An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study.

INTRODUCTION: The socio-economic impact of critical illnesses on patients and their families in Europe has yet to be determined. The aim of this exploratory study was to estimate changes in family circumstances, social and economic stability, care requirements and access to health services for patients during their first 12 months after ICU discharge. METHODS: Multi-center questionnaire-based study of survivors of critical illness at 6 and 12 months after ICU discharge. RESULTS: Data for 293 consenting patients who spent greater than 48 hours in one of 22 UK ICUs were obtained at 6 and 12 months post-ICU discharge. There was little evidence of a change in accommodation or relationship status between pre-admission and 12 months following discharge from an ICU. A negative impact on family income was reported by 33% of all patients at 6 months and 28% at 12 months. There was nearly a 50% reduction in the number of patients who reported employment as their sole source of income at 12 months (19% to 11%) compared with pre-admission. One quarter of patients reported themselves in need of care assistance at 6 months and 22% at 12 months. The majority of care was provided by family members (80% and 78%, respectively), for half of whom there was a negative impact on employment. Amongst all patients receiving care, 26% reported requiring greater than 50 hours a week. Following discharge, 79% of patients reported attending their primary care physician and 44% had seen a community nurse. Mobility problems nearly doubled between pre-admission and 6 months (32% to 64%). Furthermore, 73% reported moderate or severe pain at 12 months and 44% remained significantly anxious or depressed. CONCLUSIONS: Survivors of critical illness in the UK face a negative impact on employment and commonly have a care requirement after discharge from hospital. This has a corresponding negative impact on family income. The majority of the care required is provided by family members. This effect was apparent by 6 months and had not materially improved by 12 months. This exploratory study has identified the potential for a significant socio-economic burden following critical illness

Delivering organisational adaptation through legislative mechanisms: Evidence from the Adaptation Reporting Power (Climate Change Act 2008)

There is increasing recognition that organisations, particularly in key infrastructure sectors, are potentially vulnerable to climate change and extreme weather events, and require organisational responses to ensure they are resilient and adaptive. However, detailed evidence of how adaptation is facilitated, implemented and reported, particularly through legislative mechanisms is lacking. The United Kingdom Climate Change Act (2008), introduced the Adaptation Reporting Power, enabling the Government to direct so-called reporting authorities to report their climate change risks and adaptation plans. We describe the authors' unique role and experience supporting the Department for Environment, Food and Rural Affairs (Defra) during the Adaptation Reporting Power's first round. An evaluation framework, used to review the adaptation reports, is presented alongside evidence on how the process provides new insights into adaptation activities and triggered organisational change in 78% of reporting authorities, including the embedding of climate risk and adaptation issues. The role of legislative mechanisms and risk-based approaches in driving and delivering adaptation is discussed alongside future research needs, including the development of organisational maturity models to determine resilient and well adapting organisations. The Adaptation Reporting Power process provides a basis for similar initiatives in other countries, although a clear engagement strategy to ensure buy-in to the process and research on its long-term legacy, including the potential merits of voluntary approaches, is required

NMR shim coil design utilising a rapid spherical harmonic calculation method

A rapid spherical harmonic calculation method is used for the design of Nuclear Magnetic Resonance shim coils. The aim is to design each shim such that it generates a field described purely by a single spherical harmonic. By applying simulated annealing techniques, coil arrangements are produced through the optimal positioning of current-carrying circular arc conductors of rectangular cross-section. This involves minimizing the undesirable harmonies in relation to a target harmonic. The design method is flexible enough to be applied for the production of coil arrangements that generate fields consisting significantly of either zonal or tesseral harmonics. Results are presented for several coil designs which generate tesseral harmonics of degree one

Large eddy simulation of plume dispersion behind an aircraft in the take-off phase

The aim of this paper is to provide an investigation, using large eddy simulation, into plume dispersion behind an aircraft in co-flowing take-off conditions. Validation studies of the computational model were presented by Aloysius and Wrobel (Environ Model Softw 24:929–937, 2009) and a study of the flow and dispersion properties of a double-engine aircraft jetwas presented by Aloysius et al. EEC/SEE/2007/001,EUROCONTROLExperimentalCentre, http://www.eurocontrol.int/eec/gallery/content/public/document/eec/report/2007/ 032_ALAQS_comparison_of_CFD_and_Lagrangian_dispersion_methods.pdf), in which only the engine was modelled. In this paper, the complete geometry of a Boeing 737 is modelled and investigated. The currentwork represents a contribution towards a better understanding of the source dynamics behind an airplane jet engine during the take-off and landing phases. The information provided from these simulations will be useful for future improvements of existing dispersion models

Bodily pleasure matters : velocity of touch modulates body ownership during the rubber hand illusion

Copyright © 2013 Crucianelli, Metcalf, Fotopoulou and Jenkinson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these termsThe sense of body ownership represents a fundamental aspect of our self-consciousness. Influential experimental paradigms, such as the rubber hand illusion (RHI), in which a seen rubber hand is experienced as part of one's body when one's own unseen hand receives congruent tactile stimulation, have extensively examined the role of exteroceptive, multisensory integration on body ownership. However, remarkably, despite the more general current interest in the nature and role of interoception in emotion and consciousness, no study has investigated how the illusion may be affected by interoceptive bodily signals, such as affective touch. Here, we recruited 52 healthy, adult participants and we investigated for the first time, whether applying slow velocity, light tactile stimuli, known to elicit interoceptive feelings of pleasantness, would influence the illusion more than faster, emotionally-neutral, tactile stimuli. We also examined whether seeing another person's hand vs. a rubber hand would reduce the illusion in slow vs. fast stroking conditions, as interoceptive signals are used to represent one's own body from within and it is unclear how they would be integrated with visual signals from another person's hand. We found that slow velocity touch was perceived as more pleasant and it produced higher levels of subjective embodiment during the RHI compared with fast touch. Moreover, this effect applied irrespective of whether the seen hand was a rubber or a confederate's hand. These findings provide support for the idea that affective touch, and more generally interoception, may have a unique contribution to the sense of body ownership, and by implication to our embodied psychological "self."Peer reviewe

The Selberg zeta function for convex co-compact Schottky groups

We give a new upper bound on the Selberg zeta function for a convex co-compact Schottky group acting on ${\mathbb H}^{n+1}$: in strips parallel to the imaginary axis the zeta function is bounded by $\exp (C |s|^\delta)$ where $\delta$ is the dimension of the limit set of the group. This bound is more precise than the optimal global bound $\exp (C |s|^{n+1})$, and it gives new bounds on the number of resonances (scattering poles) of $\Gamma \backslash {\mathbb H}^{n+1}$. The proof of this result is based on the application of holomorphic $L^2$-techniques to the study of the determinants of the Ruelle transfer operators and on the quasi-self-similarity of limit sets. We also study this problem numerically and provide evidence that the bound may be optimal. Our motivation comes from molecular dynamics and we consider $\Gamma \backslash {\mathbb H}^{n+1}$ as the simplest model of quantum chaotic scattering. The proof of this result is based on the application of holomorphic $L^2$-techniques to the study of the determinants of the Ruelle transfer operators and on the quasi-self-similarity of limit sets

The Lagrange and Markov spectra from the dynamical point of view

This text grew out of my lecture notes for a 4-hours minicourse delivered on October 17 \& 19, 2016 during the research school "Applications of Ergodic Theory in Number Theory" -- an activity related to the Jean-Molet Chair project of Mariusz Lema\'nczyk and S\'ebastien Ferenczi -- realized at CIRM, Marseille, France. The subject of this text is the same of my minicourse, namely, the structure of the so-called Lagrange and Markov spectra (with an special emphasis on a recent theorem of C. G. Moreira).Comment: 27 pages, 6 figures. Survey articl

Effect of Phosphorus and Strontium Additions on Formation Temperature and Nucleation Density of Primary Silicon in Al-19 Wt Pct Si Alloy and Their Effect on Eutectic Temperature

The influence of P and Sr additions on the formation temperature and nucleation density of primary silicon in Al-19 wt pct Si alloy has been determined, for small volumes of melt solidified at cooling rates _T of ~0.3 and 1 K/s. The proportion of ingot featuring primary silicon decreased progressively with increased Sr addition, which also markedly reduced the temperature for first formation of primary silicon and the number of primary silicon particles per unit volume �Nv: When combined with previously published results, the effects of amount of P addition and cooling rate on �Nv are in reasonable accord with �Nv� _T ¼ ðp=6fÞ1=2 109 [250 � 215 (wt pct P)0.17]�3, where �Nv is in mm�3, _T is in K/s, and f is volume fraction of primary silicon. Increased P addition reduces the eutectic temperature, while increased Sr appears to generate a minimum in eutectic temperature at about 100 ppmw Sr

Mindfulness-based stress reduction in Parkinson’s disease: a systematic review

Background: Mindfulness based stress reduction (MBSR) is increasingly being used to improve outcomes such as stress and depression in a range of long-term conditions (LTCs). While systematic reviews on MBSR have taken place for a number of conditions there remains limited information on its impact on individuals with Parkinson’s disease (PD). Methods: Medline, Central, Embase, Amed, CINAHAL were searched in March 2016. These databases were searched using a combination of MeSH subject headings where available and keywords in the title and abstracts. We also searched the reference lists of related reviews. Study quality was assessed based on questions from the Cochrane Collaboration risk of bias tool. Results: Two interventions and three papers with a total of 66 participants were included. The interventions were undertaken in Belgium (n = 27) and the USA (n = 39). One study reported significantly increased grey matter density (GMD) in the brains of the MBSR group compared to the usual care group. Significant improvements were reported in one study for a number of outcomes including PD outcomes, depression, mindfulness, and quality of life indicators. Only one intervention was of reasonable quality and both interventions failed to control for potential confounders in the analysis. Adverse events and reasons for drop-outs were not reported. There was also no reporting on the costs/benefits of the intervention or how they affected health service utilisation. Conclusion: This systematic review found limited and inconclusive evidence of the effectiveness of MBSR for PD patients. Both of the included interventions claimed positive effects for PD patients but significant outcomes were often contradicted by other results. Further trials with larger sample sizes, control groups and longer follow-ups are needed before the evidence for MBSR in PD can be conclusively judged

Green vehicle technology to enhance the performance of a European port: a simulation model with a cost-benefit approach

In this paper, we study the impact of using a new intelligent vehicle technology on the performance and total cost of a European port, in comparison with existing vehicle systems like trucks. Intelligent autonomous vehicles (IAVs) are a new type of automated guided vehicles (AGVs) with better maneuverability and a special ability to pick up/drop off containers by themselves. To identify the most economical fleet size for each type of vehicle to satisfy the port's performance target, and also to compare their impact on the performance/cost of container terminals, we developed a discrete-event simulation model to simulate all port activities in micro-level (low-level) details. We also developed a cost model to investigate the present values of using two types of vehicle, given the identified fleet size. Results of using the different types of vehicles are then compared based on the given performance measures such as the quay crane net moves per hour and average total discharging/loading time at berth. Besides successfully identifying the optimal fleet size for each type of vehicle, simulation results reveal two findings: first, even when not utilising their ability to pick up/drop off containers, the IAVs still have similar efficacy to regular trucks thanks to their better maneuverability. Second, enabling IAVs ability to pick up/drop off containers significantly improves the port performance. Given the best configuration and fleet size as identified by the simulation, we use the developed cost model to estimate the total cost needed for each type of vehicle to meet the performance target. Finally, we study the performance of the case study port with advanced real-time vehicle dispatching/scheduling and container placement strategies. This study reveals that the case study port can greatly benefit from upgrading its current vehicle dispatching/scheduling strategy to a more advanced one