An investigation into the approaches used by western medical herbalists for the therapeutic management of osteoarthritis

Osteoarthritis affects people from middle age onwards, an occurrence likely to increase as average age of the population rises. Physical aspects of the condition are accompanied by increased all-cause mortality and morbidity. Use of pharmaceutical medication may be unhelpful or undesired. Much research focuses on the use of single herbs contrary to current Western herbal practice of combining several herbs with diet and lifestyle advice. This research aimed to explore this knowledge gap by eliciting details of strategies used to manage osteoarthritis. A qualitative approach using audio recorded, semi-structured interviews, with additional questions to define practitioner demographics was used for the study. The study sample comprised eight herbalists, all members of either the National Institute of Medical Herbalists or the College of Practitioners of Phytotherapy, each with a minimum two years in practice and experience of treating osteoarthritis. The resulting data was analysed using thematic analysis. Practitioner demographics revealed a range of time in practice, choice of practice location and training establishment. Analysis of the interviews elicited five themes; patient picture, practitioners’ therapeutic strategy, herbal treatment, non-herbal treatment and practitioners’ perceived treatment outcomes. A core group of 11 frequently used herbs was identified with a further 33 herbs being used less often. All practitioners prescribed remedies internally with most also using topical treatments. In conclusion, the patient picture was a diverse one with no clear picture of a ‘typical’ patient with osteoarthritis; however, consensus between practitioners’ treatment approaches, both herbal and non-herbal was high. Selected herbal remedies were consistent with literature found on some single herb studies. All herbalists were of the opinion that the herbal approach to osteoarthritis had a positive effect on the condition. These outcomes were usually perceived by reduced intake of painkillers and observing improved mobility or reduced inflammation

Maser Flare Simulations from Oblate and Prolate Clouds

We investigated, through numerical models, the flaring variability that may arise from the rotation of maser clouds of approximately spheroidal geometry, ranging from strongly oblate to strongly prolate examples. Inversion solutions were obtained for each of these examples over a range of saturation levels from unsaturated to highly saturated. Formal solutions were computed for rotating clouds with many randomly chosen rotation axes, and corresponding averaged maser light curves plotted with statistical information. The dependence of results on the level of saturation and on the degree of deformation from the spherical case were investigated in terms of a variability index and duty cycle. It may be possible to distinguish observationally between flares from oblate and prolate objects. Maser flares from rotation are limited to long timescales (at least a few years) and modest values of the variability index ($\lesssim 100$), and can be aperiodic or quasi-periodic. Rotation is therefore not a good model for H$_2$O variability on timescales of weeks to months, or of truly periodic flares.Comment: 11 pages, 12 figures, accepted for publication in MNRA

Taxation and control of the Kenyan coffee industry

This paper examines the current method of taxation and control of the coffee industry in Kenya and outlines an alternative system aimed at improving the industry's efficiency. Control of the industry has been exercised through a system of acreage quotas which have been fixed since 1963, and taxes have not been made sufficiently sensitive to the wide fluctuations in income in good and bad years. A system of volume control is proposed which incorporates a more flexible system of taxation and should encourage a change in resource allocation to allow production of the desired national coffee output at a lower opportunity cost. The implications of this new system are examined for coffee estates and smallholdings , and the effects on employment and net foreign exchange earnings are discussed

Drag and inertia coefficients for horizontally submerged rectangular cylinders in waves and currents

The results of an experimental investigation carried out to measure combined wave and current loads on horizontally submerged square and rectangular cylinders are reported in this paper. The wave and current induced forces on a section of the cylinders with breadth-depth (aspect) ratios equal to 1, 0.5, and 0.75 are measured in a wave tank. The maximum value of Keulegan-Carpenter (KC) number obtained in waves alone is about 5 and Reynolds (Re) number ranged from 6.3976103 to 1.186105. The drag (CD) and inertia (CM) coefficients for each cylinder are evaluated using measured sectional wave forces and particle kinematics calculated from linear wave theory. The values of CD and CM obtained for waves alone have already been reported (Venugopal, V., Varyani, K. S., and Barltrop, N. D. P. Wave force coefficients for horizontally submerged rectangular cylinders. Ocean Engineering, 2006, 33, 11-12, 1669-1704) and the coefficients derived in combined waves and currents are presented here. The results indicate that both drag and inertia coefficients are strongly affected by the presenceof the current and show different trends for different cylinders. The values of the vertical component inertia coefficients (CMY) in waves and currents are generally smaller than the inertia coefficients obtained in waves alone, irrespective of the current's magnitude and direction. The results also illustrate the effect of a cylinder's aspect ratio on force coefficients. This study will be useful in the design of offshore structures whose columns and caissons are rectangular sections

The role of ion-molecule reactions in the growth of heavy ions in Titan's ionosphere

This is the published version. Copyright 2014 American Geophysical UnionThe Ion and Neutral Mass Spectrometer (INMS) and Cassini Plasma Spectrometer (CAPS) have observed Titan's ionospheric composition and structure over several targeted flybys. In this work we study the altitude profiles of the heavy ion population observed by the Cassini Plasma Spectrometer-Ion Beam Spectrometer (CAPS-IBS) during the nightside T57 flyby. We produce altitude profiles of heavy ions from the C6–C13 group (Ci indicates the number, i, of heavy atoms in the molecule) using a CAPS-IBS/INMS cross calibration. These altitude profiles reveal structure that indicates a region of initial formation and growth at altitudes below 1200 km followed by a stagnation and dropoff at the lowest altitudes (1050 km). We suggest that an ion-molecule reaction pathway could be responsible for the production of the heavy ions, namely reactions that utilize abundant building blocks such as C2H2 and C2H4, which have been shown to be energetically favorable and that have already been identified as ion growth patterns for the lighter ions detected by the INMS. We contrast this growth scenario with alternative growth scenarios determining the implications for the densities of the source heavy neutrals in each scenario. We show that the high-mass ion density profiles are consistent with ion-molecule reactions as the primary mechanism for large ion growth. We derive a production rate for benzene from electron recombination of C6H7+ of 2.4 × 10−16 g cm−2 s−1 and a total production rate for large molecules of 7.1 × 10−16 g cm−2 s−1

Admission Decision-Making in Hospital Emergency Departments: the Role of the Accompanying Person

In resource-stretched emergency departments, people accompanying patients play key roles in patients' care. This article presents analysis of the ways health professionals and accompanying persons talked about admission decisions and caring roles. The authors used ethnographic case study design involving participant observation and semi-structured interviews with 13 patients, 17 accompanying persons and 26 healthcare professionals in four National Health Service hospitals in south-west England. Focused analysis of interactional data revealed that professionals’ standardization of the patient-carer relationship contrasted with accompanying persons' varied connections with patients. Accompanying persons could directly or obliquely express willingness, ambivalence and resistance to supporting patients’ care. The drive to avoid admissions can lead health professionals to deploy conversational skills to enlist accompanying persons for discharge care without exploring the meanings of their particular relations with patients. Taking a relationship-centered approach could improve attention to accompanying persons as co-producers of healthcare and participants in decision-making

Developing a self‐consistent description of Titan's upper atmosphere without hydrodynamic escape

In this study, we develop a best fit description of Titan's upper atmosphere between 500 km and 1500 km, using a one‐dimensional (1‐D) version of the three‐dimensional (3‐D) Titan Global Ionosphere‐Thermosphere Model. For this modeling, we use constraints from several lower atmospheric Cassini‐Huygens investigations and validate our simulation results against in situ Cassini Ion‐Neutral Mass Spectrometer (INMS) measurements of N 2 , CH 4 , H 2 , 40 Ar, HCN, and the major stable isotopic ratios of 14 N/ 15 N in N 2 . We focus our investigation on aspects of Titan's upper atmosphere that determine the amount of atmospheric escape required to match the INMS measurements: the amount of turbulence, the inclusion of chemistry, and the effects of including a self‐consistent thermal balance. We systematically examine both hydrodynamic escape scenarios for methane and scenarios with significantly reduced atmospheric escape. Our results show that the optimum configuration of Titan's upper atmosphere is one with a methane homopause near 1000 km and atmospheric escape rates of 1.41–1.47 ×10 11 CH 4  m −2 s −1 and 1.08 ×10 14  H 2  m −2 s −1 (scaled relative to the surface). We also demonstrate that simulations consistent with hydrodynamic escape of methane systematically produce inferior fits to the multiple validation points presented here. Key Points The methane homopause is most likely near 1000 km altitude Hydrodynamic escape of methane is not required to match INMS Molecular hydrogen is best fit with a methane homopause of 1000 kmPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108005/1/jgra51076.pd