Double trouble: the impact of multimorbidity and deprivation on preference-weighted health related quality of life - a cross sectional analysis of the Scottish Health Survey

<b>Objective</b> To investigate the association between multimorbidity and Preference_Weighted Health Related Quality of Life (PW_HRQoL), a score that combines physical and mental functioning, and how this varies by socioeconomic deprivation and age.<p></p> <b>Design</b> The Scottish Health Survey (SHeS) is a cross-sectional representative survey of the general population which included the SF-12, a survey of HRQoL, for individuals 20 years and over.<p></p> <b>Methods</b> For 7,054 participants we generated PW_HRQoL scores by running SF-12 responses through the SF-6D algorithm. The resulting scores ranged from 0.29 (worst health) to 1 (perfect health). Using ordinary least squares, we first investigated associations between scores and increasing counts of longstanding conditions, and then repeated for multimorbidity (2+ conditions). Estimates were made for the general population and quintiles of socioeconomic deprivation. For multimorbidity, the analyses were repeated stratifying the population by age group (20--44, 45--64, 65+).<p></p> <b>Results</b> 45% of participants reported a longstanding condition and 18% reported multimorbidity. The presence of 1, 2, or 3+ longstanding conditions were associated with average reductions in PW_HRQoL scores of 0.081, 0.151 and 0.212 respectively. Reduction in scores associated with multimorbidity was 33% greater in the most deprived quintile compared to the least deprived quintile, with the biggest difference (80%) in the 20--44 age groups. There were no significant gender differences.<p></p> <b>Conclusions</b> PW_HRQoL decreases markedly with multimorbidity, and is exacerbated by higher deprivation and younger age. There is a need to prioritise interventions to improve the HRQoL for (especially younger) adults with multimorbidity in deprived areas

Modelling the atomic structure of very high-density amorphous ice

The structure of very high-density amorphous (VHDA) ice has been modelled by positionally disordering three crystalline phases, namely ice IV, VI and XII. These phases were chosen because only they are stable or metastable in the region of the ice phase diagram where VHDA ice is formed, and their densities are comparable to that of VHDA ice. An excellent fit to the medium range of the experimentally observed pair-correlation function g(r) of VHDA ice was obtained by introducing disorder into the positions of the H2O molecules, as well as small amounts of molecular rotational disorder, disorder in the O--H bond lengths and disorder in the H--O--H bond angles. The low-k behaviour of the experimental structure factor, S(k), is also very well reproduced by this disordered-crystal model. The fraction of each phase present in the best-fit disordered model is very close to that observed in the probable crystallization products of VHDA ice. In particular, only negligible amounts of ice IV are predicted, in accordance with experimental observation.Comment: 4 pages, 3 figures, 1 table, v2: changes made in response to referees' comments, the justification for using certain ice phases is improved, and ice IV is now disordered as wel

Economies of scale and scope in publicly funded biomedical and health research: evidence from the literature

BACKGROUND: Publicly funded biomedical and health research is expected to achieve the best return possible for taxpayers and for society generally. It is therefore important to know whether such research is more productive if concentrated into a small number of ‘research groups’ or dispersed across many. METHODS: We undertook a systematic rapid evidence assessment focused on the research question: do economies of scale and scope exist in biomedical and health research? In other words, is that research more productive per unit of cost if more of it, or a wider variety of it, is done in one location? We reviewed English language literature without date restriction to the end of 2014. To help us to classify and understand that literature, we first undertook a review of econometric literature discussing models for analysing economies of scale and/or scope in research generally (not limited to biomedical and health research). RESULTS: We found a large and disparate literature. We reviewed 60 empirical studies of (dis-)economies of scale and/or scope in biomedical and health research, or in categories of research including or overlapping with biomedical and health research. This literature is varied in methods and findings. At the level of universities or research institutes, studies more often point to positive economies of scale than to diseconomies of scale or constant returns to scale in biomedical and health research. However, all three findings exist in the literature, along with inverse U-shaped relationships. At the level of individual research units, laboratories or projects, the numbers of studies are smaller and evidence is mixed. Concerning economies of scope, the literature more often suggests positive economies of scope than diseconomies, but the picture is again mixed. The effect of varying the scope of activities by a research group was less often reported than the effect of scale and the results were more mixed. CONCLUSIONS: The absence of predominant findings for or against the existence of economies of scale or scope implies a continuing need for case by case decisions when distributing research funding, rather than a general policy either to concentrate funding in a few centres or to disperse it across many

Greenhouse gas considerations in rail infrastructure in the UK

Transportation-related greenhouse gas (GHG) emissions account for an increasing proportion of total emissions in the UK and globally. The provision of rail transit is popularly proposed to reduce transport GHG emissions, but the provision of new infrastructure is itself GHG intensive. Understanding of the GHG emissions impact of rail projects is limited and very few longitudinal studies have been carried out. Existing assessments are often limited both in their scope and the factors considered. A holistic understanding of GHG impacts must include an assessment of capital GHG emissions, operational energy and maintenance as well as an assessment of ridership mode shift and mode share impacts and the relationship between transit infrastructure and land use. This paper explores rail infrastructure projects and their associated GHG emissions. Guidance is given on the aspects of rail planning, design and construction that must be considered to more fully understand the associated GHG impacts.The authors would like to thank The Commonwealth Scholarship Commission in the UK for the scholarship funding that facilitated this work

Towards a publicly available, map-based regional software tool to estimate unregulated daily streamflow at ungauged rivers

Streamflow information is critical for addressing any number of hydrologic problems. Often, streamflow information is needed at locations that are ungauged and, therefore, have no observations on which to base water management decisions. Furthermore, there has been increasing need for daily streamflow time series to manage rivers for both human and ecological functions. To facilitate negotiation between human and ecological demands for water, this paper presents the first publicly available, map-based, regional software tool to estimate historical, unregulated, daily streamflow time series (streamflow not affected by human alteration such as dams or water withdrawals) at any user-selected ungauged river location. The map interface allows users to locate and click on a river location, which then links to a spreadsheet-based program that computes estimates of daily streamflow for the river location selected. For a demonstration region in the northeast United States, daily streamflow was, in general, shown to be reliably estimated by the software tool. Estimating the highest and lowest streamflows that occurred in the demonstration region over the period from 1960 through 2004 also was accomplished but with more difficulty and limitations. The software tool provides a general framework that can be applied to other regions for which daily streamflow estimates are needed

Xenon in Mercury-Manganese Stars

Previous studies of elemental abundances in Mercury-Manganese (HgMn) stars have occasionally reported the presence of lines of the ionized rare noble gas Xe II, especially in a few of the hottest stars with Teff ~ 13000--15000 K. A new study of this element has been undertaken using observations from Lick Observatory's Hamilton Echelle Spectrograph. In this work, the spectrum synthesis program UCLSYN has been used to undertake abundance analysis assuming LTE. We find that in the Smith & Dworetsky sample of HgMn stars, Xe is vastly over-abundant in 21 of 22 HgMn stars studied, by factors of 3.1--4.8 dex. There does not appear to be a significant correlation of Xe abundance with Teff. A comparison sample of normal late B stars shows no sign of Xe II lines that could be detected, consistent with the expected weakness of lines at normal abundance. The main reason for the previous lack of widespread detection in HgMn stars is probably due to the strongest lines being at longer wavelengths than the photographic blue. The lines used in this work were 4603.03A, 4844.33A and 5292.22A.Comment: 8 pages, 4 figures. Accepted by Monthly Notices of the Royal Astronomical Society, 8 January 200

Projected Rotational Velocities and Stellar Characterization of 350 B Stars in the Nearby Galactic Disk

Projected rotational velocities (vsini) are presented for a sample of 350 early B-type main sequence stars in the nearby Galactic disk. The stars are located within ~1.5 kpc from the Sun, and the great majority within 700 pc. The analysis is based on high-resolution spectra obtained with the MIKE spectrograph on the Magellan Clay 6.5-m telescope at the Las Campanas Observatory in Chile.Spectral types were estimated based on relative intensities of some key line absorption ratios and comparisons to synthetic spectra. Effective temperatures were estimated from the reddening-free Q index, and projected rotational velocities were then determined via interpolation on a published grid that correlates the synthetic full width at half maximum of the He I lines at 4026, 4388 and 4471 A with vsini. As the sample has been selected solely on the basis of spectral types it contains an selection of B stars in the field, in clusters, and in OB associations. The vsini distribution obtained for the entire sample is found to be essentially flat for vsini values between 0-150 km/s, with only a modest peak at low projected rotational velocities. Considering subsamples of stars, there appears to be a gradation in the vsini distribution with the field stars presenting a larger fraction of the slow rotators and the cluster stars distribution showing an excess of stars with vsini between 70 and 130 km/s. Furthermore, for a subsample of potential runaway stars we find that the vsini distribution resembles the distribution seen in denser environments, which could suggest that these runaway stars have been subject to dynamical ejection mechanisms.Comment: 38 pages, 11 figures. Complete sample table. AJ accepte