Subject(s)
Keratosis, Actinic/drug therapy , Patient Preference/statistics & numerical data , Photochemotherapy/methods , Self Care/methods , Sunlight , Humans , Keratosis, Actinic/psychology , Photochemotherapy/adverse effects , Self Care/adverse effects , Surveys and Questionnaires/statistics & numerical data , Treatment Outcome , United KingdomABSTRACT
A colloidal quantum dot laser emitting at 600 nm with a sub 10kW/cm(2) threshold at 5ns pulse pumping is reported. The device has a second order distributed feedback cavity for vertical emission and incorporates a bilayer planar waveguide structure based on a film of yellow-orange alloyed-core/shell CdS(x)Se(1-x)/ZnS quantum dots over-coated with polyvinyl alcohol. A study of the amplified spontaneous regime indicates that the quantum dot gain region behaves like a quasi-three level system and that the bilayer structure design increases the modal gain compared to a single layer of quantum dots. An output of 40nJ per pulse is measured for a total pump-to-signal efficiency above threshold of 3%.
ABSTRACT
BMT professionals were compared regarding their willingness to proceed with allogeneic BMT given select psychosocial issues. A questionnaire was sent to 660 physician members of ASBMT, 92 social work members of BMT Special Interest Group, Association of Oncology Social Work, and 626 nurse members of BMT Special Interest Group, Oncology Nursing Society; 597 responded with a response rate of 43.5%. Items included background information, followed by 17 case vignettes; each represented a different psychosocial issue to which respondents indicated whether or not they would recommend proceeding with allogeneic BMT. In every vignette, at least 10% of respondents indicated they would not proceed. In six vignettes, at least 64% indicated do not proceed: suicidal ideation (86.8%), uses addictive illicit drugs (81.7%), history of noncompliance (80.5%), no lay caregiver (69.3%), alcoholic (64.8%), and mild dementia/Alzheimer's (64.4%). In 10 vignettes, at least 73% indicated proceed. On four vignettes, professional subgroups differed in their recommendation on whether or not to proceed with allogeneic BMT. Qualitative data suggest that this decision is contingent on the perceived acuity, severity, and currency of the psychosocial issue, patient ability to comply with treatment given the issue, and its manageability as a risk factor for treatment related vulnerability and outcomes.
Subject(s)
Bone Marrow Transplantation/psychology , Decision Making , Physician-Patient Relations , Physicians/psychology , Surveys and Questionnaires , Eligibility Determination , Humans , Transplantation, HomologousABSTRACT
Social workers, physicians, and nurses from a major urban teaching hospital were assessed and compared regarding their attitudes toward the rationing of health care. Responses to eighteen statements of considered moral judgments in the rationing of health care resources were analyzed in terms of levels of agreement with each. All three professional groups rejected rationing based on patient age and socioeconomic worth. However, social workers and physicians were more likely than nurses to consider such factors as cost-benefit ratios, quality of life, relative strength of a patient's moral claim, and scarcity of resources in rationing decisions. Study findings appear to portray social workers and physicians as being more utilitarian and nurses more egalitarian in rationing decisions. Implications for practice in a managed care environment are presented.
