It’s okay to ask : development and pilot testing of a question prompt list for patients with brain tumours

Background: Previous research identified that primary brain tumour patients have significant psychological morbidity and unmet needs, particularly the need for more information and support. However, the utility of strategies to improve information provision in this setting is unknown. This study involved the development and piloting of a brain tumour specific question prompt list (QPL). A QPL is a list of questions patients may find useful to ask their health professionals, and is designed to facilitate communication and information exchange. Methods: Thematic analysis of QPLs developed for other chronic diseases and brain tumour specific patient resources informed a draft QPL. Subsequent refinement of the QPL involved an iterative process of interviews and review with 12 recently diagnosed patients and six caregivers. Final revisions were made following readability analyses and review by health professionals. Piloting of the QPL is underway using a non-randomised control group trial with patients undergoing treatment for a primary brain tumour in Brisbane, Queensland. Following baseline interviews, consenting participants are provided with the QPL or standard information materials. Follow-up interviews four to 6 weeks later allow assessment of the acceptability of the QPL, how it is used by patients, impact on information needs, and feasibility of recruitment, implementation and outcome assessment. Results: The final QPL was determined to be readable at the sixth grade level. It contains seven sections: diagnosis, prognosis, symptoms and changes, the health professional team, support, treatment and management, and post-treatment concerns. At this time, fourteen participants have been recruited for the pilot, and data collection completed for eleven. Data collection and preliminary analysis are expected to be completed by and presented at the conference. Conclusions: If acceptable to participants, the QPL may encourage patients, doctors and nurses to communicate more effectively, reducing unmet information needs and ultimately improving psychological wellbeing.

Studies on the effect of the size of polycaprolactone microspheres for the dispersion of Salbutamol Sulfate from dry powder inhaler formulations

Purpose: To study the effect of the size of the surface-coated polycaprolactone (PCL) microparticle carriers on the aerosolization and dispersion of Salbutamol Sulfate (SS) from Dry Powder Inhaler (DPI) formulations. Methods: The microparticles were fabricated using an emulsion technique in four different sizes (25, 48, 104 and 150 μm) and later coated with Magnesium stearate (MgSt) and leucine. They were characterized by laser diffraction and SEM. The Fine Particle Fraction (FPF) of SS from powder mixtures was determined by a Twin Stage Impinger (TSI). Results: As the carrier size increased from 25 μm to 150 μm, the FPF of the SS delivered by the coated PCL particles increased approximately four fold. A linear relationship was found between the FPF and Volume mean Diameter (VMD) of the particles over this range. Conclusions: The dispersion behaviour of SS from PCL carriers was dependent on the inherent size of the carriers and the increased FPF of SS with increased carrier size probably reflects the higher mechanical forces produced due to the carrier-carrier collisions or collisions between the carrier particles and the internal walls of the inhaler during aerosolization.

Combined VEGF and PDGF treatment reduces secondary degeneration after spinal cord injury

Trauma to the spinal cord creates an initial physical injury damaging neurons, glia, and blood vessels, which then induces a prolonged inflammatory response, leading to secondary degeneration of spinal cord tissue, and further loss of neurons and glia surrounding the initial site of injury. Angiogenesis is a critical step in tissue repair, but in the injured spinal cord angiogenesis fails; blood vessels formed initially later regress. Stabilizing the angiogenic response is therefore a potential target to improve recovery after spinal cord injury (SCI). Vascular endothelial growth factor (VEGF) can initiate angiogenesis, but cannot sustain blood vessel maturation. Platelet-derived growth factor (PDGF) can promote blood vessel stability and maturation. We therefore investigated a combined application of VEGF and PDGF as treatment for traumatic spinal cord injury, with the aim to reduce secondary degeneration by promotion of angiogenesis. Immediately after hemisection of the spinal cord in the rat we delivered VEGF and PDGF and to the injury site. One and 3 months later the size of the lesion was significantly smaller in the treated group compared to controls, and there was significantly reduced gliosis surrounding the lesion. There was no significant effect of the treatment on blood vessel density, although there was a significant reduction in the numbers of macrophages/microglia surrounding the lesion, and a shift in the distribution of morphological and immunological phenotypes of these inflammatory cells. VEGF and PDGF delivered singly exacerbated secondary degeneration, increasing the size of the lesion cavity. These results demonstrate a novel therapeutic intervention for SCI, and reveal an unanticipated synergy for these growth factors whereby they modulated inflammatory processes and created a microenvironment conducive to axon preservation/sprouting.

Measuring the apparent size of the Moon with a digital camera

The Moon appears to be much larger closer to the horizon than when higher in the sky. This is called the ‘Moon Illusion’ since the observed size of the Moon is not actually larger when the Moon is just above the horizon. This article describes a technique for verifying that the observed size of the Moon in not larger on the horizon. The technique can be easily performed in a high school teaching environment. Moreover, the technique demonstrates the surprising fact that the observed size of the Moon is actually smaller on the horizon due to atmospheric refraction. For the purposes of this paper, several images of the moon were taken with the Moon close to the horizon and close to the zenith. Images were processed using a free program called ImageJ. The Moon was found to be 5.73 ±0.04% smaller in area on the horizon then at the zenith.

Quality and readability of information materials for people with brain tumours and their families

Written information is commonly used to inform patients about their disease and treatment, but must be evidence-based and understandable to be useful. This study assessed the quality of the content and the readability of information brochures for people affected by brain tumours. We randomly selected 18 publicly available brochures. Brochures were assessed by criteria to assess the quality of content using the DISCERN instrument. Readability was tested using three commonly used formulas, which yield the reading grade level required to comprehend the brochure (sixth grade level recommended). The mean overall DISCERN score was 3.17 out of a maximum of 5 (moderate quality); only one achieved a rating greater than 4 (high quality). Only one brochure met the sixth grade readability criteria. Although brochures may have accurate content, few satisfied all of the recommended criteria to evaluate their content. Existing brochures need to be critically reviewed and simplified, consumer-focused brochures produced.

Health professionals’ perspectives on information provision for patients with brain tumours and their families

A significant number of patients diagnosed with primary brain tumours report unmet information needs. Using concept mapping methodology, this study aimed to identify strategies for improving information provision, and to describe factors that health professionals understood to influence their provision of information to patients with brain tumours and their families. Concept mapping is a mixed methods approach that uses statistical methods to represent participants’ perceived relationships between elements as conceptual maps. These maps, and results of associated data collection and analyses, are used to extract concepts involved in information provision to these patients. Thirty health professionals working across a range of neuro-oncology roles and settings participated in the concept mapping process. Participants rated a care coordinator as the most important strategy for improving brain tumour care, with psychological support as a whole rated as the most important element of care. Five major themes were identified as facilitating information provision: health professionals’ communication skills, style and attitudes; patients’ needs and preferences; perceptions of patients’ need for protection and initiative; rapport and continuity between patients and health professionals; and the nature of the health care system. Overall, health professionals conceptualised information provision as ‘individualised’, dependent on these interconnected personal and environmental factors.

Does occupational aggregation matter in determining the size of the gender wage gap?

The traditional decomposition of the gender wage gap distinguishes between a component attributable to gender differences in productivity-related characteristics and a residual component that is often taken as a measure of discrimination. This study of data from the 1989 Canadian Labour Market Activity Survey shows that when occupation is treated as a productivity-related characteristic, the proportion of the gender wage gap labeled explained increases with the number of occupational classifications distinguished. However, on the basis of evidence that occupational differences reflect the presence of barriers faced by women attempting to enter male-dominated occupations, the authors conclude that occupation should not be treated as a productivity-related characteristic; and in a decomposition of the gender wage gap that treats occupation as endogenously determined, they find that the level of occupational aggregation has little effect on the size of the "explained" component of the gap.

The effect of screen size on mission commander's situation awareness

Situation awareness lost is a common factor leading to human error in the aviation industry. However, few studies have investigated the effect on situation awareness where the control interface is a touch-screen device that supports simultaneous multi-touch input and information output. This research aims to conduct an experiment to evaluate the difference in situation awareness on a large screen device, DiamondTouch (DT107), and a small screen device, iPad, both with multi-touch interactive functions. The Interface Operation and Situation Awareness Testing Simulator (IOSATS), is a simulator to test the three basis interface operations (Search Target, Information Reading, and Change Detection) by implementing a simplified search and rescue scenario. The result of this experiment will provide reliable data for future research for improving operator's situation awareness in the avionic domain.

Compact arrays for mobile platforms : trade-off between size and performance for SDMA and MIMO applications

Smart antenna receiver and transmitter systems consist of multi-port arrays with an individual receiver channel (including ADC) and an individual transmitter channel (including DAC)at every of the M antenna ports, respectively. By means of digital beamforming, an unlimited number of simultaneous complex-valued vector radiation patterns with M-1 degrees of freedom can be formed. Applications of smart antennas in communication systems include space-division multiple access. If both stations of a communication link are equipped with smart antennas (multiple-input-multiple-output, MIMO). multiple independent channels can be formed in a "multi-path-rich" environment. In this article, it will be shown that under certain circumstances, the correlation between signals from adjacent ports of a dense array (M + ΔM elements) can be kept as low as the correlation between signals from adjacent ports of a conventional array (M elements and half-wavelength pacing). This attractive feature is attained by means of a novel approach which employs a RF decoupling network at the array ports in order to form new ports which are decoupled and associated with mutually orthogonal (de-correlated) radiation patterns.

Large body size in an island-dwelling bird : a microevolutionary analysis

Island races of passerine birds display repeated evolution towards larger body size compared with their continental ancestors. The Capricorn silvereye (Zosterops lateralis chlorocephalus) has become up to six phenotypic standard deviations bigger in several morphological measures since colonization of an island approximately 4000 years ago. We estimated the genetic variance-covariance (G) matrix using full-sib and 'animal model' analyses, and selection gradients, for six morphological traits under field conditions in three consecutive cohorts of nestlings. Significant levels of genetic variance were found for all traits. Significant directional selection was detected for wing and tail lengths in one year and quadratic selection on culmen depth in another year. Although selection gradients on many traits were negative, the predicted evolutionary response to selection of these traits for all cohorts was uniformly positive. These results indicate that the G matrix and predicted evolutionary responses are consistent with those of a population evolving in the manner observed in the island passerine trend, that is, towards larger body size.

One size fits one : customizing work through manager-employee exchange

While prior research has addressed how collective workplace outcomes are negotiated between employers and trade unions, less attention has been afforded to the ‘everyday’, micro-level exchanges between managers and employees in adjusting work, alongside the ‘standard’ terms and conditions set out in employment contracts. Building on previous work on idiosyncratic deals and requests for flexible scheduling, this article presents the findings from a survey of Australian parents which addressed manager-employee exchanges which led to customized work arrangements. The survey examined the frequency with which various employment terms and conditions were negotiated, who initiated the interactions, where they occurred, and the extent of perceived compromise. The study revealed that manager-employee exchanges occur frequently in the context of roles in nuclear and extended families, and are influenced by the parameters around which formal childcare and educational settings function. Women rated the exchanges as more important than men, but men and women were similarly comfortable with the interactions and satisfied with outcomes. The findings have important implications for managers and organizations in terms of balancing the goals of efficiency with employees’ preferences for workplace flexibility and other terms beyond those which are standardized.

Optimal image sample size for corneal nerve morphometry

Purpose Arbitrary numbers of corneal confocal microscopy images have been used for analysis of corneal subbasal nerve parameters under the implicit assumption that these are a representative sample of the central corneal nerve plexus. The purpose of this study is to present a technique for quantifying the number of random central corneal images required to achieve an acceptable level of accuracy in the measurement of corneal nerve fiber length and branch density. Methods Every possible combination of 2 to 16 images (where 16 was deemed the true mean) of the central corneal subbasal nerve plexus, not overlapping by more than 20%, were assessed for nerve fiber length and branch density in 20 subjects with type 2 diabetes and varying degrees of functional nerve deficit. Mean ratios were calculated to allow comparisons between and within subjects. Results In assessing nerve branch density, eight randomly chosen images not overlapping by more than 20% produced an average that was within 30% of the true mean 95% of the time. A similar sampling strategy of five images was 13% within the true mean 80% of the time for corneal nerve fiber length. Conclusions The “sample combination analysis” presented here can be used to determine the sample size required for a desired level of accuracy of quantification of corneal subbasal nerve parameters. This technique may have applications in other biological sampling studies.

Orthogonality defect and reduced search-space size for solving integer least-squares problems

In the context of ambiguity resolution (AR) of Global Navigation Satellite Systems (GNSS), decorrelation among entries of an ambiguity vector, integer ambiguity search and ambiguity validations are three standard procedures for solving integer least-squares problems. This paper contributes to AR issues from three aspects. Firstly, the orthogonality defect is introduced as a new measure of the performance of ambiguity decorrelation methods, and compared with the decorrelation number and with the condition number which are currently used as the judging criterion to measure the correlation of ambiguity variance-covariance matrix. Numerically, the orthogonality defect demonstrates slightly better performance as a measure of the correlation between decorrelation impact and computational efficiency than the condition number measure. Secondly, the paper examines the relationship of the decorrelation number, the condition number, the orthogonality defect and the size of the ambiguity search space with the ambiguity search candidates and search nodes. The size of the ambiguity search space can be properly estimated if the ambiguity matrix is decorrelated well, which is shown to be a significant parameter in the ambiguity search progress. Thirdly, a new ambiguity resolution scheme is proposed to improve ambiguity search efficiency through the control of the size of the ambiguity search space. The new AR scheme combines the LAMBDA search and validation procedures together, which results in a much smaller size of the search space and higher computational efficiency while retaining the same AR validation outcomes. In fact, the new scheme can deal with the case there are only one candidate, while the existing search methods require at least two candidates. If there are more than one candidate, the new scheme turns to the usual ratio-test procedure. Experimental results indicate that this combined method can indeed improve ambiguity search efficiency for both the single constellation and dual constellations respectively, showing the potential for processing high dimension integer parameters in multi-GNSS environment.