202 research outputs found

    A systematic review and meta-analysis of out of hospital nursing interventions to reduce emergency department attendances in children and young people

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    Linking pre- and post-adoption records for research in anonymised form in a data safe haven:

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    Introduction: The long-term health and wellbeing of adoptees is under-researched. One reason for this has been limited data accessibility regarding the adoption process, and another is a practice common in some UK jurisdictions of changing the NHS number (or equivalent) at adoption, as part of creating the new identity. The SAIL Databank holds data from the Wales Children and Family Court Advisory and Support Service (Cafcass Cymru), together with children’s social care data, and can link these with routine health and administrative data in anonymised form. However, because the linkage key at SAIL is based on an encryption of the NHS number, working with pre- and post-adoption records for longitudinal research remains a major challenge. We set out to explore the legal implications of, and social support for, linking these records for use in anonymised form for longitudinal research. Methods: We reviewed the main legislation and regulations governing the use of data about adoptees in England and Wales. We gauged support for a social licence in Wales by carrying out interviews with individuals who had been involved in the adoptions process, and by engaging with general public groups for their views. We drew out the main emerging themes and, in combination with the review, propose a way forward. Results: The legal review indicated that there are provisions in the Family Procedure Rules (England and Wales) and the General Data Protection Regulation that can be relied upon for the lawful processing of adoption data into anonymised form for research. The main points of concern about linking pre- and post-adoption records were privacy, data security, the need to limit the number of organisations involved in data sharing, and re-identification risk. The over-riding message was favourable with longitudinal research seen as strongly beneficial. Conclusion: This study has indicated that in Wales, there is no legal impediment, nor major objection from individuals involved in the adoptions process, as well as the general public for the use of adoption data in anonymised form, in a data safe haven. This includes the linkage of pre- and post‑adoption records to enable novel longitudinal research to take place. The provisos were that robust safeguards must be in place, and that the research should aim to benefit adoptees and to improve policy and practice. We conclude that it is reasonable to proceed with caution to develop practical ways to link pre- and post‑adoption records in a data safe haven

    The Hamiltonian limit of (3+1)D SU(3) lattice gauge theory on anisotropic lattices

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    The extreme anisotropic limit of Euclidean SU(3) lattice gauge theory is examined to extract the Hamiltonian limit, using standard path integral Monte Carlo (PIMC) methods. We examine the mean plaquette and string tension and compare them to results obtained within the Hamiltonian framework of Kogut and Susskind. The results are a significant improvement upon previous Hamiltonian estimates, despite the extrapolation procedure necessary to extract observables. We conclude that the PIMC method is a reliable method of obtaining results for the Hamiltonian version of the theory. Our results also clearly demonstrate the universality between the Hamiltonian and Euclidean formulations of lattice gauge theory. It is particularly important to take into account the renormalization of both the anisotropy, and the Euclidean coupling ÎČE \beta_E , in obtaining these results.Comment: 10 pages, 11 figure

    Understanding parents and professionals knowledge and awareness of autism in Nepal

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    Autism is a global phenomenon. Yet, there is a dearth of knowledge of how it is understood and its impact in low-income countries. We examined parents’ and professionals’ understanding of autism in one low-income country, Nepal. We conducted focus groups and semi-structured interviews with parents of autistic and non-autistic children and education and health professionals from urban and rural settings (n = 106), asking questions about typical and atypical development and presenting vignettes of children to prompt discussion. Overall, parents of typically developing children and professionals had little explicit awareness of autism. They did, however, use some distinctive terms to describe children with autism from children with other developmental conditions. Furthermore, most participants felt that environmental factors, including in-utero stressors and birth complications, parenting style and home or school environment were key causes of atypical child development and further called for greater efforts to raise awareness and build community capacity to address autism. This is the first study to show the striking lack of awareness of autism by parents and professionals alike. These results have important implications for future work in Nepal aiming both to estimate the prevalence of autism and to enhance support available for autistic children and their families

    Quantum Monte Carlo study of the one-dimensional Holstein model of spinless fermions

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    The Holstein model of spinless fermions interacting with dispersionless phonons in one dimension is studied by a Green's function Monte Carlo technique. The ground state energy, first fermionic excited state, density wave correlations, and mean lattice displacement are calculated for lattices of up to 16 sites, for one fermion per two sites, i.e., a half-filled band. Results are obtained for values of the fermion hopping parameter of t=0.1ωt=0.1 \omega, ω\omega, and 10ω10 \omega where ω\omega is the phonon frequency. At a finite fermion-phonon coupling gg there is a transition from a metallic phase to an insulating phase in which there is charge-density-wave order. Finite size scaling is found to hold in the metallic phase and is used to extract the coupling dependence of the Luttinger liquid parameters, uρu_\rho and KρK_\rho, the velocity of charge excitations and the correlation exponent, respectively. For free fermions (g=0g=0) and for strong coupling (g2≫tωg^2 \gg t \omega) our results agree well with known analytic results. For t=ωt=\omega and t=10ωt=10\omega our results are inconsistent with the metal-insulator transition being a Kosterlitz-Thouless transition.\\Comment: 16 pages of ReVTeX, 11 figures in uuencoded compressed tar file. Minor changes to text. Our results are inconsistent with the metal-insulator transition studied being a Kosterlitz-Thouless transition. The figures are now in the correct order. To appear in Physical Review B, April 15, 199

    Path Integral Monte Carlo Approach to the U(1) Lattice Gauge Theory in (2+1) Dimensions

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    Path Integral Monte Carlo simulations have been performed for U(1) lattice gauge theory in (2+1) dimensions on anisotropic lattices. We extractthe static quark potential, the string tension and the low-lying "glueball" spectrum.The Euclidean string tension and mass gap decrease exponentially at weakcoupling in excellent agreement with the predictions of Polyakov and G{\" o}pfert and Mack, but their magnitudes are five times bigger than predicted. Extrapolations are made to the extreme anisotropic or Hamiltonian limit, and comparisons are made with previous estimates obtained in the Hamiltonian formulation.Comment: 12 pages, 16 figure

    The effects of adding zoledronic acid to neoadjuvant chemotherapy on tumour response: exploratory evidence for direct anti-tumour activity in breast cancer

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    Background: Pre-clinical studies have demonstrated synergistic anti-tumour effects of chemotherapy (CT) and zoledronic acid (ZOL). Within the AZURE trial, designed to determine whether the addition of ZOL to neoadjuvant therapy improves disease outcomes, a subgroup received neoadjuvant CT. We report a retrospective evaluation comparing pathological response in the primary tumour between treatment groups. Methods: In total, 205 patients received neoadjuvant CT±ZOL (CT+ZOL, n=102; CT, n=103). The primary end point was pathologically assessed residual invasive tumour size (RITS) at surgery. Secondary end points were pathological complete response (pCR) rate and axillary nodal involvement. Following review of surgical pathology reports (n=195), outcome differences between groups were assessed adjusting for potential response modifiers. Results: Baseline characteristics and CT treatments were similar. In multivariate analysis, allowing for biological and clinical factors known to influence tumour response, the adjusted mean RITS in CT and CT+ZOL groups were 27.4 and 15.5 mm, respectively, giving a difference in means of 12 mm (95% confidence interval: 3.5–20.4 mm; P=0.006). The pCR rate was 6.9% in the CT group and 11.7% in the CT+ZOL group (P=0.146). There was no difference in axillary nodal involvement (P=0.6315). Conclusion: These data suggest a possible direct anti-tumour effect of ZOL in combination with CT, warranting formal evaluation in prospective studies

    Childhood meat eating and inflammatory markers: The Guangzhou Biobank Cohort Study

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    <p>Abstract</p> <p>Background</p> <p>We hypothesized that socio-economic development could, via nutritionally driven levels of pubertal sex-steroids, promote a pro-inflammatory state among men but not women in developing countries. We tested this hypothesis, using recalled childhood meat eating as a proxy for childhood nutrition, in southern China.</p> <p>Methods</p> <p>We used multivariable linear regression in the Guangzhou Biobank Cohort Study phase 3 (2006-8) to examine the adjusted associations of recalled childhood meat eating, <1/week (n = 5,023), about once per week (n = 3,592) and almost daily (n = 1,252), with white blood cell count and its differentials among older (≄50 years) men (n = 2,498) and women (n = 7,369).</p> <p>Results</p> <p>Adjusted for age, childhood socio-economic position, education and smoking, childhood meat eating had sex-specific associations with white blood cell count and lymphocyte count, but not granulocyte count. Men with childhood meat eating almost daily compared to <1/week had higher white blood cell count (0.33 10<sup>9</sup>/L, 95% confidence interval (CI) 0.10 to 0.56) and higher lymphocyte count (0.16 10<sup>9</sup>/L, 95% CI 0.07 to 0.25). Adjustment for obesity slightly attenuated these associations.</p> <p>Conclusion</p> <p>If confirmed, this hypothesis implies that economic development and the associated improvements in nutrition at puberty may be less beneficial among men than women; consistent with the widening sex differentials in life expectancy with economic development.</p
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