What impact did a Paediatric Early Warning system have on emergency admissions to the paediatric intensive care unit? An observational cohort study

Summary The ideology underpinning Paediatric Early Warning systems (PEWs) is that earlier recognition of deteriorating in-patients would improve clinical outcomes. Objective To explore how the introduction of PEWs at a tertiary children's hospital affects emergency admissions to the Paediatric Intensive Care Unit (PICU) and the impact on service delivery. To compare ‘in-house’ emergency admissions to PICU with ‘external’ admissions transferred from District General Hospitals (without PEWs). Method A before-and-after observational study August 2005–July 2006 (pre), August 2006–July 2007 (post) implementation of PEWs at the tertiary children's hospital. Results The median Paediatric Index of Mortality (PIM2) reduced; 0.44 vs 0.60 (p < 0.001). Fewer admissions required invasive ventilation 62.7% vs 75.2% (p = 0.015) for a shorter median duration; four to two days. The median length of PICU stay reduced; five to three days (p = 0.002). There was a non-significant reduction in mortality (p = 0.47). There was no comparable improvement in outcome seen in external emergency admissions to PICU. A 39% reduction in emergency admission total beds days reduced cancellation of major elective surgical cases and refusal of external PICU referrals. Conclusions Following introduction of PEWs at a tertiary children's hospital PIM2 was reduced, patients required less PICU interventions and had a shorter length of stay. PICU service delivery improved

Found in translation: a psycholinguistic investigation of idiom processing in native and non-native speakers

Idioms, as highly familiar word combinations, are processed quickly by native speakers, but are problematic for non-native speakers even at high levels of proficiency. In this thesis I explore the representation of idioms in the monolingual and bilingual lexicons. In a series of studies I investigate how native and non-native speakers of English process English idioms and idioms translated from another language. In Study 1 I used a lexical decision task to test how much an expected word is primed following the first part of an idiom, e.g. on the edge of your… seat. English native speakers and Chinese-English bilinguals were tested using English idioms and translations of Chinese idioms (e.g. draw a snake and add… feet). In Study 2 I presented the same materials in short passages to allow for more natural presentation and used eye-tracking to investigate the reading patterns for all items. I also compared figurative and literal uses of the same items to see how easily non-native speakers were able to process non-compositional meaning in the L2. In Study 3 I used the same methodology (eye-tracking of idioms used in short sentence contexts) with a higher proficiency group (Swedish-English bilinguals), with much shorter, less predictable idioms (e.g. break the ice/bryta isen) and included a set of idioms that exist in both L1 and L2. All three studies point to the same conclusion: that even in an unfamiliar translated form, the expected lexical combination was facilitated (idioms showed faster processing than control phrases), but only the highest proficiency participants also showed evidence that they were able to process the figurative meanings without disruption. Congruent items show no additional advantage, hence it is clearly L1 knowledge of what words ‘go together’ that drives the effect in translation. In Study 4 I extended this by contrasting idioms with other types of formulaic phrase: literal binomials (king and queen) and collocations (abject poverty). All types showed faster reading compared to equally plausible control phrases. I then used formulaic component words in separated contexts to see whether any lexical priming effects are observed when the formulaic frame is compromised. Only idioms showed evidence of a formulaic advantage in this condition, while binomials showed evidence of semantic priming and collocations showed evidence of disruption. Importantly, different factors relevant to each formulaic type show an effect on how they are processed, e.g. idioms were driven by predictability, while binomials were driven more by the strength of semantic association between component words. The results overall provide a valuable new perspective on how formulaic units are represented in the mental lexicon. The fact that faster processing is seen for translated forms shows that idioms are not processed as unanalysed whole units, since L1 influence must be contingent on the individual words activating translation equivalent forms. This also shows that non-native speakers do not show fundamentally different processing in their L2 than native speakers, and ‘known’ word combinations are processed quickly regardless of the language of presentation. Compared to idioms, other formulaic types also show fast processing in canonical forms, but are more variable in whether or not the component words also show lexical priming in non-formulaic contexts. Formulaicity therefore exists at multiple levels of representation, encompassing lexical, structural and conceptual properties of word combinations

Could the Pioneer anomaly have a gravitational origin?

If the Pioneer anomaly has a gravitational origin, it would, according to the equivalence principle, distort the motions of the planets in the Solar System. Since no anomalous motion of the planets has been detected, it is generally believed that the Pioneer anomaly can not originate from a gravitational source in the Solar System. However, this conclusion becomes less obvious when considering models that either imply modifications to gravity at long range or gravitational sources localized to the outer Solar System, given the uncertainty in the orbital parameters of the outer planets. Following the general assumption that the Pioneer spacecraft move geodesically in a spherically symmetric spacetime metric, we derive the metric disturbance that is needed in order to account for the Pioneer anomaly. We then analyze the residual effects on the astronomical observables of the three outer planets that would arise from this metric disturbance, given an arbitrary metric theory of gravity. Providing a method for comparing the computed residuals with actual residuals, our results imply that the presence of a perturbation to the gravitational field necessary to induce the Pioneer anomaly is in conflict with available data for the planets Uranus and Pluto, but not for Neptune. We therefore conclude that the motion of the Pioneer spacecraft must be non-geodesic. Since our results are model independent within the class of metric theories of gravity, they can be applied to rule out any model of the Pioneer anomaly that implies that the Pioneer spacecraft move geodesically in a perturbed spacetime metric, regardless of the origin of this metric disturbance.Comment: 16 pages, 6 figures. Rev. 3: Major revision. Accepted for publication in Phys. Rev. D. Rev. 4: Added two reference

Found in translation: a psycholinguistic investigation of idiom processing in native and non-native speakers

Idioms, as highly familiar word combinations, are processed quickly by native speakers, but are problematic for non-native speakers even at high levels of proficiency. In this thesis I explore the representation of idioms in the monolingual and bilingual lexicons. In a series of studies I investigate how native and non-native speakers of English process English idioms and idioms translated from another language. In Study 1 I used a lexical decision task to test how much an expected word is primed following the first part of an idiom, e.g. on the edge of your… seat. English native speakers and Chinese-English bilinguals were tested using English idioms and translations of Chinese idioms (e.g. draw a snake and add… feet). In Study 2 I presented the same materials in short passages to allow for more natural presentation and used eye-tracking to investigate the reading patterns for all items. I also compared figurative and literal uses of the same items to see how easily non-native speakers were able to process non-compositional meaning in the L2. In Study 3 I used the same methodology (eye-tracking of idioms used in short sentence contexts) with a higher proficiency group (Swedish-English bilinguals), with much shorter, less predictable idioms (e.g. break the ice/bryta isen) and included a set of idioms that exist in both L1 and L2. All three studies point to the same conclusion: that even in an unfamiliar translated form, the expected lexical combination was facilitated (idioms showed faster processing than control phrases), but only the highest proficiency participants also showed evidence that they were able to process the figurative meanings without disruption. Congruent items show no additional advantage, hence it is clearly L1 knowledge of what words ‘go together’ that drives the effect in translation. In Study 4 I extended this by contrasting idioms with other types of formulaic phrase: literal binomials (king and queen) and collocations (abject poverty). All types showed faster reading compared to equally plausible control phrases. I then used formulaic component words in separated contexts to see whether any lexical priming effects are observed when the formulaic frame is compromised. Only idioms showed evidence of a formulaic advantage in this condition, while binomials showed evidence of semantic priming and collocations showed evidence of disruption. Importantly, different factors relevant to each formulaic type show an effect on how they are processed, e.g. idioms were driven by predictability, while binomials were driven more by the strength of semantic association between component words. The results overall provide a valuable new perspective on how formulaic units are represented in the mental lexicon. The fact that faster processing is seen for translated forms shows that idioms are not processed as unanalysed whole units, since L1 influence must be contingent on the individual words activating translation equivalent forms. This also shows that non-native speakers do not show fundamentally different processing in their L2 than native speakers, and ‘known’ word combinations are processed quickly regardless of the language of presentation. Compared to idioms, other formulaic types also show fast processing in canonical forms, but are more variable in whether or not the component words also show lexical priming in non-formulaic contexts. Formulaicity therefore exists at multiple levels of representation, encompassing lexical, structural and conceptual properties of word combinations

Rotordynamic Stability - A Simplified Approach.

LecturePg. 3-10Straightforward mechanics are used to give a physical understanding of the important parameters involved in rotor dynamic instability. A concise analysis procedure is proposed for assembling available information into a meaningful design stability analysis of between-bearing rotors. The technique combines the destabilizing effects on the rotor into an equivalent single source at the rotor mid-span, and uses an excitation "threshold value" to rate the system stability. Results of applying this design analysis technique to an unstable compressor and the benefit from bearing redesign are presented

Trauma Exposure Among Women in the Pacific Rim

Purpose Healthcare professionals who provide services in the immediate or long‐term aftermath of traumatic events need to understand the nature and frequency of traumatic events in the lives of women. However, research on trauma exposure in women has only recently begun to assess events other than intimate partner and sexual violence and has not supported direct statistical comparison of cross‐national and cross‐cultural data. The purpose of this descriptive, correlational study was to describe and compare trauma exposure prevalence and type in community‐based samples of women in the United States, Colombia, and Hong Kong. Design Women were recruited through posted notices at community health sites, snowball sampling, and online advertisements (N = 576). The Life Stressor Checklist‐Revised (total score range 0 to 30) was used to determine the type and prevalence of trauma exposure. Data were collected by native language members of the research team. Methods Descriptive statistics were used to summarize demographic characteristics and trauma exposure for the total sample and each community‐based sample (location). Between‐location differences were tested using Fisher\u27s exact tests for categorical measures and general linear models with pairwise a posteriori least squares t‐test for continuous measures. Responses to open‐ended questions were translated and categorized. Findings Over 99% of women in the total sample reported at least one traumatic life event. The mean number of traumatic life events per participant was 7, ranging from 0 to 24. Although there was consistency in the most commonly reported trauma exposures across locations, the rates of specific events often differed. Conclusions Historical, political, geographic, and cultural factors may explain differences in trauma exposure among women in the four locations studied. Clinical Relevance This study offers relevant knowledge for providers in diverse locations who provide services to women who have experienced traumatic events and provides evidence for the need for future research to further enhance knowledge of trauma exposure among women, and on the effects of trauma in women\u27s lives

The optical system of the H.E.S.S. imaging atmospheric Cherenkov telescopes, Part II: mirror alignment and point spread function

Mirror facets of the H.E.S.S. imaging atmospheric Cherenkov telescopes are aligned using stars imaged onto the closed lid of the PMT camera, viewed by a CCD camera. The alignment procedure works reliably and includes the automatic analysis of CCD images and control of the facet alignment actuators. On-axis, 80% of the reflected light is contained in a circle of less than 1 mrad diameter. The spot widens with increasing angle to the telescope axis. In accordance with simulations, the spot size has roughly doubled at an angle of 1.4 degr. from the axis. The expected variation of spot size with elevation due to deformations of the support structure is visible, but is completely non-critical over the usual working range. Overall, the optical quality of the telescope exceeds the specifications.Comment: 23 pages, 13 figure

Steady shocks around black holes produced by sub-keplerian flows with negative energy

We discuss a special case of formation of axisymmetric shocks in the accretion flow of ideal gas onto a Schwarzschild black hole: when the total energy of the flow is negative. The result of our analysis enlarges the parameter space for which these steady shocks are exhibited in the accretion of gas rotating around relativistic stellar objects. Since keplerian disks have negative total energy, we guess that, in this energy range, the production of the shock phenomenon might be easier than in the case of positive energy. So our outcome reinforces the view that sub-keplerian flows of matter may significantly affect the physics of the high energy radiation emission from black hole candidates. We give a simple procedure to obtain analytically the position of the shocks. The comparison of the analytical results with the data of 1D and 2D axisymmetric numerical simulations confirms that the shocks form and are stable.Comment: 5 pages, 5 figures, accepted by MNRAS on 10 November 200

Mild place illusion: a virtual reality factor to spark creativity in writing

Developments in Virtual Reality (VR) technology have modified the creative potential of each individual. We introduce a new con cept, called "mild place illusion", as a new paradigm for designing VR-based user interfaces targeted at stimulating creativity. We show that for creative tasks - such as creative writing, new product ideation, and brainstorming - a "just-enough" amount of place illu sion leads to a greater self-perception of creativity, as opposed to a "full-level" place illusion. This is a somewhat unexpected result since one would suppose, a priori, to have the full-level place illu sion as the optimal setup for stimulating creativity. We considered that the methodology in this work was fairly complex, but our re sults show – through a data triangulation approach – that we were able to identify more consistent and personal creative experiences. Therefore, the main contribution of this paper is a new paradigm for designing VR user interfaces targeted at stimulating creativity by showing that a “one-illusion interspace” leads to a greater self perception of creativity.info:eu-repo/semantics/publishedVersio

Opening research sites in multicentre clinical trials within the UK: a detailed analysis of delays

While recently imposed targets are reducing the time taken for R&D departments to approve valid applications, the time taken to open UK research sites remains excessive and must be reduced. At present significant public funds are being used inefficiently in order to navigate NHS systems, challenging the resolve of trial teams and the competitiveness of the UK