Quality of care for cancer patients on home parenteral nutrition: Development of key interventions and outcome indicators using a two-round Delphi approach

Purpose: Clear recommendations on how to guide patients with cancer on home parenteral nutrition (HPN) are lacking as the use of HPN in this population remains a controversial issue. Therefore, the aims of this study were to rank treatment recommendations and main outcome indicators to ensure high-quality care and to indicate differences in care concerning benign versus malignant patients. Methods: Treatment recommendations, identified from published guidelines, were used as a starting point for a two-round Delphi approach. Comments and additional interventions proposed in the first round were reevaluated in the second round. Ordinal logistic regression with SPSS 2.0 was used to identify differences in care concerning benign versus malignant patients. Results: Twenty-seven experts from five European countries completed two Delphi rounds. After the second Delphi round, the top three most important outcome indicators were (1) quality of life (QoL), (2) incidence of hospital readmission and (3) incidence of catheter-related infections. Forty-two interventions were considered as important for quality of care (28/42 based on published guidelines; 14/42 newly suggested by Delphi panel). The topics 'Liver disease' and 'Metabolic bone disease' were considered less important for cancer patients, together with use of infusion pumps (p = 0.004) and monitoring of vitamins and trace elements (p = 0.000). Monitoring of QoL is considered more important for cancer patients (p = 0.03). Conclusion: Using a two-round Delphi approach, we developed a minimal set of 42 interventions that may be used to determine quality of care in HPN patients with malignancies. This set of interventions differs from a similar set developed for benign patients. © 2012 Springer-Verlag Berlin Heidelberg.

Examining Relationships between Culture, Creativity and Business Stage in an Emerging Market: A Categorical Data Analysis of Vietnam’s Data Set

In this article, we offer a new way of exploring relationships between three different dimensions of a business operation, namely the stage of business development, the methods of creativity and the major cultural values. Although separately, each of these has gained enormous attention from the management research community, evidenced by a large volume of research studies, there have been not many studies that attempt to describe the logic that connect these three important aspects of a business; let alone empirical evidences that support any significant relationships among these variables. The paper also provides a data set and an empirical investigation on that data set, using a categorical data analysis, to conclude that examinations of these possible relationships are meaningful and possible for seemingly unquantifiable information. The results also show that the most significant category among all creativity methods employed in Vietnamese enterprises is the “creative disciplines” rule in the “entrepreneurial phase,” while in general creative disciplines have played a critical role in explaining the structure of our data sample, for both stages of development in our consideration.

The Fantasio set-up: High resolution overtone spectroscopy of acetylene containing van der Waals dimers

info:eu-repo/semantics/nonPublished

Gamma-rays from heavy minimal dark matter

Motivated by the Minimal Dark Matter scenario, we consider the annihilation into gamma rays of candidates in the fermionic 5-plet and scalar 7-plet representations of SU(2)L, taking into account both the Sommerfeld effect and the internal bremsstrahlung. Assuming the Einasto profile, we show that present measurements of the Galactic Center by the H.E.S.S. instrument exclude the 5-plet and 7-plet as the dominant form of dark matter for masses between 1 TeV and 20 TeV, in particular, the 5-plet mass leading to the observed dark matter density via thermal freeze-out. We also discuss prospects for the upcoming Cherenkov Telescope Array, which will be able to probe even heavier dark matter masses, including the scenario where the scalar 7-plet is thermally produced.

FANTASIO: a versatile experimental set-up to investigate jet-cooled molecules

The design of a new apparatus, named FANTASIO, for studying jet-cooled molecules is described. It includes, around the same supersonic expansion cell, a high resolution Fourier transform spectrometer with single or multipass optics, a tunable diode laser spectrometer with optional cavity ring-down facilities, and a quadrupole mass spectrometer. Performance and operational procedures are illustrated.