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The purpose of this study was to explore the influence that chronic and potentially fatal illness has on the caregiving process over time. Data were collected through in-depth interviews with 26 family caregivers of people experiencing AIDS or advanced cancer over a 4-month period. Constant comparative analysis was used to analyze the data. A substantive theory of family caregiving for people with life-threatening illnesses was developed around a core organizing theme: the labor of caregiving. Four phases emerged: becoming a caregiver, taking care, midwifing the death, and taking the next step. This study validates the taking-care or "tasks" aspect of caregiving, revealing that issues and tasks vary in each phase of caregiving. The key role of the caregiver in contributing to the quality of life of the ill person was apparent in the initial phase of an illness as well as at the time of death.
Primary Sclerosing Cholangitis (PSC) is a progressive cholestatic liver disease with no licensed therapies. Previous Genome Wide Association Studies (GWAS) have identified genes that correlate significantly with PSC, and these were identified by systematic review. Here we use novel Network Proximity Analysis (NPA) methods to identify already licensed candidate drugs that may have an effect on the genetically coded aspects of PSC pathophysiology.Over 2000 agents were identified as significantly linked to genes implicated in PSC by this method. The most significant results include previously researched agents such as metronidazole, as well as biological agents such as basiliximab, abatacept and belatacept. This in silico analysis could potentially serve as a basis for developing novel clinical trials in this rare disease.
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In several optical technologies for glaucoma diagnosis, polarized light is used to assess the retinal nerve fiber layer (RNFL) of the eye. For better understanding of the polarization properties of the RNFL, it was modeled as a thick birefringent slab containing parallel light-scattering cylinders, and the Mueller matrix for reflectance was derived. The model predicts that (1) the RNFL reflectance has weak intrinsic diattenuation; (2) the diattenuation spectrum depends strongly on the relative refractive indices of the cylinders; (3) both scattering and birefringence contribute to retardation; and (4) the RNFL reflectance generally preserves polarization, but depolarization may be detectable for thick RNFL at short wavelengths.
We present a detailed analytical model to describe optical coherence tomography (OCT) systems, which considers the propagation of the optical field within a scattering medium in the framework of the extended Huygens-Fresnel principle. The model includes use of the discrete-particle model and the fractal approach in treating biological tissue as being packed with scattering particles with a power-law distribution. In contrast to previous models, an imaginary lens proximal to the tissue surface is introduced that approximates the real focusing lens in the sample arm of the OCT system. This treatment avoids the consideration of backscattering light as traveling in the free space between the focusing lens and the tissue surface before mixing with the reference beam. Experiments on tissue phantoms were carried out to verify the validity of this model.
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Mechanical models for capsules freely suspended in another liquid, are devised to predict the deformation, motion, breakup of one particle and also the rheological flow behaviour of a suspension. The capsule is filled with a newtonian liquid, and is surrounded by a thin deformable membrane having otherwise arbitrary mechanical properties. Initially spherical capsules in simple shear flow, are found to deform and orient with respect to streamlines, while their membrane is continuously rotating around the internal liquid. A dilute suspension of such capsules has a viscoelastic constitutive law which depends on the particle physical properties. It is then possible to use such models to interpret experiments in terms of the mean intrinsic properties of a capsule population.
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This paper attempts to highlight some of the presently accepted models of health, behaviour and their usage in explaining illness, sickness and utilisation behaviour. The limitations of each of the model have also been described. Finally an attempt has been made to visualise the applicability of such models on Indian health system. A viable model already tested has been proposed to assess the social patterns of seeking medical care in rural setting in India.
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The Southeastern Aerosol and Visibility Study (SEAVS) was undertaken to characterize the size-dependent composition, thermodynamic properties, and optical characteristics of the ambient atmospheric particles in the southeastern United States. The field portion of the study was carried out from July 15 to August 25, 1995. As part of the study a relative humidity controlled inlet was built to raise or lower the relative humidity to predetermined levels before the aerosol was passed into an integrating nephelometer or particle-sizing device. Five other integrating nephelometers were operated in various configurations, two of which were fitted with a 2.5 microns inlet. Fine particle (< 2.5 microns) samplers were operated to measure concentrations of sulfate, nitrate, and ammonium ions, organic and elemental carbon, and fine soil. Mass size distributions were measured with an eight-stage, single orifice cascade impactor. Four different strategies for estimating scattering were used. First, an externally mixed model with constant specific scattering coefficients, sulfate ion mass interpreted as ammonium bisulfate, and ammonium bisulfate growth as a function of relative humidity, is assumed. Second, an externally mixed aerosol model, assuming constant dry specific scattering but with sulfate ammoniation and associated composition-dependent hygroscopicity explicitly accounted for, is used. Third, an externally mixed aerosol model, but with sulfate ammoniation, associated growth as a function of relative humidity, and sulfate size distributions, is applied. Fourth, an internally mixed aerosol model with measured sulfur size distributions and estimated size distributions for other species is used with the growth characteristics of the mixture being estimated using the Zdanovskii-Stokes-Robinson (ZSR) assumptions. Only ionic species were considered to be hygroscopic. The second, third, and fourth approaches yield similar results with reconstructed scattering comparing quite favorably with measured scattering. Accounting for sulfate ammoniation and associated water uptake was the most important detail in achieving closure between measurements and modeled scattering. In general, differences between estimated scattering, assuming internally or externally mixed models, was small. These same models were used to estimate wet to dry scattering ratios. The R2 for an ordinary least-squares regression between measured and predicted ratios was high (0.71-0.92), and in most cases the scattering ratio was insensitive to modeling assumptions. However, during some sample periods differences between predicted scattering ratios for the different modeling assumptions were as high as 30%.