Design study of magnetic eddy-current vibration suppression dampers for application to cryogenic turbomachinery

Cryogenic turbomachinery used to pump high pressure fuel (liquid H2) and oxidizer (liquid O2) to the main engines of the Space Shuttle have experienced rotor instabilities. Subsynchronous whirl, an extremely destructive instability, has caused bearing failures and severe rubs in the seals. These failures have resulted in premature engine shutdowns or, in many instances, have limited the power level to which the turbopumps could be operated. The feasibility of using an eddy current type of damping mechanism for the Space Shuttle Main Engine is outlined

RIDGE and InterRidge: Cooperative interdisciplynary studies of mid-ocean ridges

RIDGE (gidge mer-Oisciplinary Boba1 bperiments) is a major research initiative in the United States designed to complement existing research on spreading centers. RIDGE has been designed to integrate exploration, expenment and theory into a major, decade-long effort to understand one of the pnmary processes that have shaped the evolution of our planet. Its objectives are twofold: (1) to provide a focus for a coordinated, interdisciplinary research program directed at geological, hydrothermal and biological processes associated with the formation of oceanic cmst, and (2) to provide a framework within which a rich diversity of investigator-initiated research can be undertaken. The RIDGE initiative has led to parallel efforts in other nations which have recently joined together to form InterRidge, an intemational collaboration of some sixteen countries focused on ridge crest studies

The importance of acknowledgement of emotions in routine patient psychological assessment:The example of the dental setting

This work was funded by the Chief Scientist Office, Scotland under their Clinical Academic Fellowship Scheme (grant number: CAF/07/02).Objective:  To investigate, by means of a conceptual model, the effect of dental staff engaging with their patients who share their level of dental anxiety in a short screening questionnaire. Methods :  Three consecutive studies based in the UK primary dental care services were conducted. Each study adopted a randomised group design to focus on the possible influence on patient state anxiety of the dentist becoming aware of their patients' dental anxiety from the self-reports of the Modified Dental Anxiety Scale (MDAS). Results :  A consistent finding in the first two studies was that the presentation of MDAS score sheet to the dentist was effective in reducing patient state anxiety when leaving the surgery. The third study provided supportive evidence that a more permanent anxiolytic effect of the presentation of the MDAS to the dentist was associated with the dentist responding openly to their patient about the fears expressed. Conclusion:  The active engagement of dental staff in the formal presentation of dental anxiety screening confers a reliable benefit to dentally anxious patients. Clinical implications:   Anxiety assessments in clinical service may give patients significant relief when staff acknowledge and engage patients when presented with their self-reported ratings.PostprintPeer reviewe

Virtual Reality Relaxation to Decrease Dental Anxiety:Immediate Effect Randomized Clinical Trial

Introduction: Dental anxiety is common and causes symptomatic use of oral health services. Objectives: The aim was to study if a short-term virtual reality intervention reduced preoperative dental anxiety. Methods: A randomized controlled single-center trial was conducted with 2 parallel arms in a public oral health care unit: virtual reality relaxation (VRR) and treatment as usual (TAU). The VRR group received a 1- to 3.5-min 360° immersion video of a peaceful virtual landscape with audio features and sound supporting the experience. TAU groups remained seated for 3 min. Of the powered sample of 280 participants, 255 consented and had complete data. Total and secondary sex-specific mixed effects linear regression models were completed for posttest dental anxiety (Modified Dental Anxiety Scale [MDAS] total score) and its 2 factors (anticipatory and treatment-related dental anxiety) adjusted for baseline (pretest) MDAS total and factor scores and age, taking into account the effect of blocking. Results: Total and anticipatory dental anxiety decreased more in the VRR group than the TAU group (β = −0.75, P < .001, for MDAS total score; β = −0.43, P < .001, for anticipatory anxiety score) in patients of a primary dental care clinic. In women, dental anxiety decreased more in VRR than TAU for total MDAS score (β = −1.08, P < .001) and treatment-related dental anxiety (β = −0.597, P = .011). Anticipatory dental anxiety decreased more in VRR than TAU in both men (β = −0.217, P < .026) and women (β = −0.498, P < .001). Conclusion: Short application of VRR is both feasible and effective to reduce preoperative dental anxiety in public dental care settings (ClinicalTrials.gov NCT03993080). Knowledge Transfer Statement: Dental anxiety, which is a common problem, can be reduced with short application of virtual reality relaxation applied preoperatively in the waiting room. Findings of this study indicate that it is a feasible and effective procedure to help patients with dental anxiety in normal public dental care settings.Publisher PDFPeer reviewe

MapMySmoke : feasibility of a new quit cigarette smoking mobile phone application using integrated geo-positioning technology, and motivational messaging within a primary care setting

This work was funded in part by an NHS Fife Research and Development Bursary Award to all authors. In addition, we have received funding from the University of St Andrews’ EPSRC Impact Acceleration Account. In 2013, Schick received a LEADERS award from the Scottish Universities Life Sciences Alliance that started this project.Background:  Approximately 11,000 people die in Scotland each year as a result of smoking-related causes. Quitting smoking is relatively easy; maintaining a quit attempt is a very difficult task with success rates for unaided quit attempts stubbornly remaining in the single digits. Pharmaceutical treatment can improve these rates by lowering the overall reward factor of nicotine. However, these and related nicotine replacement therapies do not operate on, or address, the spatial and contextual aspects of smoking behaviour. With the ubiquity of smartphones that can log spatial, quantitative and qualitative data related to smoking behaviour, there exists a person-centred clinical opportunity to support smokers attempting to quit by first understanding their smoking behaviour and subsequently sending them dynamic messages to encourage health behaviour change within a situational context. Methods:  We have built a smartphone app—MapMySmoke—that works on Android and iOS platforms. The deployment of this app within a clinical National Health Service (NHS) setting has two distinct phases: (1) a 2-week logging phase where pre-quit patients log all of their smoking and craving events; and (2) a post-quit phase where users receive dynamic support messages and can continue to log craving events, and should they occur, relapse events. Following the initial logging phase, patients consult with their general practitioner (GP) or healthcare provider to review their smoking patterns and to outline a precise, individualised quit attempt plan. Our feasibility study consists of assessment of an initial app version during and after use by eight patients recruited from an NHS Fife GP practice. In addition to evaluation of the app as a potential smoking cessation aid, we have assessed the user experience, technological requirements and security of the data flow. Results:  In an initial feasibility study, we have deployed the app for a small number of patients within one GP practice in NHS Fife. We recruited eight patients within one surgery, four of whom actively logged information about their smoking behaviour. Initial feedback was very positive, and users indicated a willingness to log their craving and smoking events. In addition, two out of three patients who completed follow-up interviews noted that the app helped them reduce the number of cigarettes they smoked per day, while the third indicated that it had helped them quit. The study highlighted the use of pushed notifications as a potential technology for maintaining quit attempts, and the security of collection of data was audited. These initial results influenced the design of a planned second larger study, comprised of 100 patients, the primary objectives of which are to use statistical modelling to identify times and places of probable switches into smoking states, and to target these times with dynamic health behaviour messaging. Conclusions:  While the health benefits of quitting smoking are unequivocal, such behaviour change is very difficult to achieve. Many factors are likely to contribute to maintaining smoking behaviour, yet the precise role of cues derived from the spatial environment remains unclear. The rise of smartphones, therefore, allows clinicians the opportunity to better understand the spatial aspects of smoking behaviour and affords them the opportunity to push targeted individualised health support messages at vulnerable times and places.Publisher PDFPeer reviewe

Assessing sedation need and managing referred dentally anxious patients:is there a role for the Index of Sedation Need?

Aim: To conduct an exploratory investigation of public dental service (PDS) practitioners' planned sedation modality using a structural equation modelling approach, in order to identify the explanatory value of using the Index of Sedation Need (IOSN), or its component parts, to predict sedation modality in patients referred with dental anxiety. Methods: A convenience sample of patients referred to the PDS for dental anxiety management was invited to take part. The IOSN was completed for each patient (patient dental anxiety, medical and behavioural indicators and dental treatment complexity) as well as the American Society of Anesthesiologists Physical Status Classification System and the Case Mix Tool. The practitioners completed details of their planned sedation modality and identified normative dental treatment need. The data were entered onto an SPSS v21 database and subjected to frequency distributions, t-tests, correlation analysis and exploratory partial structural equation modelling (SEM). Results: Ninety-five percent of patients were ranked as MDAS 3 or 4, indicating high dental anxiety; 69% had a medical condition, which might impact on dental treatment and 82% had a dental treatment need, which was classified as intermediate/complex according to the IOSN. Eighty-eight percent of the patients in accordance with the IOSN required sedation: 62% of patients were assessed as requiring intravenous sedation. The IOSN discriminated between patients who were assessed as requiring more complex sedation modalities and had a greater normative treatment need. The SEM showed that the patient dental anxiety (P &lt;0.02) and dental treatment complexity (P &lt;0.02) predicted planned sedation modality. Functional morbidity was less strong, as a predictor, and was significant at the ten percent level. Conclusions: The IOSN is a useful and valid assessment of sedation need and predicted sedation modality for patients referred with high dental anxiety states and secondly, that component parts of the IOSN add explanatory value in practitioners' choice of planned sedation modality

Prevalence and clinical and psychological correlates of high fear of cancer recurrence in patients newly diagnosed with head and neck cancer

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Cross-sectional evaluation of a longitudinal consultation skills course at a new UK medical school

Background: Good communication is a crucial element of good clinical care, and it is important to provide appropriate consultation skills teaching in undergraduate medical training to ensure that doctors have the necessary skills to communicate effectively with patients and other key stakeholders. This article aims to provide research evidence of the acceptability of a longitudinal consultation skills strand in an undergraduate medical course, as assessed by a cross-sectional evaluation of students' perceptions of their teaching and learning experiences. Methods: A structured questionnaire was used to collect student views. The questionnaire comprised two parts: 16 closed questions to evaluate content and process of teaching and 5 open-ended questions. Questionnaires were completed at the end of each consultation skills session across all year groups during the 2006-7 academic year (5 sessions in Year 1, 3 in Year 2, 3 in Year 3, 10 in Year 4 and 10 in Year 5). 2519 questionnaires were returned in total. Results: Students rated Tutor Facilitation most favourably, followed by Teaching, then Practice & Feedback, with suitability of the Rooms being most poorly rated. All years listed the following as important aspects they had learnt during the session: • how to structure the consultation • importance of patient-centredness • aspects of professionalism (including recognising own limits, being prepared, generally acting professionally). All years also noted that the sessions had increased their confidence, particularly through practice. Conclusions: Our results suggest that a longitudinal and integrated approach to teaching consultation skills using a well structured model such as Calgary-Cambridge, facilitates and consolidates learning of desired process skills, increases student confidence, encourages integration of process and content, and reinforces appreciation of patient-centredness and professionalism

The care and support needs of residential care home residents with comorbid cancer and dementia: A qualitative review and ethnographic study.

Background: Prevalence of cancer and dementia are strongly related to age. In the UK, 70% of care home residents have dementia. By 2040, older people (aged 65+) will account for 77% of all people living with cancer. Residents with only one of these conditions may have complex care needs. Having comorbid cancer and dementia (CCD) is likely to bring further challenges. This is the first research project to examine the care and support needs of people with CCD living in residential care homes and areas for improvement. Aims: To explore: (1) The care and support needs of people with CCD living in residential care homes. (2) What constitutes good care for people with CCD, their family/supporters, and residential care home staff. (3) Potential barriers and facilitators to providing good care for people with CCD. Methods: (1) Literature review to examine implications for cancerrelated care for people with dementia living in residential care homes. (2) Interviews with 5‐10 men and women with CCD, their family members/ supporters, and residential care home staff. (3) Ethnographic observations of 5‐10 people with CCD to further explore barriers and facilitators to good care. Results: Emergent findings from the literature review will be presented, and their implications for supporting people with CCD living in residential care homes discussed. Conclusions: Findings from this study will help improve the care and support of people with CCD and will contribute to a wider programme of research exploring the cancer care needs of people with dementia across a variety of care settings