Reporting participation rates in studies of non-pharmacological interventions for patients with chronic obstructive pulmonary disease: a systematic review

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Understanding the reasons for non participation in self-manegement intervemtions amongst aptienrs with chronic conditions: addressing and increasing opportunities for patients with advanced chronic obstructive pulmonary disease to access self-management

Background In chronic obstructive pulmonary disease (COPD), understanding the problem of poor patient participation in evidence-based self-management (SM) and pulmonary rehabilitation (PR) programmes (together referred to as SM support programmes) is critical. This thesis aimed to improve understanding of poor patient participation and retention in these programmes; how participation might be improved; and how might patients be better supported with their SM. Methods Using the Medical Research Council guidance on complex interventions this thesis (1) quantified the ‘actual’ patient participation and completion rates; (2) explained, using theory, the factors that influenced participation in studies of SM support including the programmes among chronic disease and COPD patients; and (3) explored patient and expert stakeholders’ perspectives on the reasons for non-participation in SM support programmes, how participation might be improved, how might patients be supported with their SM. Results (1) Among 56 studies, high study participation rates and completion rates were seen however, the incomplete reporting of participant flow confused the problem of participation. (2) Among 31 studies, participation among patients with chronic disease including COPD was shown to be influenced by their ‘attitude’ and ‘perceived social influence/subjective norms’; ‘illness’ and ‘intervention perceptions’. (3) From 38 interviewees, besides patients’ beliefs, non-participation was also influenced by resignation and denial of the illness; health systems; and programme organisational factors. Professionals building relationships and supporting patients with their SM alongside programme organisational improvements might encourage patient participation in SM and the programmes. Conclusions Patient participation is a complex behaviour, besides socio-behavioural factors, participation behaviour can by influenced by a mix of several health system and programme organisational factors. Changing the behaviour of health professionals and indeed the wider health system, towards normalising a patient partnership approach, with implementation of SM support in routine care might help more patients to consider participation in their care and improve patient participation in COPD SM support programmes.The National Institute for Health Researc

"Test me and treat me" - attitudes to vitamin D deficiency and supplementation: a qualitative study

© 2015 BMJ Open, "Test me and treat me"-attitudes to vitamin D deficiency and supplementation: a qualitative study. This manuscript version is made available under the Creative Commons Attribution Licens

Scalable Bandwidth and High-Precision Spectral Measurement by Frequency Chirped Comb

A cost-effective scan technique enabling scalable measurement range is presented by injecting a sweep RF signal of 27.5-30 GHz into an electro-optic comb generator. The 10th-order harmonic scans over an extended span (275-300 GHz) where an ultra-narrow (Q >106) resonance is well-resolved with sub-MHz resolution

On the Impact of Frequency Variation on Nonlinearity Mitigation using Frequency Combs

We investigated the impact of linewidth and dithering-induced frequency variation on the performance of nonlinearity mitigation using frequency combs. Compared to independent laser arrays, >2dB SNR gain can be achieved using comb sources

Pilot-aided Pump Dithering Removal in Degenerate FWM-based Optical Phase Conjugation Systems with Higher-order QAM

A pump dithering removal algorithm, based on pilot sequence-aided DSP, is proposed and experimentally validated in dual polarization 64 QAM optical phase conjugation system. A 4.2 dB SNR improvement was observed due to the SBS suppression

Implementing psychological interventions delivered by respiratory professionals for people with COPD. A stakeholder interview study.

Implementing psychological interventions in healthcare services requires an understanding of the organisational context. We conducted an interview study with UK National Health Service stakeholders to understand the barriers and facilitators for implementing psychological interventions for people with chronic obstructive pulmonary disorder (COPD). We used TANDEM as an exemplar intervention; a psychological intervention recently evaluated in a randomised controlled trial. Twenty participants providing care and/or services to people with COPD were purposively sampled from NHS primary/secondary care, and commissioning organisations. Participants were recruited via professional networks and referrals. Verbatim transcripts of semi-structured interviews were analysed using thematic analysis. Four themes were identified: (1) Living with COPD and emotional distress affects engagement with physical and psychological services; (2) Resource limitations affects service provision in COPD; (3) Provision of integrated care is important for patient well-being; and (4) Healthcare communication can be an enabler or a barrier to patient engagement. People need support with physical and psychological symptoms inherent with COPD and healthcare should be provided holistically. Respiratory healthcare professionals are considered able to provide psychologically informed approaches, but resources must be available for training, staff supervision and service integration. Communication between professionals is vital for clear understanding of an intervention's aims and content, to facilitate referrals and uptake. There was widespread commitment to integrating psychological and physical care, and support of respiratory healthcare professionals' role in delivering psychological interventions but significant barriers to implementation due to concerns around resources and cost efficiency. The current study informs future intervention development and implementation

Clock and Data Recovery-Free Data Communications Enabled by Multi-core Fiber with Low Thermal Sensitivity of Skew

Optical switching has the potential to scale the capacity of data center networks (DCN) with a simultaneously reduction in latency and power consumption. One of the main challenges of optically-switched DCNs is the need for fast clock and data recovery (CDR). Because the DCN traffic is dominated by small packets, the CDR locking time is required to be less than one nanosecond for achieving high network throughput. This need for sub-nanosecond CDR locking time has motivated research on optical clock synchronization techniques, which deliver synchronized clock signals through optical fibers such that the CDR modules in each transceiver only need to track the slow change of clock phase, due to change of the time of flight as temperature varies. It is desired to remove the need for clock phase tracking (and thereby the CDR modules) if the temperatureinduced clock phase drift can be significantly reduced, which would reduce the power consumption and the cost of transceivers. Previous studies have shown that the temperature-induced skew change between multi-core fiber (MCF) cores can be forty times lower than that of standard single mode fibers. Thus, clock-synchronized transmission maybe possible by using two different MCF cores for clock and data transmission, respectively, enabling the sharing of an optical clock with stable clock phase. To investigate the potential of MCF for CDR-free short-reach communications, we first improve the measurement method of the temperature dependent inter-core skew change by using a modified delay interferometer, achieving a resolution of 3.8 femtoseconds for accurate inter-core skew measurements. Building on the MCF measurement results, we carried out an MCF-based clock-synchronized transmission experiment, demonstrating the feasibility of CDR-free data communications over a temperature range of 43 ◦C that meets DCN requirements