491 research outputs found
Development of a superconductor magnetic suspension and balance prototype facility for studying the feasibility of applying this technique to large scale aerodynamic testing
The basic research and development work towards proving the feasibility of operating an all-superconductor magnetic suspension and balance device for aerodynamic testing is presented. The feasibility of applying a quasi-six-degree-of freedom free support technique to dynamic stability research was studied along with the design concepts and parameters for applying magnetic suspension techniques to large-scale aerodynamic facilities. A prototype aerodynamic test facility was implemented. Relevant aspects of the development of the prototype facility are described in three sections: (1) design characteristics; (2) operational characteristics; and (3) scaling to larger facilities
How are emotional distress and reassurance expressed in medical consultations for people with long-term conditions who were unable to receive curative treatment? A pilot observational study with huntington’s disease and prostate cancer
Objective It is unclear whether how people with long-term conditions express distress, and how clinicians respond, influences perceptions of consultation outcomes. The pilot study examined emotional distress and reassurance in consultations with people whose long-term conditions (at the time of consultations) were treated using active surveillance or symptom management (as no curative treatment was suitable). Methods An observational pilot study was conducted involving consultations between people with long-term conditions and their respective clinician. Consultations between three clinicians (two Huntington’s Disease; one Prostate Cancer) and 22 people with long-term conditions (11 Huntington’s Disease; 11 Prostate Cancer) were audio-recorded. Participants also completed an expanded Consultation and Relational Empathy (CARE) Measure. Two researchers coded sessions using Verona Coding Definitions of Emotional Sequences (VR-CoDES/VR-CoDES-P). Code frequencies were calculated, t tests performed between conditions, and Pearson’s correlations performed for associations between CARE responses and clinician utterances. Results People with long-term conditions expressed emotional distress on average 4.45 times per session, averaging 1.09 Concern and 3.36 Cue utterances. Clinicians responded with more explicit (2.59) and space-providing (3.36), than non-explicit (1.86) and space-reducing (1.09), responses per session. Clinicians expressed spontaneous reassurance on average 5.18 times per session, averaging 3.77 Cognitive and 1.5 Affective reassurance utterances. Huntington’s Disease consultations featured significantly more 'Cues', 'Concerns' and 'Overall' 'Emotional Distress', and 'Cognitive' and 'Overall' ‘Reassurance'. Conclusion Emotional distress was expressed more using hints than explicit concern utterances. Clinicians predominantly explicitly explored distress rather than providing information/advice and provided advice using spontaneous cognitive reassurance. People with Huntington’s Disease expressed more concerns and received more reassurance, indicating different needs between conditions. Future research is required to explore emotional distress and reassurance in a larger sample of participants and long-term condition types, and how the practical implications of these findings may be used to enhance outcomes of consultations.Publisher PDFPeer reviewe
Quality of life considerations in head and neck cancer: United Kingdom National Multidisciplinary Guidelines
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It identifies the current evidence base and role of health-related quality of life assessment for this group of patients.Publisher PDFPeer reviewe
The technology and craft organisation of Kushite technical ceramic production at Meroe and Hamadab, Sudan
This paper seeks to contribute to the growing knowledge of iron production in ancient Sudan by examining the technology and craft organisation involved in the production of technical ceramics, which were integral to the iron smelting process. The focus of this study are the technical ceramics including tuyères, furnace linings, and furnace bricks, recovered from various slag heaps located at the archaeological sites of the Royal City of Meroe and the Meroitic town site of Hamadab. We used macroscopic examination and thin-section petrography to identify the source of raw materials and methods used in preparing the raw materials, to characterise the level of craft specialisation, and to infer the broader socio-political developments that might have influenced how the production of technical ceramics was organised. The resulting data reveal that changes occurred within the production of technical ceramics throughout different periods of Kushite history (traditionally divided into Napatan and Meroitic) and during the post-Meroitic period, and we argue that the observed changes might have been related to the rise and fall of the Kingdom of Kush. The production of technical ceramics was marked by clear distinction in raw materials and paste preparation methods used for different types of technical ceramics, and a high degree of compositional and technological homogeneity within each type of technical ceramic during the Napatan and earlier Meroitic periods, coinciding with the time when Kush rose to and was at the height of its power. The production of technical ceramics appears to have exhibited more diversity in terms of the raw materials and paste preparation methods and lower degree of homogeneity during the later and post-Meroitic periods when the economic and political influence and power of the Kingdom of Kush is described as declining and ultimately ceasing to exist. Perhaps the most drastic change in the production of technical ceramics took place in the post-Meroitic period, which was characterised by lower level of specialisation, as well as the possibility of using a different technological approach to iron smelting.Qatar Sudan Archaeology Project grant 037
UCL Qatar core fundin
Low Power Magnetic Bearing Design for High Speed Rotating Machinery
Magnetic suspension technology has advanced to the point of being able to offer a number of advantages to a variety of applications in the rotating machinery and aerospace fields. One strong advantage is the decrease in power consumption. The design and construction of a set of permanent magnet biased, actively controlled magnetic bearing for a flexible rotor are presented. Both permanent magnets and electromagnets are used in a configuration which effectively provides the necessary fluxes in the appropriate air gaps, while simultaneously keeping the undesirable destabilizing forces to a minimum. The design includes two radial bearings and a thrust bearing. The theoretical development behind the design is briefly discussed. Experimental performance results for a set of operating prototype bearings is presented. The results include measurements of load capacity, bearing stiffness and damping, and the dynamic response of the rotor. With few exceptions, the experimental results matched very well with the predicted performance. The power consumption of these bearings was found to be significantly reduced from that for a comparable set of all electromagnetic bearings
Decision support in addiction: the development of an e-health tool to assess and prevent risk of fatal overdose. The ORION project
Background and Objective. The application of e-health technology to the field of substance use disorders is at a relatively early stage, and methodological quality is still variable. Few have explored the extent of utilization of communication technology in exploring risk perception by patients enrolled in substance abuse services. The Overdose RIsk InfOrmatioN (ORION) project is a European Commission funded programme, aimed to develop and pilot an e-health psycho-educational tool to provide information to drug using individuals about the risks of suffering a drug overdose. Methods. In this article we report on phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) of the ORION project. Results. The development of ORION e-health tool underlined the importance of an evidence-based intervention aimed in obtaining reliable evaluation of risk. The ORION tool supported a decision making process aimed at influencing the substance users' self-efficacy and the degree to which the substance users' understand risk factors. Therefore its innovative power consisted in translating risks combination into a clear estimation for the user who will then appear more likely to be interested in his/her risk perception. Conclusion. Exploratory field testing and validation confirmed the next stage of evaluation, namely, collection of routine patient samples in study clinics. The associations between risk perception of overdose, engagement with the ORION tool and willingness to alter overdose risk factors, in a clinical setting across various EU member states will further confirm the ORION tool's generalisability and effectiveness.PostprintPeer reviewe
The care and support needs of residential care home residents with comorbid cancer and dementia: A qualitative review and ethnographic study.
Background: Prevalence of cancer and dementia are strongly related to age. In the UK, 70% of care home residents have dementia. By 2040, older people (aged 65+) will account for 77% of all people living with cancer. Residents with only one of these conditions may have complex care needs. Having comorbid cancer and dementia (CCD) is likely to bring further challenges. This is the first research project to examine the care and support needs of people with CCD living in residential care homes and areas for improvement. Aims: To explore: (1) The care and support needs of people with CCD living in residential care homes. (2) What constitutes good care for people with CCD, their family/supporters, and residential care home staff. (3) Potential barriers and facilitators to providing good care for people with CCD. Methods: (1) Literature review to examine implications for cancerrelated care for people with dementia living in residential care homes. (2) Interviews with 5‐10 men and women with CCD, their family members/ supporters, and residential care home staff. (3) Ethnographic observations of 5‐10 people with CCD to further explore barriers and facilitators to good care. Results: Emergent findings from the literature review will be presented, and their implications for supporting people with CCD living in residential care homes discussed. Conclusions: Findings from this study will help improve the care and support of people with CCD and will contribute to a wider programme of research exploring the cancer care needs of people with dementia across a variety of care settings
Does emotional talk vary with fears of cancer recurrence trajectory? A content analysis of interactions between women with breast cancer and their therapeutic radiographers
Funding: Breast Cancer Now (grant number 6873).Fears of cancer recurrence (FCR) in patients with breast cancer are hypothesised to develop over the period from diagnosis, through treatment and thereafter. A crucial point may be the contact that patients have with their therapeutic radiographer in review appointments. The study aimed to (1) describe and categorise the content of the identified emotional talk, and (2) consider the evidence for an association of content with FCR trajectory. Methods: A concurrent mixed methods approach was applied as part of a larger investigation (FORECAST) of breast cancer patients (n = 87). Patients completed a daily diary during their radiotherapy treatment. Audio recordings were collected of review appointments. The Verona Coding Definitions of Emotional Sequences (VR-CoDES) system was used to code patient emotional cues and concerns (CCs). Purposeful sampling of the daily diary ratings identified 12 patients (30 consultations) with an increasing (n=6) or decreasing (n=6) FCR trajectory. The emotional talk of these patients at their weekly reviews was content analysed. Results: Four themes were identified from 185 CCs: Physical Symptoms, Factors External to Hospital, Treatment, and Labelling Cancer. FCR decreasing trajectory group consultations were longer (p < 0.02), expressed twice as many CCs as the increasing trajectory group (p < 0.001), and were more likely to refer to cancer directly (p < 0.05). Conclusions: The emotional content expressed matched features outlined in the Lee-Jones et al (1997) FCR model, and showed evidence of avoidance in increasing FCR trajectory patients.PostprintPeer reviewe
Assessing sedation need and managing referred dentally anxious patients:is there a role for the Index of Sedation Need?
Aim: To conduct an exploratory investigation of public dental service (PDS) practitioners' planned sedation modality using a structural equation modelling approach, in order to identify the explanatory value of using the Index of Sedation Need (IOSN), or its component parts, to predict sedation modality in patients referred with dental anxiety.
Methods: A convenience sample of patients referred to the PDS for dental anxiety management was invited to take part. The IOSN was completed for each patient (patient dental anxiety, medical and behavioural indicators and dental treatment complexity) as well as the American Society of Anesthesiologists Physical Status Classification System and the Case Mix Tool. The practitioners completed details of their planned sedation modality and identified normative dental treatment need. The data were entered onto an SPSS v21 database and subjected to frequency distributions, t-tests, correlation analysis and exploratory partial structural equation modelling (SEM).
Results: Ninety-five percent of patients were ranked as MDAS 3 or 4, indicating high dental anxiety; 69% had a medical condition, which might impact on dental treatment and 82% had a dental treatment need, which was classified as intermediate/complex according to the IOSN. Eighty-eight percent of the patients in accordance with the IOSN required sedation: 62% of patients were assessed as requiring intravenous sedation. The IOSN discriminated between patients who were assessed as requiring more complex sedation modalities and had a greater normative treatment need. The SEM showed that the patient dental anxiety (P <0.02) and dental treatment complexity (P <0.02) predicted planned sedation modality. Functional morbidity was less strong, as a predictor, and was significant at the ten percent level.
Conclusions: The IOSN is a useful and valid assessment of sedation need and predicted sedation modality for patients referred with high dental anxiety states and secondly, that component parts of the IOSN add explanatory value in practitioners' choice of planned sedation modality
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