74 research outputs found
Protocol investigating the clinical utility of an objective measure of activity and attention (QbTest) on diagnostic and treatment decision-making in children and young people with ADHD--'Assessing QbTest Utility in ADHD'(AQUA): a randomised controlled trial
Introduction: The National Institute for Health and Care Excellence (NICE) guidelines for attention deficit/hyperactivity disorder (ADHD) state that young people need to have access to the best evidence-based care to improve outcome. The current ‘gold standard’ ADHD diagnostic assessment combines clinical observation with subjective parent, teacher and self-reports. In routine practice, reports from multiple informants may be unavailable or contradictory, leading to diagnostic uncertainty and delay. The addition of objective tests of attention and activity may help reduce diagnostic uncertainty and delays in initiating treatment leading to improved outcomes. This trial investigates whether providing clinicians with an objective report of levels of attention, impulsivity and activity can lead to an earlier, and more accurate, clinical diagnosis and improved patient outcome.
Methods and analysis: This multisite randomised controlled trial will recruit young people (aged 6–17 years old) who have been referred for an ADHD diagnostic assessment at Child and Adolescent Mental Health Services (CAMHS) and Community Paediatric clinics across England. Routine clinical assessment will be augmented by the QbTest, incorporating a continuous performance test (CPT) and infrared motion tracking of activity. The participant will be randomised into one of two study arms: QbOpen (clinician has immediate access to a QbTest report): QbBlind (report is withheld until the study end). Primary outcomes are time to diagnosis and diagnostic accuracy. Secondary outcomes include clinician's diagnostic confidence and routine clinical outcome measures. Cost-effective analysis will be conducted, alongside a qualitative assessment of the feasibility and acceptability of incorporating QbTest in routine practice.
Ethics and dissemination: The findings from the study will inform commissioners, clinicians and managers about the feasibility, acceptability, clinical utility and cost-effectiveness of incorporating QbTest into routine diagnostic assessment of young people with ADHD. The results will be submitted for publication in peer-reviewed journals. The study has received ethical approval
Silicon pore optics mirror modules for inner and outer radii
Athena (Advanced Telescope for High Energy Astrophysics) is an x-ray observatory using a Silicon Pore Optics telescope and was selected as ESA's second L-class science mission for a launch in 2028. The x-ray telescope consists of several hundreds of mirror modules distributed over about 15-20 radial rings. The radius of curvature and the module sizes vary among the different radial positions of the rings resulting in different technical challenges for mirror modules for inner and outer radii. We present first results of demonstrating Silicon Pore Optics for the extreme radial positions of the Athena telescope. For the inner most radii (0.25 m) a new mirror plate design is shown which overcomes the challenges of larger curvatures, higher stress values and bigger plates. Preliminary designs for the mounting system and its mechanical properties are discussed for mirror modules covering all other radial positions up to the most outer radius of the Athena telescope
Die Tridactyloidea-Fauna Kolumbiens (Orthoptera, Caelifera) ‘The Tridactyloidea of Colombia (Orthoptera, Caelifera)’
Urinary Tract Fistulas: Transrenal Reversible Ureteral Occlusion With Detachable Semicompliant Balloons
Development of the ATHENA Mirror
The development of the X-ray optics for ATHENA (Advanced Telescope for High ENergy Astrophysics)[1-4], the selected second large class mission in the ESA Science Programme, is progressing further, in parallel with the payload preparation and the system level studies. The optics technology is based on the Silicon Pore Optics (SPO) [5-48], which utilises the excellent material properties of Silicon and benefits from the extensive investments made in the semiconductor industry. With its pore geometry the SPO is intrinsically very robust and permits the use of very thin mirrors while achieving good angular resolution. In consequence, the specific mass of the resultant ATHENA optics is very low compared to other technologies, and suitable to cope with the imposed environmental requirements. Further technology developments preparing the ATHENA optics are ongoing, addressing additive manufacturing of the telescope structure, the integration and alignment of the mirror assembly, numerical simulators, coating optimisations, metrology, test facilities, studies of proton reflections and meteorite impacts, etc. A detailed Technology Development Plan was elaborated and is regularly being updated, reflecting the progress and the mission evolution. The required series production and integration of the many hundred mirror modules constituting the ATHENA telescope optics is an important consideration and a leading element in the technology development. The developments are guided by ESA, implemented in industry and supported by research institutions. The many ongoing SPO technology development activities aim at demonstrating the readiness of the optics technology at the review deciding the adoption of ATHENA onto the ESA Science flight programme, currently expected for 2021. Technology readiness levels of 5/6 have to be demonstrated for all critical elements, but also the compliance to cost and schedule constraints for the mission
Making the ATHENA optics using silicon pore optics
Silicon Pore Optics, after 10 years of development, forms now the basis for future large (L) class astrophysics Xray observatories, such as the ATHENA mission to study the hot and energetic universe, matching the L2 science theme recently selected by ESA for launch in 2028. The scientific requirements result in an optical design that demands high angular resolution (5") and large effective area (2 m2 at a few keV) of an X-ray lens with a focal length of 12 to14 m. Silicon Pore Optics was initially based on long (25 to 50 m) focal length telescope designs, which could achieve several arc second angular resolution by curving the silicon mirror in only one direction (conical approximation). With the advent of shorter focal length missions we started to develop mirrors having a secondary curvature, allowing the production of Wolter-I type optics, which are on axis aberration-free. In this paper we will present the new manufacturing process, discuss the impact of the ATHENA optics design on the technology development and present the results of the latest X-ray test campaigns
Preparing the optics technology to observe the hot universe
With the selection of "The hot and energetic Universe" as science theme for ESA's second large class mission (L2) in the Cosmic Vision programme, work is focusing on the technology preparation for an advanced X-ray observatory. The core enabling technology for the high performance mirror is the Silicon Pore Optics (SPO) [1 to 23], a modular X-ray optics technology, which utilises processes and equipment developed for the semiconductor industry. The paper provides an overview of the programmatic background, the status of SPO technology and gives an outline of the development roadmap and activities undertaken and planned by ESA on optics, coatings [24 to 30] and test facilities [31, 33]
Optics developments for ATHENA
Mission studies and technology preparation for the ATHENA (Advanced Telescope for High ENergy Astrophysics) [1- 5] mission are continuing to progress. The X-ray optics of this future space observatory are based on the Silicon Pore Optics (SPO) technology [6-58], and is being evolved in a joint effort by industry, research institutions and ESA. The SPO technology benefits from substantial investments made by the semiconductor industry, and spins-in materials, processes and equipment into the development of novel X-ray optics. A comprehensive Technology Development Plan (TDP) is being implemented, funded by ESA and involving a large number of experts in key areas ranging from micro machining of Silicon, over sophisticated automation and robotic systems, to hybrid manufacturing. The performance, environmental compatibility and serial automated production and testing are being addressed in parallel, aiming at the demonstration of the required technology readiness for the ATHENA Mission Adoption Review (MAR) expected by the end of 2021. A formal Technology Readiness Assessment is in place and is being currently exercised in preparation of the ATHENA Mission Formulation review (MFR). The programmatics for the flight model implementation is being defined in detail, and preparations are starting for the design and implementation of the necessary facilities. An overview of the ATHENA optics technology preparation, the technology readiness assessment and the related activities is provided
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