Measuring impact of nursing intervention on cancer patients' ability to control symptoms

Cancer patients' ability to control symptoms and to maintain reasonable quality of life is limited due to lack of knowledge, guidance, and instructions from health care providers, who usually refrain from transferring responsibility for the treatment to the patient. The present study describes a measured effect of a structured nursing intervention in which nurses were trained to apply the self-care model to 48 ambulatory cancer patients under chemo- or radiotherapy or both. The intervention included 10 structured home visits to each patient during 3 months, in which the nurse assessed symptoms and advised, guided, supported, and educated the patient in the relevant areas. The symptoms were quantitatively assessed using the Symptom Control Assessment (SCA) instrument, which was developed and validated specifically for this study. The SCA relates to 16 signs, symptoms, and complaints that encompass both the universal and the deviation-from-health needs, in addition to anxiety, body image, and sexuality. The instrument allows either the patient or the nurse to rate the severity of the complaint, the patient's independence in controlling it, the patient's perception of the familial and external help extended to him or her, and the knowledge of the symptom and its control possessed by the patient. Also, the SCA allows comparing the patient's ratings with the professional view of the visiting nurse. The SCA was proven to be a highly reliable and valid instrument. The results indicate that the intensity of the complaints decreased in the experimental group during the 3-month period while they increased in the matched control group, creating a considerable difference between the two groups on multivariate analysis of covariance (MANCOVA). On t-tests, significant improvement was found in 15 out of the 16 symptoms, including pain. The greatest reduction was found in the "psychosocial symptoms," namely anxiety, sociability, body image, and sexuality. Similarly, the patients' independence, knowledge, and perception of familial help increased in the experimental group and declined in the control group. Perhaps the most meaningful change was a significant increase in the ability of the experimental patients to assume responsibility for their own treatment as it is reflected by the increase of the independence ratings for all 16 symptoms. This is in sharp contrast to the decrease in 15 of the 16 symptoms among control patients. The results suggest that the self-care approach is effective also in improving the quality of life for unstable cancer patients by reduction of suffering and increase in controlling capabilities.     

冶金企业实验室认可工作探讨

对冶金企业实验室认可方面的工作进行了几方面的探讨冶金企业实验室的基本状况;冶金企业实验室认可的目的;冶金企业实验室认可的基本状况以及认可的检测实验室(tesing laboratory)应注意的几个问题.     

Friendships in Middle School: Influences on Motivation and School Adjustment.

In this 2-year longitudinal study (n=242), the authors examined relations of having a reciprocated friend and characteristics of a reciprocated friend to students' social and academic adjustment to middle school. With respect to having a friend, 6th-grade students without friends showed lower levels of prosocial behavior, academic achievement, and emotional distress than did students with reciprocated friendships. Not having a friend in 6th grade also was related to emotional distress 2 years later. Evidence that motivational processes mediate relations between friends' and individuals' prosocial behavior was obtained. For students with reciprocated friendships (n=173). friends' prosocial behavior predicted change in individuals' prosocial behavior in 8th grade by way of changes in goals to behave prosocially. Implications for studying friendship influence in middle school are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validation of procedures for fatigue life assessment of a steel pressure vessel

A full‐size pressure vessel, made of steel plate P355NL1 (EN 10028‐3), was tested under repeated internal pressure until its failure was observed. Also, four representative structural details of the tested pressure vessel were fatigue tested under load control with a stress ratio of R= 0. These structural details are basically two seam‐welded joints, namely a butt‐welded joint and a joggle‐welded joint, one plate attachment using fillet‐welded joints and a nozzle‐to‐plate connection. S–N curves were generated for these details based on both nominal and structural stresses. These curves are critically compared with those proposed in pressure vessel design codes like the ASME VIII – Division 2, the PD 5500 and the recently approved EN procedures, the EN 13445 standard. Finally, predictions of the fatigue life of the pressure vessel, obtained using the previously referred procedures and the experimentally derived design curves are critically compared with the observed life of the vessel.     

A multilevel approach to the optimisation of a composite light rail vehicle bodyshell

The optimisation of design parameters associated with composite sandwich bodyshell walls of light rail vehicles (LRV) is investigated. The main objective is to evaluate a multi-level computational procedure that leads to optimum wall ply thickness and geometric shapes for areas such as door and window openings. The optimisation procedures are extensively automated whereby iterative finite element solutions are executed under the control of a software suite containing information on the optimisation parameters, objective functions and constraints. The steps in the process include a global finite element analysis of the complete LRV bodyshell subjected to an industry standard loading, identification of a critically loaded panel and its division into domains, and optimisation of a window panel fillet radius within these domains. Numerical results are obtained in order to demonstrate the viability of the method as a design tool.     

Optimality in discrete model-following systems in the presence of unmodelled dynamics.

The problem of optimal model-following linear control of discrete stochastic adaptive systems is studied in the presence of unmodelled dynamics. The controller complexity is restricted to that corresponding to the perfectly modelled situation. The key for a control design to be robust in the presence of unmodelled dynamics is closely related to some parametrical conditions that ensure a certain linear filter (involving parametrical uncertainties related to unmodelled dynamics) maintains the output stationarity of any stationary random input signal, as in the nominal situation. Partial results concerning robustness are obtained from stability considerations. In any case, a priori knowledge on the unmodelled dynamics is not available for the implementation of the control law.     

Fully polarimetric classification of the Black Forest MAESTRO 1 AIRSAR data

In this paper we present a study on the application of polarimetric supervised classification techniques to the case of a forested area where the influence of topography is important. For the experimental part of the study, we use the polarimetric AIRSAR data at C, Land P band, acquired over the Black Forest near Freiburg “Germany” during the 1989 MAESTRO I Campaign. Two classification schemes are considered: one is of the classical Bayes type, while the other is based on the concept of maximum contrast. We show practical results of the use of both classifiers in a classification context based on tree age classes. Also the dependency of the classification accuracy on a number of parameters, such as calibration, feature vector dimensions and covariance matrix representation, is discussed. Finally, we focus on the influence of topography on classification and indicate how we can improve the classification results using a priori knowledge of the terrain slope.     

Stabilization of gas cavitation nuclei by surface-active compounds

Gas bubbles are the primary agent in producing the pathogenic effects of decompression sickness. Numerous experiments indicate that bubbles originate in water, and probably also in man, as pre-existing gas nuclei. This is surprising considering that gas phases larger than 1 micron should rise to the surface of a standing liquid, whereas smaller ones should dissolve rapidly due to surface tension. Several stabilizing mechanisms have been suggested, and each has been refuted on experimental grounds. In this article, we propose a new model that arises out of a systematic study of the earlier theories. We review these theories and conclude that gas cavitation nuclei must be held intact by surface-active skins that are initially permeable. The first quantitative analysis of bubble formation data from supersaturated gelatin is summarized and leads to the further conclusion that skins can become impermeable if the ambient pressure is increased rapidly by a sufficient amount. Our model owes much to Sirotyuk, who "demonstrated experimentally that stabilization of gas bubbles acting as cavitation nuclei in water is always attributable to the presence of surface-active substances in the water".     

Pyrroloquinoline quinone acts with flavin reductase to reduce ferryl myoglobin in vitro and protects isolated heart from re-oxygenation injury

Pyrroloquinoline quinone has been isolated from bacteria and recently has been detected in mammalian tissues and fluids. We report in vitro studies which show that pyrroloquinoline quinone serves as a high-affinity substrate for an erythrocyte "flavin reductase" and that the pyrroloquinoline quinol generated by this catalysis reacts rapidly with ferryl myoglobin radical. Western blot analysis of rat and rabbit heart homogenates detects a cross-reactive protein which has a molecular weight identical to the erythrocyte reductase from the same species. Low concentrations of pyrroloquinoline quinone protect isolated rabbit heart from re-oxygenation injury, serving as an effective tissue-protective agent in this model for cellular oxidative damage. We propose that this tissue protection is due to a pyrroloquinoline quinol-mediated reduction of reactive oxygen species.     

Effects of non-proportional loading paths on the orientation of fatigue crack path

Fatigue crack path prediction and crack arrest are very important for structural safety. In real engineering structures, there are many factors influencing the fatigue crack paths, such as the material type (microstructure), structural geometry and loading path, etc. In this paper, both experimental and numerical methods are applied to study the effects of loading path on crack orientations. Experiments were conducted on a biaxial testing machine, using specimens made of two steels: 42CrMo4 and CK45 (equivalent to AISI 1045), with six different biaxial loading paths. Fractographical analyses of the plane of the stage I crack propagation were carried out and the crack orientations were measured using optical microscopy. The multiaxial fatigue models, such as the critical plane models and also the energy‐based critical plane models, were applied for predicting the orientation of the critical plane. Comparisons of the predicted orientation of the damage plane with the experimental observations show that the shear‐based multiaxial fatigue models provide good predictions for stage I crack growth for the ductile materials studied in this paper.