Project description:Despite intense recent interest in weakly bound nonlinear ("exponential") multilayers, the underlying structure-property relationships of these films are still poorly understood. This study explores the effect of time used for deposition of individual layers of nonlinearly growing layer-by-layer (LbL) films composed of poly(methacrylic acid) (PMAA) and quaternized poly-2-(dimethylamino)ethyl methacrylate (QPC) on film internal structure, swelling, and stability in salt solution, as well as the rate of penetration of invading polyelectrolyte chains. Thicknesses of dry and swollen films were measured by spectroscopic ellipsometry, film internal structure-by neutron reflectometry (NR), and degree of PMAA ionization-by Fourier-transform infrared spectroscopy (FTIR). The results suggest that longer deposition times resulted in thicker films with higher degrees of swelling (up to swelling ratio as high as 4 compared to dry film thickness) and stronger film intermixing. The stronger intermixed films were more swollen in water, exhibited lower stability in salt solutions, and supported a faster penetration rate of invading polyelectrolyte chains. These results can be useful in designing polyelectrolyte nanoassemblies for biomedical applications, such as drug delivery coatings for medical implants or tissue engineering matrices.
Project description:This study explores the perspectives of doctors, nurses, and technicians on the medical clown. A total of 35 subjects were interviewed one on one. Interviews were transcribed and analyzed for common themes. Medical staff outlined novel limitations and views of future directions for the field of medical clowning. Most importantly, many previously unpublished benefits of medical clowns were described. These reported benefits included cost-saving measures for the hospital, increases in staff efficiency, better patient outcomes, and lower stress in medical staff. Given that most of the limitations on medical clowning are financial in nature, these findings have substantial implications for the future of the field. As medical clowning continues to grow, this study outlines the potential for various future research projects within this field of study.
Project description:Background:Posthospital syndrome is associated with a decrease in physical and cognitive function and can contribute to overall patient decline. We can speculate on contributors to this decline (eg, poor sleep and nutrition), but other factors may also contribute. This study seeks to explain how patients experience hospitalization with particular attention on what makes the hospital stay difficult. Design:Qualitative interview study using grounded theory methodology. Setting:Single-site academic medical center. Patients:Hospitalized general medicine patients. Measurements:Interviews using a semistructured interview guide. Results:We recruited 20 general medicine inpatients from an academic medical center. Of the participants, 12 were women and the mean age was 55 years (range = 22-82 years). We found 4 major themes contributing to the hospital experience: (1) hospital environment (eg, food quality and entertainment), (2) patient factors (eg, indifference and expectations), (3) hospital personnel (eg, care team size and level of helpfulness), and (4) patient feelings (eg, level of control and feeling like an object). We discovered that these emotions arising from hospital experiences, together with the other 3 major themes, led to the patients' perception of their hospital experience overall. We also explore the role that patient tolerance may play in the reporting of patient satisfaction. Conclusions:This article demonstrates the factors affecting how patients experience hospitalization. It provides insight into possible contributors to posthospital syndrome and offers a blueprint for specific quality improvement initiatives. Lastly, it briefly explores how patient tolerance may prove a challenge to the current system of quality reporting.
Project description:The migration of the primary/peritectic interface in local isothermal condition is observed in dendritic structure of Sn-Ni peritectic alloy after experiencing interrupted directional solidification. It was observed that this migration of primary Ni3Sn2/peritectic Ni3Sn4 interface towards the primary Ni3Sn2 phase was accompanied by migration of liquid film located at this interface. The migration velocity of this interface was confirmed to be much faster than that of peritectic transformation, so this migration was mostly caused by superheating of primary Ni3Sn2 phase below TP, leading to nucleation and migration of liquid film at this interface. This migration can be classified as a kind of liquid film migration (LFM), and the migration velocity at the horizontal direction has been confirmed to be much faster than that along the direction of temperature gradient. Analytical prediction has shown that the migration of liquid film could be divided into two stages depending on whether primary phase exists below TP. If the isothermal annealing time is not long enough, both the liquid film and the primary/peritectic interface migrate towards the primary phase until the superheated primary phase has all been dissolved. Then, this migration process towards higher temperature is controlled by temperature gradient zone melting (TGZM).
Project description:As a noncentrosymmetric crystal with spin-polarized band structure, MoS2 nanomaterials have attracts increasing attention in many areas such as lithium ion batteries, flexible electronic devices, photoluminescence and valleytronics. The investigation of MoS2 is mainly focused on the electronics and spintronics instead of optics, which restrict its applications as key elements of photonics. In this work, we demonstrate the first observation of the polarization-dependent optical absorption of the MoS2 thin film, which is integrated onto an optical waveguide device. With this feature, a novel optical sensor combining MoS2 thin-film and a microfluidic structure has been constituted to achieve the sensitive monitoring of refractive index. Our work indicates the MoS2 thin film as a complementary material to graphene for the optical polarizer in the visible light range, and explores a new application direction of MoS2 nanomaterials for the construction of photonic circuits.
Project description:BACKGROUND:Malaysia is widely credited to have achieved universal health coverage for citizens. However, the accessibility of healthcare services to migrant workers is questionable. Recently, medical fees for foreigners at public facilities were substantially increased. Mandatory health insurance only covers public hospital admissions and excludes undocumented migrants. This study explores barriers to healthcare access faced by documented and undocumented migrant workers in Malaysia. METHODS:We use qualitative data from 17 in-depth interviews conducted with key informants from civil society organisations, trade unions, academia, medical professionals, as well as migrant workers and their representatives. We interviewed doctors working in public hospitals and private clinics frequented by migrants. Data were analysed using thematic analysis. RESULTS:We found that healthcare services in Malaysia are often inaccessible to migrant workers. Complex access barriers were identified, many beyond the control of the health sector. Major themes include affordability and financial constraints, the need for legal documents like valid passports and work permits, language barriers, discrimination and xenophobia, physical inaccessibility and employer-related barriers. Our study suggests that government mandated insurance for migrant workers is insufficient in view of the recent increase in medical fees. The perceived close working relationship between the ministries of health and immigration effectively excludes undocumented migrants from access to public healthcare facilities. Language barriers may affect the quality of care received by migrant workers, by inadvertently resulting in medical errors, while preventing them from giving truly informed consent. CONCLUSIONS:We propose instituting migrant-friendly health services at public facilities. We also suggest implementing a comprehensive health insurance to enable healthcare access and financial risk protection for all migrant workers. Non-health sector solutions include the formation of a multi-stakeholder migration management body towards a comprehensive national policy on labour migration which includes health.
Project description:Introduction:Medical student mistreatment continues to be a significant problem despite increased awareness and longitudinal efforts to address the issue. Through audience discussions of a previously published film depicting learner mistreatment, we identified challenges created by student behaviors that negatively impact the learning environment. In addition, the need to address cultural competency in a multigenerational clinical environment became apparent. Methods:We created a film of three vignettes based on perspectives shared in focus groups by faculty, residents, nurses, and staff who work with medical students. We used this film to develop student and faculty curricula elucidating generational differences in behaviors and expectations while also exploring the learner's role in creating a more positive learning environment. Results:Our film was presented to medical education professionals at faculty development workshops and meetings, clerkship students at orientation sessions, residents as part of residents-as-teachers curricula, and faculty at departmental grand rounds. Evaluation data from 176 students and 42 faculty showed that a majority of our participants believed the film accurately reflected challenges they faced in the learning environment and felt better equipped to address them. Discussion:Film is an effective way to stimulate discussion about complex interactions in the clinical learning environment. Divergent perspectives on behaviors depicted in the film served as a stimulus to create targeted curricula for faculty and student education. Stimulating dialogue through film may enhance understanding and empathy among disparate groups, which is likely to be a necessary step for lasting change.
Project description:The study's objective was to describe the decision-making about voting rights of protected adults, which includes the medical assessment and the magistrate's decision to maintain voting rights or not.This work explores using an interdisciplinary approach: first, magistrate's decision-making with a systematic review of jurisprudence and second medical assessment with semistructured questionnaires sent to physicians assessing adults under guardianship.France.For jurisprudence's analysis, all guardianship decisions found on the Legifrance.gouv.fr website and that specified the protected person's voting rights were analysed. For the survey about medical civic assessment, an 18-item questionnaire was sent to all physicians drawing up medical certificates prior to placement under guardianship in one urban (Paris and the three surrounding departments) and one rural area of France (the 10 most rural French administrative departments).The analysis of jurisprudence explores the situation concerning protected adults' voting rights and the reasons for magistrates' decision. The survey about medical civic assessment explores the means of medical assessment (persons consulted, information collected), the content of the medical certificate, the physicians' opinions regarding their role.The analysis of the jurisprudence demonstrates that 30% (51/171) of protected adults kept the right to vote. The survey shows that medical assessment varied according to the physician's gender, specialty and geographical location. Voting capacity was the main criterion common to both physicians and magistrates in the decision whether to maintain voting rights. 27% (34/124) of physicians would like the official texts to be more precise, and one-third (41/133) wished to have tools to facilitate assessment of civic capacity.Official guides need to be drawn up to detail the criteria for and means of medical assessment of the civil capacity of protected adults, with a view to ensuring transparency and homogeneity in the exercise of justice.
Project description:Film-forming sprays offer many advantages compared to conventional topical preparations because they can provide uniform drug distribution and dose, increased bioavailability, lower incidence of irritation, continuous drug release, and accelerated wound healing through moisture control. Film-forming sprays consist of polymers and excipients that improve the characteristics of preparations and enhance the stability of active substances. Each type of polymer and excipient will produce films with different features. Therefore, the various types of polymers and excipients and their evaluation standards need to be examined for the development of a more optimal form of film-forming spray. The selected literature included research on polymers as film-forming matrices and the application of these sprays for medical purposes or for potential medical use. This article discusses the types and concentrations of polymers and excipients, sprayer types, evaluations, and critical parameters in determining the sprayability and film characteristics. The review concludes that both natural and synthetic polymers that have in situ film or viscoelastic properties can be used to optimise topical drug delivery.
Project description:Transport, mechanical and global migration data concern multilayer food packaging films with different layouts, all incorporating a layered silicate/polyamide nanocomposite as oxygen barrier layer, and a low-density polyethylene (LDPE) as moisture resistant layer in direct contact with food. The data are related to "Tuning of co-extrusion processing conditions and film layout to optimize the performances of PA/PE multilayer nanocomposite films for food packaging" by Garofalo et al. (2017) . Nanocomposite multilayer films, with different relative layer thicknesses and clay types, were produced using a laboratory scale co-extrusion blown-film equipment and were analyzed in terms of transport to oxygen and water vapor, mechanical properties and overall migration. The results have shown that all the multilayer hybrid films, based on the copolyamide layer filled with Cloisite 30B, displayed the most significant oxygen barrier improvements and the best mechanical properties compared to the unfilled films. No significant alteration of the overall migration values was observed, as expectable , , . The performance improvement was more relevant in the case of the film with the thinner nanocomposite layer.