4,041 research outputs found

    In-flight friction and wear mechanism

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    A unique mechanism developed for conducting friction and wear experiments in orbit is described. The device is capable of testing twelve material samples simultaneously. Parameters considered critical include: power, weight, volume, mounting, cleanliness, and thermal designs. The device performed flawlessly in orbit over an eighteen month period and demonstrated the usefulness of this design for future unmanned spacecraft or shuttle applications

    DETECTING EVIDENCE OF NON-COMPLIANCE IN SELF-REPORTED POLLUTION EMISSIONS DATA: AN APPLICATION OF BENFORD'S LAW

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    The paper introduces Digital Frequency Analysis (DFA) based on Benford's Law as a new technique for detecting non-compliance in self-reported pollution emissions data. Public accounting firms are currently adopting DFA to detect fraud in financial data. We argue that DFA can be employed by environmental regulators to detect fraud in self-reported pollution emissions data. The theory of Benford's Law is reviewed, and statistical justifications for its potentially widespread applicability are presented. Several common DFA tests are described and applied to North Carolina air pollution emissions data in an empirical example.Benford, digital frequency analysis, pollution monitoring, pollution regulation, enforcement, Environmental Economics and Policy, Q25, Q28,

    Complex permeability of soft magnetic ferrite polyester resin composites at frequencies above 1 MHz

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    Composite soft magnetic materials consist of magnetic particles in a non-magnetic matrix. The properties of such materials can be modelled using effective medium theory. Measurements have been made of the complex permeability of composites produced using ferrite powder and polyester resin. The success of various effective medium expressions in predicting the variation of complex permeability with composition has been assessed

    The translational potential of human induced pluripotent stem cells for clinical neurology: The translational potential of hiPSCs in neurology

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    The induced pluripotent state represents a decade-old Nobel prize-winning discovery. Human-induced pluripotent stem cells (hiPSCs) are generated by the nuclear reprogramming of any somatic cell using a variety of established but evolving methods. This approach offers medical science unparalleled experimental opportunity to model an individual patient's disease "in a dish." HiPSCs permit developmentally rationalized directed differentiation into any cell type, which express donor cell mutation(s) at pathophysiological levels and thus hold considerable potential for disease modeling, drug discovery, and potentially cell-based therapies. This review will focus on the translational potential of hiPSCs in clinical neurology and the importance of integrating this approach with complementary model systems to increase the translational yield of preclinical testing for the benefit of patients. This strategy is particularly important given the expected increase in prevalence of neurodegenerative disease, which poses a major burden to global health over the coming decades

    Physical outcome measure for critical care patients following intensive care discharge

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    Introduction: The aim of this study was to evaluate the most suitable physical outcome measures to be used with critical care patients following discharge. ICU survivors experience physical problems such as reduced exercise capacity and intensive care acquired weakness. NICE guideline ‘Rehabilitation after critical illness’ (1) recommends the use of outcome measures however does not provide any specific guidance. A recent Cochrane review noted wide variability in measures used following ICU discharge (2). Methods: Discharged ICU patients attended a five week multidisciplinary programme. Patients’ physical function was assessed during the programme, at 6 months and 12 months post discharge. Three outcome measures were included in the initial two cohorts. The Six Minute Walk Test (6MWT) and the Incremental Shuttle Walk test (ISWT) were chosen as they have been used within the critical care follow up setting (2). The Chester Step Test (CST) is widely thought to be a good indicator of ability to return to work (one of the programmes primary aims). Ethics approval was waived as the programme was part of a quality improvement initiative. Results: Data was collected for the initial patients attending the programme (n = 13), median age was 52 (IQR = 38-72), median ICU LOS was 19 days (IQR = 4-91), median APACHE II was 23 (IQR = 19-41) and 11 were men. One patient was so physically debilitated that the CST or ISWT could not be completed however a score was achieved using the 6MWT. Another patient almost failed to achieve level 1 of the ISWT. Subsequent patients for this project (total n = 47) have all therefore been tested using the 6MWT. Good inter-rater and intrarater reliability and validity have been reported for the 6MWT (3). Conclusions: Exercise capacity measurement is not achievable for some patients with either the ISWT or the CST due to the severity of their physical debilitation. Anxiety, post-traumatic stress disorder and depression are common psychological problems post discharge (4), therefore using a test with a bleep is not appropriate. Therefore, the 6MWT is the most appropriate physical outcome measure to be used with critical care patients post discharge

    Classification of pain and its treatment at an intensive care rehabilitation clinic

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    Introduction Treatment in an Intensive Care Unit (ICU) often necessitates uncomfortable and painful procedures for patients throughout their admission. There is growing evidence to suggest that chronic pain is becoming increasingly recognised as a long term problem for patients following an ICU admission [1]. Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE) is a five week rehabilitation programme for patients and their caregivers after ICU discharge at Glasgow Royal Infirmary. This study investigated the incidence and location of chronic pain in patients discharged from ICU and classified the analgesics prescribed according to the World Health Organization analgesic Methods The InS:PIRE programme involved individual sessions for patients and their caregivers with a physiotherapist and a pharmacist along with interventions from medical, nursing, psychology and community services. The physiotherapist documented the incidence and pain location during the assessment. The pharmacist recorded all analgesic medications prescribed prior to admission and at their clinic visit. The patient’s analgesic medication was classified according to the WHO pain ladder from zero to three, zero being no pain medication and three being treatment with a strong opioid. Data collected was part of an evaluation of a quality improvement initiative, therefore ethics approval was waived. Results Data was collected from 47 of the 48 patients who attended the rehabilitation clinic (median age was 52 (IQR, 44-57) median ICU LOS was 15 (IQR 9-25), median APACHE II was 23 (IQR 18-27) and 32 of the patients were men (67 %)). Prior to admission to ICU 43 % of patients were taking analgesics and this increased to 81 % at the time of their clinic visit. The number of patients at step two and above on the WHO pain ladder also increased from 34 % to 56 %. Conclusions Of the patients seen at the InS:PIRE clinic two-thirds stated that they had new pain since their ICU admission. Despite the increase in the number and strength of analgesics prescribed, almost a quarter of patients still complained of pain at their clinic visit. These results confirm that pain continues to be a significant problem in this patient group. Raising awareness in primary care of the incidence of chronic pain and improving its management is essential to the recovery process following an ICU admission

    Fair chances and hard work? Families making sense of inequality and opportunity in 21st-century Britain

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    © London School of Economics and Political Science 2018. In British social mobility discourse, the rhetoric of fair access can obscure wider issues of social justice. While socio-economic inequalities continue to shape young people's lives, sociological work on class dis-identification suggests social class is less obviously meaningful as a source of individual and collective identity. This paper considers subjective understandings of the post-16 education and employment landscape in this context, drawing on qualitative research exploring the aspirations of young men and women as they completed compulsory education in north-west England, and the hopes their parents had for their future. It shows how unequal access to resources shaped the older generation's expectations for their children, although this was rarely articulated using the explicit language of class. Their children recognized they faced a difficult job market but embraced the idea that success was possible through hard work. Both generations drew moral boundaries and made judgments based on implicit classed discourses about undeserving others, while at the same time disavowing class identities. There was a more explicit recognition of gender inequality among the parents framed with reference to hopes for greater freedom for their daughters. Opportunities and inequalities were thus understood in complex and sometimes contradictory ways

    Pharmacy intervention at an intensive care rehabilitation clinic

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    Introduction: During an intensive care stay, patients often have their chronic medications withheld for a variety of reasons and new drugs commenced [1]. As patients are often under the care of a number of different medical teams during their admission there is potential for these changes to be inadvertently continued [2]. Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE) is a five week rehabilitation programme for patients and their caregivers after ICU (Intensive Care Unit) discharge at Glasgow Royal Infirmary. Within this programme a medication review by the critical care pharmacist provided an opportunity to identify and resolve any pharmaceutical care issues and also an opportunity to educate patients and their caregivers about changes to their medication. Methods: During the medication review we identified ongoing pharmaceutical care issues which were communicated to the patient’s primary care physician (GP) by letter or a telephone call. The patients were also encouraged to discuss any issues raised with their GP. The significance of the interventions was classified from those not likely to be of clinical benefit to the patient, to those which prevented serious therapeutic failure. Results: Data was collected from 47 of the 48 patients who attended the clinic (median age was 52 (IQR, 44-57) median ICU LOS was 15 (IQR 9-25), median APACHE II was 23 (IQR 18-27) and 32 of the patients were men (67%). The pharmacist made 69 recommendations; including 20 relating to drugs which had been withheld and not restarted, dose adjustments were suggested on 13 occasions and new drug recommendations were made for 10 patients. Duration of treatment for new medications started during hospital admission was clarified on 12 occasions. Lastly adverse drug effects were reported on 4 occasions and the incorrect drug was prescribed on 2 occasions. Of the interventions made 58% were considered to be of moderate to high impact. Conclusions: The pharmacist identified pharmaceutical care issues with 18.6% of the prescribed medications. Just over half of the patients reported that they were not made aware of any alterations to their prescribed medication on discharge. Therefore a pharmacy intervention is an essential part of an intensive care rehabilitation programme to address any medication related problems, provide education and to ensure patients gain optimal benefit from their medication
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