469 research outputs found
Four forage sorghum silage additives evaluated
Two trials were conducted to evaluated four forage sorghum silage additives: ammonium iso-butyrate, aureomycin, sodium hydroxide, and a mixture of acetic and propionic acids. A control silage received no additives
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On the distribution of bids for construction contract auctions
The statistical distribution representing bid values constitutes an essential part of many auction models and has involved a wide range of assumptions, including the Uniform, Normal, Lognormal and Weibull densities. From a modelling point of view, its goodness is defined by how well it enables the probability of a particular bid value to be estimated â a past bid for ex-post analysis and a future bid for ex-ante (forecasting) analysis. However, there is no agreement to date of what is the most appropriate form and empirical work is sparse.
Twelve extant construction datasets from four continents over different time periods are analysed in this paper for their fit to a variety of candidate statistical distributions assuming homogeneity of bidders (ID not known). The results show there is no one single fit-all distribution, but that the 3p Log-Normal, FrĂ©chet/2p Log-Normal, Normal, Gamma and Gumbel generally rank the best ex-post, and the 2p Log-Normal, Normal, Gamma and Gumbel the best ex-ante â with ex-ante having around three to four times worse fit than ex-post. Final comments focus on the results relating to the third and fourth standardised moments of the bids and a post-hoc rationalisation of the empirical outcome of the analysis
Emergency care for older people living with frailty: patient and carer perspectives
Background Little is known about how frailty impacts on older peopleâs experiences of emergency care, despite patient experience being essential to providing person-centred care. This qualitative study reports on the experiences of older people with frailty in the ED and their and their carersâ preferences for emergency care.
Methods Older people (aged 75+ years) who were at least mildly frail and/or their carers, with current or recent experience of emergency care, were recruited from three EDs in England between January and June 2019. Data were collected via semi-structured in-depth interviews which explored participantsâ views on their recent experience of emergency care and their priorities and preferred outcomes. Interviews were audio-recorded, transcribed verbatim and analysed following the principles of the Framework approach.
Results Forty participants were interviewed: 24 patients and 16 carers who, between them, described ED attendances for 28 patients across the three sites. Often informed by previous negative experiences, there was a strong desire to avoid conveyance to EDs, and a sense of helplessness or acquiescence to attend. Although staff attitudes were on the whole seen as positive, the ED experience was dominated by negative experiences relating to very basic issues such as a lack of help with eating, drinking, toileting and discomfort from long waits on hard trolleys. Participants reported that communication and involvement in decision making could be improved, including involving next of kin, who were viewed as critical to supporting vulnerable older people during sometimes very protracted waits.
Conclusion Frailty reflects a vulnerability and a need for support in basic activities of daily living, which EDs in this study, and perhaps more widely, are not set up to provide. Changes at the levels of clinical practice and service design are required to deliver even the most basic care for older people with frailty in the ED environment
Co-creation of a patient-reported outcome measure for older people living with frailty receiving acute care (PROM-OPAC)
Older people living with frailty emphasize autonomy and function as acute healthcare outcome goals. Existing Patient-Reported Outcome Measures (PROMs) measure function but do not comprehensively address autonomy. This initial development of a novel autonomy outcome measure used co-creation and cognitive interviews, working toward a PROM for Older People living with frailty receiving Acute Care (âPROM-OPACâ). Novel item question stems and responses considering autonomy were devised with lay research partners. Items were examined for content by lay volunteers, and then selected based on relevance, completeness, and accessibility. Retained items were cognitively tested with patient participants. Item selection considered content validity and feasibility and was undertaken collaboratively with lay research partners. The study involved 3 lay research partners and 4 further lay collaborators throughout all stages, and 14 patient participants were recruited for the cognitive interviews. Twenty-two novel items were appraised. Seven were selected for retention. This preliminary PROM-OPAC comprised 7 items to measure autonomy and was intended for administration alongside a function measure to capture meaningful acute healthcare outcomes. Development will continue with quantitative testing and validation
What matters most in acute care: an interview study with older people living with frailty
Background
Healthcare outcome goals are central to person-centred acute care, however evidence among older people is scarce. Older people who are living with frailty have distinct requirements for healthcare delivery and have distinct risk for adverse outcomes from healthcare. There is insufficient evidence for whether those living with frailty also have distinct healthcare outcome goals. This study explored the nature of acute care outcome goals in people living with frailty.
Methods
Healthcare outcome goals were explored using semi-structured patient interviews. Participants aged over 65 with Clinical Frailty Score 5-8 (mild to very severe frailty) were recruited during their first 72 hours in a UK hospital. Purposive, maximum variation sampling was guided by lay partners from a Patient and Public Involvement Forum specialising in ageing-related research. Qualitative analysis used a blended approach based on framework and constant comparative methodologies for the identification of themes. Findings were validated through triangulation with participant, lay partner, and technical expert review.
Results
The 22 participants were aged 71 to 98 and had mild to very severe frailty. One quarter were living with dementia. Most participants had reflected on their situation and considered their outcome goals. Theme categories (and corresponding sub-categories) were âAutonomyâ (information, control, and security) and âFunctioningâ (physical, psychosocial, and relief). A novel âsecurityâ theme was identified, whereby participants sought to feel safe in their usual living place and with their health problems. Those living with milder frailty were concerned to maintain ability to support loved ones, while those living with most severe frailty were concerned about burdening others.
Conclusions
Outcome goals for acute care among older participants living with frailty were influenced by the insecurity of their situation and fear of deterioration. Patients may be supported to feel safe and in control through appropriate information provision and functional support
Origins of the Ambient Solar Wind: Implications for Space Weather
The Sun's outer atmosphere is heated to temperatures of millions of degrees,
and solar plasma flows out into interplanetary space at supersonic speeds. This
paper reviews our current understanding of these interrelated problems: coronal
heating and the acceleration of the ambient solar wind. We also discuss where
the community stands in its ability to forecast how variations in the solar
wind (i.e., fast and slow wind streams) impact the Earth. Although the last few
decades have seen significant progress in observations and modeling, we still
do not have a complete understanding of the relevant physical processes, nor do
we have a quantitatively precise census of which coronal structures contribute
to specific types of solar wind. Fast streams are known to be connected to the
central regions of large coronal holes. Slow streams, however, appear to come
from a wide range of sources, including streamers, pseudostreamers, coronal
loops, active regions, and coronal hole boundaries. Complicating our
understanding even more is the fact that processes such as turbulence,
stream-stream interactions, and Coulomb collisions can make it difficult to
unambiguously map a parcel measured at 1 AU back down to its coronal source. We
also review recent progress -- in theoretical modeling, observational data
analysis, and forecasting techniques that sit at the interface between data and
theory -- that gives us hope that the above problems are indeed solvable.Comment: Accepted for publication in Space Science Reviews. Special issue
connected with a 2016 ISSI workshop on "The Scientific Foundations of Space
Weather." 44 pages, 9 figure
A systematic review and recommendations for prom instruments for older people with frailty in emergency care
Introduction
The current service metrics used to evaluate quality in emergency care do not account for specific healthcare outcome goals for older people living with frailty. These have previously been classified under themes of âAutonomyâ and âFunctioningâ. There is no person-reported outcome measure (PROM) for older people with frailty and emergency care needs. This study aimed to identify and co-produce recommendations for instruments potentially suitable for use in this population.
Methods
In this systematic review, we searched six databases for PROMs used between 2010 and 2021 by older people living with frailty receiving acute hospital care. Studies were reviewed against predefined eligibility criteria and appraised for quality using the COSMIN Risk of Bias checklist. Data were extracted to map instrument constructs against an existing framework of acute healthcare outcome goals. Instrument face and content validity were assessed by lay collaborators. Recommendations for instruments with potential emergency care suitability were formed through co-production.
Results
Of 9392 unique citations screened, we appraised the full texts of 158 studies. Nine studies were identified, evaluating nine PROMs. Quality of included studies ranged from âdoubtfulâ to âvery goodâ. Most instruments had strong evidence for measurement properties. PROMs mainly assessed âFunctioningâ constructs, with limited coverage of âAutonomyâ. Five instruments were considered too burdensome for the emergency care setting or too specific for older people living with frailty.
Conclusions
Four PROMs were recommended as potentially suitable for further validation with older people with frailty and emergency care needs: COOP/WONCA charts, EuroQol, McGill Quality of Life (Expanded), and Palliative care Outcome Scale
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Pegasus IV: Discovery and Spectroscopic Confirmation of an Ultra-faint Dwarf Galaxy in the Constellation Pegasus
We report the discovery of Pegasus IV, an ultra-faint dwarf galaxy found in archival data from the Dark Energy Camera processed by the DECam Local Volume Exploration Survey. Pegasus IV is a compact, ultra-faint stellar system (r1 2 = 41-+68 pc; MV = â4.25 ± 0.2 mag) located at a heliocentric distance of 90-+64 kpc. Based on spectra of seven nonvariable member stars observed with Magellan/IMACS, we confidently resolve Pegasus IVâs velocity dispersion, measuring sv = 3.3-+1.11.7 km sâ1 (after excluding three velocity outliers); this implies a mass-to-light ratio of M1 2 LV,1 2 = 167-+99224Mâ Lâ for the system. From the five stars with the highest signal-to-noise spectra, we also measure a systemic metallicity of [Fe/H] =-2.63-+0.300.26 dex, making Pegasus IV one of the most metal-poor ultra-faint dwarfs. We tentatively resolve a nonzero metallicity dispersion for the system. These measurements provide strong evidence that Pegasus IV is a dark-matter-dominated dwarf galaxy, rather than a star cluster. We measure Pegasus IVâs proper motion using data from Gaia Early Data Release 3, finding (Όα*, ΌΎ) = (0.33 ± 0.07, â0.21 ± 0.08) mas yrâ1. When combined with our measured systemic velocity, this proper motion suggests that Pegasus IV is on an elliptical, retrograde orbit, and is currently near its orbital apocenter. Lastly, we identify three potential RR Lyrae variable stars within Pegasus IV, including one candidate member located more than 10 half-light radii away from the systemâs centroid. The discovery of yet another ultra-faint dwarf galaxy strongly suggests that the census of Milky Way satellites is still incomplete, even within 100 kpc
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The variation of geomagnetic storm duration with intensity
Variability in the near-Earth solar wind conditions can adversely affect a number of ground- and space-based technologies. Such space-weather impacts on ground infrastructure are expected to increase primarily with geomagnetic storm intensity, but also storm duration, through time-integrated effects. Forecasting storm duration is also necessary for scheduling the resumption of safe operating of affected infrastructure. It is therefore important to understand the degree to which storm intensity and duration are correlated. The long-running, global geomagnetic disturbance index, aa , has recently been recalibrated to account for the geographic distribution of the component stations. We use this aaH index to analyse the relationship between geomagnetic storm intensity and storm duration over the past 150 years, further adding to our understanding of the climatology of geomagnetic activity. Defining storms using a peak-above-threshold approach, we find that more intense storms have longer durations, as expected, though the relationship is nonlinear. The distribution of durations for a given intensity is found to be approximately log-normal. On this basis, we provide a method to probabilistically predict storm duration given peak intensity, and test this against the aaH dataset. By considering the average profile of storms with a superposed-epoch analysis, we show that activity becomes less recurrent on the 27-day timescale with increasing intensity. This change in the dominant physical driver, and hence average profile, of geomagnetic activity with increasing threshold is likely the reason for the nonlinear behaviour of storm duration
Road avoidance and its energetic consequences for reptiles
Roads are one of the most widespread human-caused habitat modifications that can increase wildlife mortality rates and alter behavior. Roads can act as barriers with variable permeability to movement and can increase distances wildlife travel to access habitats. Movement is energetically costly, and avoidance of roads could therefore impact an animal's energy budget. We tested whether reptiles avoid roads or road crossings and explored whether the energetic consequences of road avoidance decreased individual fitness. Using telemetry data from Blanding's turtles (Emydoidea blandingii; 11,658 locations of 286 turtles from 15 sites) and eastern massasaugas (Sistrurus catenatus; 1,868 locations of 49 snakes from 3 sites), we compared frequency of observed road crossings and use of road-adjacent habitat by reptiles to expected frequencies based on simulated correlated random walks. Turtles and snakes did not avoid habitats near roads, but both species avoided road crossings. Compared with simulations, turtles made fewer crossings of paved roads with low speed limits and more crossings of paved roads with high speed limits. Snakes made fewer crossings of all road types than expected based on simulated paths. Turtles traveled longer daily distances when their home range contained roads, but the predicted energetic cost was negligible: substantially less than the cost of producing one egg. Snakes with roads in their home range did not travel further per day than snakes without roads in their home range. We found that turtles and snakes avoided crossing roads, but road avoidance is unlikely to impact fitness through energetic expenditures. Therefore, mortality from vehicle strikes remains the most significant impact of roads on reptile populations
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