151 research outputs found
Rational design of sulfonamide inhibitor specific for human carbonic anhydrase I isozyme
This article does not have an abstract
East Midlands Research into Ageing Network (EMRAN) Discussion Paper Series
Academic geriatric medicine in Leicester
.
There has never been a better time to consider joining us. We have recently appointed a
Professor in Geriatric Medicine, alongside Tom Robinson in stroke and Victoria Haunton,
who has just joined as a Senior Lecturer in Geriatric Medicine. We have fantastic
opportunities to support students in their academic pursuits through a well-established
intercalated BSc programme, and routes on through such as ACF posts, and a successful
track-record in delivering higher degrees leading to ACL post. We collaborate strongly
with Health Sciences, including academic primary care. See below for more detail on our
existing academic set-up.
Leicester Academy for the Study of Ageing
We are also collaborating on a grander scale, through a joint academic venture focusing
on ageing, the ‘Leicester Academy for the Study of Ageing’ (LASA), which involves the
local health service providers (acute and community), De Montfort University; University
of Leicester; Leicester City Council; Leicestershire County Council and Leicester Age UK.
Professors Jayne Brown and Simon Conroy jointly Chair LASA and have recently been
joined by two further Chairs, Professors Kay de Vries and Bertha Ochieng. Karen
Harrison Dening has also recently been appointed an Honorary Chair.
LASA aims to improve outcomes for older people and those that care for them that takes
a person-centred, whole system perspective. Our research will take a global perspective,
but will seek to maximise benefits for the people of Leicester, Leicestershire and Rutland,
including building capacity. We are undertaking applied, translational, interdisciplinary
research, focused on older people, which will deliver research outcomes that address
domains from: physical/medical; functional ability, cognitive/psychological; social or
environmental factors. LASA also seeks to support commissioners and providers alike for
advice on how to improve care for older people, whether by research, education or
service delivery. Examples of recent research projects include: ‘Local History Café’
project specifically undertaking an evaluation on loneliness and social isolation; ‘Better
Visits’ project focused on improving visiting for family members of people with dementia
resident in care homes; and a study on health issues for older LGBT people in Leicester.
Clinical Geriatric Medicine in Leicester
We have developed a service which recognises the complexity of managing frail older
people at the interface (acute care, emergency care and links with community services).
There are presently 17 consultant geriatricians supported by existing multidisciplinary
teams, including the largest complement of Advance Nurse Practitioners in the country.
Together we deliver Comprehensive Geriatric Assessment to frail older people with
urgent care needs in acute and community settings.
The acute and emergency frailty units – Leicester Royal Infirmary
This development aims at delivering Comprehensive Geriatric Assessment to frail older
people in the acute setting. Patients are screened for frailty in the Emergency
Department and then undergo a multidisciplinary assessment including a consultant
geriatrician, before being triaged to the most appropriate setting. This might include
admission to in-patient care in the acute or community setting, intermediate care
(residential or home based), or occasionally other specialist care (e.g. cardiorespiratory).
Our new emergency department is the county’s first frail friendly build and includes
fantastic facilities aimed at promoting early recovering and reducing the risk of hospital
associated harms.
There is also a daily liaison service jointly run with the psychogeriatricians (FOPAL); we
have been examining geriatric outreach to oncology and surgery as part of an NIHR
funded study.
We are home to the Acute Frailty Network, and those interested in service developments
at the national scale would be welcome to get involved.
Orthogeriatrics
There are now dedicated hip fracture wards and joint care with anaesthetists,
orthopaedic surgeons and geriatricians. There are also consultants in metabolic bone
disease that run clinics.
Community work
Community work will consist of reviewing patients in clinic who have been triaged to
return to the community setting following an acute assessment described above.
Additionally, primary care colleagues refer to outpatients for sub-acute reviews. You will
work closely with local GPs with support from consultants to deliver post-acute, subacute,
intermediate and rehabilitation care services.
Stroke Medicine
24/7 thrombolysis and TIA services. The latter is considered one of the best in the UK
and along with the high standard of vascular surgery locally means one of the best
performances regarding carotid intervention
Children’s discourses of natural spaces: considerations for children’s subjective well-being
Based on the evidence provided in the literature, it is manifest that increased time spent in nature increases various aspects of children’s well-being. Using discourse analysis on focus group interviews with 28 children between the ages of 12 and 14 years old from three socio-economically diverse communities in the Western Cape of South Africa, the study aimed to explore how children construct and assign meaning to natural spaces. More specifically the study explored how children use specific discursive resources and repertoires to construct and assign meaning to their engagement with natural spaces, and the extent to which this influences their subjective well-being. Several pertinent discourses emerged from the participants’ accounts within four themes of: Safety and natural spaces, Appreciation for natural spaces, Degradation of Nature: Thinking environmentally, acting pro-environmentally, and Natural spaces and children’s subjective well-being. The study highlights the critical role that children’s engagement in natural spaces has on their subjective well-being, and how these benefits can be harnessed to better children’s overall quality of life.IS
Mahatma Gandhi and the Prisoner's Dilemma: Strategic Civil Disobedience and Great Britain's Great Loss of Empire in India
Mesalazine in the initial management of severely acutely malnourished children with environmental enteric dysfunction: a pilot randomized controlled trial
Response of a CMS HGCAL silicon-pad electromagnetic calorimeter prototype to 20-300 GeV positrons
The Compact Muon Solenoid Collaboration is designing a new high-granularity
endcap calorimeter, HGCAL, to be installed later this decade. As part of this
development work, a prototype system was built, with an electromagnetic section
consisting of 14 double-sided structures, providing 28 sampling layers. Each
sampling layer has an hexagonal module, where a multipad large-area silicon
sensor is glued between an electronics circuit board and a metal baseplate. The
sensor pads of approximately 1 cm are wire-bonded to the circuit board and
are readout by custom integrated circuits. The prototype was extensively tested
with beams at CERN's Super Proton Synchrotron in 2018. Based on the data
collected with beams of positrons, with energies ranging from 20 to 300 GeV,
measurements of the energy resolution and linearity, the position and angular
resolutions, and the shower shapes are presented and compared to a detailed
Geant4 simulation
Comparative Accuracy and Cost-Effectiveness of Dynamic Contrast Enhanced Computed Tomography and Positron Emission Tomography in the Characterisation of Solitary Pulmonary Nodules
Abstract
Introduction:
Dynamic contrast-enhanced computed tomography (DCE-CT) and Positron Emission Tomography/Computed Tomography (PET/CT) have a high reported accuracy for the diagnosis of malignancy in solitary pulmonary nodules. The aim of this study was to compare the accuracy and cost-effectiveness of these.
Methods:
In this prospective multicentre trial, 380 participants with a solitary pulmonary nodule (8-30mm) and no recent history of malignancy underwent DCE-CT and PET/CT. All patients underwent either biopsy with histological diagnosis or completed CT follow-up. Primary outcome measures were sensitivity, specificity, and overall diagnostic accuracy for PET/CT and DCE-CT. Costs and cost-effectiveness were estimated from a healthcare provider perspective using a decision-model.
Results:
312 participants (47% female, 68.1±9.0 years) completed the study, with 61% rate of malignancy at 2 years. The sensitivity, specificity, positive predictive value and negative predictive values for DCE-CT were 95.3% [95% CI 91.3;97.5], 29.8% [95% CI 22.3;38.4], 68.2% [95% CI 62.4%;73.5%] and 80.0% [95% CI 66.2;89.1] respectively, and for PET/CT were 79.1% [95% CI 72.7;84.2], 81.8% [95% CI 74.0;87.7], 87.3%[95% CI 81.5;91.5) and 71·2%
[95% CI 63.2;78.1]. The area under the receiver operator characteristic curve (AUROC) for DCE-CT and PET/CT was 0.62 [95%CI 0.58;0.67] and 0.80 [95%CI 0.76;0.85] respectively (p<0.001). Combined results significantly increased diagnostic accuracy over PET/CT alone (AUROC=0.90 [95%CI 0.86;0.93], p<0.001). DCE-CT was preferred when the willingness to pay per incremental cost per correctly treated malignancy was below £9000. Above £15500 a combined approach was preferred.
Conclusions:
PET/CT has a superior diagnostic accuracy to DCE-CT for the diagnosis of solitary pulmonary nodules. Combining both techniques improves the diagnostic accuracy over either test alone and could be cost-effective. (Clinical trials.gov - NCT02013063)
Mahatma Gandhi and the Prisoner’s Dilemma: Strategic Civil Disobedience and Great Britain’s Great Loss of Empire in India
This paper examines the relationship between statutory monopoly and collective action as a multi-person assurance game culminating in an end to British Empire in India. In a simple theoretical model, it is demonstrated whether or not a collective good enjoys (or is perceived to enjoy) pure jointness of production and why the evolutionary stable strategy of non-violence was supposed to work on the principle that the coordinated reaction of a ethnically differentiated religious crowd to a conflict between two parties (of colonizer and colonized) over confiscatory salt taxation would significantly affect its course. Following Mancur Olson (1965) and Dennis Chong (1991), a model of strategic civil disobedience is created which is used to demonstrate how collective action can be used to produce an all-or-nothing public good to achieve economic and political independence
A Comparative Study of Physical Fitness Index (PFI) and Predicted Maximum Aerobic Capacity (VO2max) among the Different Groups of FemaleStudents in West Bengal, India
- …