Understanding patient views and experiences of the IDENTIfication of PALLiative care needs (IDENTI-Pall) : a qualitative interview study protocol

Introduction: More people are living with multimorbidity, defined as two or more long-term physical or mental health conditions. Multimorbidity is associated with poor quality of life and high treatment burden. Palliative care identification tools have been developed for use in primary care to seek out patients who could benefit from a palliative approach to their care. There has been little evaluative research on such tools; patient perspectives on the process of identifying their palliative care needs is a significant gap. The aim of this research is to provide new understanding into patient perspectives of the experience of having their palliative care needs identified, and the impact on their healthcare. Methods and analysis: This qualitative study will employ semistructured interviews to elicit the views of participants. We will purposively sample 10–12 adults with advanced serious illness who have been identified by their primary care team as having palliative care needs, and/or are receiving care from specialist palliative care services. A family member or carer may be included in an interview at the participant’s request. A descriptive, thematic analysis will be carried out using the data analysis software NVivo. Ethics and dissemination: Ethical approval has been granted by the North of Scotland Research Ethics Committee. Study findings will be disseminated in peer-reviewed journals and through conference presentations. Other activities include the development of patient-centred outcomes for clinical practice and policy in relation to the use of palliative care identification tools. Trial registration number: National Institute for Health Research (NIHR) Clinical Studies Portfolio, UK Clinical Research Network (UKCRN) Study number 51296

Suppressing CMB Quadrupole with a Bounce from Contracting Phase to Inflation

Recent released WMAP data show a low value of quadrupole in the CMB temperature fluctuations, which confirms the early observations by COBE. In this paper, a scenario, in which a contracting phase is followed by an inflationary phase, is constructed. We calculate the perturbation spectrum and show that this scenario can provide a reasonable explanation for lower CMB anisotropies on large angular scales.Comment: 5 pages, 3 figure

Inflation, cold dark matter, and the central density problem

A problem with high central densities in dark halos has arisen in the context of LCDM cosmologies with scale-invariant initial power spectra. Although n=1 is often justified by appealing to the inflation scenario, inflationary models with mild deviations from scale-invariance are not uncommon and models with significant running of the spectral index are plausible. Even mild deviations from scale-invariance can be important because halo collapse times and densities depend on the relative amount of small-scale power. We choose several popular models of inflation and work out the ramifications for galaxy central densities. For each model, we calculate its COBE-normalized power spectrum and deduce the implied halo densities using a semi-analytic method calibrated against N-body simulations. We compare our predictions to a sample of dark matter-dominated galaxies using a non-parametric measure of the density. While standard n=1, LCDM halos are overdense by a factor of 6, several of our example inflation+CDM models predict halo densities well within the range preferred by observations. We also show how the presence of massive (0.5 eV) neutrinos may help to alleviate the central density problem even with n=1. We conclude that galaxy central densities may not be as problematic for the CDM paradigm as is sometimes assumed: rather than telling us something about the nature of the dark matter, galaxy rotation curves may be telling us something about inflation and/or neutrinos. An important test of this idea will be an eventual consensus on the value of sigma_8, the rms overdensity on the scale 8 h^-1 Mpc. Our successful models have values of sigma_8 approximately 0.75, which is within the range of recent determinations. Finally, models with n>1 (or sigma_8 > 1) are highly disfavored.Comment: 13 pages, 6 figures. Minor changes made to reflect referee's Comments, error in Eq. (18) corrected, references updated and corrected, conclusions unchanged. Version accepted for publication in Phys. Rev. D, scheduled for 15 August 200

Weak Lensing and CMB: Parameter forecasts including a running spectral index

We use statistical inference theory to explore the constraints from future galaxy weak lensing (cosmic shear) surveys combined with the current CMB constraints on cosmological parameters, focusing particularly on the running of the spectral index of the primordial scalar power spectrum, $\alpha_s$. Recent papers have drawn attention to the possibility of measuring $\alpha_s$ by combining the CMB with galaxy clustering and/or the Lyman-$\alpha$ forest. Weak lensing combined with the CMB provides an alternative probe of the primordial power spectrum. We run a series of simulations with variable runnings and compare them to semi-analytic non-linear mappings to test their validity for our calculations. We find that a ``Reference'' cosmic shear survey with $f_{sky}=0.01$ and $6.6\times 10^8$ galaxies per steradian can reduce the uncertainty on $n_s$ and $\alpha_s$ by roughly a factor of 2 relative to the CMB alone. We investigate the effect of shear calibration biases on lensing by including the calibration factor as a parameter, and show that for our Reference Survey, the precision of cosmological parameter determination is only slightly degraded even if the amplitude calibration is uncertain by as much as 5%. We conclude that in the near future weak lensing surveys can supplement the CMB observations to constrain the primordial power spectrum.Comment: 12 pages, 10 figures, revtex4. Final form to appear in Phys Rev

Primordial power spectrum from WMAP

The observed angular power spectrum of the cosmic microwave background temperature anisotropy, $C_l$, is a convolution of a cosmological radiative transport kernel with an assumed primordial power spectrum of inhomogeneities. Exquisite measurements of $C_l$ over a wide range of multipoles from the Wilkinson Microwave Anisotropy Probe (WMAP) has opened up the possibility to deconvolve the primordial power spectrum for a given set of cosmological parameters (base model). We implement an improved (error sensitive) Richardson-Lucy deconvolution algorithm on the measured angular power spectrum from WMAP assuming a concordance cosmological model. The most prominent feature of the recovered $P(k)$ is a sharp, infra-red cut off on the horizon scale. The resultant $C_l$ spectrum using the recovered spectrum has a likelihood far better than a scale invariant, or, `best fit' scale free spectra ($\Delta\ln{\cal L}=25$ {\it w.r.t.} Harrison Zeldovich, and, $\Delta\ln{\cal L}=11$ {\it w.r.t.} power law with $n_s=0.95$). The recovered $P(k)$ has a localized excess just below the cut-off which leads to great improvement of likelihood over the simple monotonic forms of model infra-red cut-off spectra considered in the post WMAP literature. The recovered $P(k)$, in particular, the form of infra-red cut-off is robust to small changes in the cosmological parameters. We show that remarkably similar form of infra-red cutoff is known to arise in very reasonable extensions and refinements of the predictions from simple inflationary scenarios. Our method can be extended to other cosmological observations such as the measured matter power spectrum and, in particular, the much awaited polarization spectrum from WMAP.Comment: 20 pages, 12 figures, uses Revtex4, Matches version accepted to Phys. Rev. D. More extensive discussion of the method in the appendix, references added and typos correcte

Effects of temperature at constant air dew point on leaf carboxylation efficiency and CO 2 compensation point of different leaf types

The effect of temperature on photosynthesis at constant water-vapor pressure in the air was investigated using two sclerophyll species, Arbutus unedo and Quercus suber , and one mesophytic species, Spinacia oleracea . Photosynthesis and transpiration were measured over a range of temperatures, 20–39° C. The external concentration of CO 2 was varied from 340 μbar to near CO 2 compensation. The initial slope (carboxylation efficiency, CE) of the photosynthetic response to intercellular CO 2 concentration, the CO 2 compensation point (Γ), and the extrapolated rate of CO 2 released into CO 2 -free air ( R i ) were calculated. At an external CO 2 concentration of 320–340 μbar CO 2 , photosynthesis decreased with temperature in all species. The effect of temperature on Γ was similar in all species. While CE in S. oleracea changed little with temperature, CE decreased by 50% in Q. suber as temperature increased from 25 to 34° C. Arbutus unedo also exhibited a decrease in CE at higher temperatures but not as marked as Q. suber . The absolut value of R i increased with temperature in S. oleracea , while changing little or decreasing in the sclerophylls. Variations in Γ and R i of the sclerophyll species are not consistent with greater increase of respiration with temperature in the light in these species compared with S. oleracea .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47470/1/425_2004_Article_BF00397389.pd

Planck early results V : The Low Frequency Instrument data processing

Peer reviewe

Performance of novel VUV-sensitive Silicon Photo-Multipliers for nEXO

Liquid xenon time projection chambers are promising detectors to search for neutrinoless double beta decay (0$\nu \beta \beta$), due to their response uniformity, monolithic sensitive volume, scalability to large target masses, and suitability for extremely low background operations. The nEXO collaboration has designed a tonne-scale time projection chamber that aims to search for 0$\nu \beta \beta$ of \ce{^{136}Xe} with projected half-life sensitivity of $1.35\times 10^{28}$~yr. To reach this sensitivity, the design goal for nEXO is $\leq$1\% energy resolution at the decay $Q$-value ($2458.07\pm 0.31$~keV). Reaching this resolution requires the efficient collection of both the ionization and scintillation produced in the detector. The nEXO design employs Silicon Photo-Multipliers (SiPMs) to detect the vacuum ultra-violet, 175 nm scintillation light of liquid xenon. This paper reports on the characterization of the newest vacuum ultra-violet sensitive Fondazione Bruno Kessler VUVHD3 SiPMs specifically designed for nEXO, as well as new measurements on new test samples of previously characterised Hamamatsu VUV4 Multi Pixel Photon Counters (MPPCs). Various SiPM and MPPC parameters, such as dark noise, gain, direct crosstalk, correlated avalanches and photon detection efficiency were measured as a function of the applied over voltage and wavelength at liquid xenon temperature (163~K). The results from this study are used to provide updated estimates of the achievable energy resolution at the decay $Q$-value for the nEXO design

Planck early results III : First assessment of the Low Frequency Instrument in-flight performance

Peer reviewe