UK-wide support infrastructure for low frequency noise sufferers ('LFN Network')

The project was set up to meet a need for improved treatment of Low Frequency Noise (LFN) complaints in cases where no noise source could be found. Such cases can be highly distressing for the complainant and difficult to handle by the Environmental Health Officers (EHOs) concerned and so tend to result in disproportionate use of resources. The hypothesis is that, irrespective of the (unknown) cause of the LFN perception, the perception may be lessened through application of techniques specifically adapted from the field of tinnitus and hyperacusis therapy. The aim of the project was therefore to establish, on a trial basis, a national network of treatment centres for sufferers of LFN located within the existing network of tinnitus clinics in the UK. A network of nine audiology centres was established, including eight with a good geographical spread in England and one in Scotland. A treatment protocol, specific to LFN cases, was then developed through discussions with the centres and a referral pathway was also established. Each centre made contact initially with EHOs in one or two local authorities in their vicinity to offer the service which was widened to a larger catchment area if sufficient referrals were not forthcoming. Fourteen subjects took part, eleven of which were referred from EHOs, the remaining three being self-referred. Outcome measures were based on a combination of validated questionnaires for general health, anxiety, depression, tinnitus handicap (with LFN substituted for tinnitus) and hyperacusis, combined with visual-analogue scales specifically developed for LFN to measure the pitch and loudness of the perceived LFN and the associated distress. Qualitative and open questions were also used. Potential benefits to EHOs of being able to make referrals were evaluated by semi-structured telephone interviews in which five EHOs participated. Generally, EHOs were very positive about the service and wanted it to continue. It was clear that LFN cases require significant resources which can be reduced if the referral service is available. Audiologists’ experience was evaluated in a similar way: they were generally willing to take part in the scheme and wanted it to continue and there was a feeling that they would have liked more referrals to get more experience in the use of the protocol. The results showed a mixed picture with some clients, three in particular, showing improved scores across a range of measures with little or no benefit for others and a worsening for one case. The improvement of some clients is positive given the lack of options available for this client group, however, the success of the approach can be considered partial at best. The questionnaire scores indicated that individuals taking part were significantly agitated, stressed and distressed. Those individuals with LFN complaint have a significant clinical need although in the main they were not clinically anxious or depressed. The model proposed of stress and increased auditory gain is a plausible explanation for the symptoms noted in LFN cases. In particular, the involvement of the sympathetic autonomic nervous system, and of the emotional brain, is likely to be a faithful representation of the clinical situation. A number of useful signposts for future development were derived. First, EHOs as well as audiologists should ideally receive training in best practice to help them to handle the particular sensitivities of LFN cases. More awareness and information for GPs is also recommended. A simplification of the referral route, potentially going direct to the audiologist rather than via the GP would also be beneficial. A strong argument for the continuation of the service is that some EHOs are now taking the initiative in contacting audiologists independently to refer LFN complainants in ‘No Noise Found’ cases. Without adequate training things could be made worse but access to a specific LFN protocol and associated training is likely to increase the chances of success significantly. It is recommended that existing guidance for EHOs be extended to include details of audiology services, guidelines for EHOs in making referrals and reference to the LFN treatment protocol. Using data from the study two independent estimates of the incidence rates of LFN cases can be derived. It is estimated that there are up to 160 complainants per year in the NHS corresponding to 0.32 cases per 100 thousand per year. The incidence rate based on referrals made by EHOs is 1.01 per 100 thousand per year within local authorities. It is not known to what extent, if any, these populations overlap

Manipulating the fluorescence lifetime at the sub-cellular scale via photo-switchable barcoding

Fluorescent barcoding is a pivotal technique for the investigation of the microscale world, from information storage to the monitoring of dynamic biochemical processes. Using fluorescence lifetime as the readout modality offers more reproducible and quantitative outputs compared to conventional fluorescent barcoding, being independent of sample concentration and measurement methods. However, the use of fluorescence lifetime in this area has been limited by the lack of strategies that provide spatiotemporal manipulation of the coding process. In this study, we design a two-component photo-switchable nanogel that exhibits variable fluorescence lifetime upon photoisomerization-induced energy transfer processes through light irradiation. This remotely manipulated fluorescence lifetime property could be visually mapped using fluorescence lifetime imaging microscopy (FLIM), allowing selective storage and display of information at the microscale. Most importantly, the reversibility of this system further provides a strategy for minimizing the background influence in fluorescence lifetime imaging of live cells and sub-cellular organelles. Using fluorescence lifetime as the readout modality offers more reproducible and quantitative outputs compared to conventional fluorescent barcoding, being independent of sample concentration and measurement methods. Here, the authors design a photo-switchable nanogel exhibiting variable fluorescence lifetime, and demonstrate visual mapping by using fluorescence lifetime imaging microscopy on a sub-cellular scale.This work was supported by the ERC (grant number 615142), EPSRC, and the University of Birmingham, the Ministerio de Economia y Competitividad (MINECO) of Spain (project CTQ2016-80375-P) and the Basque Government (grant IT-324-07). The authors acknowledge the computational and technical and human support provided by DIPC. Y.X. acknowledges Chancellor's International Scholarship (University ofWarwick) for funding. All three reviewers are thanked for their time and contribution to the final version of this paper

C-5A/orbiter wind tunnel testing and analysis: Piggyback ferry

Wind tunnel testing and analytical studies of the feasibility of ferrying the NASA Shuttle Orbiter on the C-5A in a piggyback mode have been accomplished. Testing was conducted in the 8x12 foot low speed wind tunnel using an existing 0.0399 scale C-5A model in conjunction with a NASA 0.0405 scale Orbiter model. Six component force and moment data were measured over a range of pitch and yaw angles to determine lift and drag characteristics, lateral/directional stability characteristics and longitudinal and directional control powers. A description of the wind tunnel test program with a run schedule and the complete plotted data for all the test runs are presented. Initial emphasis was given to determining the effects of the Orbiter above the C-5A and the optimum location for minimum interference on C-5A characteristics. A comprehensive series of cruise configurations were tested including a range of Orbiter longitudinal and vertical locations, incidences, and afterbody fairings. Subsequently, a series of configurations were devised during the test program to determine means of recovering directional stability degradation due to Orbiter interference

Magnetic resonance imaging in the detection of skeletal metastases in patients with breast cancer.

Eighty-four patients with breast cancer at high risk of bone metastases were investigated with magnetic resonance imaging (MRI) of the thoracolumbar spine. Of 58 patients with normal limited skeletal surveys (LSS) and bone scans (BS), 4 (7%) had MR images compatible with malignant infiltration. Fourteen patients had abnormal bone scans with normal or non-diagnostic plain films; 7 of these patients (50%) had MR images compatible with malignant infiltration. Twelve patients had single or multiple wedge collapses of uncertain aetiology on plain film; MR demonstrated metastatic disease as the cause of wedge collapse in 7 (58%). MRI may define a group of patients with extra-osseous relapse who have occult metastatic disease. Although the detection rate in patients with primary breast cancer is low (4/45), MRI is of value in determining the cause of wedge collapse in postmenopausal women with breast cancer and may elucidate the cause of an abnormal bone scan with normal or non-diagnostic plain films

Negotiating professional and social voices in research principles and practice

This paper draws on work conducted for a qualitative interview based study which explores the gendered racialised and professional identifications of health and social care professionals. Participants for the project were drawn from the professional executive committees of recently formed Primary Care Trusts. The paper discusses how the feminist psychosocial methodological approach developed for the project is theoretically, practically and ethically useful in exploring the voices of those in positions of relative power in relation to both health and social care services and the social relations of gender and ethnicity. The approach draws on psychodynamic accounts of (defended) subjectivity and the feminist work of Carol Gilligan on a voice-centred relational methodology. Coupling the feminist with the psychosocial facilitates an emphasis on voice and dialogic communication between participant and researcher not always captured in psychosocial approaches which tend towards favouring the interviewer as ‘good listener’. This emphasis on dialogue is important in research contexts where prior and ongoing relationships with professional participants make it difficult and indeed undesirable for researchers to maintain silence

The Rest-Frame Submillimeter Spectrum of High-Redshift, Dusty, Star-Forming Galaxies

We present the average rest-frame spectrum of high-redshift dusty, star-forming galaxies from 250-770GHz. This spectrum was constructed by stacking ALMA 3mm spectra of 22 such sources discovered by the South Pole Telescope and spanning z=2.0-5.7. In addition to multiple bright spectral features of 12CO, [CI], and H2O, we also detect several faint transitions of 13CO, HCN, HNC, HCO+, and CN, and use the observed line strengths to characterize the typical properties of the interstellar medium of these high-redshift starburst galaxies. We find that the 13CO brightness in these objects is comparable to that of the only other z>2 star-forming galaxy in which 13CO has been observed. We show that the emission from the high-critical density molecules HCN, HNC, HCO+, and CN is consistent with a warm, dense medium with T_kin ~ 55K and n_H2 >~ 10^5.5 cm^-3. High molecular hydrogen densities are required to reproduce the observed line ratios, and we demonstrate that alternatives to purely collisional excitation are unlikely to be significant for the bulk of these systems. We quantify the average emission from several species with no individually detected transitions, and find emission from the hydride CH and the linear molecule CCH for the first time at high redshift, indicating that these molecules may be powerful probes of interstellar chemistry in high-redshift systems. These observations represent the first constraints on many molecular species with rest-frame transitions from 0.4-1.2mm in star-forming systems at high redshift, and will be invaluable in making effective use of ALMA in full science operations.Comment: 19 pages, 10 figures (2 in appendices); accepted for publication in Ap

Rational design of substituted maleimide dyes with tunable fluorescence and solvafluorochromism

We herein present a simple methodology to systematically expand the scope of maleimide-based dyes and also provide an insight into the relationship between substitution pattern and optical properties.</p

Racism, anti-racist practice and social work: articulating the teaching and learning experiences of Black social workers

In the mid 1990s a Black practice teacher programme was established in Manchester and Merseyside with the primary aim to increase the number of Black practice teachers in social work organisations, and in turn provide a supportive and encouraging learning environment for Black student social workers whilst on placement. In the north‐west of England research has been undertaken, to establish the quality of the practice teaching and student learning taking place with Black practice teachers and students. This paper is an exploration of the ideas generated within the placement process that particularly focused on the discourse of racism and ant‐racist practice. Black students and practice teachers explain their understanding of racism and anti‐racist practice within social work. From the research, the paper will critique some of the ideas concerning anti‐racism. In particular, it will question whether anti‐racist social work practice needs to be re‐evaluated in the light of a context with new migrants, asylum seekers and refugees. It will concluded, by arguing that whilst the terms anti‐racism, Black and Minority Ethnic have resonance as a form of political strategic essentialism, it is important to develop more positive representations in the future