Fatigue self-management behaviors in patients with advanced cancer: A prospective longitudinal survey

Purpose: To explore the fatigue self-management behaviors and factors associated with effectiveness of these behaviors in patients with advanced cancer. Design: Prospective longitudinal interviewer-administered survey. Setting: A tertiary cancer center in Queensland Australia. Sample: One hundred fifty two outpatients with metastatic breast, lung, colorectal and prostate cancer experiencing fatigue (>3/10) were recruited. Main Research Variables: Fatigue self-management behaviors outcomes (perceived effectiveness, self-efficacy and frequency), medical/demographic characteristics (including sites of primary cancer and metastasis, comorbidity, performance status), social support, depressive, anxiety, and other symptoms were assessed. Findings: The participants reported moderate levels of fatigue at baseline (M=5.85, SD 1.44), and maintained moderate levels at 4 weeks and 8 weeks. On average, participants consistently used approximately nine behaviors at each time point. Factors significantly associated with higher levels of perceived effectiveness of fatigue self-management behaviors were higher self-efficacy (p<.001), higher education level (p=.02), and lower levels of depressive symptoms (p=.04). Conclusions: The findings of this study demonstrate that patients with cancer, even with advanced disease, still want and are able to use a number of behaviors to control their fatigue. Self-management interventions that aim to enhance self-efficacy and address any concurrent depressive symptoms have the potential to reduce fatigue severity. Implications for Nursing: Nurses are well positioned to play a key role in supporting patients in their fatigue self-management. Knowledge Translation: This study particularly focused on the perspectives of patients about fatigue self-management, highlighting a number of issues requiring further attention in clinical practice and the potential for future research.

Eating the Lonesome

From Kurt Vonnegut to Stephen King, many novelists use metanarrative techniques to insert fictional versions of themselves in the stories they tell. The function of deploying such techniques is often to draw attention to the liminal space between the fictional constructs inherent in the novel as a form, and the real world from which the constructs draw inspiration, and indeed, are read by an audience. For emerging writers working in short form narratives, however, the structural demands of the short story or flash fiction make the use of similar techniques problematic in the level of depth to which they can be deployed. ‘Eating The Lonesome’ is the sixth in a series of short stories that work to overcome the structural limitations of a succinct form by developing a fractured fictional version of the author over a number of pieces and published across a range of sites. The accumulative affect is a richer metanarrative textual arrangement that also allows for the individual short stories to function independently.

Introduction: Food literacy for contemporary food and eating

This chapter provides an introduction to the term “food literacy”. Its use in the literature, policy and practice, implies that the term is an attempt to encapsulate the knowledge, skills and behaviours needed for everyday eating. This chapter will first review the use of the term in policy and practice, then go on to review what is known about contemporary food and eating and its influence on the emergence of this term and conclude with an overview of the key ideas to be explored in this book.

Lunch eating patterns during working hours and their social and work-related determinants : Study of Finnish employees

Work has a central role in the lives of big share of adult Finns and meals they eat during the workday comprise an important factor in their nutrition, health, and well-being. On workdays, lunch is mainly eaten at worksite canteens or, especially among women, as a packed meal in the workplace s break room. No national-level data is available on the nutritional quality of the meals served by canteens, although the Finnish Institute of Occupational Health laid out the first nutrition recommendations for worksite canteens in 1971. The aim of this study was to examine the contribution of various socio-demographic, socioeconomic, and work-related factors to the lunch eating patterns of Finnish employees during the working day and how lunch eating patterns influence dietary intake. Four different population-based cross-sectional datasets were used in this thesis. Three of the datasets were collected by the National Institute for Health and Welfare (Health Behaviour and Health among the Finnish Adult Population survey from 1979 to 2001, n=24746, and 2005 to 2007, n=5585, the National Findiet 2002 Study, n=261), and one of them by the Finnish Institute of Occupational Health (Work and Health in Finland survey from 1997, 2000, and 2003, n=6369). The Health Behaviour and Health among the Finnish Adult Population survey and the Work and Health in Finland survey are nationally representative studies that are conducted repeatedly. Survey information was collected by self-administered questionnaires, dietary recalls, and telephone interviews. The frequency of worksite canteen use has been quite stable for over two decades in Finland. A small decreasing trend can be seen in all socioeconomic groups. During the whole period studied, those with more years of education ate at worksite canteens more often than the others. The size of the workplace was the most important work-related determinant associated with the use of a worksite canteen. At small workplaces, other work-related determinants, like occupation, physical strain at work, and job control, were also associated with canteen use, whereas at bigger workplaces the associations were almost nonexistent. The major social determinants of worksite canteen availability were the education and occupational status of employees and the only work-related determinant was the size of the workplace. A worksite canteen was more commonly available to employees at larger workplaces and to those with the higher education and the higher occupational status. Even when the canteen was equally available to all employees, its use was nevertheless determined by occupational class and the place of residence, especially among female employees. Those with higher occupational status and those living in the Helsinki capital area ate in canteens more frequently than the others. Employees who ate at a worksite canteen consumed more vegetables and vegetable and fish dishes at lunch than did those who ate packed lunches. Also, the daily consumption of vegetables and the proportion of the daily users of vegetables were higher among those male employees who ate at a canteen. In conclusion, life possibilities, i.e. the availability of a canteen, education, occupational status, and work-related factors, played an important role in the choice of where to eat lunch among Finnish employees. The most basic prerequisite for eating in a canteen was availability, but there were also a number of underlying social determinants. Occupational status and the place of residence were the major structural factors behind individuals choices in their lunch eating patterns. To ensure the nutrition, health, and well-being of employees, employers should provide them with the option to have good quality meals during working hours. The availability of worksite canteens should be especially supported in lower socioeconomic groups. In addition, employees should be encouraged to have lunch at a worksite canteen when one is available by removing structural barriers to its use.

Frequency characteristics and dynamical behaviors of self-modulation in vertical-cavity surface-emitting lasers

The frequency characteristics of a VCSEL with a quarter-wave plate (QWP) and an external reflector are investigated with the translation matrix of the vectorial field. Two series of eigenmode with a shift of half the free spectrum range are linearly polarized, respectively, along the neutral axes of QWP. We also numerically explore the polarization self-modulation phenomenon by using a vectorial laser equation and considering the inhomogeneous broadening of the gain medium. If the external cavity is so short that the shift is bigger than the homogeneous broadening, two stable longitudinal modes oscillate, respectively, on the neutral axes of QWP because they consume different carriers. With a long external cavity, the competition of the modes for the common carriers causes the intensity fluctuation of the modes with a period of one round-trip time of the external cavity.

Experimental Study on Hydrodynamic Behaviors of High-Speed Gas Jets in Still Water

The present paper describes experimental investigation on the flow pattern and hydrodynamic effect of underwater gas jets from supersonic and sonic nozzles operated in correct- and imperfect expansion conditions. The flow visualizations show that jetting is the flow regime for the submerged gas injection at a high speed in the parameter range under consideration. The obtained results indicate that high-speed gas jets in still water induce large pressure pulsations upstream of the nozzle exit and the presence of shock-cell structure in the over- and under-expanded jets leads to an increase in the intensity of the jet-induced hydrodynamic pressure.

Basic Mechanical Behaviors And Mechanics Of Shear Banding In Bmgs

In this paper, some basic mechanical behaviors of bulk metallic glasses (BMGs) were discussed. It can be found from the discussions that the mechanical behaviors of BMGs are mainly due to the formation and operation of shear bands in BMGs. Furthermore, the relevant mechanics of shear banding were investigated in the paper. The theoretical analysis of deformation coupling thermal softening and free volume creation softening demonstrates that the free volume creation and thermal softening can jointly promote the formation of shear bands in BMGs, and the observed post mortem. shear band width looks more like that governed by free volume creation. (C) 2007 Elsevier Ltd. All rights reserved.

On the tensile behaviors of a hard chromium coating plated on a steel substrate with periodic subsurface inclusions

The tensile behaviors of a hard chromium coating plated on a steel substrate with periodic laser pre-quenched regions have been investigated by experimental and theoretic analysis. In the experiment, three specimens are adopted to study the differences between homogeneous and periodic inhomogeneous substrates as well as between periodic inhomogeneous substrate of relatively softer and stiffer materials. The unique characteristics have been observed in the specimen of periodic inhomogeneous substrate under quasi-static tension loading. With the periodic laser pre-quenched regions being treated as periodic subsurface inclusions (PSI), the unique stress/strain pattern of the specimen is obtained by analytical modeling and FEM analysis, and the mechanisms accounting for the experimental results is preliminarily illustrated.

Anisotropic, gradient and metal-like mechanical behaviors of teeth and their implications on tooth functions

The anisotropy and gradient of the elastic modulus and the hardness of teeth were investigated by means of instrumented indentation method. Such properties are attributed to the unique microstructures of teeth based on scanning electron microscopic analysis. By comparing the relationship between the ratio of hardness to the reduced elastic modulus and the ratio of elastic unloading work to the total work of teeth in course of indentation to those of other materials, we found that the material behaviors of teeth display metal-like characteristics rather than ceramics as considered traditionally. These material behaviors and relevant functions are discussed briefly.

A general theory on media with randomly distributed inclusions .1. The average field behaviors

In this paper, a theory is developed to calculate the average strain field in the materials with randomly distributed inclusions. Many previous researches investigating the average field behaviors were based upon Mori and Tanaka's idea. Since they were restricted to studying those materials with uniform distributions of inclusions they did not need detailed statistical information of random microstructures, and could use the volume average to replace the ensemble average. To study more general materials with randomly distributed inclusions, the number density function is introduced in formulating the average field equation in this research. Both uniform and nonuniform distributions of inclusions are taken into account in detail.

Comparative Observation of DC Arc Plasma Jets and Their Arc Root Behaviors at Reduced Pressure

Experimentally observed, results are presented for the DCarcplasmajets and theirarc-rootbehaviors generated atreduced gas pressure and without or with an' applied magnetic field. Pure argon, argon -hydrogen or argon-nitrogen mixture is used as the plasma-forming gas. A specially designed copper mirror is constructed and used for better observing the arc-root behavior on the anode surface of the DC non-transferred arcplasma torch. It is shown that for the cases without applied magnetic field, the laminar plasmajets are stable and approximately axisymmetrical. The arc-root attachment on the anode surface is completely diffusive when argon is used as the plasma-forming gas, while the arc-root attachment often becomes constrictive when hydrogen or nitrogen is added into the argon. When an external magnetic field is applied, the arcroot tends to rotate along the anode surface of the non-transferred arcplasma torch.

Analysis of Behaviors of Shock Focusing in the Inner Cavities of Double Wedge and Cone

The mechanisms of shock focusing in inner cavities of double wedge and cone are compared with that of traditional curved-surface shock focusing. The results show that there are many high temperature regions just behind shock surface which appear in two place alternately, one is near the surface of wall and the other is near the centerline. Also, changes in temperature, pressure, energy and power of the high temperature regions were analyzed and the results show that energy and power per unit volume increase, but total energy and power in the high temperature regions decrease during the process of shock moving forward the apex of double wedge or cone.

Self-instability and bending behaviors of nano plates

This paper aims at investigating the size-dependent self-buckling and bending behaviors of nano plates through incorporating surface elasticity into the elasticity with residual stress fields. In the absence of external loading, positive surface tension induces a compressive residual stress field in the bulk of the nano plate and there may be self-equilibrium states corresponding to the plate self-buckling. The self-instability of nano plates is investigated and the critical self-instability size of simply supported rectangular nano plates is determined. In addition, the residual stress field in the bulk of the nano plate is usually neglected in the existing literatures, where the elastic response of the bulk is often described by the classical Hooke’s law. The present paper considered the effect of the residual stress in the bulk induced by surface tension and adopted the elasticity with residual stress fields to study the bending behaviors of nano plates without buckling. The present results show that the surface effects only modify the coefficients in corresponding equations of the classical Kirchhoff plate theory.

Macaque lateral intraparietal area and oculomotor behaviors

Neurons in the primate lateral intraparietal area (area LIP) carry visual, saccade-related and eye position activities. The visual and saccade activities are anchored in a retinotopic framework and the overall response magnitude is modulated by eye position. It was proposed that the modulation by eye position might be the basis of a distributed coding of target locations in a head-centered space. Other recording studies demonstrated that area LIP is involved in oculomotor planning. These results overall suggest that area LIP transforms sensory information for motor functions. In this thesis I further explore the role of area LIP in processing saccadic eye movements by observing the effects of reversible inactivation of this area. Macaque monkeys were trained to do visually guided and memory saccades and a double saccade task to examine the use of eye position signal. Finally, by intermixing visual saccades with trials in which two targets were presented at opposite sides of the fixation point, I examined the behavior of visual extinction.

In chapter 2, I will show that lesion of area LIP results in increased latency of contralesional visual and memory saccades. Contralesional memory saccades are also hypometric and slower in velocity. Moreover, the impairment of memory saccades does not vary with the duration of the delay period. This suggests that the oculomotor deficits observed after inactivation of area LIP is not due to the disruption of spatial memory.

In chapter 3, I will show that lesion of area LIP does not severely affect the processing of spontaneous eye movement. However, the monkeys made fewer contralesional saccades and tended to confine their gaze to the ipsilesional field after inactivation of area LIP. On the other hand, lesion of area LIP results in extinction of the contralesional stimulus. When the initial fixation position was varied so that the retinal and spatial locations of the targets could be dissociated, it was found that the extinction behavior could best be described in a head-centered coordinate.

In chapter 4, I will show that inactivation of area LIP disrupts the use of eye position signal to compute the second movement correctly in the double saccade task. If the first saccade steps into the contralesional field, the error rate and latency of the second saccade are both increased. Furthermore, the direction of the first eye movement largely does not have any effect on the impairment of the second saccade. I will argue that this study provides important evidence that the extraretinal signal used for saccadic localization is eye position rather than a displacement vector.

In chapter 5, I will demonstrate that in parietal monkeys the eye drifts toward the lesion side at the end of the memory saccade in darkness. This result suggests that the eye position activity in the posterior parietal cortex is active in nature and subserves gaze holding.

Overall, these results further support the view that area LIP neurons encode spatial locations in a craniotopic framework and is involved in processing voluntary eye movements.