Exploring parents' memories of their child's death related sensory experiences as a dimension of grieving

Little is known about how dying children and their parents experience death. Dying children have reported death related sensory experiences (DRSEs), defined as seeing or hearing someone or something not visible or audible to others, associated with dying. Although parents report that they and the dying child benefit from these experiences, healthcare providers often unknowingly dismiss them. The aims of this phenomenological inquiry were to describe children's DRSEs and their meaning from the parents' perspectives. Four fathers and six mothers of African American, Caucasian, or Hispanic ethnicity, all Christian, ranging in age from 35 to 59 years, whose child died 23 to 52 months prior and was treated at a children's cancer center, were interviewed in the home or hospital setting of their choice. Children's ages at the time of their death ranged from 4 to 13 years. A modification of van Kaarn's phenomenological method of analysis was used to analyze data. Themes emerging from the data for the first aim were: perceiving someone or something from a spiritual realm others could not, expressing awareness tempered by parental reactions, and embracing transcendence. Themes emerging from the data for the second aim were: spiritual beings prepared child; child revealed reality, preparing parents; and child transcended wholly, easing parents' grief. Post-interview surveys revealed that parents found participating in this study a "very positive" or "positive" experience, particularly being able to tell the story of their child. Children's DRSEs have clinical implications for all who provide care near the end of life. Informing parents of DRSEs, cautioning that not all dying children express them, may help parents to anticipate this phenomenon, which may decrease anxiety when their child expresses them, increasing the opportunity for open dialogue between parent and child about dying and death, and decrease regrets associated with being unreceptive to their child's expressions of death awareness. Validating a child's DRSE can have profound effects on bereaved parents. Examining DRSEs from the child's perspective and the influence of informing parents of DRSEs on the dying experience of the child and the parental grieving process are recommended. ^

Performance recovery from exercise: A review from a statistical point of view

Background. Research into methods for recovery from fatigue due to exercise is a popular topic among sport medicine, kinesiology and physical therapy. However, both the quantity and quality of studies and a clear solution of recovery are lacking. An analysis of the statistical methods in the existing literature of performance recovery can enhance the quality of research and provide some guidance for future studies. Methods: A literature review was performed using SCOPUS, SPORTDiscus, MEDLINE, CINAHL, Cochrane Library and Science Citation Index Expanded databases to extract the studies related to performance recovery from exercise of human beings. Original studies and their statistical analysis for recovery methods including Active Recovery, Cryotherapy/Contrast Therapy, Massage Therapy, Diet/Ergogenics, and Rehydration were examined. Results: The review produces a Research Design and Statistical Method Analysis Summary. Conclusion: Research design and statistical methods can be improved by using the guideline from the Research Design and Statistical Method Analysis Summary. This summary table lists the potential issues and suggested solutions, such as, sample size calculation, sports specific and research design issues consideration, population and measure markers selection, statistical methods for different analytical requirements, equality of variance and normality of data, post hoc analyses and effect size calculation.^

IDENTIFICATION AND CHARACTERIZATION OF DISTINCT POPULATIONS OF CLONOGENIC BONE MARROW STROMAL CELLS CAPABLE OF TRANSFERRING THE HEMATOPOIETIC MICROENVIRONMENT IN VIVO AND SUPPORTING LT-HSCs IN VITRO

Bone marrow (BM) stromal cells are ascribed two key functions, 1) stem cells for non-hematopoietic tissues (MSC) and 2) as components of the hematopoietic stem cell niche. Current approaches studying the stromal cell system in the mouse are complicated by the low yield of clonogenic progenitors (CFU-F). Given the perivascular location of MSC in BM, we developed an alternative methodology to isolate MSC from mBM. An intact ‘plug’ of bone marrow is expelled from bones and enzymatically disaggregated to yield a single cell suspension. The recovery of CFU-F (1917.95+199) reproducibly exceeds that obtained using the standard BM flushing technique (14.32+1.9) by at least 2 orders of magnitude (P<0.001; N = 8) with an accompanying 196-fold enrichment of CFU-F frequency. Purified BM stromal and vascular endothelial cell populations are readily obtained by FACS. A detailed immunophenotypic analysis of lineage depleted BM identified PDGFRαβPOS stromal cell subpopulations distinguished by their expression of CD105. Both subpopulations retained their original phenotype of CD105 expression in culture and demonstrate MSC properties of multi-lineage differentiation and the ability to transfer the hematopoietic microenvironment in vivo. To determine the capacity of either subpopulation to support long-term multi-lineage reconstituting HSCs, we fractionated BM stromal cells into either the LinNEGPDGFRαβPOSCD105POS and LINNEGPDGFRαβPOSCD105LOW/- populations and tested their capacity to support LT-HSC by co-culturing each population with either 1 or 10 HSCs for 10 days. Following the 10 day co-culture period, both populations supported transplantable HSCs from 10 cells/well co-cultures demonstrating high levels of donor repopulation with an average of 65+23.6% chimerism from CD105POS co-cultures and 49.3+19.5% chimerism from the CD105NEG co-cultures. However, we observed a significant difference when mice were transplanted with the progeny of a single co-cultured HSC. In these experiments, CD105POS co-cultures (100%) demonstrated long-term multi- lineage reconstitution, while only 4 of 8 mice (50%) from CD105NEG -single HSC co-cultures demonstrated long-term reconstitution, suggesting a more limited expansion of functional stem cells. Taken together, these results demonstrate that the PDGFRαβCD105POS stromal cell subpopulation is distinguished by a unique capacity to support the expansion of long-term reconstituting HSCs in vitro.

An assessment of post-disaster psychological stress in hazardous waste operations and emergency response (HAZWOPER) workers

Personnel involved in natural or man-made disaster response and recovery efforts may be exposed to a wide variety of physical and mental stressors that can exhibit long-lasting and detrimental psychopathological outcomes. In a disaster situation, huge numbers of "secondary" responders can be involved in contaminant clean-up and debris removal and can be at risk of developing stress-related mental health outcomes. The Occupational Safety and Health Administration (OSHA) worker training hierarchy typically required for response workers, known as "Hazardous Waste Operations and Emergency Response" (HAZWOPER), does not address the mental health and safety concerns of workers. This study focused on the prevalence of traumatic stress experienced by secondary responders that had received or expressed interest in receiving HAZWOPER training through the National Institute of Environmental Health Sciences Worker Education and Training Program (NIEHS WETP). ^ The study involved the modification of two preexisting and validated survey tools to assess secondary responder awareness of physical, mental, and traumatic stressors on mental health and sought to determine if a need existed to include traumatic stress-related mental health education in the current HAZWOPER training regimen. The study evaluated post-traumatic stress disorder (PTSD), resiliency, mental distress, and negative effects within a secondary responder population of 176 respondents. Elevated PTSD levels were seen in the study population as compared to a general responder population (32.9% positive vs. 8%-22.5% positive). Results indicated that HAZWOPER-trained disaster responders were likely to test positive for PTSD, whereas, untrained responders with no disaster experience and responders who possessed either training or disaster experience only were likely to test PTSD negative. A majority (68.75%) of the population tested below the mean resiliency to cope score (80.4) of the average worker population. Results indicated that those who were trained only or who possessed both training and disaster work experience were more likely to have lower resiliency scores than those with no training or experience. There were direct correlations between being PTSD positive and having worked at a disaster site and experiencing mental distress and negative effects. However, HAZWOPER training status does not significantly correlate with mental distress or negative effect. ^ The survey indicated clear support (91% of respondents) for mental health education. The development of a pre- and post-deployment training module is recommended. Such training could provide responders with the necessary knowledge and skills to recognize the symptomology of PTSD, mental stressors, and physical and traumatic stressors, thus empowering them to employ protective strategies or seek professional help if needed. It is further recommended that pre-deployment mental health education be included in the current HAZWOPER 24- and 40-hour course curriculums, as well as, consideration be given towards integrating a stand-alone post-deployment mental health education training course into the current HAZWOPER hierarchy.^

Social views of distant university

"La sociedad tiende a fundarse cada vez más en el conocimiento", expresaba la Conferencia Mundial sobre Educación Superior (París, 1998). "Por consiguiente -concluía- la educación superior ha de emprender la renovación más radical que jamás haya tenido por delante...". Hoy sólo el 1% de la humanidad accede a la Universidad, durante un período de su vida. El desafío que enfrentamos es que pueda acceder el 99% restante, durante toda su vida. Sostenemos que la plataforma de comunicación y las tecnologías para el perfil que asumirá la universidad en el nuevo siglo ya existen y se desenvolverán aceleradamente en la próxima década...

El recurso a Dionisio Areopagita por sobre Aristóteles en algunos pasajes del Comentario a las Sentencias de Santo Tomás

El Comentario a las Sentencias, una obra de juventud del Aquinate, permite reconocer la presencia de Aristóteles en su pensamiento ya desde el comienzo de su producción filosófica. Uno de los temas donde claramente se nota su influencia es en la teoría del conocimiento, pues el joven dominico parece aceptar los aspectos centrales de la visión del Estagirita, aunque evidentemente las fórmulas y desarrollos no tienen aquí la precisión que se observa en escritos posteriores y en las que ciertamente uno encuentra un Santo Tomás más maduro. En el presente artículo quisiera desarrollar algunos elementos que surgen al analizar la importancia que se da en esta obra a lo sensible. En efecto, la frecuencia con la que el Aquinate recurre a Dionisio para completar e incluso corregir algunas afirmaciones de Aristóteles en este tema no puede menos que llamar la atención. A la necesidad de lo sensible se suma por ejemplo el hecho de concebir a la creación como símbolo de Dios o a lo material como un elemento mediador, dos temas de clara inspiración dionisiana. Como intento mostrar, aun reconociendo la presencia de Aristóteles, la posición de Santo Tomás en el tema de lo sensible y sobre todo en el papel que deben ocupar los sentidos no pueden ser comprendidos cabalmente sin reconocer en qué medida su pensamiento es tributario del Areopagita.

The organizations transcomplejas from the perspective of the nursing

El propósito del artículo es el análisis de las organizaciones transcomplejas desde la perspectiva de la Enfermería, en el contexto del paradigma de la complejidad. Todos los cuestionamientos realizados a las ciencias de la modernidad fueron necesarios para dar al mundo desarrollos de enorme significación, como es el paradigma de la complejidad donde se rescata la idea de la totalidad universal y con ella el holismo dentro de las organizaciones, si se consideran estas como organismos vivo; y este aplicado al campo de la salud donde los profesionales del cuidado de la salud entre ellos la enfermería ha aceptado la perspectiva de salud holística como, más que la ausencia de enfermedad, como la realización individual. La humanidad vive una crisis de fragmentación que conduce a sentimientos y emociones destructivas de la armonía y del arte de vivir en equilibrio. La perspectiva holistica se preocupa de promover la salud mediante la prevención y se aplica a las personas que se recuperan de una enfermedad y desean aprender a prevenir su repetición y mejorar su estatus de salud futura. Así, la enfermería estudia la totalidad o la salud de los humanos, reconociendo que los humanos están en continua interacción con su medio ambiente

Measurements of neutrino oscillation in appearance and disappearance channels by the T2K experiment with 6.6×10²⁰ protons on target

We report on measurements of neutrino oscillation using data from the T2K long-baseline neutrino experiment collected between 2010 and 2013. In an analysis of muon neutrino disappearance alone, we find the following estimates and 68% confidence intervals for the two possible mass hierarchies: Normal Hierarchy: sin²θ₂₃= 0.514+0.055−0.056 and ∆m²_32 = (2.51 ± 0.10) × 10⁻³ eV²/c⁴ Inverted Hierarchy: sin²θ₂₃= 0.511 ± 0.055 and ∆m²_13 = (2.48 ± 0.10) × 10⁻³ eV²/c⁴ The analysis accounts for multi-nucleon mechanisms in neutrino interactions which were found to introduce negligible bias. We describe our first analyses that combine measurements of muon neutrino disappearance and electron neutrino appearance to estimate four oscillation parameters, |∆m^2|, sin²θ₂₃, sin²θ₁₃, δCP , and the mass hierarchy. Frequentist and Bayesian intervals are presented for combinations of these parameters, with and without including recent reactor measurements. At 90% confidence level and including reactor measurements, we exclude the region δCP = [0.15, 0.83]π for normal hierarchy and δCP = [−0.08, 1.09]π for inverted hierarchy. The T2K and reactor data weakly favor the normal hierarchy with a Bayes Factor of 2.2. The most probable values and 68% 1D credible intervals for the other oscillation parameters, when reactor data are included, are: sin²θ₂₃= 0.528+0.055−0.038 and |∆m²_32| = (2.51 ± 0.11) × 10⁻³ eV²/c⁴.

In Memory of Dr. Ali Al-Gritly (1913-1982): His Views on Egypt's experience with Socialism

This essay reexamines the great contributions made by Dr. Ali Al-Gritly to Egypt. He was the finance minister for a short period at the beginning of the 1950s and later was appointed as chairman of the Bank of Alexandria. In 1966, he completed a book (Al-Gritly [1966 (1974)]) on the economic history of Egypt. However, the book was banned from publication due to irresistible circumstances. At that time, with Arab Socialism on the ascendance, his views on certain policies were not welcomed by the top political hierarchy. In 1974, the book was finally allowed to be published, and he wrote and published another book in 1977 (Al-Gritly [1977]) on the development of the Open Door Policy and the new economic policies accompanying it.

Shrinking population and the urban hierarchy

This paper examines whether population shrinkage leads to changes in urban hierarchy in terms of their relative size and function from the standpoint of the new economic geography. We find some salient patterns in which small cities in the agglomeration shadow become relatively bigger as medium industries spill over on them. This appears to be quite robust against a variation in the rate of natural change among cities. Thus, rank-size relationship and the urban hierarchy are partly disrupted as population shrinks. Regarding the welfare of the residents, a lower demand for land initially causes rent to go down, which boosts the utility. However, the illusion is short-lived because markets soon begin to shrink and suppress wages. We also find that it is better to maintain a slow pace of overall population decline in the long-term perspective. More importantly, it is crucial to sustain the relative livability of smaller cities to minimize the overall loss of utility.

Two Different Approaches of Feature Extraction for Classifying the EEG Signals

The focus of this chapter is to study feature extraction and pattern classification methods from two medical areas, Stabilometry and Electroencephalography (EEG). Stabilometry is the branch of medicine responsible for examining balance in human beings. Balance and dizziness disorders are probably two of the most common illnesses that physicians have to deal with. In Stabilometry, the key nuggets of information in a time series signal are concentrated within definite time periods are known as events. In this chapter, two feature extraction schemes have been developed to identify and characterise the events in Stabilometry and EEG signals. Based on these extracted features, an Adaptive Fuzzy Inference Neural network has been applied for classification of Stabilometry and EEG signals.

Evaluation of a User-Adapted Spoken Language Dialogue System: Measuring the Relevance of the Contextual Information Sources

We present an evaluation of a spoken language dialogue system with a module for the management of userrelated information, stored as user preferences and privileges. The flexibility of our dialogue management approach, based on Bayesian Networks (BN), together with a contextual information module, which performs different strategies for handling such information, allows us to include user information as a new level into the Context Manager hierarchy. We propose a set of objective and subjective metrics to measure the relevance of the different contextual information sources. The analysis of our evaluation scenarios shows that the relevance of the short-term information (i.e. the system status) remains pretty stable throughout the dialogue, whereas the dialogue history and the user profile (i.e. the middle-term and the long-term information, respectively) play a complementary role, evolving their usefulness as the dialogue evolves.