One size does not fit all - Application of accelerometer thresholds in chronic disease

This is the author accepted manuscript. The final version is available from Oxford University Press via the DOI in this record National Institute for Health Research (NIHR

Kinetic Analysis of Discrete Path Sampling Stationary Point Databases

Analysing stationary point databases to extract phenomenological rate constants can become time-consuming for systems with large potential energy barriers. In the present contribution we analyse several different approaches to this problem. First, we show how the original rate constant prescription within the discrete path sampling approach can be rewritten in terms of committor probabilities. Two alternative formulations are then derived in which the steady-state assumption for intervening minima is removed, providing both a more accurate kinetic analysis, and a measure of whether a two-state description is appropriate. The first approach involves running additional short kinetic Monte Carlo (KMC) trajectories, which are used to calculate waiting times. Here we introduce `leapfrog' moves to second-neighbour minima, which prevent the KMC trajectory oscillating between structures separated by low barriers. In the second approach we successively remove minima from the intervening set, renormalising the branching probabilities and waiting times to preserve the mean first-passage times of interest. Regrouping the local minima appropriately is also shown to speed up the kinetic analysis dramatically at low temperatures. Applications are described where rates are extracted for databases containing tens of thousands of stationary points, with effective barriers that are several hundred times kT.Comment: 28 pages, 1 figure, 4 table

‘Multimorbidity’:an acceptable term for patients or time for a rebrand?

The simultaneous presence of multiple pathological conditions is the norm.1 The construct of comorbidity was defined by Feinstein as: ‘any distinct additional entity that has existed or may occur during the clinical course of a patient who has the index disease under study’.2,3 Multimorbidity refers to the co-occurrence of multiple chronic conditions in an individual,4,5 or the presence of two or more long-term conditions

Financial capability, money attitudes and socioeconomic status: risks for experiencing adverse financial events

The risk of experiencing adverse financial events (e.g. bankruptcy) depends on the world economy and on individual differences in financial and psychological variables. Analysing data from 109,472 British survey respondents, this study reports the risks associated with financial capabilities, money attitudes, and socio-economic status for suffering negative financial outcomes. The results show that (1) socio-economic status is associated with financial capabilities but not with money attitudes; (2) money attitudes and financial capabilities are largely independent; (3) money attitudes and financial capabilities each contribute independently to the risk of experiencing adverse financial outcomes, even after adjusting for socio-economic status; and (4) financial capabilities are greater risk factors of adverse financial outcomes than money attitudes; the latter, however, are likely to be promising targets for interventions

Regional policy spillovers : the national impact of demand-side policy in an interregional model of the UK economy

UK regional policy has been advocated as a means of reducing regional disparities and stimulating national growth. However, there is limited understanding of the interregional and national effects of such a policy. This paper uses an interregional computable general equilibrium model to identify the national impact of a policy-induced regional demand shock under alternative labour market closures. Our simulation results suggest that regional policy operating solely on the demand side has significant national impacts. Furthermore, the effects on the nontarget region are particularly sensitive to the treatment of the regional labour market

Perspectives of staff nurses of the reasons for and the nature of patient-initiated call lights: an exploratory survey study in four USA hospitals

<p>Abstract</p> <p>Background</p> <p>Little research has been done on patient call light use and staff response time, which were found to be associated with inpatient falls and satisfaction. Nurses' perspectives may moderate or mediate the aforementioned relationships. This exploratory study intended to understand staff's perspectives about call lights, staff responsiveness, and the reasons for and the nature of call light use. It also explored differences among hospitals and identified significant predictors of the nature of call light use.</p> <p>Methods</p> <p>This cross-sectional, multihospital survey study was conducted from September 2008 to January 2009 in four hospitals located in the Midwestern region of the United States. A brief survey was used. All 2309 licensed and unlicensed nursing staff members who provide direct patient care in 27 adult care units were invited to participate. A total of 808 completed surveys were retrieved for an overall response rate of 35%. The SPSS 16.0 Window version was used. Descriptive and binary logistic regression analyses were conducted.</p> <p>Results</p> <p>The primary reasons for patient-initiated calls were for toileting assistance, pain medication, and intravenous problems. Toileting assistance was the leading reason. Each staff responded to 6 to 7 calls per hour and a call was answered within 4 minutes (estimated). 49% of staff perceived that patient-initiated calls mattered to patient safety. 77% agreed that that these calls were meaningful. 52% thought that these calls required the attention of nursing staff. 53% thought that answering calls prevented them from doing the critical aspects of their role. Staff's perceptions about the nature of calls varied across hospitals. Junior staff tended to overlook the importance of answering calls. A nurse participant tended to perceive calls as more likely requiring nursing staff's attention than a nurse aide participant.</p> <p>Conclusions</p> <p>If answering calls was a high priority among nursing tasks, staff would perceive calls as being important, requiring nursing staff's attention, and being meaningful. Therefore, answering calls should not be perceived as preventing staff from doing the critical aspects of their role. Additional efforts are necessary to reach the ideal or even a reasonable level of patient safety-first practice in current hospital environments.</p

National variation in pulmonary metastasectomy for colorectal cancer

AIM: Evidence on patterns of use of pulmonary metastasectomy in colorectal cancer patients is limited. This population‐based study aims to investigate the use of pulmonary metastasectomy in the colorectal cancer population across the English National Health Service (NHS) and quantify the extent of any variations in practice and outcome. METHODS: All adults who underwent a major resection for colorectal cancer in an NHS hospital between 2005 and 2013 were identified in the COloRECTal cancer data Repository (CORECT‐R). All inpatient episodes corresponding to pulmonary metastasectomy, occurring within 3 years of the initial colorectal resection, were identified. Multi‐level logistic regression was used to determine patient and organizational factors associated with the use of pulmonary metastasectomy for colorectal cancer, and Kaplan–Meier and Cox models were used to assess survival following pulmonary metastasectomy. RESULTS: In all, 173 354 individuals had a major colorectal resection over the study period, with 3434 (2.0%) undergoing pulmonary resection within 3 years. The frequency of pulmonary metastasectomy increased from 1.2% of patients undergoing major colorectal resection in 2005 to 2.3% in 2013. Significant variation was observed across hospital providers in the risk‐adjusted rates of pulmonary metastasectomy (0.0%–6.8% of patients). Overall 5‐year survival following pulmonary resection was 50.8%, with 30‐day and 90‐day mortality of 0.6% and 1.2% respectively. CONCLUSIONS: This study shows significant variation in the rates of pulmonary metastasectomy for colorectal cancer across the English NHS

Development of a laboratory system and 2D routing analysis to determine solute mixing within aquatic vegetation

A laser induced fluorometry (LIF) system was developed to quantify mixing within spatially variable aquatic vegetation. A comparison is made between intrusive fluorometry techniques and the application of LIF, to quantify mixing in real vegetation in the laboratory setting. LIF provides greater spatial resolution when compared to point fluorometry. Furthermore, LIF is non-intrusive. A two-dimensional routing procedure is used to calculate the longitudinal and transverse velocities and mixing coefficients from a single pulse injection of tracer within a vegetation patch

Quantitative study of hydration of C3S and C2S by thermal analysis. Evolution and composition of C-S-H gels formed

This research is part of a European project (namely, CODICE project), main objective of which is modelling, at a multi-scale, the evolution of the mechanical performance of non-degraded and degraded cementitious matrices. For that, a series of experiments were planned with pure synthetic tri-calcium silicate (C3S) and bi-calcium silicate (C2S) (main components of the Portland cement clinker) to obtain different calcium–silicate–hydrate (C–S–H) gel structures during their hydration. The characterization of those C–S–H gels and matrices will provide experimental parameters for the validation of the multi-scale modelling scheme proposed. In this article, a quantitative method, based on thermal analyses, has been used for the determination of the chemical composition of the C–S–H gel together with the degree of hydration and quantitative evolution of all the components of the pastes. Besides, the microstructure and type of silicate tetrahedron and mean chain length (MCL) were studied by scanning electron microscopy (SEM) and 29Si magic-angle-spinning (MAS) NMR, respectively. The main results showed that the chemical compositions for the C–S–H gels have a CaO/SiO2 M ratio almost constant of 1.7 for both C3S and C2S compounds. Small differences were found in the gel water content: the H2O/SiO2 M ratio ranged from 2.9 ± 0.2 to 2.6 ± 0.2 for the C3S (decrease) and from 2.4 ± 0.2 to 3.2 ± 0.2 for the C2S (increase). The MCL values of the C–S–H gels, determined from 29Si MAS NMR, were 3.5 and 4 silicate tetrahedron, for the hydrated C3S and C2S, respectively, remaining almost constant at all hydration periods

Beyond ‘Facebook addiction’: the role of cognitive-related factors and psychiatric distress in social networking addiction

The use of social networking sites (SNSs) is rapidly increasing as billions of individuals use SNS platforms regularly to communicate with other users, follow the news and play browser games. Given the widespread use of SNS platforms, investigating the potential predictors of addictive SNS use beyond Facebook use has become paramount given that most studies were focused on ‘Facebook addiction’. In the present study, a total of 511 English-speaking SNS users (58.1% young adults aged 20-35 years; 64.6% female) were recruited online and asked to complete a battery of standardized psychometric tools assessing participants’ sociodemographic characteristics, SNS preferences and patterns of use, SNS addiction, preference for online social interaction (POSI), maladaptive cognitions, Fear of Missing Out (FoMo), dysfunctional emotion regulation, and general psychiatric distress. Overall, about 4.9% (n = 25) of all participants could be classed as having a high SNS addiction risk profile. Moreover, the results further indicated that FoMo (β = .38), maladaptive cognitions (β = .25), and psychiatric distress (β = .12) significantly predicted SNS addiction (i.e., p < .0001) and accounted for about 61% of the total variance in SNS addiction, with FoMo providing the strongest predictive contribution over and above the effects of sociodemographic variables and patterns of SNS use. The implications of the present findings were discussed in light of extant literature on behavioral addictions and Facebook addiction and further considerations were provided regarding the potential clinical implications for cognitive-based psychological treatment approaches to SNS addiction