Decision making processes in people with symptoms of acute myocardial infarction: qualitative study

Objective To identify, the themes that influence decision making processes used by patients with symptoms of acute myocardial infarction. Design Qualitative study using semistructured interviews. Setting Two district hospitals in North Yorkshire. Participants 22 patients admitted to hospital with confirmed second, third, or fourth acute myocardial infarction. Main outcome measure Patients' perceptions of their experience between the onset of symptoms and the decision to seek medical help. Results Six main themes that influence the decision making process were identified: appraisal of In symptoms, perceived risk, previous experience, psychological and emotional factors, use of the NHS, and context of the event. Conclusions Knowledge of symptoms may not be enough to promote prompt action in the event of an acute myocardial infarction. Cognitive and emotional processes, individual beliefs and values, and the influence of the context of the event should also be considered in individual interventions designed to reduce delay in the event of symptoms of acute myocardial infarction

The Effect of LHC Jet Data on MSTW PDFs

We consider the effect on LHC jet cross sections on partons distribution functions (PDFs), in particular the MSTW2008 set of PDFs. We first compare the published inclusive jet data to the predictions using MSTW2008, finding a very good description. We also use the parton distribution reweighting procedure to estimate the impact of these new data on the PDFs, finding that the combined ATLAS 2.76 TeV and 7 TeV data, and CMS 7 TeV data have some significant impact. We then also investigate the impact of ATLAS, CMS and D0 dijet data using the same techniques. In this case we investigate the effect of using different scale choices for the NLO cross section calculation. We find that the dijet data is generally not completely compatible with the corresponding inclusive jet data, often tending to pull PDFs, particularly the gluon distribution, away from the default values. However, the effect depends on the dijet data set used as well as the scale choice. We also note that conclusions may be affected by limiting the pull on the data luminosity chosen by the best fit, which is sometimes a number of standard deviations. Finally we include the inclusive jet data in a new PDF fit explicitly. This enables us to check the consistency of the exact result with that obtained from the reweighting procedure. There is generally good, but not full quantitative agreement. Hence, the conclusion remains that MSTW2008 PDFs already fit the published jet data well, but the central values and uncertainties are altered and improved respectively by significant, but not dramatic extent by inclusion of these data.Comment: 63 pages, 50 figures. Final version. Some added discussion and improved figure

Near infrared spectroscopy of W51 IRS-2

Near-infrared spectra at 2.95-3.5 μm and 3.99-10 μm have been obtained towards W51 IRS-2 and its surroundings, in order to investigate the spatial variations in intensity of the 3.28 μm unidentified feature and the 4.05 μm Brackett-α line. The Br-α and 3.28 μm features occupy a broadly similar spatial zone, which is characterised by an unresolved core responsible for most of the emission, and an extended and considerably weaker halo. Grain properties required to excite the 4.28 microns line, the nature of the 3.28 μm emission, and its relation to the source structure are discussed

Atom Formation Rates Behind Shock Waves in Hydrogen and the Effect of Added Oxygen, July 1965 - July 1966

Formation rate of atomic hydrogen behind shock waves in hydrogen-argon mixture

What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews

OBJECTIVES: To assess the extent and pattern of implementation of guidance issued by the National Institute for Clinical Excellence (NICE). DESIGN: Interrupted time series analysis, review of case notes, survey, and interviews. SETTING: Acute and primary care trusts in England and Wales. PARTICIPANTS: All primary care prescribing, hospital pharmacies; a random sample of 20 acute trusts, 17 mental health trusts, and 21 primary care trusts; and senior clinicians and managers from five acute trusts. MAIN OUTCOME MEASURES: Rates of prescribing and use of procedures and medical devices relative to evidence based guidance. RESULTS: 6308 usable patient audit forms were returned. Implementation of NICE guidance varied by trust and by topic. Prescribing of some taxanes for cancer (P <0.002) and orlistat for obesity (P <0.001) significantly increased in line with guidance. Prescribing of drugs for Alzheimer’s disease and prophylactic extraction of wisdom teeth showed trends consistent with, but not obviously a consequence of, the guidance. Prescribing practice often did not accord with the details of the guidance. No change was apparent in the use of hearing aids, hip prostheses, implantable cardioverter defibrillators, laparoscopic hernia repair, and laparoscopic colorectal cancer surgery after NICE guidance had been issued. CONCLUSIONS: Implementation of NICE guidance has been variable. Guidance seems more likely to be adopted when there is strong professional support, a stable and convincing evidence base, and no increased or unfunded costs, in organisations that have established good systems for tracking guidance implementation and where the professionals involved are not isolated. Guidance needs to be clear and reflect the clinical context

Confinement of knotted polymers in a slit

We investigate the effect of knot type on the properties of a ring polymer confined to a slit. For relatively wide slits, the more complex the knot, the more the force exerted by the polymer on the walls is decreased compared to an unknotted polymer of the same length. For more narrow slits the opposite is true. The crossover between these two regimes is, to first order, at smaller slit width for more complex knots. However, knot topology can affect these trends in subtle ways. Besides the force exerted by the polymers, we also study other quantities such as the monomer-density distribution across the slit and the anisotropic radius of gyration.Comment: 9 pages, 6 figures, submitted for publicatio

Timing of N application and water constraints on N accumulation and juice amino N concentration in Chardonnay grapevines

The amount and timing of nitrogen (N) application to a vineyard is critical for must yeast assimilable nitrogen (YAN) concentrations. YAN concentrations and amino acid profiles are important for the fermentation process and wine composition. Commonly, N is applied at flowering to optimize leaf functioning or after harvest to enhance vine productivity the following season. In this study N was applied at various stages of berry development to determine allocation patterns between vine perennial and annual components and to assess when berry YAN concentrations can best be optimized. Five year old potted 'Chardonnay' vines received ammonium sulfate fertilizer at six different times from full bloom to two weeks before harvest and were also exposed to either full or half irrigation during that period. Reduced water supply resulted in a higher allocation of N to the perennial structures and less to the annual components of the vine. N allocation to the annual components of the vine was greatest when it was applied at full bloom, however allocation to the perennial components was greatest when it was applied after fruit-set to veraison. The timing of N supply had a substantial influence on YAN concentrations, and was highest when N was applied about two weeks after veraison. Low water supply also resulted in higher juice YAN concentrations. The perennial N reserves in the roots were highest under low water supply and when N was applied at veraison, while the allocation to the annual parts was lower under this irrigation regime. The study indicates that timing of N application and the application of water constraints during berry development can impact on N partitioning, while the total amount accumulated by the vine is not altered

Competing associations in six-species predator-prey models

We study a set of six-species ecological models where each species has two predators and two preys. On a square lattice the time evolution is governed by iterated invasions between the neighboring predator-prey pairs chosen at random and by a site exchange with a probability Xs between the neutral pairs. These models involve the possibility of spontaneous formation of different defensive alliances whose members protect each other from the external invaders. The Monte Carlo simulations show a surprisingly rich variety of the stable spatial distributions of species and subsequent phase transitions when tuning the control parameter Xs. These very simple models are able to demonstrate that the competition between these associations influences their composition. Sometimes the dominant association is developed via a domain growth. In other cases larger and larger invasion processes preceed the prevalence of one of the stable asociations. Under some conditions the survival of all the species can be maintained by the cyclic dominance occuring between these associations.Comment: 8 pages, 9 figure

An Improved 96-well Turbidity Assay for T4 Lysozyme Activity

T4 lysozyme (T4L) is an important model system for investigating the relationship between protein structure and function. Despite being extensively studied, a reliable, quantitative activity assay for T4L has not been developed. Here, we present an improved T4L turbidity assay as well as an affinity-based T4L expression and purification protocol. This assay is designed for 96-well format and utilizes conditions amenable for both T4L and other lysozymes. This protocol enables easy, efficient, and quantitative characterization of T4L variants and allows comparison between different lysozymes. Our method: •Is applicable for all lysozymes, with enhanced sensitivity for T4 lysozyme compared to other 96-well plate turbidity assays;•Utilizes standardized conditions for comparing T4 lysozyme variants and other lysozymes; and•Incorporates a simplified expression and purification protocol for T4 lysozyme

Oral health-related quality of life and loneliness among older adults

Loneliness is a serious concern in aging populations. The key risk factors include poor health, depression, poor material circumstances, and low social participation and social support. Oral disease and tooth loss have a significant negative impact on the quality of life and well-being of older adults. However, there is a lack of studies relating oral health to loneliness. This study investigated the association between oral health-related quality of life (through the use of the oral impact on daily performances—OIDP—measure) and loneliness amongst older adults living in England. Data from respondents aged 50 and older from the third (2006–2007) and fifth (2010–2011) waves of the English Longitudinal Study of Ageing were analyzed. In the cross-sectional logistic regression model that adjusted for socio-demographic, socio-economic, health, and psychosocial factors, the odds of loneliness were 1.48 (1.16–1.88; p < 0.01) higher amongst those who reported at least one oral impact compared to those with no oral impact. Similarly, in the fully adjusted longitudinal model, respondents who reported an incident oral impact were 1.56 times (1.09–2.25; p < 0.05) more likely to become lonely. The association between oral health-related quality of life and loneliness was attenuated after adjusting for depressive symptoms, low social participation, and social support. Oral health-related quality of life was identified as an independent risk factor for loneliness amongst older adults. Maintaining good oral health in older age may be a protective factor against loneliness