This study aims to evaluate the impact of oncology nursing care on the quality of life (QoL) and risk perception among breast cancer survivors. Recognizing the pivotal role of oncology nurses in the multidisciplinary care team, this research investigates how tailored nursing interventions can improve patient outcomes and perception of health risks post-treatment. Through a mixed-methods approach, incorporating both quantitative measures of QoL and qualitative assessments of risk perception, findings aim to contribute to the enhancement of oncology nursing practices and patient education.

Abstract To maximize return on investment, many operators choose to re-fracture existing wells as an economic alternative to drilling new wells. While it may improve ultimate recovery, re-fracturing of wells with multiple producing zones can be challenging. Several techniques are available in the market place; each having its own limitations and benefits. The technology discussed in this paper, already implemented in the Western Hemisphere, uses a guar-based gelled fluid for temporary zonal isolation in the annulus. The need for a cost-effective solution for re-fracturing, without using a packer or other downhole isolation tool was identified in the Changqing oilfield in China. The objective was to prove the concept of using a gelled annular isolation technology for re-fracturing in this oilfield for applicability in the Asia Pacific region. Two candidate wells were selected for re-fracturing based on previously completed methodologies and observed production declines. A two stage vertical well was selected for proof of concept. The original completion used a 5 ½-in. casing, applying multi-stage sand jetting fracturing. The application of the gelled polymer system for re-fracturing utilized the 5 ½-in. casing as an outer tubing and implemented a 3 ½-in. inner string to create an annular space for isolation. The gelled fluid was pumped into the annular space between the inner tubing string and the original casing to isolate existing perforations in the two stages. After the re-fracturing treatment was completed, the gel was broken down and the inner string removed. Before the job was pumped, laboratory testing and simulation concluded that the gelled fluid would be placed within the pump time of the job and hold for the expected time frame of the fracturing operations. This testing provided detailed operational guidelines on placement time, pump rate, fluid shear rate at bottom hole temperature within the constraints of the wellbore architecture before committing to pump the job. The fluid was successfully placed and maintained isolation during fracturing stages. The inner string was removed from the hole following the breaking of the isolation fluid. The novelty of this work included the application of using a guar-based gelled fluid as a temporary annular isolation pill in a re-fracturing application in China. In addition, this work proved that an inner completion string could also be temporary and therefore removed after the job was completed to ensure that maximum access to the reservoir was achieved. Finally, this is the first cost effective and simple re-fracturing methodology introduced to this area of the Asia Pacific region.

Abstract Gelled isolation fluids are used in various applications throughout the oilfield for creating access to a specific segment of the wellbore while leaving the remaining portion of the wellbore unaffected. In single well applications, zones are isolated whereas laterals are isolated in multi-lateral completions. Gelled fluids are typically used in scenarios where isolation is not feasible or too costly to be obtained by use of a packer, plug or other downhole tool. A gelled fluid offers the benefits of being both temporary and easily cleaned up after the treatment. The objective in this application was to use a low cost gelled fluid to fully isolate existing perforations along a lateral to stimulate new zones. The candidate well selected for re-fracturing was originally completed without being stimulated due to water zones nearby. The 4200 feet of semi-continuously perforated horizontal section did not produce as expected. In order to fracture the targeted zones, a gelled fluid was used to seal off the existing perforations and maintain zonal isolation between fracturing stages. The gelled fluid was designed and optimized in the lab for the well and treatment conditions. An inner string with sliding sleeves was placed in the horizontal section of the well. The gelled fluid was then pumped into the annular space between the original casing and an inner tubing string and allowed to setup before fracturing began. Before the job was pumped, laboratory testing and simulation concluded that the gelled fluid would be placed within the pump time of the job and hold for the expected time frame of the fracturing operations. Due to the constraints of the wellbore tooling, completion system, and well conditions, this testing provided detailed operational guidelines on placement time, pump rate, fluid shear rate and temperature constraints before committing to pump the job. The fluid was successfully placed and maintained isolation for the duration of the 36 hours of a 9 stage stimulation treatment. Pressure on the backside of the tubing string was monitored throughout all 9 stages and remained fairly constant throughout the stimulation process indicating that zonal isolation was achieved and maintained. The novelty of this work included the application of using a gelled fluid in conjunction with a sliding sleeve system to optimize the zones for stimulation and address a specific need of limiting flush volumes and pump downs. This unique application provides knowledge on additional options for using this type of isolation gel for these types of applications in the re-stimulation market as a cost effective option.

OBJECTIVE:To assess the central nervous system side effects of chlorpheniramine and astemizole in children.DESIGN:Prospective, randomized, double-blind cross-over study.SETTING:Children were recruited from the out-patient allergy clinic and from respondents to an advertisement in a local newspaper. The study was conducted in the outpatient clinics of the ambulatory care services of the Children's Hospital of Eastern Ontario.PATIENTS, PARTICIPANTS:Children 8-16 years of age, with isolated allergic rhinitis or hay fever, were eligible for the study. We excluded children with: (1) chronic conditions (specifically asthma, atopic dermatitis, learning disabilities, or current treatment with oral corticosteroid medication); (2) known allergy to the study medications; (3) recent use of any antihistamine medication. One hundred and three children entered the study and 92 completed it.INTERVENTIONS:Children were stratified by age and randomly allocated to treatment with one of the two medication sequences. Over a period of 13 weeks both groups had 1 week of baseline studies, 3 weeks of one study medication, either chlorpheniramine or astemizole, a 6-week wash-out period and then 3 weeks of the other study medication for a second treatment period.MAIN OUTCOME MEASURES:Attention span (continuous performance test), short-term auditory and visual memory (visual aural digit span test), visual memory for geometric shapes (Benton visual retention test), motor coordination and visual-motor integration (grooved pegboard test), tapping speed and fine motor coordination (finger tapping test), physical side effects (such as sleepiness and dizziness), and compliance.RESULTS:One hundred and three patients were enrolled in the study, 92 (89%) completed the study. There were no significant drug effects on the visual retention test and the continuous performance test. On the visual aural digit span test, patients treated with astemizole scored higher than at baseline. There were no clinical or statistical differences in adverse effects between the two medications or between each medication and baseline.CONCLUSIONS:The two antihistamines studied had no adverse effects on the performance of children.

The hearing aids used by children attending a Grammar School for the Deaf were acoustically tested with the controls set as they were used for conversational speech. The gain and maximum acoustic output of the aids has been measured and shown to vary in a systematic manner with hearing loss but with considerable individual variation. Free field threshold measurements were made with and without the aids to establish the subjective gain for warble tones.A separate measure of comfortable listening level has been made and compared with the results from the hearing aid measurements. Based on the experimental results an area of hearing available for rehabilitation is arrived at. Concern is expressed at the low level of speech perception that seems possible with aids currently used.

This paper concerns two aspects of earmoulds for use with post-aural hearing aids. The first is the selection of the most desirable type of earmould from the extensive range currently available while the second covers some faults commonly met in fitting these aids and earmoulds.

Three types of noise-attenuating enclosure for audiometer earphones have been tested for attenuating properties and variation in audiometric threshold. A standard ear defender (RAF MK 3) and an MX 41/AR earcap have been used as controls.Results indicate no variation in audiometric threshold but only one enclosure had significantly more than 10dB attenuation over the MX 41/AR earcap. Considerably less attenuation was obtained with a group of 10-year-old children.