Psychological challenges for the oncology clinician who has to break bad news

Work-related stress of the oncology clinician is not only due to heavy clinical and administrative duties, but also arises when breaking bad news. However, there is important interindividual variation in stress levels during patient encounters, mainly due to the significance the situation represents for the oncologist. A reflection on his own development, his professional identity, and ways of dealing with the patient's suffering can reduce his levels of stress and distress and prevent burnout and other psychiatric disturbances. This chapter summarizes the psychological challenges the oncology clinician is facing when he announces the diagnosis of cancer, deals with the deception of relapse, discusses the transition to palliative care, copes with progression of the disease and uncertainty, and cares for the dying who is facing the unknown. Ways of refiecting on and dealing with these situations from a psychological and communicational perspective are described and illustrated by case vignettes.

Reflexive model of research-based theatre – processing innovation at the crossroads of theatre, reflection and practice-based innovation activities

Contemporary organisations have to embrace the notion of doing ‘more with less’. This challenges knowledge production within companies and public organisations, forcing them to reorganise their structures and rethink what knowledge production actually means in the context of innovation and how knowledge is actually produced among various professional groups within the organisation in their everyday actions. Innovations are vital for organisational survival, and ‘ordinary’ employees and customers are central but too-often ignored producers of knowledge for contemporary organisations. Broader levels of participation and reflexive practices are needed. This dissertation discusses the missing links between innovation research conducted in the context of industrial management, arts, and culture; applied drama and theatre practices (specifically post-Boalian approaches); and learning – especially organising reflection – in organisational settings. This dissertation (1) explores and extends the role of research-based theatre to organising reflection and reflexive practices in the context of practice-based innovation, (2) develops a reflexive model of RBT for investigating and developing practice-based organisational process innovations in order to contribute to the development of a tool for innovation management and analysis, and (3) operationalises this model within private- and publicsector organisations. The proposed novel reflexive model of research-based theatre for investigating and developing practice-based organisational process innovations extends existing methods and offers a different way of organising reflection and reflexive practices in the context of general innovation management. The model was developed through five participatory action research processes conducted in four different organisations. The results provide learning steps – a reflection path – for understanding complex organisational life, people, and relations amid renewal and change actions. The proposed model provides a new approach to organising and cultivating reflexivity in practice-based innovation activities via research-based theatre. The results can be utilised as a guideline when processing practice-based innovation within private or public organisations. The model helps innovation managers to construct, together with their employees, temporary communities where they can learn together through reflecting on their own and each others’ experiences and to break down assumptions related to their own perspectives. The results include recommendations for practical development steps applicable in various organisations with regard to (i) application of research-based theatre and (ii) related general innovation management. The dissertation thus contributes to the development of novel learning approaches in knowledge production. Keywords: practice-based innovation, research-based theatre, learning, reflection, mode 2b knowledge production

Break: o grito corporal da periferia

In order to question a sociology as it considers appropriate the body dimensions, which contributes in a mean singular in relation to body, not only as a matter, but mainly as a producer of knowledge, our research shows a reflection on corporality as the production of knowledge and to understand different perspectives and social logic here in contemporaneity, whose rationality seems to be placed in question through a performance expressed, a lot of 'breaks', including the space, which the dancer break appropriates of a reversed form and not more than linear. Our problem is the possibility of a greater understanding of this young body with dance the break, is not only 'breaking' his body, but fluent in their own body fragments, producing probably a break in relation to a dominant power established, by creating a kind of 'social resistance' to provide another sense for his life, out of the senses by the dominant of a social field. This is the area of production of knowledge, of the 'body' that cries keep our eyes, the challenge of dive in the depth of gestures, beyond the physical structure, restoring in a strong political constitution and cultural in so far as this body faces. The body as spectacular becomes 'cause and effect' of communication, this body is not only individual, it is not expression only for itself; when the young dance outside their walls individuals, makes it relational, turning to relate with the other, with the space, time and the world. The methodological point of view, to study this corporality in element break, the body as language of senses, we considered withdrawals in the field, observations of movements of the universe of break creative dance, performance and analysis of "attitudes" (expression peculiar world hip hop ), as well as my experience with dancing in the street interventions through 'urban' and our own attitudes to the object of research which challenges us academically and, it all, existentially

Safe Reflection Through Polymorphism

Code executed in a fully reflective system switches back and forth between application and interpreter code. These two states can be seen as contexts in which an expression is evaluated. Current language implementations obtain reflective capabilities by exposing objects to the interpreter. However, in doing so these systems break the encapsulation of the application objects. In this paper we propose safe reflection through polymorphism, \ie by unifying the interface and ensuring the encapsulation of objects from both the interpreter and application context. We demonstrate a \emphhomogeneous system that defines the execution semantics in terms of itself, thus enforcing that encapsulation is not broken.

Deep Crustal Structure of the North-West African Margin from Combined Wide-angle and Reflection Seismic Data (MIRROR Seismic Survey)

The structure of the Moroccan and Nova Scotia conjugate rifted margins is of key importance for understanding the Mesozoic break-up and evolution of the northern central Atlantic Ocean basin. Seven combined multichannel reflection (MCS) and wide-angle seismic (OBS) data profiles were acquired along the Atlantic Moroccan margin between the latitudes of 31.5° and 33° N during the MIRROR seismic survey in 2011, in order to image the transition from continental to oceanic crust, to study the variation in crustal structure and to characterize the crust under the West African Coast Magnetic Anomaly (WACMA). The data were modeled using a forward modeling approach. The final models image crustal thinning from 36 km thickness below the continent to approximately 8 km in the oceanic domain. A 100 km wide zone characterized by rough basement topography and high seismic velocities up to 7.4 km/s in the lower crust is observed westward of the West African Coast Magnetic Anomaly. No basin underlain by continental crust has been imaged in this region, as has been identified north of our study area. Comparison to the conjugate Nova Scotian margin shows a similar continental crustal thickness and layer geometry, and the existence of exhumed and serpentinized upper mantle material on the Canadian side only. The oceanic crustal thickness is lower on the Canadian margin.

[theoretical Construction In The Sociology Of Health: A Reflection On Its Trajectory].

The scope of this paper is to reflect on the theoretical construction in the constitution of the sociology of health, still called medical sociology in some countries. Two main ideas constitute the basis for this: interdisciplinarity and the degree of articulation in the fields of medicine and sociology. We sought to establish a dialogue with some dimensions - macro/micro, structure/action - that constitute the basis for understanding medicine/health in relation to the social/sociological dimension. The main aspects of these dimensions are initially presented. Straus' two medical sociologies and the theory/application impasses are then addressed, as well as the dilemmas of the sociology of medicine in the 1960s and 1970s. From these analyses the theoretical production before 1970 is placed as a counterpoint. Lastly, the sociology of health is seen in the general context of sociology, which underwent a fragmentation process from 1970 with effects in all subfields of the social sciences. This process involves a rethinking of the theoretical issues in a broadened spectrum of possibilities. The 1980s are highlighted when theoretical issues in the sociology of health are reinvigorated and the issue of interdisciplinarity is once again addressed.

[collective Health Paradigms: A Brief Reflection].

The article discusses the possibility of applying Kuhn's concept of paradigm to collective health. The concept and its use in epidemiology, planning and the social sciences are reviewed briefly. The study stresses the multi-paradigmatic character of collective health, resulting from the convergence of multiple epistemologies and the involvement of diverse fields such as the biological sciences, philosophy, the social sciences and humanities.

Quantum reflection: The invisible quantum barrier

We construct an invisible quantum barrier which represents the phenomenon of quantum reflection using available data on atom-wall and Bose-Einstein-condensate-wall reflection. We use the Abel equation to invert the data. The resulting invisible quantum barrier is double valued in both axes. We study this invisible barrier in the case of atom and Bose-Einstein condensate (BEC) reflection from a solid silicon surface. A time-dependent, one-spatial-dimension Gross-Pitaevskii equation is solved for the BEC case. We found that the BEC behaves very similarly to the single atom except for size effects, which manifest themselves in a maximum in the reflectivity at small distances from the wall. The effect of the atom-atom interaction on the BEC reflection and correspondingly on the invisible barrier is found to be appreciable at low velocities and comparable to the finite-size effect. The trapping of an ultracold atom or BEC between two walls is discussed.

Effects of drill cuttings discharge on meiofauna communities of a shelf break site in the southwest Atlantic

The present study investigates the effects of drill cutting discharges on the structure of meiofauna communities in an area of the shelf break at Campos Basin, Southeast Brazil. Drilling activities were operated, in a first phase, with water-based fluid and, in a second phase, with synthetic fluid paraffin-based (NAF-III). A total of 135 samples taken at a pre-drilling situation (MS1) and two post-drilling moments (MS2 and MS3-3 and 22 months post-drilling, respectively) were analyzed. Effects on meiofauna were dependent on two main factors: 1-the impact received during drilling operation, if water-based or synthetic/water-based drilling fluid and 2-the background state, if it already presented signs of previous drilling activities or not. Based on univariate and multivariate analysis, there were evidences that the most affected area after drilling was those under the influence of synthetic-based fluid and that already had signs of previous drillings activities. The region impacted only by water-based fluid was less affected and the only one that completely recovered after 22 months. Nematodes and copepods had different responses to the impact. While copepods flourish in the impacted area and recovered 22 months after drilling, nematodes were adversely affected shortly after drilling and the community structure only recovered where hydrocarbons had been depleted.

Ultrasonic Viscosity Measurement Using the Shear-Wave Reflection Coefficient with a Novel Signal Processing Technique

Real-time viscosity measurement remains a necessity for highly automated industry. To resolve this problem, many studies have been carried out using an ultrasonic shear wave reflectance method. This method is based on the determination of the complex reflection coefficient`s magnitude and phase at the solid-liquid interface. Although magnitude is a stable quantity and its measurement is relatively simple and precise, phase measurement is a difficult task because of strong temperature dependence. A simplified method that uses only the magnitude of the reflection coefficient and that is valid under the Newtonian regimen has been proposed by some authors, but the obtained viscosity values do not match conventional viscometry measurements. In this work, a mode conversion measurement cell was used to measure glycerin viscosity as a function of temperature (15 to 25 degrees C) and corn syrup-water mixtures as a function of concentration (70 to 100 wt% of corn syrup). Tests were carried out at 1 MHz. A novel signal processing technique that calculates the reflection coefficient magnitude in a frequency band, instead of a single frequency, was studied. The effects of the bandwidth on magnitude and viscosity were analyzed and the results were compared with the values predicted by the Newtonian liquid model. The frequency band technique improved the magnitude results. The obtained viscosity values came close to those measured by the rotational viscometer with percentage errors up to 14%, whereas errors up to 96% were found for the single frequency method.

Viscosity measurement of Newtonian liquids using the complex reflection coefficient

This work presents the implementation of the ultrasonic shear reflectance method for viscosity measurement of Newtonian liquids using wave mode conversion from longitudinal to shear waves and vice versa. The method is based on the measurement of the complex reflection coefficient (magnitude and phase) at a solid-liquid interface. The implemented measurement cell is composed of an ultrasonic transducer, a water buffer, an aluminum prism, a PMMA buffer rod, and a sample chamber. Viscosity measurements were made in the range from 1 to 3.5 MHz for olive oil and for automotive oils (SAE 40, 90, and 250) at 15 and 22.5 degrees C, respectively. Moreover, olive oil and corn oil measurements were conducted in the range from 15 to 30 degrees C at 3.5 and 2.25 MHz, respectively. The ultrasonic measurements, in the case of the less viscous liquids, agree with the results provided by a rotational viscometer, showing Newtonian behavior. In the case of the more viscous liquids, a significant difference was obtained, showing a clear non-Newtonian behavior that cannot be described by the Kelvin-Voigt model.

Denisiuk-type reflection holography display with sillenite crystals for imaging and interferometry of small objects

A novel setup for imaging and interferometry through reflection holography with Bi12TiPO20(BTO) sillenite photorefractive crystals is proposed. A variation of the lensless Denisiuk arrangement was developed resulting in a compact, robust and simple interferometer. A red He-Ne laser was used as light source and the holographic recording occurred by diffusion with the grating vector parallel to the crystal [0 0 1]-axis. In order to enhance the holographic image quality and reduce noise a polarizing beam splitter (PBS) was positioned at the BTO input and the crystal was tilted around the [0 0 1]-axis. This enabled the orthogonally polarized transmission and diffracted beams to be separated by the PBS, providing the holographic image only. The possibility of performing deformation and strain analysis as well as vibration measurement of small objects was demonstrated. (C) 2007 Elsevier B.V. All rights reserved.

Discriminant analysis of trace elements in normal, benign and malignant breast tissues measured by total reflection X-ray fluorescence

In this work total reflection X-ray fluorescence spectrometry has been employed to determine trace element concentrations in different human breast tissues (normal, normal adjacent, benign and malignant). A multivariate discriminant analysis of observed levels was performed in order to build a predictive model and perform tissue-type classifications. A total of 83 breast tissue samples were studied. Results showed the presence of Ca, Ti, Fe, Cu and Zn in all analyzed samples. All trace elements, except Ti, were found in higher concentrations in both malignant and benign tissues, when compared to normal tissues and normal adjacent tissues. In addition, the concentration of Fe was higher in malignant tissues than in benign neoplastic tissues. An opposite behavior was observed for Ca, Cu and Zn. Results have shown that discriminant analysis was able to successfully identify differences between trace element distributions from normal and malignant tissues with an overall accuracy of 80% and 65% for independent and paired breast samples respectively, and of 87% for benign and malignant tissues. (C) 2009 Elsevier B.V. All rights reserved.

Bed shear stress measurements in dam break and swash flows

A novel shear plate was used to make direct bed shear stress measurements in laboratory dam break and swash flows on smooth, fixed, impermeable beds. The pressure gradient due to the slope of the fluid free-surface across the plate was measured using pressure transducers. Surface elevation was measured at five locations using acoustic displacement sensors. Flow velocity was measured using an Acoustic-Doppler Velocimeter and calculated using the ANUGA inundation model. The measured bed shear stress at the dam break fluid tip for an initially dry, horizontal bed was close to twice that estimated using steady flow theory. The temporal variation of swash bed shear stress showed a large peak in landward directed stress at the uprush tip, followed by a rapid decay throughout the uprush flow interior. The peak seaward directed stress during the backwash phase was less than half that measured in the uprush. Close to the still water line, in the region of bore collapse and at the time of initial uprush, favourable pressure gradients were measured. In the lower swash region predominately weak adverse pressure gradients were measured.