Indexing dialysis dose for gender, body size and physical activity: Impact on survival

Current practice basing dialysis dose on urea distribution volume (V) has been questioned. We explored the impact on survival of scaling dialysis dose (Kt) to parameters reflective of metabolic activity. In a multicentre prospective cohort study of 1500 patients on thrice-weekly haemodialysis, body surface area (BSA) and resting energy expenditure (REE) were estimated using validated equations and physical activity by the Recent Physical Activity Questionnaire. Total energy expenditure (TEE) was estimated from REE and physical activity data. Kt was calculated from delivered (single-pool Kt/V)*Watson V. Kt/BSA, Kt/ REE and Kt/TEE were then calculated at baseline and 6 monthly during follow-up for 2 years. In adjusted Cox models Kt/TEE, Kt/BSA, Kt/REE, in that order, had lower hazard ratios for death than single-pool Kt/V. On the basis of adjusted survival differences, putative minimum target doses were estimated for Kt/BSA as 27119 ml/m 2 and Kt/TEE as 25.79 ml/ kcal. We identified spKt/V values equivalent to these estimated targets, ranging from 1.4 to 1.8 in patient groups based on gender, body size and physical activity. For sedentary patients, the minimum target dose was 1.4 for large males, 1.5 for small males and 1.7 for women. For active patients the target was 1.8 irrespective of gender and body-weight. Patients achieving these individualised minimum targets had greater adjusted two-year survival compared to those achieving conventional minimum targets. Metabolic activity related parameters, such as Kt/TEE and Kt/BSA, may have a clinically important role in scaling haemodialysis dose. Using such parameters or their spKt/V equivalents to adjust minimum target doses based on gender, body size and habitual physical activity may have a positive impact on survival.Peer reviewe

The challenges of renal replacement therapy and renal palliative care in the elderly

Much of the increase in take on rate for dialysis in recent years is accounted for by older patients in whom a treatment as demanding as dialysis was previously thought to be contraindicated. The decision to dialyse the elderly often remains difficult, as recent data suggest that those with significant comorbidities are unlikely to survive more than 4-6 months longer on dialysis than they would have done if treated conservatively. It is also important to recognise that conservative treatment is not simply defined by the decision not to dialyse. Good conservative care comprises active disease management eg treatment of anaemia with erythropoietin stimulating agents and intravenous iron, and supportive care which may become increasingly complex eg pain relief with fentanyl and alfentanyl, towards the end of life. Those older patients who do decide to dialyse must contend with all the usual end of life issues facing older people, in addition to the option, denied to the rest of us, of dialysis withdrawal which effectively allows them to die at a time of their choosing

Moving the Bust Dart: The Fashion Designer, Sylvia Ayton's Relationship with Pattern Cutting

This presentation is a shorter version of a paper being prepared for The Journal of Dress Historians. I was invited to write this by the editor Jennifer Daly. It explores the work and career of fashion designer, Sylvia Ayton MBE and her relationship with pattern cutting. Ayton’s career is significant because of its flexibility and longevity. She worked as a designer in business partnership with Zandra Rhodes in the 1960s and as a commercial designer for a UK high-street retailer, from the 1970s to 2002. With access to her archive, the research traces Ayton’s involvement with pattern cutting and considers her experiences as a designer/pattern cutter for different markets in a creative and skills based context. Within literature, pattern cutting has rarely been explored through the relationship of the designer with the craft, particularly designers such as Ayton who have worked anonymously for large companies or retailers. The underpinning research will bridge this gap by investigating the thinking, practices and paradigms of pattern cutting during a designer’s career. It will also identify a lasting reference point for the fusion of technology with design, expressed in the context of fashion design careers within the global fashion industry

Everyday Fashion in Yorkshire 1939 - 1999

The presentation discusses a collaborative project between Leeds Museums and Galleries and the Yorkshire Fashion Archive, which will explore Yorkshire women’s experience of wearing, buying and making fashionable clothing in the period 1939 – 1999. The project will draw on the material artifacts in both the Leeds Museums and Galleries dress and textiles collection and the Yorkshire Fashion Archive collection to explore patterns of consumption and creativity, and will engage with local fashion consumers from this period to uncover and record memories of the golden years of Yorkshire’s textile and clothing industries

The Second International Conference for Creative Pattern Cutting Abstracts

Conference Introduction The Second International Conference for Creative Pattern Cutting has been generously sponsored by fashion and apparel solutions specialist Lectra. The overriding theme of the conference is to provide a platform to develop ideas as well as continue reinforcing notions of what constitutes practice based enquiry and the value of tacit knowledge (in this case creative pattern cutting), within a research context. The cut and construction of clothing, which embellishes the human body is the overarching discourse. The papers presented here continue to emphasise how we shouldn't underestimate tacit knowledge and the making process as a form of enquiry. The conference is streamed into four definitive themes, which investigate digital technology, eco-sustainable, pedagogical and fashioned approaches to creative pattern cutting and give researchers and practitioners a platform to share new techniques, ideas and direction with their peers in education and industry. One of the prevailing themes in this year's conference is the value of "learning by doing" (active learning) and the art of reflection. This has been embedded into all the tracks through professional practice, pedagogical developments and engaging research. The networks developed through the conference underpin some of the strengths of peer learning and moving forward the benefits of interdisciplinarity as a means of creative leading to the introduction of new skills, epistemologies, and creative impact leading to a new era in fashion design. Conference Organisers: Dr. Kevin Almond Dr. Jess Powe

Wavelet based detection of changes in the composition of RLC networks

The current work discusses the compositional analysis of spectra that may be related to amorphous materials that lack discernible Lorentzian, Debye or Drude responses. We propose to model such response using a 3-dimensional random RLC network using a descriptor formulation which is converted into an input-output transfer function representation. A wavelet identification study of these networks is performed to infer the composition of the networks. It was concluded that wavelet filter banks enable a parsimonious representation of the dynamics in excited randomly connected RLC networks. Furthermore, chemometric classification using the proposed technique enables the discrimination of dielectric samples with different composition. The methodology is promising for the classification of amorphous dielectrics