The establishment of a 3D breast photography service in medical illustration

This paper aims to describe the development of a 3D breast photography service managed by the Medical Illustration Department, in the Belfast Health and Social Care Trust, Northern Ireland. Dedicated 3D breast photography equipment was installed in Medical Illustration for 18 months. Women were referred for a variety of indications including pre- and post-surgical assessment. A dedicated 3D breast photography protocol was developed locally and this requires further refinement to allow reproducibility in other centres. There are image/data artefacts associated with this technology and special techniques are required to reduce these. Specialist software is necessary for clinicians and scientists to use 3D breast photography data in surgical planning and measurement of surgical outcome.

A Pilot Evaluation of the Palliative Performance Scale in Long Term Care: Tips for Success

Aims: Palliative care in long-term care (LTC) homes is an area of growing concern. Little work has been done to explore innovative ways to identify and care for residents who become palliative. The purpose of this intervention study was to evaluate the implementation of the Palliative Performance Scale (PPS) in LTC. Specifically we explored staff perceptions about implementing the PPS and how it cued staff to initiate palliative care discussion with residents and family when a resident���s health declined.<br/><br/>Methods: This study utilized a qualitative descriptive design that included data from four separate sources: journals of three ���champions��� who were responsible for leading the implementation of the PPS; staff evaluations of three educational training sessions; minutes from meetings; and 11 interviews from key staff who were involved in the implementation process. Data were analyzed using thematic content analysis.<br/><br/>Results: Staff generally felt positively about using the PPS in LTC and stated that it increased awareness of palliative care and helped identify those residents who were nearing the end of life. There were some barriers to implementing it, such as staff resistance and lack of time to complete it. The importance of having a designated ���champion��� and effective interdisciplinary communication in addition to widespread training, were identified as successful strategies to facilitate the implementation process.<br/><br/>Conclusion: These study findings support the use of the PPS in LTC and offer some perspective about ways to implement it successfully. Future work is needed to evaluate the PPS in LTC using more rigorous designs.

Family-based associations in measures of psychological distress and quality of life in a cardiac screening clinic for inheritable cardiac diseases: a cross-sectional study

<p>BACKGROUND: Family-based cardiac screening programmes for persons at risk for genetic cardiac diseases are now recommended. However, the psychological wellbeing and health related quality of life (QoL) of such screened patients is poorly understood, especially in younger patients. We sought to examine wellbeing and QoL in a representative group of adults aged 16 and over in a dedicated family cardiac screening clinic.</p><p>METHODS: Prospective survey of consecutive consenting patients attending a cardiac screening clinic, over a 12 month period. Data were collected using two health measurement tools: the Short Form 12 (version 2) and the Hospital Anxiety and Depression Scale (HADS), along with baseline demographic and screening visit-related data. The HADS and SF-12v.2 outcomes were compared by age group. Associations with a higher HADS score were examined using logistic regression, with multi-level modelling used to account for the family-based structure of the data.</p><p>RESULTS: There was a study response rate of 86.6%, with n=334 patients providing valid HADS data (valid response rate 79.5%), and data on n=316 retained for analysis. One-fifth of patients were aged under 25 (n=61). Younger patients were less likely than older to describe significant depression on their HADS scale (p&lt;0.0001), although there were overall no difference between the prevalence of a significant HADS score between the younger and older age groups (18.0% vs 20.0%, p=0.73). Significant positive associates of a higher HADS score were having lower educational attainment, being single or separated, and being closely related to the family proband. Between-family variance in anxiety and depression scores was greater than within-family variance.</p><p>CONCLUSIONS: High levels of anxiety were seen amongst patients attending a family-based cardiac screening clinic.Younger patients also had high rates of clinically significant anxiety. Higher levels of anxiety and depression tends to run in families, and this has implications for family screening and intervention programmes.</p>

Polarization Distortion as a Means for Securing Wireless Communication

This paper presents a simple polarization encoding strategy that operates using only single element dual port transmit and receive antennas in such a way that selective spatial scrambling of QPSK data can be effected. The key transmitter and receiver relationships needed for this operation to occur are derived. The system is validated using a cross dipole antenna arrangement. Unlike all previously reported physical layer wireless solutions the approach developed in this paper transfers the security property to the receive side resulting in very simple transmit and receive side architectures thus avoiding the need for near field modulated array technology. In addition the scheme permits, for the first time, multiple spatially separated secured receive sites to operate in parallel.

Relay Selection for Security Enhancement in Cognitive Relay Networks

This letter proposes several relay selection policies for secure communication in cognitive decode-and-forward (DF) relay networks, where a pair of cognitive relays are opportunistically selected for security protection against eavesdropping. The first relay transmits the secrecy information to the destination,<br/>and the second relay, as a friendly jammer, transmits the jamming signal to confound the eavesdropper. We present new exact closed-form expressions for the secrecy outage probability. Our analysis and simulation results strongly support our conclusion that the proposed relay selection policies can enhance the performance of secure cognitive radio. We also confirm that the error floor phenomenon is created in the absence of jamming.<br/>

Transcending Boundaries of Creativity: Active learning in the Design Studio

This essay investigates the changing dynamics of interaction and paradigm of communication in the design studio. It analyses the process of practical implementation of interactive tools in architectural education which placed the<br/>diversity of students��� cultural experiences, contextual awareness and individual interests as crucial resource for design innovation and inquiry. Building on Brian Lawson���s thesis on creativity in design thinking, this research project undertook<br/>comprehensive investigation of students��� satisfaction of their roles in the studio and the room for liberal thought they are given to elaborate on genuine approach to architectural matters. The cyclical development of interactive learning strategy is explored through two different settings: first, it analyses architectural students��� position as passive/active in the studio, considering their relationships with tutors��� ideals; second, it reports on empirical strategy of students-led workshops at British schools of architecture, during which students have taken the lead of their creative design agenda. The practical implementation of interactive learning tools proved influential in helping students to personalize their design direction and to build a sense of confidence and independence.

Frequency Diverse Array OFDM Transmitter for Secure Wireless Communication

In this reported work, the frequency diverse array concept is employed to construct an orthogonal frequency-division multiplexing (OFDM) transmitter that has the capability of securing wireless communication in free space directly in the physical-layer without the need for mathematical encryption. The characteristics of the proposed scheme in terms of its secrecy performance are validated via bit error rate simulation under both high and low signal to noise ratio scenarios using the IEEE 802.11 OFDM physical-layer specification.

Participation of Smallholders in Agroforestry Agri-Environmental Scheme: A lesson from the rural Mount Kenya region

The likelihood of smallholder farmers not participating in agroforestry agri-environmental schemes and payments for ecosystem services (PES) may be due to limited farmland endowment and formal credit constraints. These deficits may lead to an ���exclusive club��� of successful farmers, which are not necessarily poor, enjoying the benefits of agri-environmental schemes and PES although agrienvironmental schemes and PES have been devised as a means of fostering rural sustainable development and improving the livelihood of poor smallholder farmers. Smallholder farmers in parts of rural Kenya continue to enroll in ���The International Small Group Tree Planting Programme��� (TIST), an agri-environmental scheme, promoting agroforestry, carbon sequestration and conservation agriculture (CA). The question remains if these farmers are really poor? This study examines factors that determine the participation of smallholder farmers in TIST in parts of rural Kenya. We use survey data compiled in 2013 on 210 randomly selected smallholder farmers from Embu, Meru and Nanyuki communities; the sample consists of TIST and non-TIST members. A random utility model and logit regression were used to test a set of non-monetary and monetary factors that influence participation in the TIST. The utility function is conceptualized to give non-monetary factors, particularly the common medium of communication in rural areas ��� formal and informal ��� a central role. Furthermore, we investigate other factors (incl. credit accessibility and interest rate) that reveal the nature of farmers participating in TIST. The findings suggest that spread of information via formal and informal networks is a major driver of participation in the TIST program. Furthermore, variables such credit constrains, age and labour supply positively correlate with TIST participation, while for education the opposite is true. It is important to mention that these correlations, although somewhat consistent, were all found to be weak. The results indicate that participation in the TIST program is not influenced by farm size; therefore we argue that the TIST scheme is NOT an ���exclusive club��� comprising wealthy and successful farmers. Older farmers��� being more likely to join the TIST is an argument for their long- rather than widely assumed short-term planning horizon and a new contribution to the literature. Given the importance of poverty alleviation and climate smart agriculture in developing countries, sustainable policy should strengthening the social and human capital as well as informal networks in rural areas. Extension services should effectively communicate benefits to less educated and credit constrained farmers.

Familial aggregation of hyperopia in an elderly population of siblings in Salisbury, Maryland.

PURPOSE: To determine whether hyperopia aggregates in families in an older mixed-race population. DESIGN: Cross-sectional familial aggregation study using sibships. METHODS: We recruited 759 subjects (mean age, 73.4 years) in 241 families through the population-based Salisbury Eye Evaluation study. Subjects underwent noncycloplegic refraction if best-corrected visual acuity (BCVA) was &lt;or=20/40, had lensometry to measure their currently worn spectacles if BCVA was &gt;20/40 with spectacles, or were considered to be plano (refraction of zero) if the BCVA was &gt;20/40 without spectacles. Preoperative refraction from medical records was used for bilaterally pseudophakic subjects. RESULTS: Utilizing hyperopia cutoffs from 1.00 to 2.50 diopters, age-, race-, and gender-adjusted odds ratios for hyperopia with an affected sibling ranged from 2.72 (95% confidence interval [CI], 1.84-4.01) to 4.87 (95% CI, 2.54-9.30). The odds of hyperopia increased with age until 75 years, after which they remained relatively constant. Black men were significantly less likely to be hyperopic than white men, white women, or black women. CONCLUSIONS: Hyperopia appears to be under strong genetic control in this older population.

Attitudes of students, parents, and teachers toward glasses use in rural China.

OBJECTIVE: <br/><br/>To use focus groups to understand barriers to glasses use among children in rural China.<br/><br/>METHODS: <br/><br/>Separate focus groups were conducted between December 17, 2007, and August 5, 2008, for the following 3 groups at each of 3 schools in rural China: children aged 14 to 18 years with myopia of less than -0.5 diopters in both eyes, those children's parents, and those children's teachers. Participants were also asked to rank their responses to questions about glasses use. The focus group transcripts were coded independently by 2 investigators using qualitative data management software.<br/><br/>RESULTS: <br/><br/>Respondents of all 3 types indicated that glasses purchase and wear should be delayed in children with early myopia and might be harmful to the eyes. Parents and students reported being uncertain about children's actual myopia status and whether glasses should be worn. Parents ranked their most common reason for not buying glasses as being "too busy with work," whereas "too expensive" ranked low. Inconvenience was ranked as an important reason for not wearing glasses among all 3 student groups. "Accuracy of lens power" was the first-ranked requirement for glasses among all student groups, whereas "new and attractive styles" was ranked last by all. All 3 types of respondents believed that wearing glasses or failing to wear them might worsen myopia.<br/><br/>CONCLUSIONS: <br/><br/>Educational programs are needed to address significant knowledge gaps in families and schools about glasses use in rural China. Cost and the need for attractive styles may not be significant barriers to use in this setting, raising the possibility of paying for such programs through cost recovery.<br/>

The effectiveness of disaster risk communication: a systematic review of intervention studies

<p>INTRODUCTION: A disaster is a serious disruption to the functioning of a community that exceeds its capacity to cope within its own resources. Risk communication in disasters aims to prevent and mitigate harm from disasters, prepare the population before a disaster, disseminate information during disasters and aid subsequent recovery. The aim of this systematic review is to identify, appraise and synthesise the findings of studies of the effects of risk communication interventions during four stages of the disaster cycle.</p><p>METHODS: We searched the Cochrane Central Register of Controlled Trials, Embase, MEDLINE, PsycInfo, Sociological Abstracts, Web of Science and grey literature sources for randomised trials, cluster randomised trials, controlled and uncontrolled before and after studies, interrupted time series studies and qualitative studies of any method of disaster risk communication to at-risk populations. Outcome criteria were disaster-related knowledge and behaviour, and health outcomes.</p><p>RESULTS: Searches yielded 5,224 unique articles, of which 100 were judged to be potentially relevant. Twenty-five studies met the inclusion criteria, and two additional studies were identified from other searching. The studies evaluated interventions in all four stages of the disaster cycle, included a variety of man-made, natural and infectious disease disasters, and were conducted in many disparate settings. Only one randomised trial and one cluster randomised trial were identified, with less robust designs used in the other studies. Several studies reported improvements in disaster-related knowledge and behaviour.</p><p>DISCUSSION: We identified and appraised intervention studies of disaster risk communication and present an overview of the contemporary literature. Most studies used non-randomised designs that make interpretation challenging. We do not make specific recommendations for practice but highlight the need for high-quality randomised trials and appropriately-analysed cluster randomised trials in the field of disaster risk communication where these can be conducted within an appropriate research ethics framework.</p>

Moral Emotions in Palliative Care: Empirical Insights from Austria and Canada

Research aims: Moral emotions as one specific group of emotions play a vital role in delivering palliative care as e.g. ethical issues and moral distress belong to daily routine.<br/>Moral emotions are oriented to the welfare of other persons or the society as a whole. To better understand moral emotions in Palliative Care the aims of the presented study are to ana- lyze care situations from Austria and Canada in different care settings and identify families of moral emotions on one hand and describe influencing contextual factors on the other hand. Methods: Within a qualitative study design a reanalysis of Austrian narratives on ethical issues and Canadian narra- tives on moral distress were conducted. Data in Austria encompass 36 narratives that were generated through qual- itative questionnaires in nursing homes. Canadian data are based on qualitative interviews with home care palliative specialists and encompass 47 critical incidents. The reanal- ysis of data was conducted with narrative analysis. Results: Preliminary results show that moral emotions in palliative care can be found in families around ���empathy and relatedness���, ���sadness, isolation and bereavement���, ���anger, frustration and powerlessness���, ���guilt and shame��� and ���being touched and feel close���. Contextual factors influencing moral emotions can be summarized as ���suffer- ing and decline of client���, ���expectations and dynamics of family���, ���structural conflicts and power issues��� and ���lack of resources and information���.<br/>Conclusion: The diversity of moral emotions reflects the everyday experiences in palliative care. It became obvious that most of the moral emotions that have been expressed appear to be interconnected within a bundle of other emo- tions. Contextual factors influencing moral emotions in pal- liative care are relatively independent of care settings. In Palliative Care moral emotions and their contextual factors constitute an important source of insight for reflection in organizational ethics.<br/>

Analogies between linguistics and information theory

An analogy is established between the syntagm and paradigm from Saussurean linguistics and the message and messages for selection from the information theory initiated by Claude Shannon. The analogy is pursued both as an end itself and for its analytic value in understanding patterns of retrieval from full text systems. The multivalency of individual words when isolated from their syntagm is contrasted with the relative stability of meaning of multi-word sequences, when searching ordinary written discourse. The syntagm is understood as the linear sequence of oral and written language. Saussure��??s understanding of the word, as a unit which compels recognition by the mind, is endorsed, although not regarded as final. The lesser multivalency of multi-word sequences is understood as the greater determination of signification by the extended syntagm. The paradigm is primarily understood as the network of associations a word acquires when considered apart from the syntagm. The restriction of information theory to expression or signals, and its focus on the combinatorial aspects of the message, is sustained. The message in the model of communication in information theory can include sequences of written language. Shannon��??s understanding of the written word, as a cohesive group of letters, with strong internal statistical influences, is added to the Saussurean conception. Sequences of more than one word are regarded as weakly correlated concatenations of cohesive units.

Non-local quantum gates: a cavity-quantum-electrodynamics implementation

The problems related to the management of large quantum registers could be handled in the context of distributed quantum computation: unitary non-local transformations among spatially separated local processors are realized performing local unitary transformations and exchanging classical communication. In this paper, a scheme is proposed for the implementation of universal non-local quantum gates such as a controlled NOT (CNOT) and a controlled quantum phase gate (CQPG). The system chosen for their physical implementation is a cavity-quantum-electrodynamics (CQED) system formed by two spatially separated microwave cavities and two trapped Rydberg atoms. The procedures to follow for the realization of each step necessary to perform a specific non-local operation are described.