Development of an efficient procedure for calculating the aerodynamic effects of planform variation

Numerical procedures to compute gradients in aerodynamic loading due to planform shape changes using panel method codes were studied. Two procedures were investigated: one computed the aerodynamic perturbation directly; the other computed the aerodynamic loading on the perturbed planform and on the base planform and then differenced these values to obtain the perturbation in loading. It is indicated that computing the perturbed values directly can not be done satisfactorily without proper aerodynamic representation of the pressure singularity at the leading edge of a thin wing. For the alternative procedure, a technique was developed which saves most of the time-consuming computations from a panel method calculation for the base planform. Using this procedure the perturbed loading can be calculated in about one-tenth the time of that for the base solution

Patient enablement requires physician empathy: a cross-sectional study of general practice consultations in areas of high and low socioeconomic deprivation in Scotland

<b>Background</b> Patient 'enablement' is a term closely aligned with 'empowerment' and its measurement in a general practice consultation has been operationalised in the widely used patient enablement instrument (PEI), a patient-rated measure of consultation outcome. However, there is limited knowledge regarding the factors that influence enablement, particularly the effect of socio-economic deprivation. The aim of the study is to assess the factors influencing patient enablement in GP consultations in areas of high and low deprivation.<p></p> <b>Methods</b> A questionnaire study was carried out on 3,044 patients attending 26 GPs (16 in areas of high socio-economic deprivation and 10 in low deprivation areas, in the west of Scotland). Patient expectation (confidence that the doctor would be able to help) was recorded prior to the consultation. PEI, GP empathy (measured by the CARE Measure), and a range of other measures and variables were recorded after the consultation. Data analysis employed multi-level modelling and multivariate analyses with the PEI as the dependant variable.<p></p> <b>Results</b> Although numerous variables showed a univariate association with patient enablement, only four factors were independently predictive after multilevel multivariate analysis; patients with multimorbidity of 3 or more long-term conditions (reflecting poor chronic general health), and those consulting about a long-standing problem had reduced enablement scores in both affluent and deprived areas. In deprived areas, emotional distress (GHQ-caseness) had an additional negative effect on enablement. Perceived GP empathy had a positive effect on enablement in both affluent and deprived areas. Maximal patient enablement was never found with low empathy.<p></p> <b>Conclusions</b> Although other factors influence patient enablement, the patients' perceptions of the doctors' empathy is of key importance in patient enablement in general practice consultations in both high and low deprivation settings

\u27iDentity\u27 and governance in synthetic biology: norms and counter norms in the \u27international genetically engineered machine\u27 (iGEM) competition

A number of commentaries preoccupied with the legal, social and ethical implications of synthetic biology have emphasised that an important element shaping options for its future governance will be the normative ethos that is adopted by the emerging field. One venue that has regularly been identified as central to the development of this normative ethos is the International Genetically Engineered Machine (iGEM) Competition, an annual synthetic biology competition, which attracts thousands of students from across the world. The ideal values promoted by iGEM of collaboration, interdisciplinarity, sharing of results, and overt commitment to the consideration of social and ethical implications of scientific work, are frequently interpreted as offering a model for the future development of the field. In the discussion that follows it will be noted that many of iGEM’s normative aspirations appear to be difficult to convert into practice and that many of the paths which various forms of synthetic biology appear to be following deviate from the types of values iGEM publicly promotes. Policy makers are invited to make a more realistic assessment of iGEM’s capacity to contribute (via generating a distinct synthetic biology normative ethos) to the future governance of the emerging field

Trend of tubercolosis mortality in Scotland during the last righty years, and the measures on which emphasis should be laid for the control of the disease

During the last eighty years, there has been a marked decline in tuberculosis mortality. From the accompanying graph, it will be seen that the education which has been accomplished in this period, took place Mainly in the earlier years. In 1870, the mortality rate was just over 400/100,000; by 1910, it had fallen to 180/100,000; and by 1950, the figure was 54/100,000. Statistics of tuberculosis mortality were first taken in Scotland in the year 1860. From these figures, it would appear that the greatest mortality occurred in the year 1862, and it is not unreasonable to assume that this year marked the peak of an epidemic wave. Similar waves have been noted in other countries, although the peaks were reached at different times. The drop in mortality must therefore be attributed more to the forces of nature, than to the endeavours of man. For example, the first anti-tuberculosis legislation, which was introduced in 1912, did not Materially affect the epidemic wave, nor have the more recent measures accelerated the decline in mortality. A closer analysis of the relevant figures is necessary however.When one compares the death rates from respiratory, and non-respiratory tuberculosis, one sees that the rapid fall in the latter half of last century, was mainly due to a fall in the mortality from pulmonary tuberculosis. Non-respiratory types have shown a less spectacular, but steadier decrease. The figures for pulmonary tuberculosis in 1870, were 275/100,000, in 1910, 120/100,000, and in 1950, 47/100,000; the non-respiratory numbers in those years were respectively, 130, 60, and 7/100,000. Thus the pulmonary mortality rate has fallen in the eighty years by 228/ 100,000, while the non-pulmonary rate fell by 123/100,000.It may be noted that there is a definite age-sex incidence in the mortality, which is more or less constant each year. Typically the incidence is low throughout childhood in both sexes, but there is a rapid rise in the female mortality rate after the age of ten . It reaches a peak about twenty-five, and thereafter shows almost as rapid a fall. In the figures for males, the rise also starts a# the age of ten, but is less abrupt and continues rising till it reaches a more plateau peak between the ages of twenty and fifty.Similarly there is a significant difference between the figures for large burghs and rural areas. The death rate in large burghs is almost twice that of the other areas, for both forms of tuberculosis.In conclusion, then, the methods on which emphasis should be laid for the control of tuberculosis mortality, include the provision of a.n adequate number of beds for isolation of all known infective cases, the discovery and isolation of all hitherto unrecognised cases, protection of vulnerable groups by vaccination, the betterment of social conditions, better health education and better treatment, with recommendations for the furtherance of research into the whole problem, including especially vaccination and antibiotics. The combination of these methods is expected to accelerate the natural decline or the disease, so that the future, far from being gloomy and despondent, is fulI of hope and promise for its ultimate eradication

Constitutional Law - Racial Discrimination within a Death Penalty System - The Petitioner\u27s Heavy Burden - McCleskey v. Kemp

Note

Geothermal reservoir simulation

The prediction of long-term geothermal reservoir performance and the environmental impact of exploiting this resource are two important problems associated with the utilization of geothermal energy for power production. Our research effort addresses these problems through numerical simulation. Computer codes based on the solution of partial-differential equations using finite-element techniques are being prepared to simulate multiphase energy transport, energy transport in fractured porous reservoirs, well bore phenomena, and subsidence

'Learning together': Sharing international experience on new models of primary care

No abstract available

Acceptability of mindfulness from the perspective of stroke survivors and caregivers: a qualitative study

Background: Depression is very common among stroke survivors with estimated prevalence rates of approximately 33% among stroke survivors, but treatment options are limited. Mindfulness-Based Stress Reduction (MBSR) is an effective treatment for depression generally, but benefits in stroke patients are unclear. The aim of this study was to determine the feasibility of delivering MBSR to stroke survivors and their caregivers in the community. We conducted a study to gain views of MBSR as a potential treatment option among stroke survivors and their caregivers in the community. Methods: Participants were recruited from an urban community in Scotland (UK) using newspaper adverts, social media and support groups run by health charities. A 2-h MBSR taster session was delivered by two experienced mindfulness instructors, followed by focus group sessions with all participants on their user experience and suggestions for MBSR modifications for stroke survivors. The focus group sessions were audio recorded and transcribed verbatim. Transcript data were analysed thematically using the framework approach. Results: The study sample consisted of 28 participants (16 females); there were 21 stroke survivors (11 females) and 7 caregivers (5 females). The median age for participants was 60 years. Most participants described the MBSR taster session as a positive experience. The main challenge reported was trying to maintain focus and concentration throughout the MBSR session. Some participants expressed reservations about the duration of standard mindfulness course sessions, suggesting a preference for shorter sessions. The potential for achieving better control over negative thoughts and emotions was viewed as a potential facilitator for future MBSR participation. Participants suggested having an orientation session prior to starting an 8-week course as a means of developing familiarity with the MBSR instructor and other participants. Conclusion: It was feasible to recruit 21 stroke survivors and 7 caregivers for MBSR taster sessions in the community. A shorter MBSR session and an orientation session prior to the full course are suggestions for potential MBSR modifications for stroke survivors, which needs further research and evaluation

Using normalisation process theory to understand barriers and facilitators to implementing mindfulness-based stress reduction for people with multiple sclerosis

Objectives: To study barriers and facilitators to implementation of mindfulness-based stress reduction for people with multiple sclerosis. Methods: Qualitative interviews were used to explore barriers and facilitators to implementation of mindfulness-based stress reduction, including 33 people with multiple sclerosis, 6 multiple sclerosis clinicians and 2 course instructors. Normalisation process theory provided the underpinning conceptual framework. Data were analysed deductively using normalisation process theory constructs (coherence, cognitive participation, collective action and reflexive monitoring). Results: Key barriers included mismatched stakeholder expectations, lack of knowledge about mindfulness-based stress reduction, high levels of comorbidity and disability and skepticism about embedding mindfulness-based stress reduction in routine multiple sclerosis care. Facilitators to implementation included introducing a pre-course orientation session; adaptations to mindfulness-based stress reduction to accommodate comorbidity and disability and participants suggested smaller, shorter classes, shortened practices, exclusion of mindful-walking and more time with peers. Post-mindfulness-based stress reduction booster sessions may be required, and objective and subjective reports of benefit would increase clinician confidence in mindfulness-based stress reduction. Discussion: Multiple sclerosis patients and clinicians know little about mindfulness-based stress reduction. Mismatched expectations are a barrier to participation, as is rigid application of mindfulness-based stress reduction in the context of disability. Course adaptations in response to patient needs would facilitate uptake and utilisation. Rendering access to mindfulness-based stress reduction rapid and flexible could facilitate implementation. Embedded outcome assessment is desirable

Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

Objective: Impairment of mental well-being (anxiety, depression, stress) is common among people with multiple sclerosis (PwMS). Treatment options are limited, particularly for anxiety. The aim of this study was to update our previous systematic review (2014) and evaluate via meta-analysis the efficacy of mindfulness-based interventions (MBIs) for improving mental well-being in PwMS. Methods: Systematic searches for eligible randomised controlled trials (RCTs) were carried out in seven major databases (November 2017, July 2018), using medical subject headings and key words. Studies were screened, data extracted, quality appraised and analysed by two independent reviewers, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Mental well-being was the primary outcome. Random effects model meta-analysis was performed, with effect size reported as standardised mean difference (SMD). Results: Twelve RCTs including 744 PwMS were eligible for inclusion in the systematic review, eight had data extractable for meta-analysis; n=635. Ethnicity, socioeconomic status, comorbidity and disability were inconsistently reported. MBIs varied from manualised to tailored versions, lasting 6–9 weeks, delivered individually and via groups, both in person and online. Overall SMD for mental well-being (eight studies) was 0.40 (0.28–0.53), p<0.01, I2=28%; against active comparators only (three studies) SMD was 0.17 (0.01–0.32), p<0.05, I2 =0%. Only three adverse events were reported. Conclusions: MBIs are effective at improving mental well-being in PwMS. More research is needed regarding optimal delivery method, cost-effectiveness and comparative-effectiveness