Incentives for breastfeeding and for smoking cessation in pregnancy: An exploration of types and meanings

Financial or tangible incentives are a strategy for improving health behaviours. The mechanisms of action of incentives are complex and debated. Using a multidisciplinary integrated mixed methods study, with service-user collaboration throughout, we developed a typology of incentives and their meanings for initiating and sustaining smoking cessation in pregnancy and breastfeeding. The ultimate aim was to inform incentive intervention design by providing insights into incentive acceptability and mechanisms of action. Systematic evidence syntheses of incentive intervention studies for smoking cessation in pregnancy or breastfeeding identified incentive characteristics, which were developed into initial categories. Little published qualitative data on user perspectives and acceptability was available. Qualitative interviews and focus groups conducted in three UK regions with a diverse socio-demographic sample of 88 women and significant others from the target population, 53 service providers, 24 experts/decision makers, and conference attendees identified new potential incentives and providers, with and without experience of incentives. Identified incentives (published and emergent) were classified into eight categories: cash and shopping vouchers, maternal wellbeing, baby and pregnancy-related, behaviour-related, health-related, general utility, awards and certificates, and experiences. A typology was refined iteratively through concurrent data collection and thematic analysis to explore participants' understandings of ‘incentives’ and to compare and contrast meanings across types. Our typology can be understood in three dimensions: the degree of restriction, the extent to which each is hedonic and/or utilitarian, and whether each has solely monetary value versus monetary with added social value. The layers of autonomy, meanings and the social value of incentive types influence their acceptability and interact with structural, social, and personal factors. Dimensions of incentive meaning that go beyond the simple incentive description should inform incentive programme design and are likely to influence outcomes

On the Elevated Temperature Thermal Stability of Nanoscale Mn-Ni-Si Precipitates Formed at Lower Temperature in Highly Irradiated Reactor Pressure Vessel Steels.

Atom probe tomography (APT) and scanning transmission electron microscopy (STEM) techniques were used to probe the long-time thermal stability of nm-scale Mn-Ni-Si precipitates (MNSPs) formed in intermediate and high Ni reactor pressure vessel steels under high fluence neutron irradiation at ≈320 °C. Post irradiation annealing (PIA) at 425 °C for up to 57 weeks was used to determine if the MNSPs are: (a) non-equilibrium solute clusters formed and sustained by radiation induced segregation (RIS); or, (b) equilibrium G or Γ2 phases, that precipitate at accelerated rates due to radiation enhanced diffusion (RED). Note the latter is consistent with both thermodynamic models and x-ray diffraction (XRD) measurements. Both the experimental and an independently calibrated cluster dynamics (CD) model results show that the stability of the MNSPs is very sensitive to the alloy Ni and, to a lesser extent, Mn content. Thus, a small fraction of the largest MNSPs in the high Ni steel persist, and begin to coarsen at long times. These results suggest that the MNSPs remain a stable phase, even at 105 °C higher than they formed at, thus are most certainly equilibrium phases at much lower service relevant temperatures of ≈290 °C

A Gapless Theory of Bose-Einstein Condensation in Dilute Gases at Finite Temperature

In this paper we develop a gapless theory of BEC which can be applied to both trapped and homogeneous gases at zero and finite temperature. The many-body Hamiltonian for the system is written in a form which is approximately quadratic with higher order cubic and quartic terms. The quadratic part is diagonalized exactly by transforming to a quasiparticle basis, while the non-quadratic terms are dealt with using first and second order perturbation theory. The conventional treatment of these terms, based on factorization approximations, is shown to be inconsistent. Infra-red divergences can appear in individual terms of the perturbation expansion, but we show analytically that the total contribution beyond quadratic order is finite. The resulting excitation spectrum is gapless and the energy shifts are small for a dilute gas away from the critical region, justifying the use of perturbation theory. Ultra-violet divergences can appear if a contact potential is used to describe particle interactions. We show that the use of this potential as an approximation to the two-body T-matrix leads naturally to a high-energy renormalization. The theory developed in this paper is therefore well-defined at both low and high energy and provides a systematic description of Bose-Einstein condensation in dilute gases. It can therefore be used to calculate the energies and decay rates of the excitations of the system at temperatures approaching the phase transition.Comment: 39 pages of Revtex. 1 figur

Testing equality of variances in the analysis of repeated measurements

The problem of comparing the precisions of two instruments using repeated measurements can be cast as an extension of the Pitman-Morgan problem of testing equality of variances of a bivariate normal distribution. Hawkins (1981) decomposes the hypothesis of equal variances in this model into two subhypotheses for which simple tests exist. For the overall hypothesis he proposes to combine the tests of the subhypotheses using Fisher's method and empirically compares the component tests and their combination with the likelihood ratio test. In this paper an attempt is made to resolve some discrepancies and puzzling conclusions in Hawkins's study and to propose simple modifications.\ud \ud The new tests are compared to the tests discussed by Hawkins and to each other both in terms of the finite sample power (estimated by Monte Carlo simulation) and theoretically in terms of asymptotic relative efficiencies

Computer-aided communication satellite system analysis and optimization

The capabilities and limitations of the various published computer programs for fixed/broadcast communication satellite system synthesis and optimization are discussed. A satellite Telecommunication analysis and Modeling Program (STAMP) for costing and sensitivity analysis work in application of communication satellites to educational development is given. The modifications made to STAMP include: extension of the six beam capability to eight; addition of generation of multiple beams from a single reflector system with an array of feeds; an improved system costing to reflect the time value of money, growth in earth terminal population with time, and to account for various measures of system reliability; inclusion of a model for scintillation at microwave frequencies in the communication link loss model; and, an updated technological environment

Protocol for a mixed-methods exploratory investigation of care following intensive care discharge: the REFLECT study

© Author(s) 2019. Re-use permitted under CC BY. Published by BMJ.INTRODUCTION: A substantial number of patients discharged from intensive care units (ICUs) subsequently die without leaving hospital. It is unclear how many of these deaths are preventable. Ward-based management following discharge from ICU is an area that patients and healthcare staff are concerned about. The primary aim of REFLECT (Recovery Following Intensive Care Treatment) is to develop an intervention plan to reduce in-hospital mortality rates in patients who have been discharged from ICU. METHODS AND ANALYSIS: REFLECT is a multicentre mixed-methods exploratory study examining ward care delivery to adult patients discharged from ICU. The study will be made up of four substudies. Medical notes of patients who were discharged from ICU and subsequently died will be examined using a retrospective case records review (RCRR) technique. Patients and their relatives will be interviewed about their post-ICU care, including relatives of patients who died in hospital following ICU discharge. Staff involved in the care of patients post-ICU discharge will be interviewed about the care of this patient group. The medical records of patients who survived their post-ICU stay will also be reviewed using the RCRR technique. The analyses of the substudies will be both descriptive and use a modified grounded theory approach to identify emerging themes. The evidence generated in these four substudies will form the basis of the intervention development, which will take place through stakeholder and clinical expert meetings. ETHICS AND DISSEMINATION: Ethical approval has been obtained through the Wales Research and Ethics Committee 4 (17/WA/0107). We aim to disseminate the findings through international conferences, international peer-reviewed journals and social media. TRIAL REGISTRATION NUMBER: ISRCTN14658054.Peer reviewedFinal Published versio

Blind extraction of an exoplanetary spectrum through Independent Component Analysis

Blind-source separation techniques are used to extract the transmission spectrum of the hot-Jupiter HD189733b recorded by the Hubble/NICMOS instrument. Such a 'blind' analysis of the data is based on the concept of independent component analysis. The de-trending of Hubble/NICMOS data using the sole assumption that nongaussian systematic noise is statistically independent from the desired light-curve signals is presented. By not assuming any prior, nor auxiliary information but the data themselves, it is shown that spectroscopic errors only about 10 - 30% larger than parametric methods can be obtained for 11 spectral bins with bin sizes of ~0.09 microns. This represents a reasonable trade-off between a higher degree of objectivity for the non-parametric methods and smaller standard errors for the parametric de-trending. Results are discussed in the light of previous analyses published in the literature. The fact that three very different analysis techniques yield comparable spectra is a strong indication of the stability of these results.Comment: ApJ accepte