7440 research outputs found
Sort by
Perceived symptom experience in head and neck cancer patients with lymphedema
No full textBackground: Lymphedema frequently develops as a long-term effect from cancer and/or its treatment, including head and neck cancer (HNC). There is a substantial lack of understanding regarding the symptoms and experiences related to head and neck lymphedema. Objective: The objective of this study was to explore HNC patients' experiences of lymphedema, with emphasis on physical findings and associated symptom burden. Design: This was a qualitative, descriptive study. A purposive sample of 20 HNC patients who completed lymphedema therapy participated in semistructured, face-to-face interviews. Thematic content analysis was utilized to assess data. Results: Participants delineated the time when lymphedema onset presented and the sites of involvement. Most participants first noticed external or internal lymphedema/swelling within three months following either surgery or radiation therapy. Participants described a broad array of concurrent symptoms and functional deficits, including altered sensations, altered functions, neck–shoulder musculoskeletal/skin impairments, and psychosocial symptoms. Discussion: HNC patients experienced multiple physical and psychosocial symptoms during the time they experienced lymphedema. Conclusions: Clinicians need to inquire about tissue swelling and associated symptoms early in the post-treatment period to initiate lymphedema management strategies in a timely manner and facilitate reduction of long-term symptom burden and functional deficits.8 page(s
Book review : 'Language learning beyond the classroom'
No full textA book review of 'Language Learning Beyond the Classroom' by D. Nunan and J. C. Richards (eds.), New York/Routledge, 9780415713153.4 page(s
Penile rehabilitation for robotic radical prostatectomy : a new game [letter to the editor]
No full text2 page(s
Life according to ME : caught in the ebb-tide
No full textIn this article, we explore the role of 'place' in shaping people's illness experiences through a data-led inductive case-study based on experiential data from people living with myalgic encephalomyelitis (ME) in Norway. Our main aim is to understand how they experience, interpret and attach meaning to various places in which they reside, and how they construct the course of a life influenced by chronic illness. The study is based on stories containing photographs and written texts, received from 10 women and men. In their stories, they describe those places where they experience their illness in the least and most taxing ways. Through a narrative and photographic analysis of their stories, we explore how they perceive the relationship between place and illness as experienced, managed and endured. Our analysis is based on a place-sensitive sociology, in which we approach place both as physicality and a symbolic construction. The participants describe how a wide range of places are intimately linked to their illness experiences, and they interpret these links by referring to both physical and symbolic factors. They describe their lives in terms of a need for equilibrium between activity and rest. Risk is a strong underlying theme: whatever they do, they risk losing something. Most of all, the participants describe how they are looking for places to escape to and from. Places to escape to are those places where privacy and peace can be found, which primarily revolve around being at home. Places to escape from are those places that make their energy 'slowly ebb away'.21 page(s
Authors' reply to Palozzo and Messori : "Disinvestment and value-based purchasing strategies for pharmaceuticals : an international review"
No full text2 page(s
Crustal evolution of the Paleoproterozoic Birimian terranes of the Baoule-Mossi domain, southern West African Craton : U-Pb and Hf-isotope studies of detrital zircons
No full textThe Paleoproterozoic Baoulé-Mossi domain of the southern West African Craton is regarded as the result of juvenile crust formation during the 2.3–1.9 Ga period. However, little is known about the complex processes that led to the formation of this highly metal endowed lithospheric block. Hence, in order to better constrain its geodynamic evolution, small catchments within modern drainage basins of the Niger and Bani Rivers were sampled for detrital zircons for U–Pb and Hf-isotope analyses, following TerraneChron® methodology. The study area stretches across southern Mali over 40,000 km2 between the Yanfolila (west) and Syama (east) belts, from where more than 1000 zircons representing eight different sub-basins have been analyzed. The results of this study identified 2 main zircon age populations. The older population with ages between 3.6 and 2.7 Ga represents approximately 10% of the total of the analyzed zircons, and is mainly restricted to the western margin of the study area across the Yanfolila Belt sampling sites. The Hf-isotope data from this zircon population yielded model ages between 3.7 and 3.6 Ga and suggest a common evolution. Conversely, the main zircon population is dominated by Paleoproterozoic age zircons ranging between 2.4 and 2.1 Ga. Main peaks within this age group were identified at ca. 2161, 2121 and 2084 Ma, and minor peaks at ca. 2343, 2263 and 2200 Ma. The Hf-isotope data of this age group indicate that the zircons are derived from a mainly juvenile source, but were contaminated with crustal rocks potentially as old as 2.8 Ga. However, a group (approximately 10%) of Paleoproterozoic age zircons, which is interpreted to be the result of stream sediment transport from distal sources or the result of multiple cycles of sedimentation, displays a minor but significant older component, up to 4.0 Ga. This study also highlights the occurrence of >2.7 Ga detrital zircons, which are of an unknown source as no rock unit in the region has been identified to yield similar Archean ages. Moreover, some Paleoproterozoic zircons show Hf-isotope composition that indicates reworking of an older crustal component. Although zircons of the Baoulé-Mossi domain generally confirm its juvenile origin, they also indicate reworking of an older crust at a much larger scale than previously recognized. The identification of Archean zircons in the region argues for greater interaction between the Baoulé-Mossi domain and the Archean Kénéma-Man domain.36 page(s
Factors predicting postoperative unilateral and bilateral speech recognition in adult cochlear implant recipients with acoustic hearing
No full textObjectives: The first objective was to examine factors that could be predictive of postoperative unilateral (cochlear implant alone) speech recognition ability in a group of subjects with greater degrees of preoperative acoustic hearing than has been previously examined. Second, the study aimed to identify factors predictive of speech recognition in the best-aided, bilateral listening condition. Design: Participants were 65 postlinguistically hearing-impaired adults with preoperative phoneme in quiet scores of greater than or equal to 46% in one or both ears. Preoperative demographic and audiometric factors were assessed as predictors of 12-month postoperative unilateral and bilateral monosyllabic word scores in quiet and of bilateral speech reception threshold (SRT) in babble. Results: The predictive regression model accounted for 34.1% of the variance in unilateral word recognition scores in quiet. Factors that predicted better scores included: a shorter duration of severe to profound hearing loss in the implanted ear; and poorer pure-tone-averaged thresholds in the contralateral ear. Predictive regression models of postimplantation bilateral function accounted for 36.0% of the variance for word scores in quiet, and 30.9% of the variance for SRT in noise. A shorter duration of severe to profound hearing loss in the implanted ear, a lower age at the time of implantation, and better contralateral hearing thresholds were associated with higher bilateral word recognition in quiet and SRT in noise. Conclusions: In this group of cochlear implant recipients with preoperative acoustic hearing, a shorter duration of severe to profound hearing loss in the implanted ear was shown to be predictive of better unilateral and bilateral outcomes. However, further research is warranted to better understand the impact of that factor in a larger number of subjects with long-term hearing impairment of greater than 30 years. Better contralateral hearing was associated with poorer unilateral word scores with the implanted ear alone, but better absolute bilateral speech recognition. As a result, it is clear that different models would need to be developed to predict unilateral and bilateral postimplantation scores.11 page(s
Attitudes of medical and allied medical students from Serbia toward whole body donation
No full textAnatomy, one of the key pre-clinical subjects in medical and allied medical disciplines, has traditionally relied on instruction based on the utilization of cadavers. Acquiring cadavers for anatomy education has presented a challenge in many countries. This challenge has been met through the organization of well informed and culturally sensitive body donation programs. Attitudes of the general population, medical professionals and students are important in devising these programs. The aim of this study was to investigate attitudes of medical and allied medical students from the University of Novi Sad toward whole body donation. A survey was carried out on the first and third year students enrolled in all degrees taught at the University and the sixth year medical students. A large number of respondents (87.38%) perceived cadavers as important in anatomy education. The majority of students (51.26%) would support the body donation of a stranger, while a much smaller proportion of respondents would become donors (19.51%) or support their family members (21.67%) to bequeath their body. There were differences in attitudes toward body donation related to respondents’ year of study, ethnicity and religion. The main reasons for donation were altruistic, while the main reasons not to donate were lack of information and religious factors. Most of the respondents were in favor of introducing memorial services for the body donors. The results of the study highlight the importance of a culturally sensitive approach to students in the anatomy laboratories and the enrichment of anatomy education through the humanities. They also underscore the significance of well-organised and informative body donation programs.15 page(s
Galaxy and Mass Assembly (GAMA) : improved emission lines measurements in four representative samples at 0.07 < z < 0.3
No full textThis paper presents a new catalog of emission lines based on the GAMA II data for galaxies between 0.07 9.4 at z ~ 0.1 and and log M⁎ > 10.6 at z ~ 0.30. We have developed a dedicated code called MARVIN that automates the main steps of the data analysis, but imposes visual individual quality control of each measurement. We use this catalog to investigate how the sample selection influences the shape of the stellar mass - metallicity relation. We find that commonly used selection criteria on line detections and by AGN rejection could affect the shape and dispersion of the high-mass end of the M - Z relation. For log M⁎ > 10.6, common selection criteria reject about 65% of the emission-line galaxies. We also find that the relation does not evolve significantly from z = 0.07 to z = 0.34 in the range of stellar mass for which the samples are representative (log M⁎ > 10.6). For lower stellar masses (log M⁎ < 10.2) we are able to show that the observed 0.15 dex metallicity decrease in the same redshift range is a consequence of a color bias arising from selecting targets in the r-band. We highlight that this color selection bias affects all samples selected in r-band (e.g., GAMA and SDSS), even those drawn from volume-limited samples. Previously reported evolution of the M - Z relation at various redshifts may need to be revised to evaluate the effect of this selection bias.16 page(s
High melphalan exposure is associated with improved overall survival in myeloma patients receiving high dose melphalan and autologous transplantation
No full textAim: High dose melphalan (HDM) and autologous stem cell transplantation (ASCT) retains a central role in the treatment of myeloma. The aim of this study was to determine whether HDM exposure (area under the concentration vs. time curve, AUC), is significantly associated with transplant outcomes. Methods: Melphalan concentrations were measured in six to 11 plasma samples collected after HDM (median 192 mg m⁻²) to determine melphalan AUC for a total of 114 patients. Binary logistic regression was used to assess whether melphalan AUC was associated with severe (≥ grade 3) oral mucositis. Multivariate Cox regression was used to assess whether melphalan AUC was significantly associated with time to progression, progression-free survival and overall survival (OS). Results: Melphalan AUC ranged from 4.9 to 24.6 mg l⁻¹ h, median 12.84 mg l⁻¹ h. Melphalan AUC above the median was a risk factor for severe mucositis (HR 1.21, 95% CI 1.06, 1.38, P = 0.004) but was also associated with significantly improved overall survival (OS) (HR 0.40, 95% CI 0.20, 0.81, P = 0.001), with an estimated median survival of 8.50 years vs. 5.38 years for high vs. low AUC groups. Multivariate analysis did not identify melphalan AUC as being significantly associated with time to progression or progression-free survival. Conclusions: This large scale pharmacodynamic analysis of HDM demonstrates that high melphalan exposure is associated with improved survival, with an acceptable increase in transplant toxicity. These results suggest studies targeting a higher AUC are warranted in patients undergoing HDM and ASCT for myeloma.11 page(s