Fluid Elasticity Can Enable Propulsion at Low Reynolds Number

Conventionally, a microscopic particle that performs a reciprocal stroke cannot move through its environment. This is because at small scales, the response of simple Newtonian fluids is purely viscous and flows are time-reversible. We show that by contrast, fluid elasticity enables propulsion by reciprocal forcing that is otherwise impossible. We present experiments on rigid objects actuated reciprocally in viscous fluids, demonstrating for the first time a purely elastic propulsion set by the object's shape and boundary conditions. We describe two different artificial "swimmers" that experimentally realize this principle.Comment: 5 pages, 4 figure

The role of home adaptations in improving later life

This report summarises the findings of a systematic review of the best, available scientific evidence on how home adaptations can contribute to improving later life. Living in a suitable home is crucially important to a good later life. The right home environment can maintain or improve people’s physical and mental health, wellbeing and social connections,enable them to carry out day-to-day activities safely and comfortably, and help them to do thethings that are important to them. More than 90% of older people in England live in mainstream housing, as opposed to specialist housing or residential care. However, current UK housing stock is often not accessible or adapted to meet people’s needs as they get older, with small room sizes, steep internal stairs, baths rather than showers and steps outside.While many people will maintain good health and fitness for much of their later years, the likelihood of having one or more long-term condition, physical impairments,disabilities and frailty that make day-to-day life at home more difficult does increase with age. The percentage of people who have difficulty with at least one activity of daily living (basic routine activities like eating, bathing and dressing) increases dramatically from 16% at age 65 to around half of those aged 85. By people’s late 80s, more than one in three people have difficulty undertaking fiveor more activities of daily living unaided (Marmot et al 2016). Installing aids and adaptations into people’s homes, such as grab rails and level access showers, can improve the accessibility and usability of a person’s home environment, maintaining or restoring their ability to carryout day-to-day activities safely and comfortably.The last comprehensive review of the evidence on home adaptations was published in 2007. Since then, there has been increasing policy attention paid to the benefits of home adaptations, particularly in relation to how they can reduce health and social care costs, many of which are outlined in this review. However, there should be much greater focus and action given to the widely acknowledged and unsustainable pressures on our health and social care systems, coupled with the fact that we are living for longer and the proportion of older people in our society is growing. In the last Spending Review, the budget for the Disabled Facilities Grant was increased to enable greater access to home adaptations for more people, yet there is still an unacceptable and under-reported number of people not getting the equipment and support they need. This review aims to provide an up-to-date analysis of evidence of the importance and effectiveness of home adaptations

Dielectric properties of thin Cr2O3 films grown on elemental and oxide metallic substrates

In an attempt to optimize leakage characteristics of α-Cr2O3 thin films, its dielectric properties were investigated at local and macroscopic scale. The films were grown on Pd(111), Pt(111), and V2O3 (0001), supported on Al2O3 substrate. The local conductivity was measured by conductive atomic force microscopy mapping of Cr2O3 surfaces, which revealed the nature of defects that formed conducting paths with the bottom Pd or Pt layer. A strong correlation was found between these electrical defects and the grain boundaries revealed in the corresponding topographic scans. In comparison, the Cr2O3 film on V2O3 exhibited no leakage paths at similar tip bias value. Electrical resistance measurements through e-beam patterned top electrodes confirmed the resistivity mismatch between the films grown on different electrodes. The x-ray analysis attributes this difference to the twin free Cr2O3 growth on V2O3 seeding

Considering Positive Psychology Constructs of Life Satisfaction and School Connectedness When Assessing Symptoms Related to Attention-Deficit/Hyperactivity Disorder

Children and adolescents diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) demonstrate significant difficulty with academic and behavioral functioning. This, in turn, can lead to lower educational attainment and vocational achievement, which has serious long-term consequences and costs to individuals and society (Barkley, 2002, 2006; Mannuzza, Klein, Bessler, Malloy, & LaPadula, 1993). Researchers from a positive psychology framework suggest that ADHD symptoms (i.e., inattention, hyperactivity/impulsivity) alone may not fully explain academic impairment (Diener, Scollon, & Lucas, 2004). From the standpoint of positive psychology, life satisfaction and school connectedness are important constructs that examine positive life functioning; however, they have been understudied, particularly in the area of ADHD. The current study investigated the relationship between ADHD symptoms and these positive psychological constructs. Results indicate that as ADHD symptoms increase, life satisfaction decreases; however, no relationship between ADHD symptoms and school connectedness was found. Beyond our primary analysis, we examined the relationship between gender and these variables. Results suggest that gender significantly moderates the relationship between ADHD and life satisfaction, with life satisfaction ratings decreasing for males as ADHD symptoms increase, yet remaining stable for females. ADHD symptoms did not significantly predict changes in school connectedness

Development and evaluation of an Individualised Outcome Measure (IOM) for randomised controlled trials in mental health

Predefined, researcher-selected outcomes are routinely used as the clinical end-point in randomised controlled trials (RCTs); however, individualised approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualised Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n=20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalised Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a predefined list at baseline, and complete a standardised questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n=84). IOM was then evaluated in an RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs

Psychometric evaluation of the Questionnaire about the Process of Recovery (QPR)

Background: Supporting recovery is the aim of national mental health policy in many countries, including England. There is a need for standardised measures of recovery, to assess policy implementation and inform clinical practice. Only one measure of recovery has been developed in England: the Questionnaire about the Process of Recovery (QPR) which measures recovery from the perspective of adult mental health service users with a psychosis diagnosis. Aims: To independently evaluate the psychometric properties of the 15-item and 22-item versions of QPR. Method: Two samples were used: Dataset 1 (n=88) involved assessment of QPR at baseline, two weeks and three months. Dataset 2 (n=399; ISRCTN02507940) involved assessment of QPR at baseline and one year. Results: For the 15-item version, internal consistency was 0.89, convergent validity was 0.73, test-retest reliability was 0.74 and sensitivity to change was 0.40. Confirmatory factor analysis showed the 15-item version offered a good fit. For the 22 item version comprising two sub-scales, the Interpersonal sub-scale was found to under-perform and the Intrapersonal sub-scale overlaps substantially with the 15 item version. Conclusions: Both the 15-item and the Intrapersonal sub-scale of the 22-item versions of the QPR demonstrated satisfactory psychometric properties. The 15-item version is slightly more robust and also less burdensome, so it can be recommended for use in research and clinical practice. Declaration of interest: None

Evaluating the feasibility of complex interventions in mental health services: standardised measure and reporting guidelines

Aims: To develop a) an empirically-based standardised measure of the feasibility of complex interventions for use within mental health services and b) reporting guidelines to facilitate feasibility assessment. Method: A focussed narrative review of studies assessing implementation blocks and enablers was conducted with thematic analysis and vote counting used to determine candidate items for the measure. Twenty purposively sampled studies (15 trial reports, 5 protocols) were included in the psychometric evaluation, spanning different interventions types. Cohen’s Kappa was calculated for inter-rater reliability and test-retest reliability. Results: 95 influences on implementation were identified from 299 reviewed references. The final measure - Structured Assessment of Feasibility (SAFE) - comprises 16 items rated on a Likert scale. SAFE demonstrated excellent inter-rater (kappa 0.84, 95% CI 0.79 - 0.89) and test re-test reliability (kappa 0.89, 95% CI 0.85 - 0.93). Cost information and training time were the two influences least likely to be reported in intervention papers. SAFE Reporting Guidelines include 16 items organised into 3 categories (Intervention, Resource consequences, Evaluation). Conclusion: SAFE is a novel approach to evaluating interventions, and supplements efficacy and health economic evidence. SAFE Reporting Guidelines will allow feasibility of an intervention to be systematically assessed

A national survey of recovery practice in community mental health teams

Background There is a policy and professional consensus about the importance of ‘recovery’ in mental health services, but the link between recovery-orientation of mental health teams and personal recovery of service users has been under-researched. Aims To investigate differences in team leader, clinician and service user perspectives of recovery orientation of community adult mental health teams in England. Objectives: (1) To compare variations between NHS Trust, team type and participant ratings of recovery-orientation of mental health teams; (2) To explore the relationship between service user ratings of recovery orientation and personal recovery; (3) To test the hypothesis that clinician-rated recovery orientation differs between clinicians with and without personal experience of mental illness or supporting a family member or friend with mental illness. Method In six English Mental Health NHS Trusts (purposively sampled to maximise geographic and demographic spread), randomly-chosen community adult mental health teams were surveyed. A random sample of ten service users, one team leader and a convenience sample of five clinicians were surveyed from each team. All respondents rated the recovery orientation of their team using parallel versions of the Recovery Self Assessment (RSA). In addition, service users also rated their own personal recovery using Questionnaire about Processes of Recovery (QPR). Results Team leaders (n=22) rated recovery orientation higher than clinicians (n=109) or service users (n=120) (Wald(7)=7.0, p=0.03), and both NHS Trust and team type influenced RSA ratings. Service user-rated recovery orientation was a predictor of personal recovery (b=0.52, p <.001; 95%CI: .31 to .74). Team leaders and clinicians with experience of mental illness (39%) or supporting a family member or friend with mental illness (76%) did not differ in their RSA ratings from other team leaders or clinicians. Conclusions Compared with team leaders, frontline clinicians and service users have less positive views on recovery orientation. Increasing recovery orientation may support personal recovery