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Twin to Twin Transfusion Syndrome (TTTS) is a well understood, yet under-recognized, placental disease affecting any given pregnancy at a rate of 1 in 1,000. There is no clustering of TTTS; instead the threat remains pathologically distinctive due to its pervasiveness. However, while incidence rates are random, survival rates are not. Despite compliant acceptance of “routine prenatal care,” sadly, there are many women who for currently unknown reasons are not receiving the advanced prenatal care needed to appropriately screen for, diagnosis and treat TTTS. And these women are paying the ultimate price for such obstetrical oversight.

This study hypothesizes that differential care being given by primary obstetricians of TTTS patients is resulting in experienced inequalities. Utilizing social reproduction theory, and through ethnographic and quantitative analyses of primary data, this study seeks to divulge the complex social processes taking place (or failing to take place) within the world of American obstetrics, and begin to understand how they are affecting TTTS mortality and morbidity rates.

Findings illuminate a profound imbalance of power and influence amongst the following entities: American Congress of Obstetricians and Gynecologists and Society of Maternal Fetal Medicine; obstetrical training and practice; and levels of patient awareness and advocacy.

This study argues that the current social relations being reproduced by these entities are perpetuating a climate that allows for disregard of proper TTTS management. Specifically, this study theoretically explores what social relations and subsequent (in)actions are being reproduced prior to TTTS diagnoses, and applies the effects of those observations.

The sequence of stress, distress and somatization has occupied much of the late twentieth-century psychological research. The anatomy of stress can be viewed from interactional and hybrid theories that suggest that the individual relates with the surroundings by buffering the harmful effects of stressors. These acts or reactions are called coping strategies and are designed as protection from the stressors and adaptation to them. Failure to successfully adapt to stressors results in psychological distress. In some individuals, elevated levels of distress and failed coping are expressed in physical symptoms, rather than through feelings, words, or actions. Such “somatization” defends against the awareness of the psychological distress, as demonstrated in the psychosocial literature. The progression of behavior resulting from somatic distress moves from a private domain into the public arena, involving an elaborate medicalization process, is however less clear in sociological discourse. The invocation of a medical diagnosis to communicate physical discomfort by way of repeated use of health care services poses a major medical, social and economic problem. The goal of this paper is to clarify this connection by investigating the relevant literature in the area of women with breast cancer. This manuscript focuses on the relationship of psychological stress, the stress response of distress, and the preoccupation with one’s body, and proposes a new theoretical construct.

The purpose of this paper was to understand the lived experiences of women who have been diagnosed, treated and are cancer free as survivors.

Using purposive sampling approach, participants were recruited from two Missouri cancer centers. A total of 15 breast cancer free women (ten white and five black) were interviewed. The participants ranged in age from 34 to 62 years, and all had at least a bachelor degree.

Eight unique themes were identified from the interviews. The women noted that maintaining positive attitude, and support from family and friends were the greatest resources that helped them through their cancer journey. They were generally positive about their experiences but uncertain what “survivor” meant individually and personally.

All the women in this study had at least a college degree, stable family economic resources and health insurance.

The women interviewed in this study did not want to be called breast cancer “survivors” which is a common name for anyone who has been diagnosed, treated and cancer free. For those who are breast cancer educators, nurses, medical practitioners and counselors it is important to consider how they use the word “survivor.” Referring to women who have successfully completed a treatment program for breast cancer as “survivors” attaches an identity that may not be accepted by all.

Many individuals are concurrently eligible for multiple sources of government-reimbursed health care services (e.g. Department of Veterans Affairs (VA) and Medicare). Unclear is whether combined eligibility translates into increased access to care and/or improved outcomes of care. Alternatively continuity of care may suffer, promoting health inequalities when patients receive health services from multiple unrelated sources of care. The current study examines the impact of dual eligibility for government-reimbursed care on long-term outcomes of care for a population of veterans diagnosed with colorectal cancer and initially treated surgically at Department of Veterans Affairs Medical Centers.

The purpose of this paper is to measure health-related quality of life (QOL) among patients with early stage cancer breast under curative treatment at department of oncology and nuclear medicine at Ain Shams University Hospitals. Identify factors affecting QOL among these patients.

A cross-sectional study measured QOL among early stage female breast cancer (BC) patients and determined the main factors affecting their QOL. Three interviewer administered questionnaires were used.

The physical domain mostly affected in BC patients and the functional domain least. Socio-demographic factors that significantly affected BC patients QOL scores were patient age, education, having children and family income. Specific patient characteristics include caregiver presence – a factor that affected different QOL scores. Age at diagnosis, affection in the side of the predominant hand, post-operative chemotherapy and difficulty in obtaining the medication were the disease-related factors that affected QOL scores.

The final model predicting QOL for early stage female BC patients included age, education and difficulty in obtaining the medication as determinants for total QOL score. Carer presence was the specific patient characteristic that affected different QOL scores.

This paper aims to present a prototype of medical transportation robot whose positioning accuracy can reach millimeter-level in terms of patient transportation. By using this kind of mobile robot, a fully automatic image diagnosis process among independent CT/PET devices and the image fusion can be achieved.

Following a short introduction, a large-load 4WD-4WS (four-wheel driving and four-wheel steering) mobile robot for carrying patient among multiple medical imaging equipments is developed. At the same time, a specially designed bedplate with self-locking function is also introduced. For further improving the positioning accuracy, the authors proposed a calibration method based on Gaussian process regression (GPR) to process the measuring data of the sensors. The performance of this robot is verified by the calibration experiment and Image fusion experiment. Finally, concluding comments are drawn.

By calibrating the robot’s positioning system through the proposed GPR method, one can obtain the accuracy of the robot’s offset distance and deflection angle, which are 0.50 mm and +0.21°, respectively. Independent repeated trials were then set up to verify this result. Subsequent phantom experiment shows the accuracy of image fusion can be accurate within 0.57 mm in the front-rear direction and 0.83 in the left-right direction, respectively, while the clinical experiment shows that the proposed robot can practically realize the transportation of patient and image fusion between multiple imaging diagnosis devices.

The proposed robot offers an economical image fusion solution for medical institutions whose imaging diagnosis system basically comprises independent MRI, CT and PET devices. Also, a fully automatic diagnosis process can be achieved so that the patient’s suffering of getting in and out of the bed and the doctor’s radiation dose can be obviated.

The general bedplate presented in Section 2 that can be mounted on the CT and PET devices and the self-locking mechanism has realized the catching and releasing motion of the patient on different medical devices. They also provide a detailed method regarding patient handling and orientation maintenance, which was hardly mentioned in previous research. By establishing the positioning system between the robot and different medical equipment, a fully automatic diagnosis process can be achieved so that the patient’s suffering of getting in and out of the bed and the doctor’s radiation dose can be obviated.

The GPR-based method proposed in this paper offers a novel method for enhancing the positioning accuracy of the industrial AGV while the transportation robot proposed in this paper also offers a solution for modern imaging fusion diagnosis, which are basically predicated on the conjoint analysis between different kinds of medical devices.

Early fault detection of bearing plays an increasingly important role in the operation of rotating machinery. Based on the properties of early fault signal of bearing, this paper aims to describe a novel hybrid early fault detection method of bearings.

In adaptive variational mode decomposition (AVMD), an adaptive strategy is proposed to select the optimal decomposition level K of variational mode decomposition. Then, a criterion based on envelope entropy is applied to select the optimal intrinsic mode functions (OIMF), which contains most useful fault information. Afterwards, local tangent space alignment (LTSA) is used to denoising of OIMF. The envelope spectrum of the OIMF is used to analyze the fault frequency, thereby detecting the fault. Experiments are conducted in a simulated signal and two experimental vibration signals of bearings to verify the effect of the new method.

The results show that the proposed method yields a good capability of detecting bearing fault at an early stage. The new method can extract more useful information and can reduce noise, which can provide better detection accuracy compared with the other two methods.

An adaptive strategy based on center frequency is proposed to select the optimal decomposition level of variational mode decomposition. Envelope entropy is used to fault feature selection. Combining the advantage of the AVMD-envelope entropy and LTSA, which suits the nature of the early fault signal. So, the proposed method has better detection accuracy, which provides a good alternative for early fault detection of bearings.

This paper aims to provide a better understanding of the foreign direct investment (FDI) decision‐making process, and to explore the roles of management accounting information to that.

An interpretive methodology was preferred, applying the case study method in a Greek company that had engaged in FDIs in the Balkans. In studying FDI decision‐making, the role of context (external environment and organisation) was taken into consideration.

The study reported here reveals that the FDI decision‐making process is cyclical in nature, with information continuously received, processed and used as feedback for subsequent action. This supports the view that the dichotomy between strategy formulation and implementation is a false one.

Although the FDI process should be recognised as iterative in nature, evidence from this study suggests that it can be thought of as comprising two main tasks, each of which makes different uses of management accounting information and reflects different decision‐making concerns. The first task concerns the decision whether or not to invest abroad while, the second task concerns decisions about how the project will be developed.

The implementation of capital investments enables the participation of various organizational actors trying to influence the final outcome of the process in line with their own interests. The recognition of differential political engagement within these two distinct decision‐making phases has implications for understanding capital investment practice and for reflecting on prior empirical evidence in this domain.

The purpose of this paper is to describe the Adaptation-Coping Model developed by Dröes in the Netherlands to frame the process of optimal adjustment for people diagnosed with dementia. This model is not well-known in English-speaking countries, but appears to have much to offer practitioners and researchers. As part of a large EU research project (MeetingDem) the authors translated and utilised this model in piloting the Dutch Meeting Centre Support Programme in the UK. This is a local community place-based approach to post-diagnostic psychosocial support. It is aimed at people diagnosed with dementia alongside their families and has proven benefits.

The Adaptation-Coping Model underpins the support provided by the Meeting Centre Programme. The model and its translation into the UK context are described. Focus groups were undertaken with people living with dementia (n=9) and family carers (n=6) at the UK Meeting Centre pilot. Examples from these focus groups are provided in order to illustrate different aspects of the model.

The translated Adaptation-Coping (adjusting to change) Model provides a way for service users (people with dementia and families) to conceptualise their journey with dementia post-diagnosis, and potentially provides service providers and researchers with aims for treatment and support.

These are initial observations based on a UK pilot service.

Ways of conceptualising psychosocial support for people living with dementia often do not get translated between countries. This model has been successfully utilised within the Netherlands for many years. This paper highlights the opportunity to build on this in English-speaking countries.

Globally, women suffer from a lack of knowledge about breast cancer (BC), its symptoms and treatment. The purpose of this paper is to examine how people living in rural and less developed areas in Pakistan perceive BC. The study investigates the level of knowledge about BC in rural communities and analyses how the prevalent perceptions and beliefs impact women's lives and delay the diagnosis.

This study is based on 42 in-depth interviews with the women who have undergone BC treatment during the past five years. The participants were interviewed were the residents of the northern Sindh, southern Pakistan.

Findings show that BC was perceived as a contagious disease transmitted through touching or being physically close to the patient. Some women were abandoned by their husbands because of this perception. Faith in fatalism and the perception that BC is an incurable disease were common in communities with low socio-economic status. This is likely to affect the prevention and early detection of BC.

The study shows a strong co-relation of awareness with the prevalent perceptions regarding BC. Therefore, we recommend promoting health literacy and introducing culturally specific interventions in remote communities to enhance their understanding of the available treatment and help remove misconceptions about BC.