Fuel distribution measurements in a model low NOx double annular combustor using laser induced fluorescence

Planar laser induced fluorescence (PLIF) was employed in a three sector, low NOx double annular combustor in order to characterise the combusting fuel spray. Naphthalene was employed as a fluorescent agent in odourless kerosene in order to determine the behavior of the light fractions in the fuel vapour, and the light to medium fractions in the fuel spray, while 2,5 di-phenyl oxizol (ppo) was employed to determine the behavior of the heavy fractions in the fuel spray. Counter-swirl air blast atomizing fuel injectors employing a nominal fuel spray included cone angle of 90 deg were employed to inject the kerosene fuel into the double annular combustor. Radial and axial measurements were performed on the combusting spray. Spatial variations in fuel spray placement were observed, together with radial anisotropy

The optical characterisation of spray and soot formation in a diesel engine

Laser sheet drop-sizing (LSD) measurements of a Diesel spray and simultaneous laser induced incandescence/Mie scattering measurements of soot have been performed in an optically accessible, common rail, 1.9 litre, turbo-charged, direct injection Diesel engine. The diesel fuel injectors employed in this study were prototype five hole injectors, supplied by R. Bosch. An oxygenated surrogate Diesel fuel with an estimated cetane number of 54 was employed in order to reduce the amount of soot formed during combustion. The prototype five-hole injector employed produced spray jets that were distinguishable in terms of the liquid volume fraction, drop-size distribution and spray penetration distance produced. The soot volume fraction formed during combustion was found to be correlated with drop-size distribution, and local soot particle size distribution was observed to be inversely correlated with local soot volume fraction

Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial

Objective To evaluate the impact of telling patients their estimated spirometric lung age as an incentive to quit smoking.Design Randomised controlled trial.Setting Five general practices in Hertfordshire, England.Participants 561 current smokers aged over 35.Intervention All participants were offered spirometric assessment of lung function. Participants in intervention group received their results in terms of "lung age" (the age of the average healthy individual who would perform similar to them on spirometry). Those in the control group received a raw figure for forced expiratory volume at one second (FEV1). Both groups were advised to quit and offered referral to local NHS smoking cessation services.Main outcome measures The primary outcome measure was verified cessation of smoking by salivary cotinine testing 12 months after recruitment. Secondary outcomes were reported changes in daily consumption of cigarettes and identification of new diagnoses of chronic obstructive lung disease.Results Follow-up was 89%. Independently verified quit rates at 12 months in the intervention and control groups, respectively, were 13.6% and 6.4% (difference 7.2%, P=0.005, 95% confidence interval 2.2% to 12.1%; number needed to treat 14). People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group. Cost per successful quitter was estimated at 280 pound ((euro) 365, $556). A new diagnosis of obstructive lung disease was made in 17% in the intervention group and 14% in the control group; a total of 16% (89/561) of participants.Conclusion Telling smokers their lung age significantly improves the likelihood of them quitting smoking, but the mechanism by which this intervention achieves its effect is unclear.Trial registration National Research Register N0096173751

Risk models and scores for type 2 diabetes: Systematic review

This article is published under a Creative Commons Attribution Non Commercial (CC BY-NC 3.0) licence that allows reuse subject only to the use being non-commercial and to the article being fully attributed (http://creativecommons.org/licenses/by-nc/3.0).Objective - To evaluate current risk models and scores for type 2 diabetes and inform selection and implementation of these in practice. Design - Systematic review using standard (quantitative) and realist (mainly qualitative) methodology. Inclusion - criteria Papers in any language describing the development or external validation, or both, of models and scores to predict the risk of an adult developing type 2 diabetes. Data sources - Medline, PreMedline, Embase, and Cochrane databases were searched. Included studies were citation tracked in Google Scholar to identify follow-on studies of usability or impact. Data extraction - Data were extracted on statistical properties of models, details of internal or external validation, and use of risk scores beyond the studies that developed them. Quantitative data were tabulated to compare model components and statistical properties. Qualitative data were analysed thematically to identify mechanisms by which use of the risk model or score might improve patient outcomes. Results - 8864 titles were scanned, 115 full text papers considered, and 43 papers included in the final sample. These described the prospective development or validation, or both, of 145 risk prediction models and scores, 94 of which were studied in detail here. They had been tested on 6.88 million participants followed for up to 28 years. Heterogeneity of primary studies precluded meta-analysis. Some but not all risk models or scores had robust statistical properties (for example, good discrimination and calibration) and had been externally validated on a different population. Genetic markers added nothing to models over clinical and sociodemographic factors. Most authors described their score as “simple” or “easily implemented,” although few were specific about the intended users and under what circumstances. Ten mechanisms were identified by which measuring diabetes risk might improve outcomes. Follow-on studies that applied a risk score as part of an intervention aimed at reducing actual risk in people were sparse. Conclusion - Much work has been done to develop diabetes risk models and scores, but most are rarely used because they require tests not routinely available or they were developed without a specific user or clear use in mind. Encouragingly, recent research has begun to tackle usability and the impact of diabetes risk scores. Two promising areas for further research are interventions that prompt lay people to check their own diabetes risk and use of risk scores on population datasets to identify high risk “hotspots” for targeted public health interventions.Tower Hamlets, Newham, and City and Hackney primary care trusts and National Institute of Health Research

RAMESES publication standards: meta-narrative reviews

PMCID: PMC3558334This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Comparison of Zero Valent Iron (ZVI) and ZVI+Sludge for the Removal of High Levels of Hexavalent Chromium and Chlorate from Waters

Remediation of contaminated groundwater is becoming increasingly more important as much of the U.S. population relies on groundwater for their drinking water. Contaminates such as Chromium, common pollutant at industrial waste sites, and Hexavalent chromium which is toxic to humans, animals, and plants are major concerns. Chlorate, another contaminate of concern, has been widely detected in ground and surface water in the United States and even locally in Henderson Nevada at the Nevada Environmental Response Trust (NERT) sites. To assist in mitigating this issue, this research focuses on the removal of high levels of hexavalent chromium (ppm range) (Cr(VI)) and chlorate (ClO3-) from water using zero valent iron (ZVI). Zero valent iron is a proven technology for the biotic and abiotic reduction of a wide variety of environmental contaminants including Cr(VI), nitrate (NO3-), chlorinated organic compounds, arsenic, ClO3-, and ClO4-. There is a lack of research investigating the reduction of Cr(VI) using ZVI+Sludge, specifically examining how competing contaminants, such as chlorate, would affect Cr(VI) remediation. The overall goal of this research was to determine whether a combination of ZVI+Sludge can improve reduction kinetics of degradation of high levels of Cr(VI) and chlorate, when they occur together. A series of batch tests were conducted in which a synthetic groundwater, containing the contaminants of interest, was added with various concentrations of ZVI, microbial seed, and an external carbon source (i.e. EOS emulsified oil). Depending on the method to be tested, varying concentrations of ZVI, Sludge, or a combination of ZVI+Sludge were added to the vials. Degradation experiments were performed first with single contaminants followed with the contaminants together. The analysis of the experiments related to ZVI+Sludge showed a statistically significant increase in the reduction of Cr(VI) alone over ZVI. The outcome of this research suggests an increase in contaminant reduction rates when combining chemical and biological treatment (ZVI+Sludge). Supporting the conclusion that a ZVI+Sludge treatment method could reduce the amount of ZVI material required and/or increase the longevity of the system

What works for whom in pharmacist-led smoking cessation support: realist review

BACKGROUND: New models of primary care are needed to address funding and staffing pressures. We addressed the research question "what works for whom in what circumstances in relation to the role of community pharmacies in providing lifestyle interventions to support smoking cessation?" METHODS: This is a realist review conducted according to RAMESES standards. We began with a sample of 103 papers included in a quantitative review of community pharmacy intervention trials identified through systematic searching of seven databases. We supplemented this with additional papers: studies that had been excluded from the quantitative review but which provided rigorous and relevant additional data for realist theorising; citation chaining (pursuing reference lists and Google Scholar forward tracking of key papers); the 'search similar citations' function on PubMed. After mapping what research questions had been addressed by these studies and how, we undertook a realist analysis to identify and refine candidate theories about context-mechanism-outcome configurations. RESULTS: Our final sample consisted of 66 papers describing 74 studies (12 systematic reviews, 6 narrative reviews, 18 RCTs, 1 process detail of a RCT, 1 cost-effectiveness study, 12 evaluations of training, 10 surveys, 8 qualitative studies, 2 case studies, 2 business models, 1 development of complex intervention). Most studies had been undertaken in the field of pharmacy practice (pharmacists studying what pharmacists do) and demonstrated the success of pharmacist training in improving confidence, knowledge and (in many but not all studies) patient outcomes. Whilst a few empirical studies had applied psychological theories to account for behaviour change in pharmacists or people attempting to quit, we found no studies that had either developed or tested specific theoretical models to explore how pharmacists' behaviour may be affected by organisational context. Because of the nature of the empirical data, only a provisional realist analysis was possible, consisting of five mechanisms (pharmacist identity, pharmacist capability, pharmacist motivation and clinician confidence and public trust). We offer hypotheses about how these mechanisms might play out differently in different contexts to account for the success, failure or partial success of pharmacy-based smoking cessation efforts. CONCLUSION: Smoking cessation support from community pharmacists and their staff has been extensively studied, but few policy-relevant conclusions are possible. We recommend that further research should avoid duplicating existing literature on individual behaviour change; seek to study the organisational and system context and how this may shape, enable and constrain pharmacists' extended role; and develop and test theory

Outcome of selective patching following carotid endarterectomy

Objectives:Routine patch angioplasty has been advocated following carotid endarterectomy but patching can be associated with complications. This study assesses the effect of a selective patching policy based on distal internal carotid diameter on the rate of restenosis and outcome following carotid endarterectomy.Design, material and methods:A consecutive series of 213 patients underwent carotid endarterectomy performed by one surgeon. Preoperative carotid dimensions were measured intraoperatively using calipers. Following endarterectomy a 5mm Dacron patch was selectively employed if the distal internal carotid was 5mm or less (group 1, 95 patients) or 6mm or less (group 2, 118 patients). Patients underwent colour-coded Duplex scanning at 24 h, 1 week, 3, 6, 9, and 12 months, and yearly following this.Results:Overall 27 restenoses (5 residual) of 50% or greater and two occlusions developed. Patching was performed in 47% of group 1 and 61% of group 2 arteries. In group 1 14% of patched compared with 24% of non-patched arteries developed restenosis at 24 months (p = 0.4). In group 2 13% of patched compared to 11% of non-patched arteries developed restenosis at 12 months (p > 0.5). Stroke rate at 24 months were similar for patched and non-patched patients in groups 1 (p > 0.5) and 2 (p = 0.4).Conclusions:This study suggests that patch angioplasty of larger carotid arteries may be unnecessary. Randomisation of larger arteries between patch and primary closure would be required to confirm this

Designing assisted living technologies 'in the wild' : preliminary experiences with cultural probe methodology

Background There is growing interest in assisted living technologies to support independence at home. Such technologies should ideally be designed ‘in the wild’ i.e. taking account of how real people live in real homes and communities. The ATHENE (Assistive Technologies for Healthy Living in Elders: Needs Assessment by Ethnography) project seeks to illuminate the living needs of older people and facilitate the co-production with older people of technologies and services. This paper describes the development of a cultural probe tool produced as part of the ATHENE project and how it was used to support home visit interviews with elders with a range of ethnic and social backgrounds, family circumstances, health conditions and assisted living needs. Method Thirty one people aged 60 to 98 were visited in their homes on three occasions. Following an initial interview, participants were given a set of cultural probe materials, including a digital camera and the ‘Home and Life Scrapbook’ to complete in their own time for one week. Activities within the Home and Life Scrapbook included maps (indicating their relationships to people, places and objects), lists (e.g. likes, dislikes, things they were concerned about, things they were comfortable with), wishes (things they wanted to change or improve), body outline (indicating symptoms or impairments), home plan (room layouts of their homes to indicate spaces and objects used) and a diary. After one week, the researcher and participant reviewed any digital photos taken and the content of the Home and Life Scrapbook as part of the home visit interview. Findings The cultural probe facilitated collection of visual, narrative and material data by older people, and appeared to generate high levels of engagement from some participants. However, others used the probe minimally or not at all for various reasons including limited literacy, physical problems (e.g. holding a pen), lack of time or energy, limited emotional or psychological resources, life events, and acute illness. Discussions between researchers and participants about the materials collected (and sometimes about what had prevented them completing the tasks) helped elicit further information relevant to assisted living technology design. The probe materials were particularly helpful when having conversations with non-English speaking participants through an interpreter. Conclusions Cultural probe methods can help build a rich picture of the lives and experiences of older people to facilitate the co-production of assisted living technologies. But their application may be constrained by the participant’s physical, mental and emotional capacity. They are most effective when used as a tool to facilitate communication and development of a deeper understanding of older people’s needs