1,450 research outputs found
Economics of smoking cessation
Smoking imposes a huge economic burden on society— currently up to 15% of total healthcare costs in developed countries. Smoking cessation can save years of life, at a very low cost compared with alternative interventions. This chapter reviews some of the economic aspects of smoking cessation
A distributed algorithm for European options with nonlinear volatility
A distributed algorithm is developed to solve nonlinear Black-Scholes equations in the hedging of portfolios. The algorithm is based on an approximate inverse Laplace transform and is particularly suitable for problems that do not require detailed knowledge of each intermediate time steps
A pilot trial to assess the effect of a structured COMmunication approach on QUality Of Life in secure mental health settings (Comquol)
Forensic mental health services have largely ignored examining users’ views on the nature of the service offered to them. Priebe and colleagues have developed a structured communication approach placing the service users’ perspective of their care at the heart of the discussions between service users and clinicians. This approach was used as the basis of a pilot study to evaluate a structured six-month approach designed to increase the quality of life of service users in secure settings. The specific objectives of the study were to:
• Establish the feasibility of the trial design as the basis for determining the viability of a large full-scale trial
• Determine the variability of the outcomes of interest
• Estimate the costs of the intervention
• If necessary, to refine the intervention following the study based upon the experiences of the clinicians and service users.
A 36 month pilot trial was undertaken. Participants were recruited from 6 medium secure in–patient services with 55 patients in the intervention group and 57 in the control group as well as 92 nurses (47 in the intervention group and 45 in the control group). The intervention was based on the structured communication approach. Assessments took place prior to the intervention (baseline), at 6 months (post intervention) and at 12 months (follow-up).
A review of the trial design indicated this approach was viable as the basis for a large full-scale trial; no refinements were needed to the intervention. The variability of the outcomes can be used start thinking about how large a full scale trial needs to be. A full trial would be able to estimate the effect of the intervention whereas this small pilot study cannot. The total cost of the intervention was ÂŁ29,100 (ÂŁ529 per patient) when assuming the intervention was part of the nurses normal work. Disturbed behaviour was also found to be costly since it was associated with significant use of NHS resources and police
Rapid microwave-assisted synthesis of sub-30 nm lipid nanoparticles
Accessing the phase inversion temperature by microwave heating may enable the rapid synthesis of small lipid nanoparticles.Nanoparticle formulations consisted of surfactants Brij 78 and Vitamin E TPGS, and trilaurin, trimyristin, or miglyol 812 as nanoparticle lipid cores. Each formulation was placed in water and heated by microwave irradiation at temperatures ranging from 65°C to 245°C. We observed a phase inversion temperature (PIT) for these formulations based on a dramatic decrease in particle Z-average diameters. Subsequently, nanoparticles were manufactured above and below the PIT and studied for (a) stability toward dilution, (b) stability over time, (c) fabrication as a function of reaction time, and (d) transmittance of lipid nanoparticle dispersions.Lipid-based nanoparticles with distinct sizes down to 20â30nm and low polydispersity could be attained by a simple, one-pot microwave synthesis. This was carried out by accessing the phase inversion temperature using microwave heating. Nanoparticles could be synthesized in just one minute and select compositions demonstrated high stability. The notable stability of these particles may be explained by the combination of van der Waals interactions and steric repulsion. 20â30nm nanoparticles were found to be optically transparent
Applications of graphics to support a testbed for autonomous space vehicle operations
Researchers describe their experience using graphics tools and utilities while building an application, AUTOPS, that uses a graphical Machintosh (TM)-like interface for the input and display of data, and animation graphics to enhance the presentation of results of autonomous space vehicle operations simulations. AUTOPS is a test bed for evaluating decisions for intelligent control systems for autonomous vehicles. Decisions made by an intelligent control system, e.g., a revised mission plan, might be displayed to the user in textual format or he can witness the effects of those decisions via out of window graphics animations. Although a textual description conveys essentials, a graphics animation conveys the replanning results in a more convincing way. Similarily, iconic and menu-driven screen interfaces provide the user with more meaningful options and displays. Presented here are experiences with the SunView and TAE Plus graphics tools used for interface design, and the Johnson Space Center Interactive Graphics Laboratory animation graphics tools used for generating out out of the window graphics
Study to assess the effect of a structured communication approach on quality of life in secure mental health settings (Comquol): study protocol for a pilot cluster randomized trial
Background
Forensic mental health services have largely ignored examining patients’ views on the nature of the service offered to them. A structured communication approach (DIALOG) has been developed with the aim of placing the patient’s perspective of their care at the heart of the discussions between patients and clinicians. The effectiveness of the structured communication approach in community mental health services has been demonstrated but no trial taken place in a secure psychiatric setting. This pilot study is evaluating a six-month intervention combining DIALOG with principles of Solution Focused Therapy (SFT) on quality of life in medium secure settings.
Methods/design
A cluster randomized controlled trial design is being employed to conduct a 36 months pilot study. Participants are recruited from six medium secure in–patient services with 48 patients in the intervention group and 48 in the control group. The intervention uses a structured communication approach. It comprises of six meetings between patient and nurse over held once a month a six month period. During each meeting patients rate their satisfaction with a range of life and treatment domains with responses displayed on a tablet. The rating is followed by a discussion on how to improve the current situation in those domains identified by the patient. Assessments take place prior to the intervention (baseline), at 6 months (post intervention) and at 12 months (follow-up). The primary outcome is self reported Quality of Life.
Discussion:
The study aims to a) establish the feasibility of the trial design as the basis for determining the viability of a large full-scale trial, b) determine the variability of the outcomes of interest (quality of life, levels of satisfaction, disturbance, ward climate, and engagement with services) c) estimate the costs of the intervention and d) refine the intervention following the outcome of the study based upon the experiences of the nurses and patients. The intervention allows patients to have a greater say in how they are treated and targets care on areas that patients identify as important to them. It is intended to establish systems that support meaningful patient (and carer) involvement and participation.
Trial registration: Current Controlled Trials ISRCTN34145189
Keywords: Comquol, DIALOG, Forensic, Mental Health, Quality of Life, Solution Focused Brief Therapy
Barriers to development and progression of women entrepreneurs in Pakistan
This article would help integration of women entrepreneurs into the mainstream economy in Pakistan.In Pakistan, women entrepreneurs do not enjoy the same opportunities as men due to a number of deep-rooted discriminatory socio-cultural values and traditions. Furthermore, these restrictions can be observed within the support mechanisms that exist to assist such fledgling businesswomen. The economic potential of female entrepreneurs is not being realised as they suffer from a lack of access to capital, land, business premises, information technology, training and agency assistance. Inherent attitudes of a patriarchal society, that men are superior to women and that women are best suited to be homemakers, create formidable challenges. Women also receive little encouragement from some male family members, resulting in limited spatial mobility and a dearth of social capital. The research suggests that in order to foster development, multi-agency cooperation is required. The media, educational policy makers and government agencies could combine to provide women with improved access to business development services and facilitate local, regional and national networks
Homeless population
The aim was to derive and analyze a model for numbers of homeless and non-homeless people in a borough, in particular to see how these figures might be affected by different policies regarding housing various categories of people. Most attention was focused on steady populations although the stability of these and possible timescales of dynamic problems were also discussed.
The main outcome of this brief study is the identification of the key role played by the constant k_1 - the constant which fixes the speed at which the homeless are rehoused in permanent council property. Reducing this constant, i.e. making the system "fairer" with less priority to accommodating homeless families, appears to have little effect on the sizes of other categories on the waiting list but there is a marked increase in the number of households in temporary accommodation.
The model, indicated by the size of its longest time-scale, should be modified to allow for births etc.
It could be varied by allowing people to remove themselves from the register or by allowing the rates at which registered and unregistered people become homeless to differ, but these modifications are unlikely to substantially change the main result.
The inclusion of movement from the homeless to the general population would have the effect of limiting the numbers in temporary accommodation. However, it is thought this effect is very small so a great reduction in k_1 would be needed for this flow to become significant
A pilot cluster randomised trial to assess the effect of a structured communication approach on quality of life in secure mental health settings: the Comquol study
Background
There is a lack of research in forensic settings examining therapeutic relationships. A structured communication approach, placing patients’ perspectives at the heart of discussions about their care, was used to improve patients’ quality of life in secure settings.
The objectives were to:
• Establish the feasibility of the trial design
• Determine the variability of the outcomes of interest
• Estimate the costs of the intervention
• If necessary, refine the intervention
Methods
A pilot cluster randomised controlled trial was conducted. Data was collected from July 2012 to January 2015 from participants in 6 medium secure in–patient services in London and Southern England. 55 patients and 47 nurses were in the intervention group with 57 patients and 45 nurses in the control group. The intervention comprised 6 nurse-patient meetings over a 6 month period. Patients rated their satisfaction with a range of domains followed by discussions on improving patient identified problems. Assessments took place at baseline, 6 months, and 12 months. Participants were not blind to their allocated group. The primary outcome was self-reported quality of life collected by a researcher blind to participants’ allocation status.
Results
The randomisation procedures and intervention approach functioned well. The measures used were understood by the participants and gave relevant outcome information. The response rates were good with low patient withdrawal rates. The quality of life estimated treatment effect was 0.2 (95% CI: -0.4 to 0.8) at 6 months and 0.4 (95% CI: -0.3 to 1.1) indicating the likely extreme boundaries of effect in the main trial. The estimated treatment effect of the primary outcome is clinically important, and a positive effect of the intervention is not ruled out. The estimate of the ICC for the primary outcome at 6 and 12 months was 0.04 (0.00 to 0.17) and 0.05 (0.00 to 0.18). The cost of the intervention was ÂŁ529 per patient.
Conclusions
The trial design was viable as the basis for a full-scale trial. A full trial is justified to estimate the effect of the intervention with greater certainty. The variability of the outcomes could be used to calculate numbers needed for a full-scale trial. Ratings of need for therapeutic security may be useful in any future study
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Applications of a 2-D moving finite element formulation to elastic/viscoplastic dynamic fracture analysis
Current efforts to resolve the near crack tip fields in elastic/viscoplastic materials using finite element methods have failed to achieve a finite non-zero energy flow to the crack tip. Motivated by these difficulties, a moving element formulation incorporating a variable order singular element to enhance the local crack tip description is presented. The moving mesh zone is embedded in a finite global mesh to provide a functional tool for the analysis of dynamic crack growth experiments. The necessary elasto-dynamic formulations have been previously implemented in a transient finite element program DYNCRACK and checked against known analytical solutions. These results have encouraged an attempt to include Perzyna's elastic-viscoplastic model in the formulation. However, the introduction of non-linear history dependent material behavior into a moving element scheme requires a method to interpolate related field quantities to new Gauss point positions for each time step. The following summary of numerical procedures outlines the approach taken to develop a transient elastic/viscoplastic moving finite element formulation. Results for a standard test problem are then compared to those obtained using the nodal relaxation technique. Further development of the code is discussed with respect to applications to dynamic fracture experiments
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