Developing and evaluating interventions to reduce inappropriate prescribing by general practitioners of antibiotics for upper respiratory tract infections: a randomised controlled trial to compare paper-based and web-based modelling experiments

Background: Much implementation research is focused on full-scale trials with little evidence of preceding modelling work. The Medical Research Council Framework for developing and evaluating complex interventions has argued for more and better theoretical and exploratory work prior to a trial as a means of improving intervention development. Intervention modelling experiments (IMEs) are a way of exploring and refining an intervention before moving to a full-scale trial. They do this by delivering key elements of the intervention in a simulation that approximates clinical practice by, for example, presenting general practitioners (GPs) with a clinical scenario about making a treatment decision. Methods: The current proposal will run a full, web-based IME involving 250 GPs that will advance the methodology of IMEs by directly comparing results with an earlier paper-based IME. Moreover, the web-based IME will evaluate an intervention that can be put into a full-scale trial that aims to reduce antibiotic prescribing for upper respiratory tract infections in primary care. The study will also include a trial of email versus postal invitations to participate. Discussion: More effective behaviour change interventions are needed and this study will develop one such intervention and a system to model and test future interventions. This system will be applicable to any situation in the National Health Service where behaviour needs to be modified, including interventions aimed directly at the public. Trial registration: ClinicalTrials (NCT): NCT0120673

Seismic vulnerability assessment: Methodological elements and applications to the case of Romania

This paper is intended to present some studies undertaken in order to develop a seismic vulnerability estimation system to fit the needs of development of earthquake scenarios and of development of an integrated disaster risk management system for Romania. Methodological aspects are dealt with, in connection with the criteria of categorization of buildings, with the definition of parameters used for characterizing vulnerability, with the setting up of an inventory of buildings and with the calibration of parameters characterizing vulnerability. Action was initiated along the coordinates referred to in connection with the methodological aspects mentioned above. The approach was made, as far as possible, specific to the conditions of Romania. Some data on results obtained to date are presented.seismic vulnerability, vulnerability estimation, earthquake scenarios, categorization of buildings, inventory of buildings, expected earthquake impact

The transferability of the low-cost model to long-haul airline operations

Since their emergence in the US in the mid 1970's there has been significant growth in the low-cost airline sector but with a few notable exceptions low-cost airlines have operated on short-haul routes. This paper examines the extent to which the low-cost model is, or could be, applicable to long-haul operations and whether the recent emergence of long-haul low-cost carriers is a sustainable phenomenon. The authors explore the extent to which elements of the so-called low-cost model might be transferable to long-haul operations. The paper seeks to quantify the potential cost differentials that might be achievable on a long-haul service. The paper also speculates as to the development and sustainability of the low-cost long-haul operations

Mars simulated exposure and the characteristic Raman biosignatures of amino acids and halophilic microbes

Though Raman bands of α-amino acids (AA) are well documented, often only the strongest intensity bands are quoted as identifiers (e.g. Jenkins et al., 2005; De Gelder et al., 2007; Zhu et al., 2011). Unknown regolith mixtures on Mars-sampling missions could obscure these bands. Here the case is made for determining, via a statistical method, sets of characteristic bands to be used as identifiers, independent of band intensity or number of bands (Rolfe et al., 2016). AA have upwards of 25 potentially identifying bands and this method defines sets of 10–19 bands per AA. Examination of AA-doped Mars-like basalt resulted in a maximum of eight bands being identified, as some characteristic bands were obscured by mineral bands, including the strongest intensity band in some cases. This proved the need for characteristic bands to be defined, enabling successful identification of AA. The ESA ExoMars Rover mission will crush and then pass the sample to the Raman Laser Spectrometer. We crushed a Mars-like basalt to a similar grain size expected to be created by the rover. Our samples were doped with 1 % (by weight) AA samples, resulting in no detection of AA, because of loss of original spatial context and spaces between the grains. We recommend that Raman spectroscopy on future missions should be conducted before the sample is crushed. Halite-entombed halophilic microbes, known to survive being entombed, were exposed to Mars-like surface (including temperature, pressure, atmospheric composition and UV) and freeze-thaw cycle (plus pressure and atmospheric composition) conditions. This test on the survival of the microbes showed that survival rates quickly deteriorated in surface conditions, but freeze-thaw cycle samples had well preserved Raman biosignatures, indicating that similar signatures could be detectable on Mars if similar life persists in evaporitic material or brines today

Applying psychological type theory to cathedral visitors : a case study of two cathedrals in England and Wales

This study employs Jungian psychological type theory to profile visitors to Chester Cathedral in England and St Davids Cathedral in Wales. Psychological type theory offers a fourfold psychographic segmentation of visitors, distinguishing between introversion and extraversion, sensing and intuition, thinking and feeling, and judging and perceiving. New data provided by 157 visitors to Chester Cathedral (considered alongside previously published data provided by 381 visitors to St Davids Cathedral) demonstrated that these two cathedrals attract more introverts than extraverts, more sensers than intuitives, and more judgers than perceivers, but equal proportions of thinkers and feelers. Comparison with the population norms demonstrated that extraverts and perceivers are significantly under-represented among visitors to these two cathedrals. The implications of these findings are discussed both for maximising the visitor experiences of those already attracted to these cathedrals and for discovering ways of attracting more extraverts and more perceivers to explore these cathedrals

The shape of high order correlation functions in CMB anisotropy maps

We present a phenomenological investigation of non-Gaussian effects that could be seen on CMB temperature maps. Explicit expressions for the temperature correlation functions are given for different types of primordial mode couplings. We argue that a simplified description of the radial transfer function for the temperature anisotropies allows to get insights into the general properties of the bi and tri-spectra. The accuracy of these results is explored together with the use of the small scale approximation to get explicit expressions of high order spectra. The bi-spectrum is found to have alternate signs for the successive acoustic peaks. Sign patterns for the trispectra are more complicated and depend specifically on the type of metric couplings. Local primordial couplings are found to give patterns that are different from those expected from weak lensing effects.Comment: 31 pages, 17 figures, submitted to Phys. Rev.

Stability Study of Some Selected Nigerian Crude Oil Emulsions and the Effectiveness of Locally Produced Demulsifier

Crude oil emulsion stability causes high viscosity of crude oil which leads to problems in pipeline transportation and processing. In this research, four samples of crude oil emulsions were collected from Ughelli East Wellhead and labeled A, B, C and D. These samples were characterized to determine their specific gravity, 0API gravity, structural composition, density, temperature, amount of water, amount of gas and the gross crude oil production. The 0API at 60 0F showed that all the samples had values below 30 0API which was an indication that the crude oil produced from these wells were heavy crude oil. The FTIR spectra showed bands at 3444.55 cm-1 for Sample A, 3418.23 cm-1 and 3175.94 cm-1for Sample B, 3444.61 cm-1 for Sample C and  3444.49 cm-1 for Sample D attributing to strong and broad O-H stretch, H-bonded and an indication of Asphaltenes presence; the alkanes signal, C-H stretch at 2961.14 cm-1 for Sample A, 2926.00 cm-1 for Sample B, 2924.15 cm-1 for Sample C and 2922.88 cm-1 for Sample D are indications of the presence of wax; C=O stretch at 1737.74 cm-1 only present in sample C is an indication of the presence of resins. The well test details showed that sample A and B had smaller water percentage in the gross crude oil production than Sample C and D with high water percentage. Therefore crude oil produced from these four wells represented by samples A, B, C and D contains natural emulsion stabilizers and stable. However, the stability of Samples A and B are more than that of Samples C and D. The performance of locally produced demulsifier increased with increase in residence time of contacting it with the emulsion samples at their operating temperatures, while equal dosage of patent Separol N46 demulsifier showed no performance within thesame residence time. However, treatments AWHT, BRT, CWHT and DWHT all at well head temperatures of 35.6 0C, 27 0C, 48.2 0C and 48.8 0C respectively showed that most water was expelled in 480 minutes. Key words: Stability, Selected, Crude oil, Emulsion, Demulsifiers, Treatmen

A study of the perceived risks, benefits and barriers to the use of SDD in adult critical care units (the SuDDICU study)

Peer reviewedPublisher PD

Optimal solutions to matrix-valued Nehari problems and related limit theorems

In a 1990 paper Helton and Young showed that under certain conditions the optimal solution of the Nehari problem corresponding to a finite rank Hankel operator with scalar entries can be efficiently approximated by certain functions defined in terms of finite dimensional restrictions of the Hankel operator. In this paper it is shown that these approximants appear as optimal solutions to restricted Nehari problems. The latter problems can be solved using relaxed commutant lifting theory. This observation is used to extent the Helton and Young approximation result to a matrix-valued setting. As in the Helton and Young paper the rate of convergence depends on the choice of the initial space in the approximation scheme.Comment: 22 page

Bipartite Fluctuations as a Probe of Many-Body Entanglement

We investigate in detail the behavior of the bipartite fluctuations of particle number $\hat{N}$ and spin $\hat{S}^z$ in many-body quantum systems, focusing on systems where such U(1) charges are both conserved and fluctuate within subsystems due to exchange of charges between subsystems. We propose that the bipartite fluctuations are an effective tool for studying many-body physics, particularly its entanglement properties, in the same way that noise and Full Counting Statistics have been used in mesoscopic transport and cold atomic gases. For systems that can be mapped to a problem of non-interacting fermions we show that the fluctuations and higher-order cumulants fully encode the information needed to determine the entanglement entropy as well as the full entanglement spectrum through the R\'{e}nyi entropies. In this connection we derive a simple formula that explicitly relates the eigenvalues of the reduced density matrix to the R\'{e}nyi entropies of integer order for any finite density matrix. In other systems, particularly in one dimension, the fluctuations are in many ways similar but not equivalent to the entanglement entropy. Fluctuations are tractable analytically, computable numerically in both density matrix renormalization group and quantum Monte Carlo calculations, and in principle accessible in condensed matter and cold atom experiments. In the context of quantum point contacts, measurement of the second charge cumulant showing a logarithmic dependence on time would constitute a strong indication of many-body entanglement.Comment: 30 pages + 25 pages supplementary materia