Increasing prevalence of asthma diagnosis and symptoms in children is confined to mild symptoms

BACKGROUND: The prevalence of childhood asthma is increasing but few studies have investigated trends in asthma severity. We investigated trends in asthma diagnosis and symptom morbidity between an eight year time period in a paired prevalence study. METHODS: All children in one single school year aged 8-9 years in the city of Sheffield were given a parent respondent questionnaire in 1991 and 1999 based on questions from the International Survey of Asthma and Allergy in Children (ISAAC). Data were obtained regarding the prevalence of asthma and wheeze and current (12 month) prevalences of wheeze attacks, speech limiting wheeze, nocturnal cough and wheeze, and exertional symptoms. RESULTS: The response rates in 1991 and 1999 were 4580/5321 (85.3%) and 5011/6021 (83.2%), respectively. There were significant increases between the two surveys in the prevalence of asthma ever (19.9% v 29.7%, mean difference 11.9%, 95% confidence interval (CI) 10.16 to 13.57, p<0.001), current asthma (10.3% v 13.0%, mean difference 2.7%, 95% CI 1.44 to 4.03, p<0.001), wheeze ever (30.3% v 35.8%, mean difference 5.7%, 95% CI 3.76 to 7.56, p<0.001), wheeze in the previous 12 months (17.0% v 19.4%, mean difference 2.5, 95% CI 0.95 to 4.07, p<0.01), and reporting of medication use (16.9% v 20%, mean difference 3.0%, 95% CI 1.46 to 4.62, p<0.001). There were also significant increases in reported hayfever and eczema diagnoses. CONCLUSIONS: Diagnostic labelling of asthma and lifetime prevalence of wheeze has increased. The current 12 month point prevalence of wheeze has increased but this is confined to occasional symptoms. The increased medication rate may be responsible for the static prevalence of severe asthma symptoms. The significant proportion of children receiving medication but reporting no asthma symptoms identified from our 1999 survey suggests that some children are being inappropriately treated or overtreated

A cusp electron gun for millimeter wave gyrodevices

The experimental results of a thermionic cusp electron gun, to drive millimeter and submillimeter wave harmonic gyrodevices, are reported in this paper. Using a "smooth" magnetic field reversal formed by two coils this gun generated an annular-shaped, axis-encircling electron beam with 1.5 A current, and an adjustable velocity ratio alpha of up to 1.56 at a beam voltage of 40 kV. The beam cross-sectional shape and transported beam current were measured by a witness plate technique and Faraday cup, respectively. These measured results were found to be in excellent agreement with the simulated results using the three-dimensional code MAGIC

Death by effectiveness:Exercise as medicine caught in the efficacy trap!

Sport and Exercise Medicine (SEM) has had a good run. For a while it was the low-cost magic bullet. With efficacy demonstrated in study after study, the conclusion was clear: ‘Exercise is Medicine’, a potential public health panacea. Sadly, the early promise waned. While we continue to be bombarded by original research and reviews extoling the efficacy of exercise, there is an apparent dearth of evidence of its effectiveness. This fact is highlighted in 2014 reports from the UK Government1 and Public Health England.

Conceptual design study for heat exhaust management in the ARC fusion pilot plant

The ARC pilot plant conceptual design study has been extended beyond its initial scope [B. N. Sorbom et al., FED 100 (2015) 378] to explore options for managing ~525 MW of fusion power generated in a compact, high field (B_0 = 9.2 T) tokamak that is approximately the size of JET (R_0 = 3.3 m). Taking advantage of ARC's novel design - demountable high temperature superconductor toroidal field (TF) magnets, poloidal magnetic field coils located inside the TF, and vacuum vessel (VV) immersed in molten salt FLiBe blanket - this follow-on study has identified innovative and potentially robust power exhaust management solutions.Comment: Accepted by Fusion Engineering and Desig

The association between long-term conditions and uptake of population-based screening for colorectal cancer: results from two English cohort studies

Introduction: Uptake of screening for colorectal cancer (CRC) can reduce mortality, and population-based screening is offered in England. To date, there is little evidence on the association between having a long-term condition (LTC) and CRC screening uptake. The objective of this study was to examine the association between having an LTC and uptake of CRC screening in England with the guaiac fecal occult blood test, with a particular focus on common mental disorders. Methods: The study was a preregistered secondary analysis of two cohorts: first, a linked data set between the regional Yorkshire Health Study (YHS) and the National Health Service National Bowel Cancer Screening Program (BCSP, years 2006–2014); second, the national English Longitudinal Study of Ageing (ELSA, years 2014–2015). Individuals eligible for BCSP screening who participated in either the YHS (7,142) or ELSA Wave 7 (4,099) were included. Study registration: ClinicalTrials.gov, number NCT02503969. Results: In both the cohorts, diabetes was associated with lower uptake (YHS odds ratio [OR] for non-uptake 1.35, 95% CI 1.03–1.78; ELSA 1.33, 1.03–1.72) and osteoarthritis was associated with increased uptake (YHS 0.75, 0.57–0.99; ELSA 0.76, 0.62–0.93). After controlling for broader determinants of health, there was no evidence of significantly different uptake for individuals with common mental disorders. Conclusion: Two large independent cohorts provided evidence that uptake of CRC screening is lower among individuals with diabetes and higher among individuals with osteoarthritis. Further work should compare barriers and facilitators to screening among individuals with either of these conditions. This study also demonstrates the benefits of data linkage for improving clinical decision-making

The XY Spin-Glass with Slow Dynamic Couplings

We investigate an XY spin-glass model in which both spins and couplings evolve in time: the spins change rapidly according to Glauber-type rules, whereas the couplings evolve slowly with a dynamics involving spin correlations and Gaussian disorder. For large times the model can be solved using replica theory. In contrast to the XY-model with static disordered couplings, solving the present model requires two levels of replicas, one for the spins and one for the couplings. Relevant order parameters are defined and a phase diagram is obtained upon making the replica-symmetric Ansatz. The system exhibits two different spin-glass phases, with distinct de Almeida-Thouless lines, marking continuous replica-symmetry breaking: one describing freezing of the spins only, and one describing freezing of both spins and couplings.Comment: 7 pages, Latex, 3 eps figure

Wideband gyro-amplifiers

Gyro-amplifiers using helically corrugated waveguides have shown exceptional gain, power, bandwidth, and efficiency performance at cm and mm wavelengths. The performance of a long pulse (and therefore high vacuum) system is strongly influenced by factors other than the intrinsic bandwidth of the interaction. We shall discuss these and other challenges, along with their mitigation in high average power wideband amplifiers