Evaluation of the Good Life Festival : a model for co-produced dementia events

The article presents an evaluation of The Good Life Festival, a co-produced event between people living with dementia, Salford University Dementia Institute, Alzheimer’s Society, Salford and Salford Adventures. This was a new way of working but important because people living with dementia said they thought there should be an event organised ‘for people with dementia by people with dementia’. A dementia friendly evaluation form was circulated asking: did you enjoy the event, did you learn something new, and do you feel more positive about living with dementia following the event. Thirty five of the eighty people who attended completed the evaluation form all of whom said they enjoyed it. 32 (91%) learned something new, and 27 (77%) left feeling more positive about living with dementia. Qualitative feedback is also included in this article including planning group reflections. Recommendations based on what we learned from planning and running the event are provided which includes having a media strategy in place and to send a follow up letter to remind people of information about resources/services advertised on the da

Structural precursor to the metal-insulator transition in V_2O_3

The temperature dependence of the local structure of V_2O_3 in the vicinity of the metal to insulator transition (MIT) has been investigated using hard X-ray absorption spectroscopy. It is shown that the vanadium pair distance along the hexagonal c-axis changes abruptly at the MIT as expected. However, a continuous increase of the tilt of these pairs sets in already at higher temperatures and reaches its maximum value at the onset of the electronic and magnetic transition. These findings confirm recent theoretical results which claim that electron-lattice coupling is important for the MIT in V_2O_3. Our results suggest that interactions in the basal plane play a decisive role for the MIT and orbital degrees of freedom drive the MIT via changes in hybridization.Comment: 6 pages, 5 figures, 2 table

Application of Design of Experiments to Extrusion Freeform Fabrication (EFF) of Functional Ceramic Prototypes

Extrusion Freeform Fabrication (EFF) is an adaptation of the Stratasys Fused Deposition Modeling (FDM) process for the Solid Freeform Fabrication (SFF) of functional ceramic prototypes. It is a complex process involving many process variables, including parameters that are operation, machine, materials, and geometry specific. A Taguchi factorial Design of Experiments (DOE) technique was utilized to study the effects of machine specific process parameters as well as their interactions based on the mechanical and physical properties of sintered ceramics specimens. Post-processing software was developed to control and modify these parameters. This software interface wasdesigned to mimic the Quickslice™ interface for setting motion parameters based upon the material and the operation. The results of this investigation provided useful information for the experimental analysis of the machine specific process parameters. Suitable parameters were selected for the EFF process for fabricating representative ceramic prototypes. With the optimized parameters, complicated parts were successfully fabricated using both Kyocera SN282 and Starck M-11 silicon nitride powders.Mechanical Engineerin

The cost-effectiveness of lamotrigine in the maintenance treatment of adults with bipolar I disorder.

OBJECTIVE: To present an economic model and cost-effectiveness estimates for lamotrigine in maintenance treatment of bipolar I disorder (BD-I) using outcomes from the pivotal lamotrigine trials. The main comparator treatments in the pivotal trials were lithium and .no maintenance. (acute-only) treatment. A comparison with olanzapine was included as an indirect analysis following publication of data during the course of our research. METHODS: A Markov model was built around the 3 health states of euthymia, mania, and depression. The base-case model simulates a cohort of 1,000 patients with BD-I who have recently stabilized after resolution of a bipolar mania episode. The cohort was modeled for a period of 18 months. Resource-use estimates were derived from best available published data, treatment guidelines, a physician survey, and published unit cost data. Outputs were measured in terms of costs per acute mood episode avoided, costs per euthymic day gained, and costs per quality-adjusted life-years (QALYs). Direct health care payer costs are used in the analyses. RESULTS: The base-case model for patients with a recent manic episode indicated that lamotrigine is the most effective treatment for avoiding both acute depression episodes and all types of acute episodes (depression and mania). It is also the most effective treatment in terms of number of euthymic days achieved (309 days per patient per year). Olanzapine is most effective for avoiding acute mania episodes. Total direct costs of treatment are lowest for the lithium treatment arm (Dollars 8,710 per patient for the 18-month period). All maintenance therapies were cost effective compared with the no-maintenance (acute-only treatment) arm. In the base case, lamotrigine had incremental cost-effectiveness ratios of Dollars 30 per euthymic day and Dollars 2,400 per acute episode avoided compared with lithium. A QALY analysis indicated that lamotrigine is cost effective in patients with a recent manic episode at Dollars 26,000 per QALY. The base-case model indicated that lamotrigine dominates olanzapine, (that is, lamotrigine costs less and is more effective than olanzapine) in patients with a recent manic episode. In a sensitivity analysis using outcomes from the pivotal trial of recently depressed patients, lamotrigine, in comparison with lithium, was not shown to be as cost effective as in the recently manic patients, but it was still cost effective compared with no maintenance treatment. CONCLUSIONS: For a defined cohort of patients with BD-I, the pharmacoeconomic model indicated that prevention of mood episodes with lithium and lamotrigine is cost effective in patients with a recent manic, mixed, or hypomanic episode. The conclusions with respect to the indirect comparison with olanzapine should be validated if and when direct trial data become available. Cost-effectiveness of maintenance treatments for patients with BD-I (recently depressed as well as recently manic) are likely to improve in models with a broader costing perspective and that take a longer time frame. Further research into the outcome implications of health-related quality of life and other BD subgroups are recommended

Increasing vertical mixing to reduce Southern Ocean deep convection in NEMO3.4

Most CMIP5 (Coupled Model Intercomparison Project Phase 5) models unrealistically form Antarctic Bottom Water by open ocean deep convection in the Weddell and Ross seas. To identify the mechanisms triggering Southern Ocean deep convection in models, we perform sensitivity experiments on the ocean model NEMO3.4 forced by prescribed atmospheric fluxes. We vary the vertical velocity scale of the Langmuir turbulence, the fraction of turbulent kinetic energy transferred below the mixed layer, and the background diffusivity and run short simulations from 1980. All experiments exhibit deep convection in the Riiser-Larsen Sea in 1987; the origin is a positive sea ice anomaly in 1985, causing a shallow anomaly in mixed layer depth, hence anomalously warm surface waters and subsequent polynya opening. Modifying the vertical mixing impacts both the climatological state and the associated surface anomalies. The experiments with enhanced mixing exhibit colder surface waters and reduced deep convection. The experiments with decreased mixing give warmer surface waters, open larger polynyas causing more saline surface waters and have deep convection across the Weddell Sea until the simulations end. Extended experiments reveal an increase in the Drake Passage transport of 4 Sv each year deep convection occurs, leading to an unrealistically large transport at the end of the simulation. North Atlantic deep convection is not significantly affected by the changes in mixing parameters. As new climate model overflow parameterisations are developed to form Antarctic Bottom Water more realistically, we argue that models would benefit from stopping Southern Ocean deep convection, for example by increasing their vertical mixing

‘Our voice started off as a whisper and now it is a great big roar’ : The Salford Dementia Associate Panel as a model of involvement in research activities

This paper presents the work of the ‘Salford Dementia Associate Panel’, based at the Salford Institute for Dementia, Salford University (UK). We discuss the roles of the Dementia Associates, in particular around the areas of engagement and research. The panel is made up of people living with dementia, and current and former care partners. It highlights the development of this group over a four-year period and demonstrates over time how the role of a Dementia Associate member has evolved. The panel is involved in research, education and public engagement activities conducted by staff and students within the Institute. The motivations for becoming involved are clearly articulated and demonstrate how the personal backgrounds of individuals have driven the collective involvement and desire to bring about change. The benefits and challenges associated with working as part of a panel are discussed. We conclude by bringing together our experiences as a set of suggestions for others who may wish to create a similar forum to promote the involvement of people living with dementia and former and current care partners

Medicines adherence: Involving patients in decisions about prescribed medicines and supporting adherence

It is thought that between a third and a half of all medicines1 There are many causes of non-adherence but they fall into two overlapping categories: intentional and unintentional. Unintentional non-adherence occurs when the patient wants to follow the agreed treatment but is prevented from doing so by barriers that are beyond their control. Examples include poor recall or difficulties in understanding the instructions, problems with using the treatment, inability to pay for the treatment, or simply forgetting to take it. prescribed for long-term conditions are not taken as recommended. If the prescription is appropriate, then this may represent a loss to patients, the healthcare system and society. The costs are both personal and economic. Adherence presumes an agreement between prescriber and patient about the prescriber’s recommendations. Adherence to medicines is defined as the extent to which the patient’s action matches the agreed recommendations. Non-adherence may limit the benefits of medicines, resulting in lack of improvement, or deterioration, in health. The economic costs are not limited to wasted medicines but also include the knock-on costs arising from increased demands for healthcare if health deteriorates. Non-adherence should not be seen as the patient’s problem. It represents a fundamental limitation in the delivery of healthcare, often because of a failure to fully agree the prescription in the first place or to identify and provide the support that patients need later on. Addressing non-adherence is not about getting patients to take more medicines per se. Rather, it starts with an exploration of patients’ perspectives of medicines and the reasons why they may not want or are unable to use them. Healthcare professionals have a duty to help patients make informed decisions about treatment and use appropriately prescribed medicines to best effec

Three Component Velocity and Acceleration Measurement Using FLEET

The femtosecond laser electronic excitation and tagging (FLEET) method has been used to measure three components of velocity and acceleration for the first time. A jet of pure N2 issuing into atmospheric pressure air was probed by the FLEET system. The femtosecond laser was focused down to a point to create a small measurement volume in the flow. The long-lived lifetime of this fluorescence was used to measure the location of the tagged particles at different times. Simultaneous images of the flow were taken from two orthogonal views using a mirror assembly and a single intensified CCD camera, allowing two components of velocity to be measured in each view. These different velocity components were combined to determine three orthogonal velocity components. The differences between subsequent velocity components could be used to measure the acceleration. Velocity accuracy and precision were roughly estimated to be +/-4 m/s and +/-10 m/s respectively. These errors were small compared to the approx. 100 m/s velocity of the subsonic jet studied