Local buckling of cold-formed steel trapezoidal sheets: Data for finite element model validation.

Data is provided from a validation example for a finite element model of a cold-formed steel trapezoidal sheet. The sheet is subjected to bending, failing due to local buckling. The numerical model and the validation procedure are carried out according to the new Eurocode 3 prEN1993-1-14 Design assisted by finite element analysis. Detailed information concerning all aspects needed to reproduce the example is included: (i) the nominal and measured values of the sheet geometry; (ii) the measured material properties of the steel; (iii) the test setup of the validation experiments; (iv) the experimental results; (v) a complete description of the finite element model and solution procedure; and (vi) the finite element results. Additionally, data related to sensitivity studies on the numerical model is also presented, including the effect of the model domain, meshing, and imperfections (shape, magnitude, direction and combinations). Overall, the article aims to provide data and guidance to designers and researchers validating similar numerical models.

Thinking clearly about dignity: relationships between cognitive processes underlying perceived dignity as determinants of psychological adjustment.

BACKGROUND: Public and professional views strongly equate dignity among the dying with their abilities to make decisions about medical and personal treatment and care. To make these decisions requires cognitive processes that inform our understanding of circumstances by integrating thoughts, experiences, and perceptions with prior knowledge. But patients with terminal illnesses, especially cancer, often experience problems stemming from cognitive changes and the cognitive state of uncertainty that can interfere with knowing what options for care are essential to targeting their sense of dignity. This paper aims to propose and test a model that defines targets for dignity-conserving care from underlying cognitive changes as antecedents to uncertainty that impact psychological adjustment of patients with advanced cancer. PARTICIPANTS AND PROCEDURE: This is a cross-sectional observational study using participant data from 257 patients with advanced cancer. The Patient Dignity Inventory and the Hospital Anxiety and Depression Scale were administered to patients and analyzed according to model hypotheses. RESULTS: Analyses used structural equational modeling to confirm model pathways. In the context of perceived dignity in advanced cancer, there was a direct pathway from patient reported problems with cognitive changes to uncertainty, that in turn had both direct and indirect effects on depression. CONCLUSIONS: The results suggest that cognitive changes challenge perceptions of dignity and can independently be targeted as modifiable processes to provide dignity-conserving care.

The role of perceived dignity and control in the wish to hasten death among advanced cancer patients: A mediation model.

OBJECTIVE: The objective of the study is to test a model in which perceived loss of dignity and control are proposed, along with symptoms of depression and functional impairment, as risk factors for the wish to hasten death (WTHD) in advanced cancer patients. METHODS: This was a cross-sectional study of 193 patients in an oncology unit. Outcome measures included perceived control, performance status, symptoms of depression, perceived dignity, and the WTHD. Structural equation modeling was performed. RESULTS: Structural equation modeling showed that perceived loss of control (-0.402) and functional impairment (-0.21) were risk factors for perceived loss of dignity. Loss of control (-0.385) and functional impairment (-0.283) were also risk factors for symptoms of depression. Perceived loss of dignity and symptoms of depression were the most proximal determinants of the WTHD, on which they had a direct, positive, and significant effect (0.246 and 0.209, respectively). Therefore, both symptoms of depression and perceived loss of dignity independently predicted the WTHD and mediated the effects of perceived loss of control and functional impairment on this wish. CONCLUSIONS: The hypothesized model provides evidence for the impact of the four aforementioned factors on the WTHD. Our results suggest that personalized care plans which are able to enhance the sense of dignity and control among advanced cancer patients could help to reduce the likelihood or intensity of a WTHD.

Meaning in Life as a Mediator Between Physical Impairment and the Wish to Hasten Death in Patients With Advanced Cancer.

CONTEXT: Meaning in life (MiL) is a key factor for ensuring spiritual well-being and quality of life among patients with life-threatening illnesses. However, the role of MiL in relation to the wish to hasten death (WTHD) and its interaction with other physical and psychological factors in patients with advanced cancer has not yet been studied. OBJECTIVE: The objective of this study was to analyze the relationship between the WTHD and MiL and to propose a theoretical model of functional relationships among WTHD, performance status, depression, and MiL. METHODS: This is a cross-sectional study of 101 patients in a palliative care unit, who were assessed in the context of a clinical interview. Outcome measures included performance status, depression, MiL, and the WTHD. Structural equation modeling was used to analyze the functional relationships between these factors. RESULTS: The WTHD correlated significantly (P < 0.01) with MiL (r = 0.60), performance status (r = 0.548), and depression (r = 0.397). The structural equation modeling analysis showed that although there was no significant direct effect between performance status and the WTHD, there was a significant total effect because of the mediation of depression and MiL. The latter played the most significant role, accounting for 76.5% of the mediation. CONCLUSION: These results support the proposed model and provide evidence of a mediator effect of MiL and depression on the relationship between physical impairment and the WTHD in advanced patients. Our findings suggest that interventions to enhance MiL could help to address and/or prevent the emergence of a WTHD in this population.