Cholesterol and coronary heart disease: screening and treatment

Coronary heart disease (CHD) is a major cause of morbidity and mortality in the United Kingdom, accounting for just under one quarter of all deaths in 1995: 27% among men and 21% among women.1 Although many CHD deaths occur among elderly people, CHD accounts for 31% of male and 13% of female deaths within the 45–64 age group

Precautionary labelling of foods for allergen content: are we ready for a global framework?

© 2014 Allen et al.; licensee BioMed Central Ltd.Food allergy appears to be on the rise with the current mainstay of treatment centred on allergen avoidance. Mandatory allergen labelling has improved the safety of food for allergic consumers. However an additional form of voluntary labelling (termed precautionary allergen labelling) has evolved on a wide range of packaged goods, in a bid by manufacturers to minimise risk to customers, and the negative impact on business that might result from exposure to trace amounts of food allergen present during cross-contamination during production. This has resulted in near ubiquitous utilisation of a multitude of different precautionary allergen labels with subsequent confusion amongst many consumers as to their significance. The global nature of food production and manufacturing makes harmonisation of allergen labelling regulations across the world a matter of increasing importance. Addressing inconsistencies across countries with regards to labelling legislation, as well as improvement or even banning of precautionary allergy labelling are both likely to be significant steps forward in improved food safety for allergic families. This article outlines the current status of allergen labelling legislation around the world and reviews the value of current existing precautionary allergen labelling for the allergic consumer. We strongly urge for an international framework to be considered to help roadmap a solution to the weaknesses of the current systems, and discuss the role of legislation in facilitating this

Naming Game on Adaptive Weighted Networks

We examine a naming game on an adaptive weighted network. A weight of connection for a given pair of agents depends on their communication success rate and determines the probability with which the agents communicate. In some cases, depending on the parameters of the model, the preference toward successfully communicating agents is basically negligible and the model behaves similarly to the naming game on a complete graph. In particular, it quickly reaches a single-language state, albeit some details of the dynamics are different from the complete-graph version. In some other cases, the preference toward successfully communicating agents becomes much more relevant and the model gets trapped in a multi-language regime. In this case gradual coarsening and extinction of languages lead to the emergence of a dominant language, albeit with some other languages still being present. A comparison of distribution of languages in our model and in the human population is discussed.Comment: 22 pages, accepted in Artificial Lif

de Sitter geodesics: reappraising the notion of motion

The de Sitter spacetime is transitive under a combination of translations and proper conformal transformations. Its usual family of geodesics, however, does not take into account this property. As a consequence, there are points in de Sitter spacetime which cannot be joined to each other by any one of these geodesics. By taking into account the appropriate transitivity properties in the variational principle, a new family of maximizing trajectories is obtained, whose members are able to connect any two points of the de Sitter spacetime. These geodesics introduce a new notion of motion, given by a combination of translations and proper conformal transformations, which may possibly become important at very-high energies, where conformal symmetry plays a significant role.Comment: 9 pages. V2: Presentation changes aiming at clarifying the text; version accepted for publication in Gen. Rel. Gra

The ROTSE-III Robotic Telescope System

The observation of a prompt optical flash from GRB990123 convincingly demonstrated the value of autonomous robotic telescope systems. Pursuing a program of rapid follow-up observations of gamma-ray bursts, the Robotic Optical Transient Search Experiment (ROTSE) has developed a next-generation instrument, ROTSE-III, that will continue the search for fast optical transients. The entire system was designed as an economical robotic facility to be installed at remote sites throughout the world. There are seven major system components: optics, optical tube assembly, CCD camera, telescope mount, enclosure, environmental sensing & protection and data acquisition. Each is described in turn in the hope that the techniques developed here will be useful in similar contexts elsewhere.Comment: 19 pages, including 4 figures. To be published in PASP in January, 2003. PASP Number IP02-11

An ethnographic study of strategies to support discussions with family members on end-of-life care for people with advanced dementia in nursing homes

BACKGROUND: Most people with advanced dementia die in nursing homes where families may have to make decisions as death approaches. Discussions about end-of-life care between families and nursing home staff are uncommon, despite a range of potential benefits. In this study we aimed to examine practices relating to end-of-life discussions with family members of people with advanced dementia residing in nursing homes and to explore strategies for improving practice. METHODS: An ethnographic study in two nursing homes where the Compassion Intervention was delivered. The Compassion Intervention provides a model of end-of-life care engaging an Interdisciplinary Care Leader to promote integrated care, educate staff, support holistic assessments and discuss end of life with families. We used a framework approach, undertaking a thematic analysis of fieldwork notes and observations recorded in a reflective diary kept by the Interdisciplinary Care Leader, and data from in-depth interviews with 23 informants: family members, GPs, nursing home staff, and external healthcare professionals. RESULTS: Four major themes described strategies for improving practice: (i) educating families and staff about dementia progression and end-of-life care; (ii) appreciating the greater value of in-depth end-of-life discussions compared with simple documentation of care preferences; (iii) providing time and space for sensitive discussions; and (iv) having an independent healthcare professional or team with responsibility for end-of-life discussions. CONCLUSIONS: The Interdisciplinary Care Leader role offers a promising method for supporting and improving end-of-life care discussions between families of people with advanced dementia and nursing home staff. These strategies warrant further evaluation in nursing home settings

Agitation near the end of life with dementia: An ethnographic study of care

Background and objectives Agitation is common in people living with dementia especially at the end of life. We examined how staff interpreted agitation behavior in people with dementia nearing end of life, how this may influence their responses and its impact on the quality of care. Research design Ethnographic study. Structured and semi-structured non-participant observations (referred to subsequently in this paper as “structured observations”) of people living with dementia nearing the end of life in hospital and care homes (south-east England) and in-depth interviews with staff, conducted August 2015-March 2017. Methods Three data sources: 1) detailed field notes, 2) observations using a structured tool and checklist for behaviors classed as agitation and staff and institutional responses, 3) staff semi-structured qualitative interviews. We calculated the time participants were agitated and described staff responses. Data sources were analyzed separately, developed continuously and relationally during the study and synthesized where appropriate. Results We identified two main ‘ideal types’ of staff explanatory models for agitation: In the first, staff attribute agitated behaviors to the person’s “moral judgement”, making them prone to rejecting or punitive responses. In the second staff adopt a more “needs-based” approach in which agitation behaviors are regarded as meaningful and managed with proactive and investigative approaches. These different approaches appear to have significant consequences for the timing, frequency and quality of staff response. While these models may overlap they tend to reflect distinct organizational resources and values. Conclusions Care worker knowledge about agitation is not enough, and staff need organizational support to care better for people living with dementia towards end of life. Positional theory may help to explain much of the cultural-structural context that produces staff disengagement from people with dementia, offering insights on how agitation behavior is reframed by some staff as dangerous. Such behavior may be associated with low-resource institutions with minimal staff training where the personhood of staff may be neglected

Generic bounds on dipolar gravitational radiation from inspiralling compact binaries

Various alternative theories of gravity predict dipolar gravitational radiation in addition to quadrupolar radiation. We show that gravitational wave (GW) observations of inspiralling compact binaries can put interesting constraints on the strengths of the dipole modes of GW polarizations. We put forward a physically motivated gravitational waveform for dipole modes, in the Fourier domain, in terms of two parameters: one which captures the relative amplitude of the dipole mode with respect to the quadrupole mode ($\alpha$) and the other a dipole term in the phase ($\beta$). We then use this two parameter representation to discuss typical bounds on their values using GW measurements. We obtain the expected bounds on the amplitude parameter $\alpha$ and the phase parameter $\beta$ for Advanced LIGO (AdvLIGO) and Einstein Telescope (ET) noise power spectral densities using Fisher information matrix. AdvLIGO and ET may at best bound $\alpha$ to an accuracy of $\sim10^{-2}$ and $\sim10^{-3}$ and $\beta$ to an accuracy of $\sim10^{-5}$ and $\sim10^{-6}$ respectively.Comment: Matches with the published versio