Adjustable mount for electro-optic transducers in an evacuated cryogenic system

The invention is an adjustable mount for positioning an electro-optic transducer in an evacuated cryogenic environment. Electro-optic transducers are used in this manner as high sensitivity detectors of gas emission lines of spectroscopic analysis. The mount is made up of an adjusting mechanism and a transducer mount. The adjusting mechanism provided five degrees of freedom, linear adjustments and angular adjustments. The mount allows the use of an internal lens to focus energy on the transducer element thereby improving the efficiency of the detection device. Further, the transducer mount, although attached to the adjusting mechanism, is isolated thermally such that a cryogenic environment can be maintained at the transducer while the adjusting mechanism remains at room temperature. Radiation shields also are incorporated to further reduce heat flow to the transducer location

A Longitudinal Analysis of Music Tourism Impacts

Music tourism has boomed in recent decades and has been part of the rise in cultural tourism. In recent years, several communities have implemented a concert series to help promote tourism during the shoulder season, or slower months during the off-season. In this study, a longitudinal examination of several concerts of various sizes and genres spanning about three years looks at the economic impacts for the tourist destination of Panama City Beach, FL. This paper will conduct an analysis comparing the tourism development tax, hotel/motel data provided by the industry leading data resource, Smith Travel Research (STR), in order to determine the best indicator of measurement for this area. After determining the best indicator of measurement, this study will examine the impact music concerts are having on a particular tourism destination and analyze the impacts of variations throughout the different seasons

Supramolecular structure in the membrane of Staphylococcus aureus

The fundamental processes of life are organized and based on common basic principles. Molecular organizers, often interacting with the membrane, capitalize on cellular polarity to precisely orientate essential processes. The study of organisms lacking apparent polarity or known cellular organizers (e.g., the bacterium Staphylococcus aureus) may enable the elucidation of the primal organizational drive in biology. How does a cell choose from infinite locations in its membrane? We have discovered a structure in the S. aureus membrane that organizes processes indispensable for life and can arise spontaneously from the geometric constraints of protein complexes on membranes. Building on this finding, the most basic cellular positioning system to optimize biological processes, known molecular coordinators could introduce further levels of complexity. All life demands the temporal and spatial control of essential biological functions. In bacteria, the recent discovery of coordinating elements provides a framework to begin to explain cell growth and division. Here we present the discovery of a supramolecular structure in the membrane of the coccal bacterium Staphylococcus aureus, which leads to the formation of a large-scale pattern across the entire cell body; this has been unveiled by studying the distribution of essential proteins involved in lipid metabolism (PlsY and CdsA). The organization is found to require MreD, which determines morphology in rod-shaped cells. The distribution of protein complexes can be explained as a spontaneous pattern formation arising from the competition between the energy cost of bending that they impose on the membrane, their entropy of mixing, and the geometric constraints in the system. Our results provide evidence for the existence of a self-organized and nonpercolating molecular scaffold involving MreD as an organizer for optimal cell function and growth based on the intrinsic self-assembling properties of biological molecules

An exploratory study investigating children's perceptions of dental behavioural management techniques

Background: Behaviour management techniques (BMTs) are utilised by dentists to aid children's dental anxiety (DA). Children's perceptions of these have been underexplored, and their feedback could help inform paediatric dentistry. Aim: To explore children's acceptability and perceptions of dental communication and BMTs and to compare these by age, gender, and DA. Design: A total of sixty-two 9- to 11-year-old school children participated in the study. Children's acceptability of BMTs was quantified using a newly developed Likert scale, alongside exploration of children's experiences and perceptions through interviews. anova and t-tests explored BMT acceptability ratings by age, gender, and DA. Thematic analysis was used to analyse interviews. Findings: Statistical analyses showed no effect of age, gender, or DA upon BMT acceptability. Children generally perceived the BMTs as acceptable or neutral; stop signals were the most acceptable, and voice control the least acceptable BMT. Beneficial experiences of distraction and positive reinforcement were common. Children described the positive nature of their dentist's communication and BMT utilisation. Conclusion: Dental anxiety did not affect children's perceptions of BMTs. Children were generally positive about dentist's communication and established BMTs. Children's coping styles may impact perceptions and effectiveness of BMTs and should be explored in future investigations

The Next Frontier in Communication and the ECLIPPSE Study: Bridging the Linguistic Divide in Secure Messaging

Health systems are heavily promoting patient portals. However, limited health literacy (HL) can restrict online communication via secure messaging (SM) because patients’ literacy skills must be sufficient to convey and comprehend content while clinicians must encourage and elicit communication from patients and match patients’ literacy level. This paper describes the Employing Computational Linguistics to Improve Patient-Provider Secure Email (ECLIPPSE) study, an interdisciplinary effort bringing together scientists in communication, computational linguistics, and health services to employ computational linguistic methods to (1) create a novel Linguistic Complexity Profile (LCP) to characterize communications of patients and clinicians and demonstrate its validity and (2) examine whether providers accommodate communication needs of patients with limited HL by tailoring their SM responses. We will study >5 million SMs generated by >150,000 ethnically diverse type 2 diabetes patients and >9000 clinicians from two settings: an integrated delivery system and a public (safety net) system. Finally, we will then create an LCP-based automated aid that delivers real-time feedback to clinicians to reduce the linguistic complexity of their SMs. This research will support health systems’ journeys to become health literate healthcare organizations and reduce HL-related disparities in diabetes care

Comfort vs risk: a grounded theory about female adolescent behaviour in the sun.

AIMS AND OBJECTIVES: To generate a grounded theory about female adolescent behaviour in the sun. BACKGROUND: Nurses have key roles in health promotion and skin cancer prevention. Adolescents' resistance to sun safety messages and their vulnerability to sunburn are of concern internationally. Understanding why young women do as they do in the sun may enhance skin cancer prevention, but their behaviour has not been explained before in the UK. DESIGN: The study incorporated a qualitative grounded theory design using the approach of Glaser. METHODS: Qualitative data were gleaned from group and one-to-one, semi-structured interviews with 20 female participants aged 14-17, research memos and literature. Sampling was purposive and theoretical. Data collection, analysis and theory generation occurred concurrently. Data were analysed using the constant comparative method. Data collection ended when a substantive theory had been generated. RESULTS: Data analysis revealed five categories of findings: fitting in, being myself, being physically comfortable, slipping up and being comfortable (the core category). The theory generated around the core explains how young women direct their sun-related activities towards meeting their physical and psychosocial comfort needs. CONCLUSIONS: A contribution of this research is the grounded theory explaining the behaviour of young women in the sun. Further, the theory challenges assumptions that female adolescents necessarily take risks; it explains their sun-related activities in terms of comfort. The theory extends findings from other researchers' descriptive qualitative studies and also appears to apply to young people in countries other than the UK. RELEVANCE TO CLINICAL PRACTICE: Understanding the sun-related activity of young women in terms of physical and psychosocial comfort may help nurses to develop new approaches to skin cancer prevention. These could complement existing messages and humanise health promotion

Evaluating summarised radionuclide concentration ratio datasets for wildlife

Concentration ratios (CRwo-media) are used in most radioecological models to predict whole-body radionuclide activity concentrations in wildlife from those in environmental media. This simplistic approach amalgamates the various factors influencing transfer within a single generic value and, as a result, comparisons of model predictions with site-specific measurements can vary by orders of magnitude. To improve model predictions, the development of 'condition-specific' CRwo-media values has been proposed (e.g. for a specific habitat). However, the underlying datasets for most CRwo-media value databases, such as the wildlife transfer database (WTD) developed within the IAEA EMRAS II programme, include summarised data. This presents challenges for the calculation and subsequent statistical evaluation of condition-specific CRwo-media values. A further complication is the common use of arithmetic summary statistics to summarise data in source references, even though CRwo-media values generally tend towards a lognormal distribution and should, therefore, be summarised using geometric statistics. In this paper, we propose a statistically-defensible and robust method for reconstructing underlying datasets to calculate condition-specific CRwo-media values from summarised data and deriving geometric summary statistics. This method is applied to terrestrial datasets from the WTD. Statistically significant differences in sub-category CRwo-media values (e.g. mammals categorised by feeding strategy) were identified, which may justify the use of these CRwomedia values for specific assessment contexts. However, biases and limitations within the underlying datasets of the WTD explain some of these differences. Given the uncertainty in the summarised CRwo-media values, we suggest that the CRwo-media approach to estimating transfer is used with caution above screening-level assessments

Aspirin as an adjuvant treatment for cancer:feasibility results from the Add-Aspirin randomised trial

BACKGROUND: Preclinical, epidemiological, and randomised data indicate that aspirin might prevent tumour development and metastasis, leading to reduced cancer mortality, particularly for gastro-oesophageal and colorectal cancer. Randomised trials evaluating aspirin use after primary radical therapy are ongoing. We present the pre-planned feasibility analysis of the run-in phase of the Add-Aspirin trial to address concerns about toxicity, particularly bleeding after radical treatment for gastro-oesophageal cancer.METHODS: The Add-Aspirin protocol includes four phase 3 randomised controlled trials evaluating the effect of daily aspirin on recurrence and survival after radical cancer therapy in four tumour cohorts: gastro-oesophageal, colorectal, breast, and prostate cancer. An open-label run-in phase (aspirin 100 mg daily for 8 weeks) precedes double-blind randomisation (for participants aged under 75 years, aspirin 300 mg, aspirin 100 mg, or matched placebo in a 1:1:1 ratio; for patients aged 75 years or older, aspirin 100 mg or matched placebo in a 2:1 ratio). A preplanned analysis of feasibility, including recruitment rate, adherence, and toxicity was performed. The trial is registered with the International Standard Randomised Controlled Trials Number registry (ISRCTN74358648) and remains open to recruitment.FINDINGS: After 2 years of recruitment (October, 2015, to October, 2017), 3494 participants were registered (115 in the gastro-oesophageal cancer cohort, 950 in the colorectal cancer cohort, 1675 in the breast cancer cohort, and 754 in the prostate cancer cohort); 2719 (85%) of 3194 participants who had finished the run-in period proceeded to randomisation, with rates consistent across tumour cohorts. End of run-in data were available for 2253 patients; 2148 (95%) of the participants took six or seven tablets per week. 11 (0·5%) of the 2253 participants reported grade 3 toxicity during the run-in period, with no upper gastrointestinal bleeding (any grade) in the gastro-oesophageal cancer cohort. The most frequent grade 1-2 toxicity overall was dyspepsia (246 [11%] of 2253 participants).INTERPRETATION: Aspirin is well-tolerated after radical cancer therapy. Toxicity has been low and there is no evidence of a difference in adherence, acceptance of randomisation, or toxicity between the different cancer cohorts. Trial recruitment continues to determine whether aspirin could offer a potential low cost and well tolerated therapy to improve cancer outcomes.FUNDING: Cancer Research UK, The National Institute for Health Research Health Technology Assessment Programme, The MRC Clinical Trials Unit at UCL.</p

Development of a personalised device for systemic magnetic drug targeting to brain tumours

Delivering therapies to deeply seated brain tumours (BT) is a major clinical challenge. Magnetic drug targeting (MDT) could overcome this by rapidly transporting magnetised drugs directly into BT. We have developed a magnetic device for application in murine BT models using an array of neodymium magnets with a combined strength of 0.7T. In a closed fluidic system, the magnetic device trapped magnetic nanoparticles (MNP) up to distances of 0.8cm. In mice, the magnetic device guided intravenously administered MNP (<50nm) from the circulation into the brain where they localised within mouse BT. Furthermore, MDT of magnetised Temozolomide (TMZmag+) significantly reduced tumour growth and extended mouse survival to 48 days compared to the other treatment groups. Using the same principles, we built a proof of principle scalable magnetic device for human use with a strength of 1.1T. This magnetic device demonstrated trapping of MNP undergoing flow at distances up to 5cm. MDT using our magnetic device provides an opportunity for targeted delivery of magnetised drugs to human BT

An ethnographic study of knowledge sharing across the boundaries between care processes, services and organisations: the contributions to ‘safe’ hospital discharge

Background Hospital discharge is a vulnerable stage in the patient pathway. Research highlights communication failures and the problems of co-ordination as resulting in delayed, poorly timed and unsafe discharges. The complexity of hospital discharge exemplifies the threats to patient safety found ‘between’ care processes and organisations. In developing this perspective, safe discharge is seen as relying upon enhanced knowledge sharing and collaboration between stakeholders, which can mitigate system complexity and promote safety. Aim To identify interventions and practices that support knowledge sharing and collaboration in the processes of discharge planning and care transition. Setting The study was undertaken between 2011 and 2013 in two English health-care systems, each comprising an acute health-care provider, community and primary care providers, local authority social services and social care agencies. The study sites were selected to reflect known variations in local population demographics as well as in the size and composition of the care systems. The study compared the experiences of stroke and hip fracture patients as exemplars of acute care with complex discharge pathways. Design The study involved in-depth ethnographic research in the two sites. This combined (a) over 180 hours of observations of discharge processes and knowledge-sharing activities in various care settings; (b) focused ‘patient tracking’ to trace and understand discharge activities across the entire patient journey; and (c) qualitative interviews with 169 individuals working in health, social and voluntary care sectors. Findings The study reinforces the view of hospital discharge as a complex system involving dynamic and multidirectional patterns of knowledge sharing between multiple groups. The study shows that discharge planning and care transitions develop through a series of linked ‘situations’ or opportunities for knowledge sharing. It also shows variations in these situations, in terms of the range of actors, forms of knowledge shared, and media and resources used, and the wider culture and organisation of discharge. The study also describes the threats to patient safety associated with hospital discharge, as perceived by participants and stakeholders. These related to falls, medicines, infection, clinical procedures, equipment, timing and scheduling of discharge, and communication. Each of these identified risks are analysed and explained with reference to the observed patterns of knowledge sharing to elaborate how variations in knowledge sharing can hinder or promote safe discharge. Conclusions The study supports the view of hospital discharge as a complex system involving tightly coupled and interdependent patterns of interaction between multiple health and social care agencies. Knowledge sharing can help to mitigate system complexity through supporting collaboration and co-ordination. The study suggests four areas of change that might enhance knowledge sharing, reduce system complexity and promote safety. First, knowledge brokers in the form of discharge co-ordinators can facilitate knowledge sharing and co-ordination; second, colocation and functional proximity of stakeholders can support knowledge sharing and mutual appreciation and alignment of divergent practices; third, local cultures should prioritise and value collaboration; and finally, organisational resources, procedures and leadership should be aligned to fostering knowledge sharing and collaborative working. These learning points provide insight for future interventions to enhance discharge planning and care transition. Future research might consider the implementation of interviews to mediate system complexity through fostering enhanced knowledge sharing across occupational and organisational boundaries. Research might also consider in more detail the underlying complexity of both health and social care systems and how opportunities for knowledge sharing might be engendered to promote patient safety in other areas