Designing with Care - Interior Design and Residential Child Care Final Report

This exploratory study examined the attitudes to a range of design interventions in four residential care homes for children in South Lanarkshire. The project set out to identify the benefits and disadvantages to young people and staff of a change in approach to the design of interior spaces. It was undertaken by Farm7 (specialists in design research and consultancy) and the Scottish Institute for Residential Child Care (SIRCC). The main focus of the research was to evaluate design interventions aimed at removing 'institutional' approaches to design in the care environment and improving the experience of looked after children. This involved the commissioning of interior design consultants Graven Images in the development and design of South Lanarkshire's residential children's homes. Post-occupancy evaluation of the four residential homes was undertaken with the participation of both looked after children and staff. It was envisaged that this study would contribute to the development of design guidance that will promote a more systematic approach to the design of care environments. This will allow social work and design professionals to draw on a design framework in order to significantly enhance the experience of looked after children and staff

An independently validated nomogram for isocitrate dehydrogenase-wild-type glioblastoma patient survival.

BackgroundIn 2016, the World Health Organization reclassified the definition of glioblastoma (GBM), dividing these tumors into isocitrate dehydrogenase (IDH)-wild-type and IDH-mutant GBM, where the vast majority of GBMs are IDH-wild-type. Nomograms are useful tools for individualized estimation of survival. This study aimed to develop and independently validate a nomogram for IDH-wild-type patients with newly diagnosed GBM.MethodsData were obtained from newly diagnosed GBM patients from the Ohio Brain Tumor Study (OBTS) and the University of California San Francisco (UCSF) for diagnosis years 2007-2017 with the following variables: age at diagnosis, sex, extent of resection, concurrent radiation/temozolomide (TMZ) status, Karnofsky Performance Status (KPS), O6-methylguanine-DNA methyltransferase (MGMT) methylation status, and IDH mutation status. Survival was assessed using Cox proportional hazards regression, random survival forests, and recursive partitioning analysis, with adjustment for known prognostic factors. The models were developed using the OBTS data and independently validated using the UCSF data. Models were internally validated using 10-fold cross-validation and externally validated by plotting calibration curves.ResultsA final nomogram was validated for IDH-wild-type newly diagnosed GBM. Factors that increased the probability of survival included younger age at diagnosis, female sex, having gross total resection, having concurrent radiation/TMZ, having a high KPS, and having MGMT methylation.ConclusionsA nomogram that calculates individualized survival probabilities for IDH-wild-type patients with newly diagnosed GBM could be useful to physicians for counseling patients regarding treatment decisions and optimizing therapeutic approaches. Free software for implementing this nomogram is provided: https://gcioffi.shinyapps.io/Nomogram_For_IDH_Wildtype_GBM_H_Gittleman/

One-pot radioiodination of aryl amines via stable diazonium salts: preparation of 125I-imaging agents

An operationally simple, one-pot, two-step tandem procedure that allows the incorporation of radioactive iodine into aryl amines via stable diazonium salts is described. The mild conditions are tolerant of various functional groups and substitution patterns, allowing late-stage, rapid access to a wide range of 125I-labelled aryl compounds and SPECT radiotracers

The Internal Spin Angular Momentum of an Asymptotically Flat Spacetime

In this paper we investigate the manner in which the internal spin angular momentum of a spinor field is encoded in the gravitational field at asymptotic infinity. The inclusion of internal spin requires us to re-analyze our notion of asymptotic flatness. In particular, the Poincar\'{e} symmetry at asymptotic infinity must replaced by a spin-enlarged Poincar\'{e} symmetry. Likewise, the generators of the asymptotic symmetry group must be supplemented to account for the internal spin. In the Hamiltonian framework of first order Einstein-Cartan gravity, the extra generator comes from the boundary term of the Gauss constraint in the asymptotically flat context. With the additional term, we establish the relations among the Noether charges of a Dirac field, the Komar integral, and the asymptotic ADM-like geometric integral. We show that by imposing mild restraints on the generating functionals of gauge transformations at asymptotic infinity, the phase space is rendered explicitly finite. We construct the energy-momentum and the new total (spin+orbital) angular momentum boundary integrals that satisfy the appropriate algebra to be the generators of the spin-enlarged Poincar\'{e} symmetry. This demonstrates that the internal spin is encoded in the tetrad at asymptotic infinity. In addition, we find that a new conserved and (spin-enlarged) Poincar\'{e} invariant charge emerges that is associated with the global structure of a gauge transformation.Comment: V2: No major changes, journal reference adde

Monitoring and evaluation of strategic change programme implementation—Lessons from a case analysis

This study considered the monitoring and evaluation of a large-scale and domestic and global strategic change programme implementation. It considers the necessary prerequisites to overcome challenges and barriers that prevent systematic and effective monitoring and evaluation to take place alongside its operationalisation. The work involves a case study based on a major industrial company from the energy sector. The change programme makes particular reference to changes in business models, business processes, organisation structures as well as Enterprise Resource Planning infrastructure. The case study focussed on the summative evaluation of the programme post-implementation. This assessment involved 25 semi-structured interviews with employees across a range of managerial strata capturing more than 65 roles within the change programme at both local and global levels. Data relating to their perception of evaluation effectiveness and shortcomings were analysed by means of template analysis. The study identifies responsibilities for executing an evaluation alongside various methods and tools that are appropriate, thereby focussing on the “Who” (roles, responsibility for particular activities) and “How” (methods and tools) rather than “What” to monitor and evaluate. The findings are presented generically so they offer new insights and transferability for practitioners involved in managing strategic change and its associated evaluation

The importance of clinical pharmacokinetic–pharmacodynamic studies in unraveling the determinants of early and late tuberculosis outcomes

Tuberculosis remains a major infectious cause of morbidity and mortality worldwide. Current antibiotic regimens, constructed prior to the development of modern pharmacokinetic-pharmacodynamic (PK–PD) tools, are based on incomplete understanding of exposure–response relationships in drug susceptible and multidrug resistant tuberculosis. Preclinical and population PK data suggest that clinical PK–PD studies may enable therapeutic drug monitoring for some agents and revised dosingf or others. Future clinical PK–PD challenges include: incorporation of PK methods to assay free concentrations for all active metabolites; selection of appropriate early outcome measures which reflect therapeutic response; elucidation of genetic contributors to interindividual PK variability; conduct of targeted studies on special populations (including children); and measurement of PK–PD parameters at the site of disease.Publisher PDFPeer reviewe

Development of a composite model derived from cardiopulmonary exercise tests to predict mortality risk in patients with mild-to-moderate heart failure

Objective: Cardiopulmonary exercise testing (CPET) is used to predict outcome in patients with mild-to-moderate heart failure (HF). Single CPET-derived variables are often used, but we wanted to see if a composite score achieved better predictive power. Methods: Retrospective analysis of patient records at the Department of Cardiology, Castle Hill Hospital, Kingston-upon-Hull. 387 patients [median (25th-75th percentile)] [age 65 (56-72) years; 79% males; LVEF 34 (31-37) %] were included. Patients underwent a symptomlimited, maximal CPET on a treadmill. During a median follow up of 8.6 ± 2.1 years in survivors, 107 patients died. Survival models were built and validated using a hybrid approach between the bootstrap and Cox regression. Nine CPET-derived variables were included. Z-score defined each variable's predictive strength. Model coefficients were converted to a risk score. Results: Four CPET-related variables were independent predictors of all-cause mortality in the survival model: the presence of exertional oscillatory ventilation (EOV), increasing slope of the relation between ventilation and carbon dioxide production (VE/VCO2 slope), decreasing oxygen uptake efficiency slope (OUES), and an increase in the lowest ventilatory equivalent for carbon dioxide (VEqCO2 nadir). Individual predictors of mortality ranged from 0.60 to 0.71 using Harrell’s C-statistic, but the optimal combination of EOV + VE/VCO2 slope + OUES + VEqCO2 nadir reached 0.75. The Hull CPET risk score had a significantly higher area under the curve (0.78) when compared to the Heart Failure Survival Score (AUC=0.70;