A low-altitude satellite interaction study /Neutral gases/ Final report

Low-altitude satellite interaction study of neutral gases and Monte Carlo computer techniques for describing flow field and spacecraft interaction

A low-altitude satellite interaction study

Two computer programs calculate interaction effects of high speed spacecraft on the environment at altitudes from 90 km to 150 km. EXT program determines fluid field in bodies of arbitrary geometries in transient flow regime. INT program uses EXT output and measures flow conditions inside spacecraft body

Mitigating the carbon footprint and improving productivity of ruminant livestock agriculture using a red seaweed

Ruminants are responsible for a large proportion of agricultural greenhouse gas emissions in the form of methane. This can be managed. It is a global initiative to increase productivity of the livestock sector to meet a growing population, but with emphasis on decreasing enteric methane to achieve emissions targets. We investigated the marine red macroalga (seaweed) Asparagopsis taxiformis as a feed ingredient to fundamentally eliminate enteric methane in beef cattle fed a high grain diet and provide evidence of improved livestock production performance. Asparagopsis was included in the feed of Brahman-Angus cross steers at 0.00%, 0.05%, 0.10%, and 0.20% of feed organic matter. Emissions were monitored in respiration chambers fortnightly over 90 d of treatment, steers were weighed weekly prior to feeding, feed intake monitored daily, rumen fluid samples collected in conjunction with respiration chambers for assessment of rumen function, feces were collected for bromoform residue analysis, and meat, organ, and fat were collected post slaughter for residue analysis and sensory evaluation. Steers receiving 0.10% and 0.20% Asparagopsis demonstrated decreased methane up to 40% and 98%, and demonstrated weight gain improvements of 53% and 42%, respectively. There was no negative effect on daily feed intake, feed conversion efficiencies, or rumen function, and no residues or changes in meat eating quality were detected. Commercial production of Asparagopsis could create new economies, and with low inclusion rates of this seaweed in ruminant diets the industry has the potential to revolutionize management of greenhouse gas emissions across the ruminant livestock sector with complementary benefits to the environment, and economy of the wider agriculture sector

Delivery of Supported Self‐Management in Primary Care Asthma Reviews: Insights From the IMP2 ART Programme

Background Supported self-management (SSM) for asthma reduces the risk of asthma attacks and improves asthma control and quality of life. SSM optimally includes patient-centred communication and behaviour change support, however, the extent to which this occurs in routine primary care is unclear. This project was nested within the IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) programme; a UK-wide trial evaluating an implementation strategy (including healthcare professional (HCP) training on behaviour change strategies and patient-centred care) to improve support for asthma self-management. Objective To provide an understanding of how healthcare professionals deliver SSM in UK clinical practice; through assessing time spent on SSM strategies, how and to what extent patient-centred care and behaviour change discussions are delivered, and to explore whether factors such as mode of review or implementation support influence delivery. Design, Setting and Participants We conducted an observational study using video-recordings of 12 HCPs delivering routine face-to-face and telephone asthma reviews (n = 64) in a sample of general practices participating in the IMP2ART trial (implementation n = 4; control n = 6). Analytical methods included: ALFA Toolkit Multi-Channel Video Observation (to code and quantify tasks undertaken); the Patient-Centred Observation Form; and The Behaviour Change Counselling Index (to assess patient-centeredness and behaviour change counselling used by HCPs). Results HCPs mostly spent time during routine asthma reviews discussing: an individual's asthma condition and management (average of 27.8% of consultation time); collaboratively reviewing and completing a personalised asthma action plan (6.3%) and training for practical self-management activities (5.4%). Areas of patient-centred care delivery and behavioural discussions included: creating and maintaining relationships, discussing asthma action plans and medication reconciliation. Professionals in IMP2ART implementation group practices delivered more SSM strategies. Comparison of face-to-face and remote consultations found no significant differences in HCP delivery of SSM. Conclusions HCPs in UK primary care spent half the time in both face-to-face and remote asthma reviews delivering components of SSM suggesting that either mode of delivery may be acceptable. Reviews carried out in IMP2ART implementation group practices demonstrated more behaviour change and collaborative SSM strategies compared to those in the control group. Patient and Public Contribution Asthma UK Centre for Applied Research (AUKCAR) PPI members were involved throughout, including project conception, providing feedback on participant-facing documents, and discussing implications of study findings

Effectiveness and perceptions of using templates in long-term condition reviews: a systematic synthesis of quantitative and qualitative studies

Background Review templates are commonly used in long-term condition (LTC) consultations to standardise care for patients and promote consistent data recording. However, templates may affect interactions during the review and, potentially, inhibit patient-centred care. Aim To systematically review the literature about the impact that LTC review templates have on process and health outcomes, and the views of health professionals and patients on using review templates in consultations. Design and setting Parallel qualitative and quantitative systematic reviews. Method Following Cochrane methodology, nine databases were searched (1995–2019; updated July 2020) for clinical trials and qualitative studies of LTC templates in healthcare settings. Duplicate selection, risk-of-bias assessment, and data extraction were performed. The quantitative and qualitative analyses were conducted in parallel, and findings synthesised narratively. Results In total, 12 qualitative and 14 quantitative studies were included (two studies reported both qualitative and quantitative data, and were included in both analyses). Review templates were well used, but the only study to assess health outcomes showed no effect. Templates can improve documentation of key measures and act as a reminder tool; however, they can restrict the review process, and risk health professionals’ agendas being prioritised over those of patients. Templates may also limit opportunities to discuss individuals’ concerns about living with their condition and act as a barrier to providing patient-centred care. Conclusion Future research should evaluate health, as well as process, outcomes. The potential benefits of templates in improving documentation should be balanced against concerns that ‘tick boxes’ may override patient agendas, unless templates are designed to promote patient-centred care

Delivery of supported self-management in remote asthma reviews: A systematic rapid realist review

Background: The COVID-19 pandemic forced health care systems globally to adapt quickly to remote modes of health care delivery, including for routine asthma reviews. A core component of asthma care is supporting self-management, a guideline-recommended intervention that reduces the risk of acute attacks, and improves asthma control and quality of life. Objective: We aimed to explore context and mechanisms for the outcomes of clinical effectiveness, acceptability and safety of supported self-management delivery within remote asthma consultations. Design: The review followed standard methodology for rapid realist reviews. An External Reference Group (ERG) provided expert advice and guidance throughout the study. We systematically searched four electronic databases and, with ERG advice, selected 18 papers that explored self-management delivery during routine asthma reviews. Setting, Participants and Intervention: Health care professional delivery of supported self-management for asthma patients during remote (specifically including telephone and video) consultations. Main Outcome Measures: Data were extracted using Context-Mechanism-Outcome (C-M-O) configurations and synthesised into overarching themes using the PRISMS taxonomy of supported self-management as a framework to structure the findings. Results: The review findings identified how support for self-management delivered remotely was acceptable (often more acceptable than in-person consultations), and was a safe and effective alternative to face-to-face reviews. In addition, remote delivery of supported self-management was associated with; increased patient convenience, improved access to and attendance at remote reviews, and offered continuity of care. Discussion: Remote delivery of supported self-management for asthma was generally found to be clinically effective, acceptable, and safe with the added advantage of increasing accessibility. Remote reviews could provide the core content of an asthma review, including remote completion of asthma action plans. Conclusion: Our findings support the option of remote delivery of routine asthma care for those who have this preference, and offer healthcare professionals guidance on embedding supported self-management into remote asthma reviews. Patient and Public Contribution: Patient and public contribution was provided by a representative of the Asthma UK Centre for Applied Research (AUKCAR) patient and public involvement (PPI) group. The PPI representative reviewed the findings, and feedback and comments were considered. This lead to further interpretations of the data which were included in the final manuscript

Understanding interventions delivered in the emergency department targeting improved asthma outcomes beyond the emergency department: an integrative review

Objectives The emergency department (ED) represents a place and moment of opportunity to provide interventions to improve long- term asthma outcomes, but feasibility, effectiveness and mechanisms of impact are poorly understood. We aimed to review the existing literature on interventions that are delivered in the ED for adults and adolescents, targeting asthma outcomes beyond the ED, and to code the interventions according to theory used, and to understand the barriers and facilitators to their implementation. Methods We systematically searched seven electronic databases and research registers, and manually searched reference lists of included studies and relevant reviews. Both quantitative and qualitative studies that reported on interventions delivered in the ED which aimed to improve asthma outcomes beyond management of the acute exacerbation, for adolescents or adults were included. Methodological quality was assessed using the Mixed Methods Appraisal Tool and informed study interpretation. Theory was coded using the Theoretical Domains Framework. Findings were summarised by narrative synthesis. Results 12 articles were included, representing 10 unique interventions, including educational and medication- based changes (6 randomised controlled trials and 4 non- randomised studies). Six trials reported statistically significant improvements in one or more outcome measures relating to long- term asthma control, including unscheduled healthcare, asthma control, asthma knowledge or quality of life. We identified limited use of theory in the intervention designs with only one intervention explicitly underpinned by theory. There was little reporting on facilitators or barriers, although brief interventions appeared more feasible. Conclusion The results of this review suggest that ED- based asthma interventions may be capable of improving long- term outcomes. However, there was significant variation in the range of interventions, reported outcomes and duration of follow- up. Future interventions would benefit from using behaviour change theory, such as constructs from the Theoretical Domains Framework

Quasi-monocrystalline silicon for low-noise end mirrors in cryogenic gravitational-wave detectors

Mirrors made of silicon have been proposed for use in future cryogenic gravitational-wave detectors, which will be significantly more sensitive than current room-temperature detectors. These mirrors are planned to have diameters of ≈50 cm and a mass of ≈200 kg. While single-crystalline float-zone silicon meets the requirements of low optical absorption and low mechanical loss, the production of this type of material is restricted to sizes much smaller than required. Here we present studies of silicon produced by directional solidification. This material can be grown as quasi-monocrystalline ingots in sizes larger than currently required. We present measurements of a low room-temperature and cryogenic mechanical loss comparable with float-zone silicon. While the optical absorption of our test sample is significantly higher than required, the low mechanical loss motivates research into further absorption reduction in the future. While it is unclear if material pure enough for the transmissive detector input mirrors can be achieved, an absorption level suitable for the highly reflective coated end mirrors seems realistic. Together with the potential to produce samples much larger than ≈50 cm, this material may be of great benefit for realizing silicon-based gravitational-wave detectors

First narrow-band search for continuous gravitational waves from known pulsars in advanced detector data

Spinning neutron stars asymmetric with respect to their rotation axis are potential sources of continuous gravitational waves for ground-based interferometric detectors. In the case of known pulsars a fully coherent search, based on matched filtering, which uses the position and rotational parameters obtained from electromagnetic observations, can be carried out. Matched filtering maximizes the signalto- noise (SNR) ratio, but a large sensitivity loss is expected in case of even a very small mismatch between the assumed and the true signal parameters. For this reason, narrow-band analysis methods have been developed, allowing a fully coherent search for gravitational waves from known pulsars over a fraction of a hertz and several spin-down values. In this paper we describe a narrow-band search of 11 pulsars using data from Advanced LIGO’s first observing run. Although we have found several initial outliers, further studies show no significant evidence for the presence of a gravitational wave signal. Finally, we have placed upper limits on the signal strain amplitude lower than the spin-down limit for 5 of the 11 targets over the bands searched; in the case of J1813-1749 the spin-down limit has been beaten for the first time. For an additional 3 targets, the median upper limit across the search bands is below the spin-down limit. This is the most sensitive narrow-band search for continuous gravitational waves carried out so far