Barriers to the development of palliative care in Western Europe

The Eurobarometer Survey of the <i>EAPC Task Force on the Development of Palliative Care in Europe</i> is part of a programme of work to produce comprehensive information on the provision of palliative care across Europe. Aim: To identify barriers to the development of palliative care in Western Europe. Method: A qualitative survey was undertaken amongst boards of national associations, eliciting opinions on opportunities for, and barriers to, palliative care development. By July 2006, 44/52 (85%) European countries had responded to the survey; we report here on the results from 22/25 (88%) countries in Western Europe. Analysis: Data from the Eurobarometer survey were analysed thematically by geographical region and by the degree of development of palliative care in each country. Results: From the data contained within the Eurobarometer, we identified six significant barriers to the development of palliative care in Western Europe: (i) Lack of palliative care education and training programmes (ii) Lack of awareness and recognition of palliative care (iii) Limited availability of/knowledge about opioid analgesics (iv) Limited funding (v) Lack of coordination amongst services (vi) Uneven palliative care coverage. Conclusion: Findings from the EAPC Eurobarometer survey suggest that barriers to the development of palliative care in Western Europe may differ substantially from each other in both their scope and context and that some may be considered to be of greater significance than others. A number of common barriers to the development of the discipline do exist and much work still remains to be done in the identified areas. This paper provides a road map of which barriers need to be addressed

Analysis of surface waves generated on subwavelength-structured silver films

Using transmission electron microscopy (TEM) to analyse the physical-chemical surface properties of subwavlength structured silver films and finite-difference time-domain (FDTD) numerical simulations of the optical response of these structures to plane-wave excitation, we report on the origin and nature of the persistent surface waves generated by a single slit-groove motif and recently measured by far-field optical interferometry. The surface analysis shows that the silver films are free of detectable oxide or sulfide contaminants, and the numerical simulations show very good agreement with the results previously reported.Comment: 9 Figure

Deflection and Rotation of CMEs from Active Region 11158

Between the 13 and 16 of February 2011 a series of coronal mass ejections (CMEs) erupted from multiple polarity inversion lines within active region 11158. For seven of these CMEs we use the Graduated Cylindrical Shell (GCS) flux rope model to determine the CME trajectory using both Solar Terrestrial Relations Observatory (STEREO) extreme ultraviolet (EUV) and coronagraph images. We then use the Forecasting a CME's Altered Trajectory (ForeCAT) model for nonradial CME dynamics driven by magnetic forces, to simulate the deflection and rotation of the seven CMEs. We find good agreement between the ForeCAT results and the reconstructed CME positions and orientations. The CME deflections range in magnitude between 10 degrees and 30 degrees. All CMEs deflect to the north but we find variations in the direction of the longitudinal deflection. The rotations range between 5\mydeg and 50\mydeg with both clockwise and counterclockwise rotations occurring. Three of the CMEs begin with initial positions within 2 degrees of one another. These three CMEs all deflect primarily northward, with some minor eastward deflection, and rotate counterclockwise. Their final positions and orientations, however, respectively differ by 20 degrees and 30 degrees. This variation in deflection and rotation results from differences in the CME expansion and radial propagation close to the Sun, as well as the CME mass. Ultimately, only one of these seven CMEs yielded discernible in situ signatures near Earth, despite the active region facing near Earth throughout the eruptions. We suggest that the differences in the deflection and rotation of the CMEs can explain whether each CME impacted or missed the Earth.Comment: 18 pages, 6 figures, accepted in Solar Physic

Brewing of filter coffee

We report progress on mathematical modelling of coffee grounds in a drip filter coffee machine. The report focuses on the evolution of the shape of the bed of coffee grounds during extraction with some work also carried out on the chemistry of extraction. This work was sponsored by Philips who are interested in understanding an observed correlation between the final shape of the coffee grounds and the quality of the coffee. We used experimental data gathered by Philips and ourselves to identify regimes in the coffee brewing process and relevant regions of parameter space. Our work makes it clear that a number of separate processes define the shape of the coffee bed depending on the values of the parameters involved e.g. the size of the grains and the speed of fluid flow during extraction. We began work on constructing mathematical models of the redistribution of the coffee grounds specialised to each region and on a model of extraction. A variety of analytic and numerical tools were used. Furthermore our research has progressed far enough to allow us to begin to exploit connections between this problem and other areas of science, in particular the areas of sedimentology and geomorphology, where the processes we have observed in coffee brewing have been studied

Autologous hematopoietic stem cell transplantation for mantle cell lymphoma

AbstractThis study evaluated the outcomes of patients who underwent high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation (autoHSCT) for mantle cell non-Hodgkin's lymphoma and the effect of clinical and treatment characteristics. The clinical outcome and prognostic factors in 40 patients who underwent HDC and autoHSCT for mantle cell lymphoma between June 1991 and August 1998 were analyzed. With a median follow-up of 24 months for the surviving patients (range, 4-68 months), the 2-year overall survival was 65% and the 2-year event-free survival (EFS) was 36%. In univariate analysis, characteristics predictive of a poor EFS were blastic morphology (P = .019) and the patient having received 3 or more prior chemotherapy regimens (P = .004). In a multivariate analysis, the only factor associated with a poor EFS was the number of prior chemotherapy regimens. Those patients who received 3 or more prior therapies had a 2-year EFS of 0%, and those who received <3 therapies had a 2-year EFS of 45% (P = .004). Patients with mantle cell lymphoma can obtain prolonged EFS with HDC and autoHSCT; however, this strategy for prolonged EFS appears to work optimally in patients who are less heavily pretreated. Whether this therapy will increase the overall survival or EFS in patients receiving transplants in first complete remission will need to be tested in prospective randomized clinical trials.Biol Blood Marrow Transplant 2000;6(6):640-5

Life Beyond the Solar System: Space Weather and Its Impact on Habitable Worlds

The search of life in the Universe is a fundamental problem of astrobiology and a major priority for NASA. A key area of major progress since the NASA Astrobiology Strategy 2015 (NAS15) has been a shift from the exoplanet discovery phase to a phase of characterization and modeling of the physics and chemistry of exoplanetary atmospheres, and the development of observational strategies for the search for life in the Universe by combining expertise from four NASA science disciplines including heliophysics, astrophysics, planetary science and Earth science. The NASA Nexus for Exoplanetary System Science (NExSS) has provided an efficient environment for such interdisciplinary studies. Solar flares, coronal mass ejections and solar energetic particles produce disturbances in interplanetary space collectively referred to as space weather, which interacts with the Earth upper atmosphere and causes dramatic impact on space and ground-based technological systems. Exoplanets within close in habitable zones around M dwarfs and other active stars are exposed to extreme ionizing radiation fluxes, thus making exoplanetary space weather (ESW) effects a crucial factor of habitability. In this paper, we describe the recent developments and provide recommendations in this interdisciplinary effort with the focus on the impacts of ESW on habitability, and the prospects for future progress in searching for signs of life in the Universe as the outcome of the NExSS workshop held in Nov 29 - Dec 2, 2016, New Orleans, LA. This is one of five Life Beyond the Solar System white papers submitted by NExSS to the National Academy of Sciences in support of the Astrobiology Science Strategy for the Search for Life in the Universe.Comment: 5 pages, the white paper was submitted to the National Academy of Sciences in support of the Astrobiology Science Strategy for the Search for Life in the Univers

The Importance of Forage Legume Inclusion in Agricultural Swards to Enhance Earthworm Activity and Water Infiltration Rates

Increased grassland productivity in temperate regions has largely been achieved through perennial ryegrass Lolium perenne (PRG), coupled with large quantities of nitrogen fertiliser. However, concern is growing regarding the negative implications of excessive dependence on nitrogen fertilisers. Research has demonstrated the benefits of legume inclusion on primary productivity, however, their potential to influence other processes is less well established. Sampling was undertaken in autumn 2017 on twenty randomised plots representing five sward types, replicated four times. These had been established and managed by cutting since 2013. Sward types included: 1) PRG (250kg N ha-1 yr-1 ); 2) PRG; 3) PRG and white clover Trifolium repens; 4) 6 species mix comprised of PRG, timothy Phleum pratense, cocksfoot Dactylis glomerata, white clover, red clover Trifolium pratensis and greater birdsfoot trefoil Lotus pedunculatus; 5) species included in mix 4 with the addition of ribwort plantain Plantago lanceolate, chicory Cichorium intybus and yarrow Achillea millefolium. Mixes 2-5 inclusive received 90kg N ha-1 yr-1 . Measurements included: soil bulk density, water infiltration rates, and estimated earthworm activity via surface cast counts. Soil bulk density did not differ in response to sward type. However, highest infiltration rates were recorded within the PRG and white clover swards, with an average of 29.7 (±3.5) mm hr-1 , while lowest rates were recorded from the two PRG monocultures (2.43 (±0.5) and 4.2 (±1.2) mm hr⁻¹ for the 90 and 250 kg N ha-1 yr-1 swards respectively). Surface cast numbers differed significantly between sward types (P\u3c 0.001). Numbers ranged from 127 (±7) casts m⁻² for PRG & white clover, to 48 (±5) casts m⁻² for the PRG monocultures. Our findings indicate the importance of legume inclusion within agricultural grasslands managed under reduced nitrogen fertiliser inputs for wider ecosystem service provision

Using schedulers to test probabilistic distributed systems

This is the author's accepted manuscript. The final publication is available at Springer via http://dx.doi.org/10.1007/s00165-012-0244-5. Copyright © 2012, British Computer Society.Formal methods are one of the most important approaches to increasing the confidence in the correctness of software systems. A formal specification can be used as an oracle in testing since one can determine whether an observed behaviour is allowed by the specification. This is an important feature of formal testing: behaviours of the system observed in testing are compared with the specification and ideally this comparison is automated. In this paper we study a formal testing framework to deal with systems that interact with their environment at physically distributed interfaces, called ports, and where choices between different possibilities are probabilistically quantified. Building on previous work, we introduce two families of schedulers to resolve nondeterministic choices among different actions of the system. The first type of schedulers, which we call global schedulers, resolves nondeterministic choices by representing the environment as a single global scheduler. The second type, which we call localised schedulers, models the environment as a set of schedulers with there being one scheduler for each port. We formally define the application of schedulers to systems and provide and study different implementation relations in this setting

Interpolating Coherent States for Heisenberg-Weyl and Single-Photon SU(1,1) Algebras

New quantal states which interpolate between the coherent states of the Heisenberg_Weyl and SU(1,1) algebras are introduced. The interpolating states are obtained as the coherent states of a closed and symmetric algebra which interpolates between the two algebras. The overcompleteness of the interpolating coherent states is established. Differential operator representations in suitable spaces of entire functions are given for the generators of the algebra. A nonsymmetric set of operators to realize the Heisenberg-Weyl algebra is provided and the relevant coherent states are studied.Comment: 13 pages nd 5 ps figure

A Cluster of Legionnaires' Disease and Associated Pontiac Fever Morbidity in Office Workers, Dublin, June-July 2008

In June and July 2008, two office workers were admitted to a Dublin hospital with Legionnaires' disease. Investigations showed that cooling towers in the basement car park were the most likely source of infection. However, positive results from cooling tower samples by polymerase chain reaction (PCR) did not correlate with subsequent culture results. Also, many employees reported Pontiac fever-like morbidity following notification of the second case of Legionnaires' disease. In total, 54 employees attended their general practitioner or emergency department with symptoms of Legionnaires' disease or Pontiac fever. However, all laboratory tests for Legionnaires' disease or Pontiac fever were negative. In this investigation, email was used extensively for active case finding and provision of time information to employees and medical colleagues. We recommend clarification of the role of PCR in the diagnosis of legionellosis and also advocate for a specific laboratory test for the diagnosis of the milder form of legionellosis as in Pontiac fever