IMR platform was sparsely used. Objective: This study aimed to evaluate the added value of the e-IMR intervention and the barriers and facilitators that can explain the low use of the e-IMR platform. Methods: This process evaluation was designed alongside a multicenter, cluster randomized controlled trial. In this study, we included all available participants and trainers from the intervention arm of the trial. Baseline characteristics were used to compare users with nonusers. Qualitative data were gathered at the end of the semistructured interviews. Using theoretical thematic analyses, the data were analyzed deductively using a pre-existing coding frame. Results: Out of 41 eligible participants and 14 trainers, 27 participants and 11 trainers were interviewed. Of the 27 participants, 10 were identified as users. eHealth components that had added value were the persuasive nature of the goal-tracking sheets, monitoring, and the peer testimonials, which had the potential to enhance group discussions and disclosure by participants. The low use of the e-IMR platform was influenced by the inflexibility of the platform, the lack of information technology (IT) resources, the group context, participants' low computer skills and disabilities, and the hesitant eHealth attitude of the trainers. Conclusions: The extent of eHealth readiness and correlations with vulnerabilities in persons with SMI need further investigation. This study shows that flexible options were needed for the use of e-IMR components and that options should be provided only in response to a participant's need. Use of the e-IMR intervention in the future is preconditioned by checking the available IT resources (such as tablets for participants) providing computer or internet guidance to participants outside the group sessions, evaluating the eHealth attitude and skills of trainers, and tailoring eHealth training to increase the skills of future e-IMR trainers

Pimonidazole binding in C6 rat brain glioma: relation with lipid droplet detection

Item does not contain fulltextIn C6 rat brain glioma, we have investigated the relation between hypoxia and the presence of lipid droplets in the cytoplasm of viable cells adjacent to necrosis. For this purpose, rats were stereotaxically implanted with C6 cells. Experiments were carried out by the end of the tumour development. A multifluorescence staining protocol combined with digital image analysis was used to quantitatively study the spatial distribution of hypoxic cells (pimonidazole), blood perfusion (Hoechst 33342), total vascular bed (collagen type IV) and lipid droplets (Red Oil) in single frozen sections. All tumours (n=6) showed necrosis, pimonidazole binding and lipid droplets. Pimonidazole binding occurred at a mean distance of 114 microm from perfused vessels mainly around necrosis. Lipid droplets were principally located in the necrotic tissue. Some smaller droplets were also observed in part of the pimonidazole-binding cells surrounding necrosis. Hence, lipid droplets appeared only in hypoxic cells adjacent to necrosis, at an approximate distance of 181 microm from perfused vessels. In conclusion, our results show that severe hypoxic cells accumulated small lipid droplets. However, a 100% colocalisation of hypoxia and lipid droplets does not exist. Thus, lipid droplets cannot be considered as a surrogate marker of hypoxia, but rather of severe, prenecrotic hypoxia

Interventions for treating asymptomatic impacted wisdom teeth in adolescents and adults

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.TG Mettes, MEL Nienhuijs, WJM van der Sanden, EH Verdonschot, AJM Plasschaer

Towards a knowledge-rich learning environment in preparatory secondary education

In this case study a novel educational programme for students in preparatory vocational education was studied. The research questions were: (1) Which teaching/learning processes occur in a simulated workplace using the concept of a knowledge-rich workplace? (2) What is the role of models and modelling in the teaching/learning processes? The curriculum project consisted of design and construction tasks. The students were collaboratively involved in the process of designing a tricycle for a real customer. This real-life activity creates opportunities for students to develop and use models, which can be used in more than in one context. The case study explored how the teachers deal with the students' explicit and implicit need for knowledge and skills. The main findings are that teachers more often provide this knowledge, rather than guide the students in reconstructing it, and towards the end of the project, knowledge tended to remain situated

Study protocol of the TIRED study:A randomised controlled trial comparing either graded exercise therapy for severe fatigue or cognitive behaviour therapy with usual care in patients with incurable cancer

Background: Fatigue is a common and debilitating symptom for patients with incurable cancer receiving systemic treatment with palliative intent. There is evidence that non-pharmacological interventions such as graded exercise therapy (GET) or cognitive behaviour therapy (CBT) reduce cancer-related fatigue in disease-free cancer patients and in patients receiving treatment with curative intent. These interventions may also result in a reduction of fatigue in patients receiving treatment with palliative intent, by improving physical fitness (GET) or changing fatigue-related cognitions and behaviour (CBT). The primary aim of our study is to assess the efficacy of GET or CBT compared to usual care (UC) in reducing fatigue in patients with incurable cancer. Methods: The TIRED study is a multicentre three-armed randomised controlled trial (RCT) for incurable cancer patients receiving systemic treatment with palliative intent. Participants will be randomised to GET, CBT, or UC. In addition to UC, the GET group will participate in a 12-week supervised exercise programme. The CBT group will receive a 12-week CBT intervention in addition to UC. Primary and secondary outcome measures will be assessed at baseline, post-intervention (14 weeks), and at follow-up assessments (18 and 26 weeks post-randomisation). The primary outcome measure is fatigue severity (Checklist Individual Strength subscale fatigue severity). Secondary outcome measures are fatigue (EORTC-QLQ-C30 subscale fatigue), functional impairments (Sickness Impact Profile total score, EORTC-QLQ-C30 subscale emotional functioning, subscale physical functioning) and quality of life (EORTC-QLQ-C30 subscale QoL). Outcomes at 14 weeks (primary endpoint) of either treatment arm will be compared to those of UC participants. In addition, outcomes at 18 and 26 weeks (follow-up assessments) of either treatment arm will be compared to those of UC participants. Discussion: To our knowledge, the TIRED study is the first RCT investigating the efficacy of GET and CBT on reducing fatigue during treatment with palliative intent in incurable cancer patients. The results of this study will provide information about the possibility and efficacy of GET and CBT for severely fatigued incurable cancer patients

Mapping Arctic Bottomfast Sea Ice Using SAR Interferometry

Bottomfast sea ice is an integral part of many near-coastal Arctic ecosystems with implications for subsea permafrost, coastal stability and morphology. Bottomfast sea ice is also of great relevance to over-ice travel by coastal communities, industrial ice roads, and marine habitats. There are currently large uncertainties around where and how much bottomfast ice is present in the Arctic due to the lack of effective approaches for detecting bottomfast sea ice on large spatial scales. Here, we suggest a robust method capable of detecting bottomfast sea ice using spaceborne synthetic aperture radar interferometry. This approach is used to discriminate between slowly deforming floating ice and completely stationary bottomfast ice based on the interferometric phase. We validate the approach over freshwater ice in the Mackenzie Delta, Canada, and over sea ice in the Colville Delta and Elson Lagoon, Alaska. For these areas, bottomfast ice, as interpreted from the interferometric phase, shows high correlation with local bathymetry and in-situ ice auger and ground penetrating radar measurements. The technique is further used to track the seasonal evolution of bottomfast ice in the Kasegaluk Lagoon, Alaska, by identifying freeze-up progression and areas of liquid water throughout winter

Neonatal screening for congenital hypothyroidism in the Netherlands: Cognitive and motor outcome at 10 years of age

Contains fulltext : 35300.pdf (publisher's version ) (Open Access)CONTEXT: Patients with thyroidal congenital hypothyroidism (CH-T) born in The Netherlands in 1981-1982 showed persistent intellectual and motor deficits during childhood and adulthood, despite initiation of T(4) supplementation at a median age of 28 d after birth. OBJECTIVE: The present study examined whether advancement of treatment initiation to 20 d had resulted in improved cognitive and motor outcome. DESIGN/SETTING/PATIENTS: In 82 Dutch CH-T patients, born in 1992 to 1993 and treated at a median age of 20 d (mean, 22 d; range, 2-73 d), cognitive and motor outcome was assessed (mean age, 10.5 yr; range, 9.6-11.4 yr). Severity of CH-T was classified according to pretreatment free T(4) concentration. MAIN OUTCOME MEASURE: Cognitive and motor outcome of the 1992-1993 cohort in comparison to the 1981 to 1982 cohort was the main outcome measure. RESULTS: Patients with severe CH-T had lower full-scale (93.7), verbal (94.9), and performance (93.9) IQ scores than the normative population (P < 0.05), whereas IQ scores of patients with moderate and mild CH-T were comparable to those of the normative population. In all three severity subgroups, significant motor problems were observed, most pronounced in the severe CH-T group. No correlations were found between starting day of treatment and IQ or motor outcome. CONCLUSIONS: Essentially, findings from the 1992-1993 cohort were similar to those of the 1981-1982 cohort. Apparently, advancing initiation of T(4) supplementation from 28 to 20 d after birth did not result in improved cognitive or motor outcome in CH-T patients

Atmospheric pressure roll-to-roll plasma enhanced CVD of high quality silica-like bilayer encapsulation films

A glow like atmospheric pressure dielectric barrier discharge in a roll-to-roll setup was used to synthesize 90 nm silica-like bilayer encapsulation films composed of a 30 nm dense “barrier layer” and a comparatively less dense 60 nm “buffer layer” onto a polyethylene 2,6 naphthalate substrate by means of plasma enhanced chemical vapor deposition. Tetraethyl orthosilicate was used as the precursor gas, together with a mixture of nitrogen, oxygen, and argon. The microstructure, chemical composition, morphology, and permeation properties of the films were studied as a function of the specific energy delivered per precursor molecule, and oxygen concentration in the gas mixture, during the deposition of the barrier layer. The presence of the buffer layer within the bilayer architecture critically enhanced the encapsulation performance of the bilayer films, and this in conjunction with increasing the specific energy delivered per precursor molecule during the barrier layer deposition to a value of 20 keV, enabled an effective water vapor transmission rate as low as 6.9 × 10−4 g m−2 d−1 (at 40 °C, 90% relative humidity (RH)) to be achieved. Furthermore, the bilayer film structure has given rise to a remarkable 50% reduction in deposition energy consumption per barrier area with respect to single layer silica-like films of equivalent encapsulation performance and thickness.</p

Exploring the provision and motives behind the adoption of health-promotion programmes in professional football clubs across four European countries

This study mapped existing health-promotion provisions targeting adults in professional football clubs across England, the Netherlands, Norway, and Portugal, and explored motives behind the clubs’ adoption of the European Fans in Training (EuroFIT) programme. We surveyed top-tier football clubs in the four countries and interviewed representatives from football clubs and the clubs’ charitable foundation who delivered EuroFIT. The findings showed large between-country differences, with football clubs in England reporting far greater healthy lifestyle provision than other countries. Relatively few health-promotion programmes targeted adults, particularly in the Netherlands, Portugal, and Norway. Club representatives reported that the motives for adopting the EuroFIT programme often involved adhering to both the social objectives of the football club or club’s foundation and business-related objectives. They viewed the scientific evidence and evaluation underpinning EuroFIT as helpful in demonstrating the value and potential future impact of both the programme and the clubs’ wider corporate social responsibility provision