The MRC trial of assessment and management of older people in the community: objectives, design and interventions [ISRCTN23494848].

BACKGROUND: The benefit of regular multidimensional assessment of older people remains controversial. The majority of trials have been too small to produce adequate evidence to inform policy. Despite the lack of a firm evidence base, UK primary care practitioners (general practitioners) are required to offer an annual health check to patients aged 75 years and over. DESIGN: Cluster-randomised factorial trial in primary care comparing a package of assessments (i) universal versus targeted assessment and (ii) management by the primary care team (PC) or a multidisciplinary geriatric assessment team (GM). The unit of randomization is the general practice. METHODS: Older people aged 75 and over eligible for the over 75s health check and excluding those in nursing homes or terminally ill were invited to participate. All participants receive a brief assessment covering all areas of the over 75s check. In the universal arm all participants also receive a detailed health and social assessment by a study nurse while in the targeted arm only participants with a pre-determined number and range of problems at the brief assessment go on to have the detailed assessment. The study nurse follows a standard protocol based on results and responses in the detailed assessment to make referrals to (i) the randomised management team (PC or GM) (ii) other medical services, health care workers or agencies (iii) emergency referrals to the GP. The main outcomes are mortality, hospital and institutional admissions and quality of life. 106 practices and 33,000 older people have been recruited to the trial

Modelling and predicting fatigue crack growth in structural adhesive joints

The present paper examines crack growth in a range of structural adhesive joints under cyclic-fatigue loadings. It is shown that cyclic-fatigue crack-growth in such materials can be modelled by a form of the Hartman and Schijve crack-growth equation which aims to give a unique and linear ‘master’ representation for the fatigue data points that have been experimentally obtained. This relationship is shown to capture the experimental data representing the effects of test conditions, such as the R-ratio (=σmin /σmax) present in the fatigue cycle and test temperature. It also captures the typical scatter often seen in such tests, especially at low values of the fatigue crack-growth rate. Furthermore, the methodology is shown to be applicable to, and to unify, the results from Mode I (opening tensile), Mode II (in-plane shear) and Mixed-Mode I/II fatigue tests. Finally, it is used to predict successfully the rate of fatigue crack-growth in two bonded-repair type joints where naturally-occurring disbonds have initiated and grown

Application of the Eulerian subgrid Probability Density Function method in the Large Eddy Simulation of a partially premixed swirl flame

A gas turbine model combustor is studied using Large Eddy Simulation with a transported Probability Density Function approach solved by the Eulerian stochastic field method. The chemistry is represented by a reduced methane mechanism containing 15 steps and 19 species while the subgrid scale stresses and scalar fluxes are modelled, respectively, via a dynamic Smagorinsky model and a gradient diffusion approximation. The test case comprises a partially premixed swirl flame in a complex geometry. Four stochastic fields are utilised in the simulations, which are performed for two different combustor operating conditions involving a stable and an unstable flame. Good agreement between the simulation and measurement data is shown in a comparison of mean velocity, temperature and species mass fraction profiles, as well as scatter plots of the instantaneous thermochemical properties. In conclusion, the predictive capabilities of the employed Large Eddy Simulation method are successfully demonstrated in this work

LES of the Cambridge Stratified Swirl Burner using a Sub-grid pdf Approach

The sub-grid scale probability density function equation is rearranged in order to separate the resolved and sub-grid-scale (sgs) contributions to the sgs mixing term. This allows modelling that is consistent with the limiting case of negligible sub-grid scale variations, a property required for applications to laboratory premixed flames. The new method is applied to the Cambridge Stratified Swirl Burner for 6 operating conditions, 2 isothermal and 4 burning, with varying degrees of swirl and mixture stratification. The simulations are performed with the Large Eddy Simulation (LES) code BOFFIN in which the modelled pdf transport equation is solved using the Eulerian stochastic field method. Eight stochastic fields are used to account for the influence of the sub-grid fluctuations and the chemistry is modelled with a reduced version of the GRI 3.0 mechanism for methane involving 19 species and 15 reaction steps. The simulated velocities for both the isothermal and burning cases show good agreement with the experimental data. The measured temperature and major species profiles are also reproduced to a good accuracy