Development of the Carers’ Alert Thermometer (CAT) to identify family carers struggling with caring for someone dying at home: a mixed method consensus study

Background: There is an increasing international policy direction to promote home death for dying patients which will impact on the demands placed on family carers. The early identification of carer needs and appropriate intervention can help avoid crisis situations for the carer and avoidable hospital admissions which are reported to be a global concern. The aim of the study was to explore what professionals and carers of patients with cancer and advanced progressive illness, in their last year of life, find burdensome and to develop an alert system for use by non-specialist staff. Methods: A mixed-method, multi-phased, consensus study sequentially utilising qualitative and quantitative data to develop and pilot the Carers’ Alert Thermometer (CAT). 245 people (117 carers and 128 professionals) participated in the study across a range of health and social care settings in the North West of England (2011–2014). Results: A number of key domains were identified and prioritised by consensus for inclusion in the CAT. The 8 domains fit within two overarching themes of the reported carer experience; the support needed by the carer to provide care and the support needed for the carer’s own health and well-being. The resultant CAT is an evidence-based alert thermometer consisting of 10 questions, guidance on the possible actions for each alert and space for an action plan to be jointly agreed by the assessor and carer. Preliminary piloting of the CAT has shown it to be valued, fit for purpose and it can be administered by a range of personnel. Conclusions: The CAT enables the identification of current and potential future needs so a proactive approach can be taken to supporting the carer as their role develops over time, with a view to enhancing their well-being and preventing avoidable hospital admissions; ultimately supporting patient choice to remain in their own home

Benefits and impacts of Active Lives groups for older people living in the community

There are an increasing number of older people globally and nationally. However this rise in life expectancy is not always paralleled with a good quality of life. Within the north west of England Age UK Lancashire was awarded three-year funding by the Big Lottery to undertake an Active Lives programme. This programme delivered a range of local activity groups aimed at promoting the health, activity, lifestyle and wellbeing of older people living within the community. This paper reports the findings of a three-year descriptive study which evaluated older people’s experiences of participating in the activity groups. The study identified the impact on their health, quality of life and wellbeing, use and benefits of the groups and suggestions for future service developments. Data were collected in three phases utilising focus groups and self-completed questionnaire surveys. Qualitative data were analysed by content analysis to identify key themes. Standard descriptive analysis was used for quantitative data. Key findings were benefits with general improvements in participants’ physical and mental health, their wellbeing and quality of life. It was concluded that Active Lives groups in the community presented an effective means of maintaining and improving older people’s health and social wellbeing

Land-Use Experiments in the Loch Laidon Catchment

This report presents the results from the Stream Water Quality component of the Loch Laidon catchment land-use experiment which commenced in 1992. The experiment was established with the aim of examining the effects of cattle grazing on the aquatic and terrestrial habitats and biota of a moorland area of upland Scotland

Use of a dual reporter plasmid to demonstrate bactofection with an attenuated aroa- derivative of Pasteurella multocida b:2

A reporter plasmid pSRG has been developed which expresses red fluorescent protein (RFP) from a constitutive prokaryotic promoter within Pasteurella multocida B:2 and green fluorescent protein (GFP) from a constitutive eukaryotic promoter within mammalian cells. This construct has been used to determine the location and viability of the bacteria when moving from the extracellular environment into the intracellular compartment of mammalian cells. Invasion assays with embryonic bovine lung (EBL) cells and an attenuated AroA- derivative of Pasteurella multocida B:2 (strain JRMT12), harbouring the plasmid pSRG, showed that RFP-expressing bacteria could be detected intracellularly at 3 h post-invasion. At this stage, some EBL cells harbouring RFP-expressing bacteria were observed to express GFP simultaneously, indicating release of the plasmid into the intracellular environment. At 5 h post-invasion, more EBL cells were expressing GFP, while still harbouring RFP-expressing bacteria. Concurrently, some EBL cells were shown to express only GFP, indicating loss of viable bacteria within these cells. These experiments proved the functionality of the pSRG dual reporter system and the potential of P. multocida B:2 JRMT12 for bactofection and delivery of a DNA vaccine

Ultrasonic Monitoring of Recrystallization Textures in Aluminum

The present paper is an attempt to use ultrasonic velocity measurements to characterize the texture of an aluminum-magnesium alloy (Al 5xxx) and to compare the results with orientation imaging microscopy (OIM) results. The results are characterized in terms of three orientation distribution coefficients (ODC’s), W400, W420, and W440, each of which describes a particular forming anisotropy, and each of which has significant impact on the final products

Runge-Kutta residual distribution schemes

We are concerned with the solution of time-dependent non-linear hyperbolic partial differential equations. We investigate the combination of residual distribution methods with a consistent mass matrix (discretisation in space) and a Runge–Kutta-type time-stepping (discretisation in time). The introduced non-linear blending procedure allows us to retain the explicit character of the time-stepping procedure. The resulting methods are second order accurate provided that both spatial and temporal approximations are. The proposed approach results in a global linear system that has to be solved at each time-step. An efficient way of solving this system is also proposed. To test and validate this new framework, we perform extensive numerical experiments on a wide variety of classical problems. An extensive numerical comparison of our approach with other multi-stage residual distribution schemes is also given

Effect of Texture on Ultrasonic Backscattering Coefficient in Pure Titanium Plate

Ultrasonic grain noise is one of the important factors which limit the detectability of small defects. The intensity of the grain noise may be represented by the ultrasonic backscattering coefficient which directly relates microstructure to the grain noise intensity. Various microstructures affect the backscattering coefficient, as reported in previous volumes of this series of proceedings1–3. In the present article, the effect of texture will be quantitatively discussed.</p

Enzymology of the branched-chain amino acid oxidation disorders: the valine pathway

Valine is one of the three branched-chain amino acids which undergoes oxidation within mitochondria. In this paper, we describe the current state of knowledge with respect to the enzymology of the valine oxidation pathway and the different disorders affecting oxidation