Interventions to promote patients and families' involvement in adult intensive care settings: a protocol for a mixed-method systematic review.

BACKGROUND: There has been an identified need for greater patient and family member involvement in healthcare. This is particularly relevant in an intensive care unit (ICU), as the family provides a key communicative and practical link between patient and clinician. Family members have been deemed a positive beneficial influence on ICU care and recovery processes, yet they themselves are often emotionally affected after discharge. There has been no standardised evidenced-based approach which explores research on family member involvement and the range and quality of contributions remain unclear. This project will undertake a systematic review to assess the evidence base for interventions designed to promote patient and family member involvement in adult intensive care settings and develop a comprehensive typology of interventions for use by clinicians, patients and carers. METHODS: The following databases will be searched without date restriction: MEDLINE, EMBASE and CINAHL, as well as the Cochrane Central Register of Controlled Trials, Joanna Briggs and Cochrane Libraries. Manual searches of recent back issues of leading ICU and patient experience journals will also be undertaken, as will the reference lists of included studies. Unpublished literature will be sought through grey literature databases, including GreyLit and OpenGrey. All evaluation studies that consider intervention activities to promote patient and family member involvement in adult ICUs will be included; all research designs will be eligible. We will seek to include studies that report on a mixture of relevant outcomes for patients and family members. Abstracts and papers will be independently screened by at least two members of the team to determine their inclusion. Included papers will be assessed for methodological rigour using a standard rating approach, which assesses 'quality of study' and 'quality of information'. Quality assessment will be completed by at least two members of the team. Data on interventions, evaluation methods and outcomes will be collated using a predetermined extraction table. These are likely to be heterogeneous in nature, which will mean that the review will follow a narrative approach to synthesis. DISCUSSION: The review will provide valuable and rigorous insight into the range and quality of interventions available to promote patient and family member involvement in ICU. This is the first step towards addressing the absence of a synthesis of research for this context, and will, in addition, develop a typology of available interventions that will help service users and clinicians make informed decisions about the approaches to patient and family member involvement which they might want to adopt. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42018086325)

Probabilistic Mobility Models for Mobile and Wireless Networks

International audienceIn this paper we present a probabilistic broadcast calculus for mobile and wireless networks whose connections are unreliable. In our calculus, broadcasted messages can be lost with a certain probability, and due to mobility the connection probabilities may change. If a network broadcasts a message from a location, it will evolve to a network distribution depending on whether nodes at other locations receive the message or not. Mobility of nodes is not arbitrary but guarded by a probabilistic mobility function (PMF), and we also define the notion of a weak bisimulation given a PMF. It is possible to have weak bisimular networks which have different probabilistic connectivity information. We furthermore examine the relation between our weak bisimulation and a minor variant of PCTL* [1]. Finally, we apply our calculus on a small example called the Zeroconf protocol [2]

Roles of fibrin α- and γ-chain specific cross-linking by FXIIIa in fibrin structure and function

Factor XIII is responsible for the cross-linking of fibrin γ-chains in the early stages of clot formation, whilst α-chain cross-linking occurs at a slower rate. Although γ- and α-chain cross-linking was previously shown to contribute to clot stiffness, the role of cross-linking of both chains in determining clot structure is currently unknown. Therefore, the aim of this study was to determine the role of individual α- and γ-chain cross-linking during clot formation, and its effects on clot structure. We made use of a recombinant fibrinogen (γQ398N/Q399N/K406R), which does not allow for γ-chain cross-linking. In the absence of cross-linking, intact D-D interface was shown to play a potential role in fibre appearance time, clot stiffness and elasticity. Cross-linking of the fibrin α-chain played a role in the thickening of the fibrin fibres over time, and decreased lysis rate in the absence of α2-antiplasmin. We also showed that α-chain cross-linking played a role in the timing of fibre appearance, straightening fibres, increasing clot stiffness and reducing clot deformation. Cross-linking of the γ-chain played a role in fibrin fibre appearance time and fibre density. Our results show that α- and γ-chain cross-linking play independent and specific roles in fibrin clot formation and structure

Fermat-linked relations for the Boubaker polynomial sequences via Riordan matrices analysis

The Boubaker polynomials are investigated in this paper. Using Riordan matrices analysis, a sequence of relations outlining the relations with Chebyshev and Fermat polynomials have been obtained. The obtained expressions are a meaningful supply to recent applied physics studies using the Boubaker polynomials expansion scheme (BPES).Comment: 12 pages, LaTe

ARIADNE - A novel optical LArTPC: technical design report and initial characterisation using a secondary beam from the CERN PS and cosmic muons

ARIADNE is a 1-ton (330 kg fiducial mass) dual-phase liquid argon (LAr) time projection chamber (TPC) featuring a novel optical readout. Four electron-multiplying charge-coupled device (EMCCD) cameras are mounted externally, and these capture the secondary scintillation light produced in the holes of a thick electron gas multiplier (THGEM). Track reconstruction using this novel readout approach is demonstrated. Optical readout has the potential to be a cost effective alternative to charge readout in future LArTPCs. In this paper, the technical design of the detector is detailed. Results of mixed particle detection using a secondary beam from the CERN PS (representing the first ever optical images of argon interactions in a dual-phase LArTPC at a beamline) and cosmic muon detection at the University of Liverpool are also presented.Comment: 58 pages, 40 figures. Changes from previous version based on pre-publication review: improved quality of various figures, improved clarity of some definitions and reduced longer sentences for better readability, fixed typos and formatting error

Healthcare stakeholders’ perceptions and experiences of factors affecting the implementation of critical care telemedicine (CCT): qualitative evidence synthesis

This is the published version of the following article: Xyrichis A, Mackintosh NJ, Terblanche M, Bench S, Philippou J, Sandall J. Healthcare stakeholders’ perceptions and experiences of factors affecting the implementation of critical care telemedicine (CCT): qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No.: CD012876. which has been published at 10.1002/14651858.CD012876 © 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. This is a protocol for a Cochrane Review (Qualitative). The objectives are as follows: To identify, appraise and synthesise qualitative research evidence on healthcare stakeholders' perceptions and experiences of factors affecting the implementation of CCT. To identify hypotheses, for subsequent consideration and assessment in effectiveness reviews, about factors that are more likely to ensure successful implementation of CCT

Reversibility in Chemical Reactions

open access bookIn this chapter we give an overview of techniques for the modelling and reasoning about reversibility of systems, including outof- causal-order reversibility, as it appears in chemical reactions. We consider the autoprotolysis of water reaction, and model it with the Calculus of Covalent Bonding, the Bonding Calculus, and Reversing Petri Nets. This exercise demonstrates that the formalisms, developed for expressing advanced forms of reversibility, are able to model autoprotolysis of water very accurately. Characteristics and expressiveness of the three formalisms are discussed and illustrated