Support for older people with COPD in community settings: a systematic review of qualitative research.

There are an estimated three million people affected by Chronic Obstructive Pulmonary Disease (COPD) in the UK with only about 900,000 of these being diagnosed according to the Healthcare Commission, and prevalence is increasing. Significant progress has been made in respect of treatment and management of the disease. However, there is limited evidence related to the perspective of those with COPD despite an acknowledgement that lung function, as determined by spirometry, does not necessarily equate with pulmonary disease5 and subsequent functional level or disability. The impact of COPD on patients, their family, carers and healthcare services demands that better ill health prevention and disease maintenance strategies be employed. The objective of this review was to explore the common and shared experiences of those in caring partnership for patients with COPD receiving care and support in their community. For this review, the definition of support takes the view that support relates to ‘any activity or intervention aimed at improving or maintaining the health status of a patient with COPD’. The review focused on the experiences of patients, carers, family members, nurses and doctors involved in providing support to patients with COPD in their own home. Patients aged 65 years and over were included. The review considered studies that represented patient, carer, nursing and medical staff experiences and perceptions of support relating to COPD. The review considered evidence from qualitative research including phenomenology, grounded theory, and descriptive studies, where support for COPD in a community context was the focus. The search set out to find published studies in English from 1990-2010. The studies were appraised and findings extracted using the JBI critical appraisal tool for qualitative research. Three reviewers appraised the studies independently. 72 studies were critically appraised and 39 met the inclusion criteria. Findings from included papers were aggregated, categorised and synthesised. Three syntheses were extracted from the categorised findings: 1) Consistence in service provision. If those with COPD received more consistent support in relation to information, rehabilitation, end of life care and other service provision then their quality of life could be enhanced. 2) Home based care. Better planned and more integrated support for home based care around self-care/management and in managing exacerbations can reduce patient and carer anxiety and distress related to COPD. 3) Individualisation of care. Individualisation of care, which is not based on the patient's ‘disease state’ (i.e. physical parameters) but on assessed need, is a necessary part of care for those with COPD

Determination of the top quark mass circa 2013: methods, subtleties, perspectives

We present an up-to-date overview of the problem of top quark mass determination. We assess the need for precision in the top mass extraction in the LHC era together with the main theoretical and experimental issues arising in precision top mass determination. We collect and document existing results on top mass determination at hadron colliders and map the prospects for future precision top mass determination at e+e- colliders. We present a collection of estimates for the ultimate precision of various methods for top quark mass extraction at the LHC.Comment: 26 pages. Snowmass White Pape

Exploring Students' Experiences in Occupational Therapy Education:A Phenomenological Study of Professional Identity Development

The existing literature on professional identity enactment and development, subscribes to students’ socializing in a learning environment, where they regularly encounter practicing professionals throughout their education period. However, in most countries with less resourced occupational therapists like Ghana, education in occupational therapy is fraught with inadequate number of same professionals to mentor undergraduate occupational therapy students. The students are thus faced with serious dilemma regarding their professional identity which tends to elicit a bleak perception of their chosen career. The present study was therefore envisaged to interpret and analyse the students’ lived experiences, with the view to capture the process of constructing and developing professional identity. The study focused on purposively sampled group of nine undergraduate occupational therapy students during their practice placement education, and their learning styles on didactic lectures. A hermeneutic phenomenological approach was adopted for the study. The students were followed up throughout their four-year study program for data collection, using one-to-one semi-structured interviews each year. With reference to the threshold concepts, transcribed interview data were analyzed using interpretative phenomenological procedures. The study established a transformational development of professional identity from the novice stage into graduate professionals, amidst complex interaction of co-constructed themes which included: personal knowing, professional knowing and experiential knowing

Herbivore management for biodiversity conservation: A case study of kangaroos in the Australian Capital Territory (ACT)

Populations of macropods are higher than estimated pre-European densities in many parts of Australia. To achieve appropriate densities of macropods in the Australian Capital Territory's nature reserves, multi-tenure kangaroo management units are used to tailor management of kangaroos and total grazing pressure to achieve conservation objectives. An adaptive management framework is recommended that monitors the state of the ground-layer vegetation and alters the cull accordingly. This case study may provide insights for kangaroo management in other temperate areas of Australia

Inconsistencies in Guidelines for Visual Health Surveillance of VDT Workers

Objectives: In Europe, 25% of workers use video display terminals (VDTs). Occupational health surveillance has been considered a key element in the protection of these workers. Nevertheless, it is unclear if guidelines available for this purpose, based on EU standards and available evidence, meet currently accepted quality criteria. The aim of this study was to appraise three sets of European VDT guidelines (UK, France, Spain) in which regulatory and evidence-based approaches for visual health have been formulated and recommendations for practice made. Methods: Three independent appraisers used an adapted AGREE instrument with seven domains to appraise the guidelines. A modified nominal group technique approach was used in two consecutive phases: first, individual evaluation of the three guidelines simultaneously, and second, a face-to-face meeting of appraisers to discuss scoring. Analysis of ratings obtained in each domain and variability among appraisers was undertaken (correlation and kappa coefficients). Results: All guidelines had low domain scores. The domain evaluated most highly was Scope and purpose, while Applicability was scored minimally. The UK guidelines had the highest overall score, and the Spanish ones had the lowest. The analysis of reliability and differences between scores in each domain showed a high level of agreement. Conclusions: These results suggest current guidelines used in these countries need an update. The formulation of evidence-base European guidelines on VDT could help to reduce the significant variation of national guidelines, which may have an impact on practical application.This study was supported by the National Institute for Occupational Safety and Health at Work of the Spanish Work and Immigration Ministry (INSHT). Project reference: 606/UAL/PVDVIS

Fall, Recovery and Characterization of the Novato L6 Chondrite Breccia

The Novato L6 chondrite fragmental breccia fell in California on 17 October 2012, and was recovered after the Cameras for Allsky Meteor Surveillance (CAMS) project determined the meteor's trajectory between 95 and 45 km altitude. The final fragmentation at 33 1 km altitude was exceptionally well documented by digital photographs. The first sample was recovered before rain hit the area. First results from a consortium study of the meteorite's characterization, cosmogenic and radiogenic nuclides, origin and conditions of the fall are presented. Some meteorites did not retain fusion crust and show evidence of spallation. Before entry, the meteoroid was 35+/-5 cm in diameter (mass 80+/-35 kg) with a cosmic ray exposure age of 9+/-1 Ma, if it had a one-stage exposure history. However, based on the cosmogenic nuclide inventory, a two-stage exposure history is more likely, with lower shielding in the last few Ma. Thermoluminescence data suggest a collision event within the last approx. 0.1 Ma. Novato likely belonged to the class of shocked L chondrites that have a common shock age of 470 Ma, based on the U,Th-He age of 460+/-220 Ma. The measured orbits of Novato, Jesenice and Innisfree are consistent with a proposed origin of these shocked L chondrites in the Gefion asteroid family, but leave open the possibility that they came to us directly from the 5:2 mean motion resonance with Jupiter. Novato experienced a stronger compaction than did other L6 chondrites of shock-stage S4. Despite this, a freshly broken surface shows a wide range of organic compounds

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good