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Helena Johansson,1,2 Carina Berterö,2 Katarina Berg,2 Lise-Lotte Jonasson3 1Department of Medical Specialist, Linköping University, Motala, Sweden; 2Department of Medical Health Sciences, Linköping University, Linköping, Sweden; 3Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden Background: Chronic obstructive pulmonary disease (COPD) is a prevalent illness that, due to its symptoms and treatment, entails a significant burden for the affected person, and his/her family, health care and private finances. Today, knowledge and understanding are sparse regarding COPD-affected persons’ own lived experiences and about the symptom burden and its effect on their daily life. Due to this knowledge gap the aim of this study was to identify and describe the symptom burden and its effect on daily life in people with COPD, based on their own lived experiences.Subject and method: Eleven males and 14 females in GOLD stages III and IV, in an age range of 58–82 years, were interviewed. An interview guide was used to direct the face-to-face interviews. Data was analyzed with thematic analysis following the six steps according to Braun and Clarke.Results: The results highlighted one theme: an altered everyday life. The altered everyday life leads to a need for support to handle everyday life and for different strategies to live as desired. Persons with COPD need to take each day as it comes and their life is not easy to plan since it depends on how they feel from day to day. Life is handled with several strategies such as breathing techniques, and ways to take care of the home and garden as well as the emotions. Support from the next of kin, society and the health care service is important.Conclusion: This study provides the insight that persons with COPD in stages III and IV have an altered life caused by the symptom burden. They must struggle with strategies to handle everyday life. There is a need of support from the next of kin and society to facilitate daily living, but this support needs to be well-balanced. Keywords: chronic obstructive pulmonary disease, symptom burden, daily life, thematic analysis

Background: Frailty is strongly correlated with mortality in intensive care unit patients, yet routine screening among intensive care patients is rarely performed. The aim of this study is to assess frailty and health‐related quality of life (HRQoL) in patients before intensive care admission and to compare this with outcomes after 3 and 12‐months. The Clinical Frailty Scale and EQ‐5D‐5L will be used to assess frailty and HRQoL, respectively. Methods: This is an ongoing, prospective observational study including patients from five Norwegian ICU's. Inclusion criteria are patients aged ≥65 years requiring invasive mechanical ventilation for ≥24 h. The Clinical Frailty Scale and EQ‐5D‐5L are administered at baseline (before critical illness) and at 3‐ and 12‐months post‐inclusion. Additional data collected includes patient characteristics, ICU treatment details, illness severity and mortality. The EQ‐5D‐5L will be compared to Norwegian population norms and assessed for measurement properties. Results: Inclusion started July 2022 and will be stopped at 350 patients. The study will be completed in 2025. Conclusion: The study will assess the feasibility and measurement properties of the Clinical Frailty Scale and EQ‐5D‐5L in ICU survivors by telephone at long‐term follow‐up study and will give additional information on the frailty and HRQoL of intensive care survivors. Clinical trial registration: The study is registered in ClinicalTrials.gov NCT06012942. Protocol version 2.7.1, 19.05.2023. [ABSTRACT FROM AUTHOR]

Introduction: Bipolar disorder is a severe mental health problem with limited treatment success. There is a call for improving interventions, requiring an increased understanding of factors driving mood instability. One promising avenue is to study temporal associations between factors that appear relevant according to the emotional amplifier model of Holmes are changes in mood, anxiety and mental imagery. Methods: The current study used data from a recent RCT for a secondary analysis which applied a network analysis approach to explore temporal associations between weekly measurements of mania, depression, anxiety and mental imagery measured during 32 weeks in two randomised groups (N = 55) receiving either imagery‐focused cognitive therapy (ImCT) or group psychoeducation (PE). Results: Both negative intrusive mental imagery and anxiety appeared central in the network analyses, driving changes in both mania and depression, but only in the PE group. In the ImCT group, only anxiety was driving changes in mania and depression. Conclusion: Although exploratory, findings suggest that prior increases in anxiety and negative intrusive mental imagery might be associated with subsequent increases in depression and mania symptoms in patients with bipolar disorder. Anxiety might in turn increase negative intrusive imagery and associated negative emotions. Although more research is needed, results are in line with the emotional amplifier model and stress that future interventions with a focus on anxiety and imagery might help to improve psychosocial therapies for patients with bipolar disorder. In addition, this study suggests that a network approach is a helpful and feasible way to study mood instability, anxiety and mental imagery to increase our understanding of mechanisms underpinning mood instability. [ABSTRACT FROM AUTHOR]

This study describes the profile of repetitive behaviour in individuals with Williams syndrome, utilising cross-syndrome comparisons with people with Prader-Willi and Down syndromes. The Repetitive Behaviour Questionnaire was administered to caregivers of adults with Williams (n = 96), Prader-Willi (n = 103) and Down (n = 78) syndromes. There were few group differences, although participants with Williams syndrome were more likely to show body stereotypies. Individuals with Williams syndrome also showed more hoarding and less tidying behaviours than those with Down syndrome. IQ and adaptive ability were negatively associated with repetitive questioning in people with Williams syndrome. The profile of repetitive behaviour amongst individuals with Williams syndrome was similar to the comparison syndromes. The cognitive mechanisms underlying these behaviours in genetic syndromes warrant further investigation.

The Advanced Light Source (ALS) at Berkeley Lab remains one of the brightest sources for soft x-rays worldwide. A multiyear upgrade of the ALS is underway, which includes new and replacement x-ray beamlines, a replacement of many of the original insertion devices and many upgrades to the accelerator. The accelerator upgrade that affects the ALS performance most directly is the ALS brightness upgrade [1], which reduces the horizontal emittance from 6.3 to 2.0 nm (2.5 nm effective). Magnets for this upgrade were installed in late 2012 and early 2013 followed by user operation with the reduced emittance.

The Advanced Light Source (ALS) at Berkeley Lab remains one of the brightest sources for soft x-rays worldwide. A multiyear upgrade of the ALS is underway, which includes new and replacement x-ray beamlines, a replacement of many of the original insertion devices and many upgrades to the accelerator. The accelerator upgrade that affects the ALS performance most directly is the ALS brightness upgrade, which reduced the horizontal emittance from 6.3 to 2.0 nm (2.5 nm effective). Magnets for this upgrade were installed starting in 2012 followed by a transition to user operations with 2.0 nm emittance in spring 2013. Copyright © 2013 by JACoW.

While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation. Their accuracy, expressed as sensitivity and specificity, are reported in a number of studies suggests that they have a potential for cost effective, real-time, in situ diagnosis. We review the Third Scientific Meeting of the Head and Neck Optical Diagnostics Society held in Congress Innsbruck, Innsbruck, Austria on the 11th May 2011. For the first time the HNODS Annual Scientific Meeting was held in association with the International Photodynamic Association (IPA) and the European Platform for Photodynamic Medicine (EPPM). The aim was to enhance the interdisciplinary aspects of optical diagnostics and other photodynamic applications. The meeting included 2 sections: oral communication sessions running in parallel to the IPA programme and poster presentation sessions combined with the IPA and EPPM posters sessions. © 2011 Jerjes et al; licensee BioMed Central Ltd.

The complete surgical removal of disease is a desirable outcome particularly in oncology. Unfortunately much disease is microscopic and difficult to detect causing a liability to recurrence and worsened overall prognosis with attendant costs in terms of morbidity and mortality. It is hoped that by advances in optical diagnostic technology we could better define our surgical margin and so increase the rate of truly negative margins on the one hand and on the other hand to take out only the necessary amount of tissue and leave more unaffected non-diseased areas so preserving function of vital structures. The task has not been easy but progress is being made as exemplified by the presentations at the 2nd Scientific Meeting of the Head and Neck Optical Diagnostics Society (HNODS) in San Francisco in January 2010. We review the salient advances in the field and propose further directions of investigation. © 2011 Upile et al; licensee BioMed Central Ltd.

Joline S Hartheimer,1 Brooke W Bullington,2,3 Kristen A Berg,4 Kari White,5 Margaret Boozer,6 Tania Serna,7 Emily S Miller,8 Jennifer L Bailit,9 Kavita Shah Arora10 1Swedish First Hill Family Medicine Residency, Swedish Medical Center, Seattle, WA, USA; 2Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 4Center for Health Care Research & Policy; MetroHealth Medical Center at Case Western Reserve University School of Medicine, Cleveland, OH, USA; 5Population Research Center, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA; 6Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA; 7Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA, USA; 8Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; 9Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA; 10Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USACorrespondence: Kavita Shah Arora, Email Kavita.shah.arora@gmail.comObjective: The Medicaid Consent to Sterilization policy is a known barrier to permanent contraception (PC) fulfillment and is associated with disparities in fulfillment. While physician perspectives regarding the policy are well described, knowledge of how patients with Medicaid seeking PC perceive this waiting period is limited.Study Design: We interviewed 81 participants with a documented desire for PC at discharge from their hospital-based delivery at four medical centers across the United States. Interviews were audio-recorded, transcribed, and analyzed using rapid qualitative methodologies and thematic content analysis.Results: Of the 81 participants interviewed, the 56 participants subject to the mandatory waiting period through insurance status or state residency were included in this analysis. Key positive themes included the role of the waiting period in facilitating minimization of regret, independent decision making, and protection against coercion and bias. Key negative themes included interference with reproductive autonomy, harm to the patient-clinician relationship, and introduction of unwanted doubt into contraceptive decisions. In addition, participants expressed both indifference and nuance when discussing the waiting period, and misinformation about the waiting period was prevalent during interviews. Participants with favorable opinions commonly changed their mind regarding PC, while participants with negative opinions were steadfast in their desires for PC and often experienced PC non-fulfillment.Conclusion: Postpartum patients hold diverse views on the current Medicaid Consent to Sterilization policy’s mandated waiting period. Patient engagement is fundamental when reevaluating and revising this policy to balance supporting autonomous decision-making about PC while protecting against reproductive coercion and regret.Implications: In policy revision discussions, it is important to consider whether a mandated waiting period is the best way to minimize regret and promote autonomy. Revision that accounts for the complexity of patient desires and needs is imperative to achieving the dual goals of minimizing coercion and ensuring autonomously-desired provision.Keywords: contraception, sterilization, Medicaid, health disparities, health policy, reproductive health

Purpose: The definition of rectal cancer based on the sigmoid take-off (STO) was incorporated into the Dutch guideline in 2019, and became mandatory in the national audit from December 2020. This study aimed to evaluate the use of the STO in clinical practice and the added value of online training, stratified for the period before (group A, historical cohort) and after (group B, current cohort) incorporation into the national audit. Methods: Participants, including radiologists, surgeons, surgical and radiological residents, interns, PhD students, and physician assistants, were asked to complete an online training program, consisting of questionnaires, 20 MRI cases, and a training document. Outcomes were agreement with the expert reference, inter-rater variability, and accuracy before and after the training. Results: Group A consisted of 86 participants and group B consisted of 114 participants. Familiarity with the STO was higher in group B (76% vs 88%, p = 0.027). Its use in multidisciplinary meetings was not significantly higher (50% vs 67%, p = 0.237). Agreement with the expert reference was similar for both groups before (79% vs 80%, p = 0.423) and after the training (87% vs 87%, p = 0.848). Training resulted in significant improvement for both groups in classifying tumors located around the STO (group A, 69–79%; group B, 67–79%, p < 0.001). Conclusions: The results of this study show that after the inclusion of the STO in the mandatory Dutch national audit, the STO was consequently used in only 67% of the represented hospitals. Online training has the potential to improve implementation and unambiguous assessment. [ABSTRACT FROM AUTHOR]