A feasibility study of signed consent for the collection of patient identifiable information for a national paediatric clinical audit database

Objectives: To investigate the feasibility of obtaining signed consent for submission of patient identifiable data to a national clinical audit database and to identify factors influencing the consent process and its success. Design: Feasibility study. Setting: Seven paediatric intensive care units in England. Participants: Parents/guardians of patients, or patients aged 12-16 years old, approached consecutively over three months for signed consent for submission of patient identifiable data to the national clinical audit database the Paediatric Intensive Care Audit Network (PICANet). Main outcome measures: The numbers and proportions of admissions for which signed consent was given, refused, or not obtained (form not returned or form partially completed but not signed), by age, sex, level of deprivation, ethnicity (South Asian or not), paediatric index of mortality score, length of hospital stay (days in paediatric intensive care). Results: One unit did not start and one did not fully implement the protocol, so analysis excluded these two units. Consent was obtained for 182 of 422 admissions (43%) (range by unit 9% to 84%). Most (101/182; 55%) consents were taken by staff nurses. One refusal (0.2%) was received. Consent rates were significantly better for children who were more severely ill on admission and for hospital stays of six days or more, and significantly poorer for children aged 10-14 years. Long hospital stays and children aged 10-14 years remained significant in a stepwise regression model of the factors that were significant in the univariate model. Conclusion: Systematically obtaining individual signed consent for sharing patient identifiable information with an externally located clinical audit database is difficult. Obtaining such consent is unlikely to be successful unless additional resources are specifically allocated to training, staff time, and administrative support

Exchange bias in GeMn nanocolumns: the role of surface oxidation

We report on the exchange biasing of self-assembled ferromagnetic GeMn nanocolumns by GeMn-oxide caps. The x-ray absorption spectroscopy analysis of this surface oxide shows a multiplet fine structure that is typical of the Mn2+ valence state in MnO. A magnetization hysteresis shift |HE|~100 Oe and a coercivity enhancement of about 70 Oe have been obtained upon cooling (300-5 K) in a magnetic field as low as 0.25 T. This exchange bias is attributed to the interface coupling between the ferromagnetic nanocolumns and the antiferromagnetic MnO-like caps. The effect enhancement is achieved by depositing a MnO layer on the GeMn nanocolumns.Comment: 7 pages, 5 figure

Facilities for macromolecular crystallography at the Helmholtz Zentrum Berlin

Three macromolecular crystallography MX beamlines at the Helmholtz Zentrum Berlin HZB are available for the regional, national and international structural biology user community. The state of the art synchrotron beamlines for MX BL14.1, BL14.2 and BL14.3 are located within the low section of the BESSY II electron storage ring. All beamlines are fed from a superconducting 7 T wavelength shifter insertion device. BL14.1 and BL14.2 are energy tunable in the range 5 16 keV, while BL14.3 is a fixed energy side station operated at 13.8 keV. All three beamlines are equipped with CCD detectors. BL14.1 and BL14.2 are in regular user operation providing about 200 beam days per year and about 600 user shifts to approximately 50 research groups across Europe. BL14.3 has initially been used as a test facility and was brought into regular user mode operation during the year 2010. BL14.1 has recently been upgraded with a microdiffractometer including a mini k goniometer and an automated sample changer. Additional user facilities include office space adjacent to the beamlines, a sample preparation laboratory, a biology laboratory safety level 1 and high end computing resources. In this article the instrumentation of the beamlines is described, and a summary of the experimental possibilities of the beamlines and the provided ancillary equipment for the user community is give

Bridging the Divide Between Iterative Optical Polishing and Automation

Several recent business reports have described the global growth in demand for optical and photonic components, paralleled by technical reports on the growing shortage of skilled manufacturing staf to meet this demand. It is remarkable that producing ultraprecision surfaces remains so dependent on people, in contrast to other sectors of the economy, e.g., car manufacturing. Clearly, training can play some role, but ultimately, only process automation can provide the solution. This paper explores why automation is a challenge and summarizes multidisciplinary work aiming to assemble the building blocks required to realize automation

“Supposing that truth is a woman, what then?” The Lie Detector, The Love Machine and the Logic of Fantasy

One of the consequences of the public outcry over the 1929 St Valentine’s Day massacre was the establishment of a Scientific Crime Detection Laboratory at Northwestern University. The photogenic “Lie Detector Man”, Leonarde Keeler, was the Laboratory’s poster boy and his instrument the jewel in the crown of forensic science. The press often depicted Keeler gazing at a female suspect attached to his “sweat box”; a galvanometer electrode in her hand, a sphygmomanometer cuff on her arm and a rubber pneumograph tube strapped across her breasts. Keeler’s fascination with the deceptive charms of the female body was one he shared with his fellow lie detector pioneers, all of whom met their wives – and in William Marston’s case his mistress too – through their engagement with the instrument. Marston employed his own “Love Meter”, as the press dubbed it, to prove that “brunettes react far more violently to amatory stimuli than blondes”. In this paper I draw on the psychoanalytic concepts of fantasy and pleasure to argue that the female body played a pivotal role in establishing the lie detector’s reputation as an infallible and benign mechanical technology of truth

EtCO₂ -Based Biofeedback Method of Breath Regulation Increases Speech Fluency of Stuttering People

Respiratory disturbances frequently accompany stuttering. Their influence on lung ventilation can be assessed by measurement of the end-tidal CO2 concentration (EtCO2). The effectiveness of the CO2-based visual feedback method of breath regulation (VF) designed for stuttering therapy was tested in this study. The aim of the study was to answer the question if the VF helps to reduce respiratory disturbances in stuttering and increase speech fluency. 20 stuttering volunteers aged 13–45 years took part in the 3-parts test consisting of: 1. speaking without any techniques improving speech fluency, 2. learning the VF method, 3. VF-assisted speaking. The CO2/time signal and an acoustic signal of an utterance were recorded during the test. Significant increase of FE – the factor of breath ergonomics during speaking (based on both signals), from 47% to 71% (P < 0.01), and significant decrease of %SS – the percent of syllables stuttered, from 14% to 10% (P < 0.01) were received for VF-assisted utterances compared to the utterances without VF assistance. The results indicate that the VF can help to eliminate respiratory disturbances in stuttering and increase speech fluency

Urządzenie ECP-100 do nieinwazyjnego wspomagania układu krążenia wykorzystujące metodę kontrpulsacji zewnętrznej

Urządzenie ECP-100, opracowane przez ITAM Zabrze przy współpracy z 1B1B PAN Warszawa, umożliwia terapię pacjentów z chorobą niedokrwienną serca. Podczas zabiegu pacjent z zestawem mankietów pneumatycznych spoczywa na leżu zabiegowym. Zestaw składa się z trzech mankietów (podobnych do tych stosowanych przy pomiarze ciśnienia), które są owinięte dookoła łydek, ud i pośladków. Mankiety są napełniane sekwencyjnie na początku fazy rozkurczu serca i opróżniane przed fazą skurczu. Napełnianie i opróżnianie mankietów jest zsynchronizowane z przebiegiem EKG, tak by zoptymalizować korzyści terapeutyczne

Virtual respiratory system for interactive e-learning of spirometry

Progress in computer simulation technology offers new possibilities for modern medicine. On one hand – virtual organs can help to create animal or human models for research, on the other hand – e-learning or distant learning through Internet is now possible. The aim of our work was to create a system for interactive learning of spirometry (SILS), enabling students or physicians to observe spirometric measurements (flow-volume) modified by setting level and kind of abnormalities within the respiratory system. SILS is based on a virtual respiratory system presented previously in several papers. Its main features are: separation of the lungs and chest; anatomical division of the lungs; division of airway resistance into transmural pressure dependent (Rp) and lung volume dependent (Rv) parts. The one mathematical formula that represents Rp describes both flow limitation (forced expiration) and dependence of Raw on lungs volume (small airflows). The output of system are spirometric parameters (as FEV1, FVC, FEV1%FVC) and a flow–volume loop constructed according to results of simulation of forced expiration for the chosen abnormality kind and level. As a result – this system may be used in teaching process in medical schools and postgraduate education. We offer access to a basic version of SILS for students and physicians at: www.spirometry.ibib.waw.pl and www.zpigichp.edu.pl. As we expect feedback from users, it is possible to modify user interface or model features to comply with users' requests