Organophilic clays in stabilisation and solidification of hazardous wastes

Imperial Users onl

The assessment of airflow obstruction from tidal breathing expiratory flow recordings in patients with chronic obstructive pulmonary disease

The research presented in this thesis focuses on the identification and utilisation of novel indices measured from tidal breathing expiratory flow patterns to assess airflow obstruction in adults. The work is in two parts, firstly the development of the data collection protocol and the identification of suitable indices and secondly the evaluation ofthe reproducibility of these indices and their comparison with conventional indices and reported symptoms.The current routine method used to assess airflow obstruction is the measurement of FEV], however this test requires patient understanding of the test procedure and maximal effort to produce satisfactory results. Furthermore, forced expiration is not a breathing manoeuvre that people perform in every day life. The usefulness of FEVi in assessing reversibility to bronchodilation was studied in a retrospective study which showed that 41% of patients who were identified as non-reversible by FEVi criteria showed reversibility of forced or relaxed vital capacity, indicating that FEVi does not detect all the physiological effects of bronchodilators. Iftidal breathing is measured, a number of the disadvantages of FEVi are overcome. It is effort-independent, requires no learning of special breathing manoeuvres on the patient's part and so can be performed even in acutely breathless patients.A method ofrecording tidal breathing patterns was developed in which the type of equipment and the measurement protocol was comfortable for the subject, applicable to the routine clinical setting and impacted minimally on the tidal breathing pattern. A five-minute collection time was chosen, recorded after a two-minute acclimatisation period. A method of producing an averaged breath was developed from which a number of novel tidal indices could be measured. After analysis of these indices in pilot studies, three indices, (TBEV i (volume of air exhaled in the first second of a tidal breath), TPEF (peak tidal expiratory flow rate) and EF25 (expiratory flow at end tidal volume plus 25% end tidal volume) were identified which changed consistently following bronchodilators and these were subsequently studied in more depth. Each of these indices correlated with specific conductance (sGaw) at baseline and showed significant increases after bronchodilator but not after placebo treatment in patients known to have reversible airflow obstruction.placebo treatment in patients known to have reversible airflow obstruction. For the tidal breathing method to be clinical acceptable it had to be shown to be reproducible and ideally to correlate with patient perceived breathlessness. The final section ofthe thesis reports studies of reversibility of these measures. Reproducibility was similar to conventional indices of airway obstruction.In summary this thesis describes development of a method for the measurement and analysis of tidal breathing expiratory flow patterns, which yields consistent and physiologically plausible changes in defined tidal indices following bronchodilator treatment

Further Notes on Ice Islands in the Canadian Arctic

Contains account of ice islands discovered since those discussed by L.S. Koenig, q.v. 31 new islands are indicated on a map as well as changes in location of the islands previously reported, all the data assembled from air photographs. The distribution, position, drift, etc. of the islands are discussed. Some unexplained features ("lakes") of the inland-ice on Ellesmere are noted (from recent photographs) in relation to features of northern Ellesmere shelf ice

Online Public Denunciation: A Preliminary Inquiry on the Experience of those who Call-Out on Social Media

Online public denunciations, colloquially referred to as call-outs, have become a prevalent way to expose perceived moral and social wrongdoing in our society. Posting a denunciation online welcomes debate on the in situ incident, the participants, preferred outcomes, and the morality of exposure - creating additional issues and embroiling the poster. Research on this phenomenon has focused on public figures, celebrities, or otherwise viral incidents, and despite the prevalence of social media call-outs, little is known about the experiences of those who initiate them. This preliminary study uses a phenomenological lens to understand the desires, experience, and outcomes for those who post initial denunciations of community members online. Believing that call-outs happen because of some kind of in situ conflict, where disparate values, norms, ideas, experiences or perceptions about a situation shape the trajectory of the outcome, a conflict theory lens is used to examine this phenomenon. The experience of eight Minneapolis and St. Paul residents who posted initial denunciations that called-out community members is explored. Findings indicate the proximity to the in situ incident impacts the experience of the person who posted the call-out. Other salient findings include the participants’ needs not being met, surprise with the way the call-out played out, and that social media was not a platform that supported reconciliation or healing. The implication of this study is greater depth of understanding of online public denunciation as a tool for conflict intervention from the perspective of those who initiate call-outs

Ice, Open Water, and Winter Climate in the Eastern Arctic of North America: Part I

Part 1. Hare, F.K. Distribution of winter temperature over the eastern Arctic and sub-Arctic. From climatic data for Canadian and Greenland Arctic, 1940-48, the author presents new air temperature maps, and evidence of the freezing over of Hudson Bay after January; discusses the open water bodies as "gulf of warmth" in Davies Strait-Baffin Bay, Hudson Strait and Hudson Bay

Ice, Open Water, and Winter Climate in the Eastern Arctic of North America: Part II

Montgomery, M.R. The pattern of winter ice. The author summarizes present knowledge of winter conditions in each of the "gulfs of warmth", based on records of observers on land and sea in earlier years, and on flight observations 1927-28 (Hudson Strait), also winters of 1948-49 (Hudson Bay). Indicates that in late winter and early spring Hudson Bay was completely icecovered (1947-48,1948-49) and that further observations are planned for 1949-50

Assessing the National Cancer Institute\u27s SmokefreeMOM Text-Messaging Program for Pregnant Smokers: Pilot Randomized Trial.

BACKGROUND: Automated text messages on mobile phones have been found to be effective for smoking cessation in adult smokers. OBJECTIVE: This study aims to test the acceptability and feasibility of SmokefreeMOM, a national smoking cessation text-messaging program for pregnant smokers. METHODS: Participants were recruited from prenatal care and randomized to receive SmokefreeMOM (n=55), an automated smoking cessation text-messaging program, or a control text message quitline referral (n=44). Participants were surveyed by phone at baseline and at 1 month and 3 months after enrollment. RESULTS: Results indicate that the SmokefreeMOM program was highly rated overall and rated more favorably than the control condition in its helpfulness at 3-month follow-up (P CONCLUSIONS: SmokefreeMOM is acceptable for pregnant smokers. It is recommended that SmokefreeMOM be further refined and evaluated. TRIAL REGISTRATION: Clinicaltrials.gov NCT02412956; https://clinicaltrials.gov/ct2/show/NCT02412956 (Archived by WebCite at http://www.webcitation.org/6tcmeRnbC)

Reporting of factorial trials of complex interventions in community settings: a systematic review

<p>Abstract</p> <p>Background</p> <p>Standards for the reporting of factorial randomised trials remain to be established. We aimed to review the quality of reporting of methodological aspects of published factorial trials of complex interventions in community settings.</p> <p>Methods</p> <p>We searched MEDLINE, EMBASE, PsychInfo and the Cochrane Controlled Trials Register to identify factorial randomised trials of complex interventions in community settings from January 2000 to August 2009. We also conducted a citation search of two review papers published in 2003. Data were extracted by two reviewers on 22 items relating to study design, analysis and presentation.</p> <p>Results</p> <p>We identified 5941 unique titles, from which 116 full papers were obtained and 76 were included in the review. The included trials reflected a broad range of target conditions and types of intervention. The median sample size was 400 (interquartile range 191-1001). Most (88%) trials employed a 2 × 2 factorial design. Few trials (21%) explicitly stated the rationale for using a factorial design. Reporting of aspects of design, analysis or presentation specific to factorial trials was variable, but there was no evidence that reporting of these aspects was different for trials published before or after 2003. However, for CONSORT items that apply generally to the reporting of all trials, there was some evidence that later studies were more likely to report employing an intention-to-treat (ITT) approach (78% vs 52%), present appropriate between-group estimates of effect (88% vs 63%), and present standard errors or 95% confidence intervals for such estimates (78% vs 56%). Interactions between interventions and some measure of the precision associated with such effects were reported in only 14 (18%) trials.</p> <p>Conclusions</p> <p>Reports of factorial trials of complex interventions in community settings vary in the amount of information they provide regarding important methodological aspects of design and analysis. This variability supports the extension of CONSORT guidelines to include the specific reporting of factorial trials.</p

Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): economic evaluation of a randomised controlled trial

Objective To estimate the cost to the NHS and to parents and carers of treating febrile preschool children with paracetamol, ibuprofen, or both, and to compare these costs with the benefits of each treatment regimen