Roles, service knowledge and priorities in the provision of palliative care: a postal survey of London GPs

Objectives: To explore general practitioners' (GPs) current involvement in and attitudes towards the provision of palliative care in primary care. Methods: Postal survey of 356 London-based GPs, assessing attitudes towards palliative care provision, district nursing and specialist palliative care services, and priorities for future service development. Results: Currently, 65% of GPs were providing palliative care to patients on their list; 72% agreed or strongly agreed palliative care was a central part of their role; and 27% wanted to hand care over to specialists. Most GPs (66%) disagreed with the statement that 'palliative care is mainly district nursing (DN) work'. Many were unaware of out-of-hours DN and specialist palliative care services. Multi-variable analysis found four GP characteristics - larger practice size, more years experience as a GP, receipt of palliative care education, and current provision of palliative care - were associated with agreement that palliative care was central to a GP's role. Conclusion: A minority of NHS GPs in London would rather have no involvement in palliative care in primary care. Knowledge of current services for palliative care is generally poor among GPs. These findings highlight potential gaps in services, particularly in small practices. Specialists will need to consider these factors in working with GPs to develop primary palliative care and to enable greater access to specialist palliative care

Increasing security of supply by the use of a local power controller during large system disturbances

This paper describes intelligent ways in which distributed generation and local loads can be controlled during large system disturbances, using Local Power Controllers. When distributed generation is available, and a system disturbance is detected early enough, the generation can be dispatched, and its output power can be matched as closely as possible to local microgrid demand levels. Priority-based load shedding can be implemented to aid this process. In this state, the local microgrid supports the wider network by relieving the wider network of the micro-grid load. Should grid performance degrade further, the local microgrid can separate itself from the network and maintain power to the most important local loads, re-synchronising to the grid only after more normal performance is regained. Such an intelligent system would be a suitable for hospitals, data centres, or any other industrial facility where there are critical loads. The paper demonstrates the actions of such Local Power Controllers using laboratory experiments at the 10kVA scale

Fabrication techniques developed for small- diameter, thin-wall tungsten and tungsten alloy tubing

Report describes methods for the fabrication of tungsten and tungsten alloys into small-diameter, thin-wall tubing of nuclear quality. The tungsten, or tungsten alloy tube blanks are produced by double extrusion. Plug-drawing has emerged as an excellent secondary fabrication technique for the reduction of the overall tube dimensions

Romantic Partnerships and the Dispersion of Social Ties: A Network Analysis of Relationship Status on Facebook

A crucial task in the analysis of on-line social-networking systems is to identify important people --- those linked by strong social ties --- within an individual's network neighborhood. Here we investigate this question for a particular category of strong ties, those involving spouses or romantic partners. We organize our analysis around a basic question: given all the connections among a person's friends, can you recognize his or her romantic partner from the network structure alone? Using data from a large sample of Facebook users, we find that this task can be accomplished with high accuracy, but doing so requires the development of a new measure of tie strength that we term `dispersion' --- the extent to which two people's mutual friends are not themselves well-connected. The results offer methods for identifying types of structurally significant people in on-line applications, and suggest a potential expansion of existing theories of tie strength.Comment: Proc. 17th ACM Conference on Computer Supported Cooperative Work and Social Computing (CSCW), 201

Entangled and disentangled evolution for a single atom in a driven cavity

For an atom in an externally driven cavity, we show that special initial states lead to near-disentangled atom-field evolution, and superpositions of these can lead to near maximally-entangled states. Somewhat counterintutively, we find that (moderate) spontaneous emission in this system actually leads to a transient increase in entanglement beyond the steady-state value. We also show that a particular field correlation function could be used, in an experimental setting, to track the time evolution of this entanglement

Molecular immunophenotyping of lungs and spleens in naive and vaccinated chickens early after pulmonary avian influenza A (H9N2) virus infection

In a respiratory-infection-model with the avian influenza A H9N2 virus we studied lung and splenic immune reactions in chickens using a recently developed 5K chicken immuno-microarray. Groups of chickens were either mock-immunized (referred to as non-immune), vaccinated with inactivated viral antigen only (immune) or with viral antigen in a water-in-oil (W/O) immunopotentiator (immune potentiated). Three weeks after vaccination all animals were given a respiratory infection. Immune potentiated birds developed inhibitory antiviral antibodies, showed minimal lung histopathology and no detectable viral sequences, while non-immune animals showed microscopic immunopathology and detectable virus. Immune birds, receiving antigen in saline only, showed minimal microscopic histopathology, and intermediate levels of virus detection. These classical features in the different groups were mirrored by overlapping or specific mRNA gene expression profiles in lungs and spleen using microarray analysis. To our knowledge this is the first study demonstrating pneumonia-associated lung pathology of the low pathogenic avian influenza H9N2 virus. Our data provide insights into the molecular interaction of this virus with its natural host when naive or primed by vaccination

Identification of a non-mammalian leptin-like gene:characterization and expression in the tiger salamander (Ambystoma tigrinum)

Leptin is well established as a multifunctional cytokine in mammals. However, little is known about the evolution of the leptin gene in other vertebrates. A recently published set of ESTs from the tiger salamander (Ambystoma tigrinum) contains a sequence sharing 56% nucleotide sequence identity with the human leptin cDNA. To confirm that the EST is naturally expressed in the salamander, a 409 bp cDNA was amplified by RT-PCR of salamander testis and stomach mRNAs. The coding sequence of the cDNA is predicted to encode 169 amino acids, and the mature peptide to consist of 146 residues, as in mammals. Although the overall amino acid identity with mammalian leptins is only 29%, the salamander and mammalian peptides share common structural features. An intron was identified between coding exons providing evidence that the sequence is present in the salamander genome. Phylogenetic analysis showed a rate of molecular divergence consistent with the accepted view of vertebrate evolution. The pattern of tissue expression of the leptin-like cDNA differed between metamorphosed adult individuals of different sizes suggesting possible developmental regulation. Expression was most prominent in the skin and testis, but was also detected in tissues in which leptin mRNA is present in mammals, including the fat body, stomach, and muscle. The characterization of a salamander leptin-like gene provides a basis for understanding how the structure and functions of leptin have altered during the evolution of tetrapod vertebrates

MOS CCDs for the wide field imager on the XEUS spacecraft

In recent years the XEUS mission concept has evolved and has been the subject of several industrial studies. The mission concept has now matured to the point that it could be proposed for a Phase A study and subsequent flight programme. The key feature of XEUS will be its X-ray optic with collecting area ~30-100x that of XMM. The mission is envisaged at an orbit around the L2 point in space, and is formed from two spacecraft; one for the mirrors, and the other for the focal plane detectors. With a focal length of 50m, the plate scale of the optic is 6.5x that of XMM, which using existing focal plane technology will reduce the effective field of view to a few arc minutes. Cryogenic instrumentation, with detector sizes of a few mm can only be used for narrow field studies of target objects, and a wide field instrument is under consideration using a DEPFET pixel array to image out to a diameter of 5 arcminutes, requiring an array of dimension 70mm. It is envisaged to extend this field of view possibly out to 15 arcminutes through the use of an outer detection ring comprised of MOS CCD

An ion ring in a linear multipole trap for optical frequency metrology

A ring crystal of ions trapped in a linear multipole trap is studied as a basis for an optical frequency standard. The equilibrium conditions and cooling possibilities are discussed through an analytical model and molecular dynamics simulations. A configuration which reduces the frequency sensitivity to the fluctuations of the number of trapped ions is proposed. The systematic shifts for the electric quadrupole transition of calcium ions are evaluated for this ring configuration. This study shows that a ring of 10 or 20 ions allows to reach a short term stability better than for a single ion without introducing limiting long term fluctuations

Symbiodinium thermophilum sp. nov., a thermotolerant symbiotic alga prevalent in corals of the world's hottest sea, the Persian/Arabian Gulf

Coral reefs are in rapid decline on a global scale due to human activities and a changing climate. Shallow water reefs depend on the obligatory symbiosis between the habitat forming coral host and its algal symbiont from the genus Symbiodinium (zooxanthellae). This association is highly sensitive to thermal perturbations and temperatures as little as 1°C above the average summer maxima can cause the breakdown of this symbiosis, termed coral bleaching. Predicting the capacity of corals to survive the expected increase in seawater temperatures depends strongly on our understanding of the thermal tolerance of the symbiotic algae. Here we use molecular phylogenetic analysis of four genetic markers to describe Symbiodinium thermophilum, sp. nov. from the Persian/Arabian Gulf, a thermally tolerant coral symbiont. Phylogenetic inference using the non-coding region of the chloroplast psbA gene resolves S. thermophilum as a monophyletic lineage with large genetic distances from any other ITS2 C3 type found outside the Gulf. Through the characterisation of Symbiodinium associations of 6 species (5 genera) of Gulf corals, we demonstrate that S. thermophilum is the prevalent symbiont all year round in the world's hottest sea, the southern Persian/Arabian Gulf