669 research outputs found

    MC4 CHOOSING BETWEEN SFI2/SF-36 PREFERENCE-BASED ALGORITHMS FOR COST-UTILITY ANALYSIS

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    Development of electric scooter alerting sounds using psychoacoustical metrics

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    In recent years electric micromobility transportation, including electric scooters, has seen a surge in popularity due to technological advances and the move to lower emission transport. Although offering a range of societal benefits, such as reduced pollution and increased personal mobility, concerns have been raised regarding the implications for pedestrian safety, most notably within the blind and partially sighted community. The issue of pedestrian safety is well studied in the context of larger electric vehicles (EVs), and indeed regulations are now in place that specify mandatory Acoustic Vehicle Alerting Systems (AVAS) for such vehicles. However, limited research has been done on the development of acoustic alerting systems for micromobility. In this paper, the development of an electric scooter (e-scooter) AVAS is considered by taking a perception-influenced design approach to designing alert sounds that optimise detectability and annoyance. A listening experiment has been conducted using ambisonic soundscapes and simulated auralisations of e-scooter passes at 20 km/h, in which a detection-based task and annoyance rating task were conducted. Objective metrics for detectability and annoyance were subsequently evaluated in relation to the subjective responses, so as to enable a more focused approach to the development of alert sounds. Results show that without additional alert sounds, the rate of detection for e-scooters in a soundscape of 60 dBA is as low as 23%. Regression analysis showed that the objective metric of Zwicker’s psychoacoustic annoyance is a useful predictor of subjective annoyance for AVAS sounds, with a coefficient of determination of R^2 = 0.96, and explains more variance than other metrics previously reported in the literature. Partial loudness was also studied as a predictor of detectability, with strong positive association seen (R^2 = 0.9). Of the alert sounds evaluated, those comprising pure tones with frequency content in the 800 Hz - 1 kHz range, and with amplitude modulation or impulsive characteristics, offered the greatest balance between detectability and annoyance. This study offers much needed research into detectability of electric micromobility transport in a range of environmental noise conditions, and furthermore provides objective metrics for the development of micromobility AVAS sounds going forward

    What is the experience of receiving healthcare for neck pain?

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    This study used a descriptive phenomenological approach to describe the experience of finding and receiving health services for neck pain. Nineteen participants (18 females, 1 male) with neck pain (>3 months) were interviewed using a semi-structured questionnaire guide. Interviews were recorded, transcribed and coded. Two overarching themes described the experience: complexity in finding effective health care; and the need for informative, personalized, respectful communication. Complexity in finding effective health care was attributed to the variable approach and effectiveness of different health professionals, the need to experiment with care to find what works, the need to differentiate temporary versus permanent treatment effects, concerns about treatment side effects and the sense that financial factors influence personal treatment choices and provider behaviours. The need for informative, personalized, respectful communications was broken down into the following subthemes: the importance of being listened to, seen and believed; the need for useful information; and a desire to have outcomes formally tracked as a means of individualizing treatment. Overall, patients struggled to navigate the variable health services and providers that were available and that provided variable outcomes. They often did so through a trial and error approach. As such, patients remain open to unproven, even controversial treatment options. Research evidence was not a key ingredient in patient decision-making about accessing health services. The environmental, personal, health behavior factors interacted to contribute to health service utilization and would increase the burden of these for both the individual and society at large. The effectiveness of neck pain interventions is dependent on complex interactions between the context, individual, and health care provider, therefore, physiological responses cannot be considered as being distinct from these determinants

    A Survey of Scale Insects (Sternorryncha: Coccoidea) Occurring on Table Grapes in South Africa

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    Increasing international trade and tourism have led to an increase in the introduction of exotic pests that pose a considerable economic threat to the agro-ecosystems of importing countries. Scale insects (Sternorryncha: Coccoidea) may be contaminants of export consignments from the South African deciduous fruit industry to the European Union, Israel, United Kingdom and the United States, for example. Infestations of immature scale insects found on South African fruit destined for export have resulted in increasing rates of rejection of such consignments. To identify the risk posed by scale insect species listed as phytosanitary pests on table grapes to the abovementioned importing countries, a field survey was undertaken in 2004–2005 in vineyards throughout all grape-producing regions in South Africa. Coccoidea species found during the current field survey were Planococcus ficus (Signoret), Pseudococcus longispinus (Targioni Tozzetti), Coccus hesperidum L. and Nipaecoccus viridis (Newstead). With the exception of Pl. ficus, which has only been collected from Vitis vinifera (Vitaceae) and Ficus carica (Moraceae) in South Africa, these species are polyphagous and have a wide host range. None of the scale insect species found to occur in vineyards in South Africa pose a phytosanitary risk to countries where fruit are exported except for Ferrisia malvastra (McDaniel) and N. viridis that have not been recorded in the USA. All scale insects previously found in vineyards in South Africa are listed and their phytosanitary status discussed. The results of the survey show that the risk of exporting scale insect pests of phytosanitary importance on table grapes from South Africa is limited

    Provenancing Archaeological Wool Textiles from Medieval Northern Europe by Light Stable Isotope Analysis (δ13C, δ15N, δ2H)

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    We investigate the origin of archaeological wool textiles preserved by anoxic waterlogging from seven medieval archaeological deposits in north-western Europe (c. 700-1600 AD), using geospatial patterning in carbon (δ13C), nitrogen (δ15N) and non-exchangeable hydrogen (δ2H) composition of modern and ancient sheep proteins. δ13C, δ15N and δ2H values from archaeological wool keratin (n = 83) and bone collagen (n = 59) from four sites were interpreted with reference to the composition of modern sheep wool from the same regions. The isotopic composition of wool and bone collagen samples clustered strongly by settlement; inter-regional relationships were largely parallel in modern and ancient samples, though landscape change was also significant. Degradation in archaeological wool samples, examined by elemental and amino acid composition, was greater in samples from Iceland (Reykholt) than in samples from north-east England (York, Newcastle) or northern Germany (Hessens). A nominal assignment approach was used to classify textiles into local/non-local at each site, based on maximal estimates of isotopic variability in modern sheep wool. Light element stable isotope analysis provided new insights into the origins of wool textiles, and demonstrates that isotopic provenancing of keratin preserved in anoxic waterlogged contexts is feasible. We also demonstrate the utility of δ2H analysis to understand the location of origin of archaeological protein samples

    The second data release of the INT Photometric Ha Survey of the Northern Galactic Plane (IPHAS DR2)

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    The INT/WFC Photometric Hα Survey of the Northern Galactic Plane (IPHAS) is a 1800 deg2 imaging survey covering Galactic latitudes |b| < 5° and longitudes ℓ = 30°–215° in the r, i, and Hα filters using the Wide Field Camera (WFC) on the 2.5-m Isaac Newton Telescope (INT) in La Palma. We present the first quality-controlled and globally calibrated source catalogue derived from the survey, providing single-epoch photometry for 219 million unique sources across 92 per cent of the footprint. The observations were carried out between 2003 and 2012 at a median seeing of 1.1 arcsec (sampled at 0.33 arcsec pixel−1) and to a mean 5σ depth of 21.2 (r), 20.0 (i), and 20.3 (Hα) in the Vega magnitude system. We explain the data reduction and quality control procedures, describe and test the global re-calibration, and detail the construction of the new catalogue. We show that the new calibration is accurate to 0.03 mag (root mean square) and recommend a series of quality criteria to select accurate data from the catalogue. Finally, we demonstrate the ability of the catalogue's unique (r − Hα, r − i) diagram to (i) characterize stellar populations and extinction regimes towards different Galactic sightlines and (ii) select and quantify Hα emission-line objects. IPHAS is the first survey to offer comprehensive CCD photometry of point sources across the Galactic plane at visible wavelengths, providing the much-needed counterpart to recent infrared surveys

    Epithelioid sarcoma in the thoracic spine

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    Epithelioid sarcoma is a rare and highly malignant soft tissue tumor that is commonly found in the extremities and rarely in the trunk area. This malignant tumor often mimics granuloma or nodular fasciitis, which causes a delay in establishing the diagnosis. This type of cancer has a high recurrence rate. Surgical treatment requires wide radical resection. The objective of this case report is to highlight the unique location of a rare neoplasm and to illustrate the relentless course of epithelioid sarcoma despite initial radical resection. A 14-year-old boy was admitted to our facility with a soft tissue mass on the right lower thoracic spine. The large tumor mass had deeply penetrated into the muscles, infiltrated the neuroforamen of T9–T10 level, and compressed the dural sac. Immunohistological study of the biopsy was highly consistent with an epithelioid sarcoma. Wide excision of the mass, laminectomy and spine fusion with instrumentation was performed. The patient received chemotherapy and irradiation. The first recurrence of the neoplasm was seen as a contralateral metastasis 21 months after the resection. On the last follow-up, 3 years postoperatively, the patient was in a good general condition. However, further progression of the sarcoma had to be recognized. Our case encompasses multiple features that represent negative prognostic factors. Initial wide excision of the neoplasm and adjuvant therapy including chemotherapy and irradiation seem to slow down the relentless course of epithelioid sarcoma in the trunk

    Assessment of an undergraduate psychiatry course in an African setting

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    <p>Abstract</p> <p>Background</p> <p>International reports recommend the improvement in the amount and quality of training for mental health workers in low and middle income countries. The Scotland-Malawi Mental Health Education Project (SMMHEP) has been established to support the teaching of psychiatry to medical students in the University of Malawi. While anecdotally supportive medical educational initiatives appear of value, little quantitative evidence exists to demonstrate whether such initiatives can deliver comparable educational standards. This study aimed to assess the effectiveness of an undergraduate psychiatry course given by UK psychiatrists in Malawi by studying University of Malawi and Edinburgh University medical students' performance on an MCQ examination paper.</p> <p>Methods</p> <p>An undergraduate psychiatry course followed by an MCQ exam was delivered by the SMMHEP to 57 Malawi medical students. This same MCQ exam was given to 71 Edinburgh University medical students who subsequently sat their own Edinburgh University examination.</p> <p>Results</p> <p>There were no significant differences between Edinburgh students' performance on the Malawi exam and their own Edinburgh University exam. (p = 0.65). This would suggest that the Malawi exam is a comparable standard to the Edinburgh exam. Malawi students marks ranged from 52.4%–84.6%. Importantly 84.4% of Malawi students scored above 60% on their exam which would equate to a hypothetical pass by UK university standards.</p> <p>Conclusion</p> <p>The support of an undergraduate course in an African setting by high income country specialists can attain a high percentage pass rate by UK standards. Although didactic teaching has been surpassed by more novel educational methods, in resource poor countries it remains an effective and cost effective method of gaining an important educational standard.</p

    Process evaluation of a randomised pilot trial of home-based rehabilitation compared to usual care in patients with heart failure with preserved ejection fraction and their caregiver’s

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    Background: Whilst heart failure (HF) with preserved ejection fraction (HFpEF) affects almost 50 percent of the HF population, evidence-based treatment options remain limited. However, there is growing evidence of the potential value of exercise-based cardiac rehabilitation. This study reports the process evaluation of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention for HFpEF patients and their caregivers conducted as part of the REACH-HFpEF pilot trial. Methods: Process evaluation sub-study parallel to a single centre (Tayside, Scotland) randomised controlled pilot trial with qualitative assessment of both intervention fidelity delivery and HFpEF patients’ and caregivers’ experiences. The REACH-HF intervention consisted of self-help manual for patients and caregivers, facilitated over 12 weeks by trained healthcare professionals. Interviews were conducted following completion of intervention in a purposeful sample of 15 HFpEF patients and 7 caregivers. Results: Qualitative information from the facilitator interactions and interviews identified three key themes for patients and caregivers: (1) understanding their condition, (2) emotional consequences of HF, and (3) patients’ and caregivers’ responses to the REACH-HF intervention. The differing professional backgrounds demonstrate the possibility of delivering REACH-HF by either existing HF or cardiac rehabilitation services of a combination of the two. Conclusions: The REACH-HF home-based facilitated intervention for HFpEF appears feasible and well accepted model for delivery of a cardiac rehabilitation intervention, with the potential to address key unmet needs of patients and their caregivers who are often excluded from service provision and current CR programmes. Results of this study will inform a recently funded full multicentre randomised clinical trial
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