Prognostic variables and scores identifying the last year of life in COPD: a systematic review protocol

Introduction People living with advanced chronic obstructive pulmonary disease (COPD) suffer from significant morbidity, reduced quality of life and high mortality, and are likely to benefit from many aspects of a palliative care approach. Prognostic estimates are a meaningful part of decision-making and better evidence for such estimates would facilitate advance care planning. We aim to provide quality evidence on known prognostic variables and scores which predict a prognosis in COPD of <12 months for use in the community. Methods and analysis We will conduct a systematic review of randomised or quasi-randomised controlled trials, prospective and retrospective longitudinal cohort and case–control studies on prognostic variables, multivariate scores or models for COPD. The search will cover the period up to April 2016. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with data extraction using fields from the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) checklist for multivariate models, and study quality will be assessed using a modified version of the Quality In Prognosis Studies (QUIPS) tool. Ethics and dissemination The results will be disseminated through peer-reviewed publications and national and international conference presentations

Failure properties of loaded fiber bundles having a lower cutoff in fiber threshold distribution

Presence of lower cutoff in fiber threshold distribution may affect the failure properties of a bundle of fibers subjected to external load. We investigate this possibility both in a equal load sharing (ELS) fiber bundle model and in local load sharing (LLS) one. We show analytically that in ELS model, the critical strength gets modified due to the presence of lower cutoff and it becomes bounded by an upper limit. Although the dynamic exponents for the susceptibility and relaxation time remain unchanged, the avalanche size distribution shows a permanent deviation from the mean-fiels power law. In the LLS model, we analytically estimate the upper limit of the lower cutoff above which the bundle fails at one instant. Also the system size variation of bundle's strength and the avalanche statistics show strong dependence on the lower cutoff level.Comment: 7 pages and 7 figure

Adherence to prophylaxis in adolescents and young adults with severe haemophilia, A qualitative study with patients

© 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Abstract Introduction: Reported levels of adherence to prophylaxis among young people with haemophilia (YPH) vary widely and are predominately based on estimations made by healthcare professionals and parents. Reasons for (non)adherence among YPH in particular have not been evidenced. Aim: to examine experiences in relation to prophylaxis with YPH themselves, and barriers and facilitators to their adherence. Methods: 11 Participants were recruited in five haemophilia centres across England and Wales. All patients who met the inclusion criteria (aged 12-25, diagnosed with haemophilia, on prophylaxis) were approached during a routine check-up appointment, and all participants who agreed to take part were interviewed. Interviews were audio recorded, transcribed and analysed using Interpretative Phenomenological Analysis. Results: Self-reported adherence to prophylaxis was good. Few participants admitted to intentionally skipping injections although they reported sometimes forgetting. However, due to the increasingly personalised and flexible approach to prophylaxis, adherence is not straightforward to define. Barriers to adherence included a busy lifestyle, dislike of the intravenous injection, venous access issues, anxiety or stress and being out of one’s normal routine. Support was an important facilitator to adherence, including support from health professionals at the haemophilia centre as well as friends. Parents appear to be very involved with their sons’ haemophilia management, even after their sons leave home. Conclusion: What this study adds is that the increasingly flexible and personalized approach to managing prophylaxis in haemophilia may sometimes lead to confusion around treatment frequency and dosing. This may lead to accidental non-adherence, which is distinct from both skipping and forgetting. Advice from haemophilia teams may not always be consistent, and is likely to be interpreted differently by different individuals. Some additional training and education of patients and their families to increase their knowledge and skills around prophylaxis may reduce this confusion and therefore is likely to improve adherence further.Peer reviewedFinal Published versio

Symplectic Lefschetz fibrations with arbitrary fundamental groups

In this paper we give an explicit construction of a symplectic Lefschetz fibration whose total space is a smooth compact four dimensional manifold with a prescribed fundamental group. We also study the numerical properties of the sections in symplectic Lefschetz fibrations and their relation to the structure of the monodromy group.Comment: 45 pages, LaTeX2e. Minor mistakes corrected. New appendix by Ivan Smith added, proving the non-existence of SLF with monodromy contained in the Torelli grou

Large-Alphabet Time-Frequency Entangled Quantum Key Distribution by means of Time-to-Frequency Conversion

We introduce a novel time-frequency quantum key distribution (TFQKD) scheme based on photon pairs entangled in these two conjugate degrees of freedom. The scheme uses spectral detection and phase modulation to enable measurements in the temporal basis by means of time-to-frequency conversion. This allows large-alphabet encoding to be implemented with realistic components. A general security analysis for TFQKD with binned measurements reveals a close connection with finite-dimensional QKD protocols and enables analysis of the effects of dark counts on the secure key size.Comment: 14 pages, 3 figures, submitte

National evaluation of the neighbourhood nurseries: integrated report

Report description: The NNI was launched in 2001 to provide high quality childcare in the most disadvantaged neighbourhoods of England, to help parents into employment, reduce child poverty and boost children’s development. By 2005 45,000 new childcare places had been created in approximately 1,400 neighbourhood nurseries. This report brings together the findings of the four individual strands of the National Evaluation of Neighbourhood Nurseries Initiative as shown above and makes a number of recommendations. The report shows the rationale for the government’s strategy in targeting disadvantaged neighbourhoods and in focusing on high quality childcare to provide the link between raising parental employment and income and improving children’s life chances

Temperature perturbation model of the opto-galvanic effect in CO2-laser discharges

A detailed discharge model of the opto-galvanic effect in molecular laser gas mixtures is developed based on the temperature perturbation or discharge cooling mechanism of Smith and Brooks (1979). Excellent agreement between the model and experimental results in CO2 laser gas mixtures is obtained. The model should be applicable to other molecular systems where the OGE is being used for laser stabilisation and as a spectroscopic tool

National evaluation of the neighbourhood nurseries: impact report

This study assessed the impact of NNI on parental employment, use of formal childcare, and take-up of benefits and tax credits, particularly for disadvantaged groups such as lone parents, low income families and ethnic minority groups

The importance of the classical channel in the impurity transport of optimized stellarators

In toroidal magnetic confinement devices, such as tokamaks and stellarators, neoclassical transport is usually an order of magnitude larger than its classical counterpart. However, when a high-collisionality species is present in a stellarator optimized for low Pfirsch-Schl\"uter current, its classical transport can be comparable to the neoclassical transport. In this letter, we compare neoclassical and classical fluxes and transport coefficients calculated for Wendelstein 7-X (W7-X) and Large Helical Device (LHD) cases. In W7-X, we find that the classical transport of a collisional impurity is comparable to the neoclassical transport for all radii, while it is negligible in the LHD cases, except in the vicinity of radii where the neoclassical transport changes sign. In the LHD case, electrostatic potential variations on the flux-surface significantly enhance the neoclassical impurity transport, while the classical transport is largely insensitive to this effect in the cases studied.Comment: 10 pages, 2 figure

A randomized trial of brief intervention strategies in patients with alcohol-related facial trauma as a result of interpersonal violence

Facial trauma is associated with male gender, low socioeconomic status, alcohol misuse, and violence. Brief intervention (BI) for alcohol is effective at reducing consumption in patients presenting with facial trauma. Singlesession control of violence for angry impulsive drinkers(SS-COVAID) is a new intervention that attempts to address alcohol-related violence. This study assessed the effect of SS-COVAID and BI on drinking and aggression in facial trauma patients. Male facial trauma patients who sustained their injuries as a result of interpersonal violence while drinking and who had Alcohol Use Disorders Identification Test (AUDIT) scores of &#8805;8 were randomized to either BI or SS-COVAID. Patients were followed up at six and 12 months, and drinking and aggression outcomes were analyzed. One hundred ninety-nine patients entered the trial, and 187 were included in the analysis. Of these, 165 (89%) considered themselves to be victims, 92 (51%) had sustained a previous alcohol-related injury, and 28 (15%) had previous convictions for violence. Both interventions resulted in a significant decrease in negative drinking outcomes over 12 months of follow-up (p&#60;0.001). Neither intervention had a significant effect on aggression scores, nor was there a significant difference between interventions in terms of either outcome. Both SS-COVAID and BI had a significant effect on drinking variables in this patient cohort. No effect on aggressionwas seen despite the fact that SS-COVAID specifically addresses the relationship between alcohol and violence. One reason for this may be that the facial trauma patients in this study considered themselves to be victims rather than aggressors. Another possibility is that, while BI may successfully address lifestyle factors such as hazardous or harmful drinking, it may not be effective in modifying personality traits such as aggression