Pain management programmes for non-English-speaking black and minority ethnic groups with long-term or chronic pain

Increasing ethnic diversity in the UK means that there is a growing need for National Health Service care to be delivered to non-English-speaking patients. The aims of the present systematic review were to: (1) better understand the outcomes of chronic pain management programmes (PMPs) for ethnic minority and non-English-speaking patients and (2) explore the perspectives on and experiences of chronic pain for these groups. A systematic review identified 26 papers meeting the inclusion criteria; no papers reported on the outcomes of PMPs delivered in the UK. Of the papers obtained, four reported on PMPs conducted outside the UK; eight reported on ethnic differences in patients seeking support from pain management services in America; and the remaining papers included literature reviews, an experimental pain study, a collaborative enquiry, and a survey of patient and clinician ratings of pain. The findings indicate a lack of research into UK-based pain management for ethnic minorities and non-English-speaking patients. The literature suggests that effective PMPs must be tailored to meet cultural experiences of pain and beliefs about pain management. There is a need for further research to explore these cultural beliefs in non-English-speaking groups in the UK. Culturally sensitive evaluations of interpreted PMPs with long-term follow-up are needed to assess the effectiveness of current provision

'I'd like to know what causes it, you know, anything I've done?' Are we meeting the information and support needs of patients with macular degeneration? A qualitative study

Objective: To examine patients' experiences of information and support provision for age-related macular degeneration (AMD) in the UK. Study design: Exploratory qualitative study investigating patient experiences of healthcare consultations and living with AMD over 18 months. Setting: Specialist eye clinics at a Birmingham hospital. Participants: 13 patients diagnosed with AMD. Main outcome measures: Analysis of patients' narratives to identify key themes and issues relating to information and support needs. Results: Information was accessed from a variety of sources. There was evidence of clear information deficits prior to diagnosis, following diagnosis and ongoing across the course of the condition. Patients were often ill informed and therefore unable to self-advocate and recognise when support was needed, what support was available and how to access support. Conclusions: AMD patients have a variety of information needs that are variable across the course of the condition. Further research is needed to determine whether these experiences are typical and identify ways of translating the guidelines into practice. Methods of providing information need to be investigated and improved for this patient group

Relaxation kinetics in two-dimensional structures

We have studied the approach to equilibrium of islands and pores in two dimensions. The two-regime scenario observed when islands evolve according to a set of particular rules, namely relaxation by steps at low temperature and smooth at high temperature, is generalized to a wide class of kinetic models and the two kinds of structures. Scaling laws for equilibration times are analytically derived and confirmed by kinetic Monte Carlo simulations.Comment: 6 pages, 7 figures, 1 tabl

Topological entropy and secondary folding

A convenient measure of a map or flow's chaotic action is the topological entropy. In many cases, the entropy has a homological origin: it is forced by the topology of the space. For example, in simple toral maps, the topological entropy is exactly equal to the growth induced by the map on the fundamental group of the torus. However, in many situations the numerically-computed topological entropy is greater than the bound implied by this action. We associate this gap between the bound and the true entropy with 'secondary folding': material lines undergo folding which is not homologically forced. We examine this phenomenon both for physical rod-stirring devices and toral linked twist maps, and show rigorously that for the latter secondary folds occur.Comment: 13 pages, 8 figures. pdfLaTeX with RevTeX4 macro

Finding co-solvers on Twitter, with a little help from Linked Data

In this paper we propose a method for suggesting potential collaborators for solving innovation challenges online, based on their competence, similarity of interests and social proximity with the user. We rely on Linked Data to derive a measure of semantic relatedness that we use to enrich both user profiles and innovation problems with additional relevant topics, thereby improving the performance of co-solver recommendation. We evaluate this approach against state of the art methods for query enrichment based on the distribution of topics in user profiles, and demonstrate its usefulness in recommending collaborators that are both complementary in competence and compatible with the user. Our experiments are grounded using data from the social networking service Twitter.com

Asymptotic step profiles from a nonlinear growth equation for vicinal surfaces

We study a recently proposed nonlinear evolution equation describing the collective step meander on a vicinal surface subject to the Bales-Zangwill growth instability [O. Pierre-Louis et al., Phys. Rev. Lett. (80), 4221 (1998)]. A careful numerical analysis shows that the dynamically selected step profile consists of sloped segments, given by an inverse error function and steepening as sqrt(t), which are matched to pieces of a stationary (time-independent) solution describing the maxima and minima. The effect of smoothening by step edge diffusion is included heuristically, and a one-parameter family of evolution equations is introduced which contains relaxation by step edge diffusion and by attachment-detachment as special cases. The question of the persistence of an initially imposed meander wavelength is investigated in relation to recent experiments.Comment: 4 pages, 5 included figures. Typo in Eq.(5) corrected, section headlines added and Ref.[12] update

Analytical solution of generalized Burton--Cabrera--Frank equations for growth and post--growth equilibration on vicinal surfaces

We investigate growth on vicinal surfaces by molecular beam epitaxy making use of a generalized Burton--Cabrera--Frank model. Our primary aim is to propose and implement a novel analytical program based on a perturbative solution of the non--linear equations describing the coupled adatom and dimer kinetics. These equations are considered as originating from a fully microscopic description that allows the step boundary conditions to be directly formulated in terms of the sticking coefficients at each step. As an example, we study the importance of diffusion barriers for adatoms hopping down descending steps (Schwoebel effect) during growth and post-growth equilibration of the surface.Comment: 16 pages, REVTeX 3.0, IC-DDV-94-00

Prediction of Severe Complications and Mortality in Patients Admitted to a Coronary Care Unit

The aim of this study was to design a statistical model which will predict death or life-threatening complications in patients admitted to Coronary Care Unit using data which is available at the time of presentation. The study included 3721 consecutive admissions over a period four year period. Predictive models were developed using logistic regression analysis (with data from 1000 patients) and their performance was assessed using receiver operating characteristic (ROC) curve analysis. The most useful model included nine data items and was tested on data from 2721 patients. These could be divided into four groups according to their calculated probability of developing a serious complication. The lowest risk group had a mortality of 0.05%, compared with 3.5%, 6.4% and 18.1% respectively in the higher risk groups (p1000 U/1) in the four groups was 14.1%, 21.2%, 46.9% and 51.5% respectively (p<0.001). The overall complication rates were 16.9%, 35.4%, 75.4% and 71.8% respectively (p<0.001)

Numerical convergence of the block-maxima approach to the Generalized Extreme Value distribution

In this paper we perform an analytical and numerical study of Extreme Value distributions in discrete dynamical systems. In this setting, recent works have shown how to get a statistics of extremes in agreement with the classical Extreme Value Theory. We pursue these investigations by giving analytical expressions of Extreme Value distribution parameters for maps that have an absolutely continuous invariant measure. We compare these analytical results with numerical experiments in which we study the convergence to limiting distributions using the so called block-maxima approach, pointing out in which cases we obtain robust estimation of parameters. In regular maps for which mixing properties do not hold, we show that the fitting procedure to the classical Extreme Value Distribution fails, as expected. However, we obtain an empirical distribution that can be explained starting from a different observable function for which Nicolis et al. [2006] have found analytical results.Comment: 34 pages, 7 figures; Journal of Statistical Physics 201