Transition to adult services for children and young people with palliative care needs : a systematic review

Objective: To evaluate the evidence on the transition process from child to adult services for young people with palliative care needs. Design: Systematic review Setting: Child and adult services and interface between healthcare providers. Patients: Young people aged 13 to 24 years with palliative care conditions in the process of transition. Main outcome measures: Young people and their families’ experiences of transition, the process of transition between services and its impact on continuity of care, and models of good practice. Results: 92 studies included. Papers on transition services were of variable quality when applied to palliative care contexts. Most focused on common life threatening and life limiting conditions. No standardised transition programme identified and most guidelines used to develop transition services were not evidence based. Most studies on transition programmes were predominantly condition-specific (e.g. cystic fibrosis, cancer) services. Cystic fibrosis services offered high quality transition with the most robust empirical evaluation. There were differing condition-dependent viewpoints on when transition should occur but agreement on major principles guiding transition planning and probable barriers. There was evidence of poor continuity between child and adult providers with most originating from within child settings. Conclusions: Palliative care was not, in itself, a useful concept for locating transition-related evidence. It is not possible to evaluate the merits of the various transition models for palliative care contexts, or their effects on continuity of care, as there are no long-term outcome data to measure their effectiveness. Use of validated outcome measures would facilitate research and service development

Lightweight Composite Materials for Heavy Duty Vehicles

The main objective of this project is to develop, analyze and validate data, methodologies and tools that support widespread applications of automotive lightweighting technologies. Two underlying principles are guiding the research efforts towards this objective: • Seamless integration between the lightweight materials selected for certain vehicle systems, cost-effective methods for their design and manufacturing, and practical means to enhance their durability while reducing their Life-Cycle-Costs (LCC). • Smooth migration of the experience and findings accumulated so far at WVU in the areas of designing with lightweight materials, innovative joining concepts and durability predictions, from applications to the area of weight savings for heavy vehicle systems and hydrogen storage tanks, to lightweighting applications of selected systems or assemblies in light–duty vehicles

Knowledge and information needs of informal caregivers in palliative care : a qualitative systematic review

Objectives: To review current understanding of the knowledge and information needs of informal caregivers in palliative settings. Data sources: Seven electronic databases were searched for the period January 1994–November 2006: Medline, CINAHL, PsychINFO, Embase, Ovid, Zetoc and Pubmed using a meta-search engine (Metalib®). Key journals and reference lists of selected papers were hand searched. Review methods: Included studies were peer-reviewed journal articles presenting original research. Given a variety of approaches to palliative care research, a validated systematic review methodology for assessing disparate evidence was used in order to assign scores to different aspects of each study (introduction and aims, method and data, sampling, data analysis, ethics and bias, findings/results, transferability/generalizability, implications and usefulness). Analysis was assisted by abstraction of key details of study into a table. Results: Thirty-four studies were included from eight different countries. The evidence was strongest in relation to pain management, where inadequacies in caregiver knowledge and the importance of education were emphasized. The significance of effective communication and information sharing between patient, caregiver and service provider was also emphasized. The evidence for other caregiver knowledge and information needs, for example in relation to welfare and social support was weaker. There was limited literature on non-cancer conditions and the care-giving information needs of black and minority ethnic populations. Overall, the evidence base was predominantly descriptive and dominated by small-scale studies, limiting generalizability. Conclusions: As palliative care shifts into patients’ homes, a more rigorously researched evidence base devoted to understanding caregivers knowledge and information needs is required. Research design needs to move beyond the current focus on dyads to incorporate the complex, three-way interactions between patients, service providers and caregivers in end-of-life care setting

Management of the respiratory distress symptom cluster in lung cancer: a randomised controlled feasibility trial.

BACKGROUND: Breathlessness, cough and fatigue are distressing symptoms for patients with lung cancer. There is evidence that these three symptoms form a discreet symptom cluster. This study aimed to feasibly test a new non-pharmacological intervention for the management of the Respiratory Distress Symptom Cluster (breathlessness-cough-fatigue) in lung cancer. METHOD: This was a multi-centre, randomised controlled non-blinded parallel group feasibility trial. Eligible patients (patients with primary lung cancer and 'bothered' by at least two of the three cluster symptoms) received usual care plus a multicomponent intervention delivered over two intervention training sessions and a follow-up telephone call or usual care only. Follow-up was for 12 weeks, and end-points included six numerical rating scales for breathlessness severity, Dyspnoea-12, Manchester Cough in Lung Cancer scale, FACIT-Fatigue scale, Hospital Anxiety and Depression scale, Lung Cancer Symptom Scale and the EQ-5D-3L, collected at baseline, week 4 and week 12. RESULTS: One hundred seven patients were randomised over 8 months; however, six were removed from further analysis due to protocol violations (intervention group n = 50 and control group n = 51). Of the ineligible patients (n = 608), 29 % reported either not experiencing two or more symptoms or not being 'bothered' by at least two symptoms. There was 29 % drop-out by week 4, and by week 12, a further two patients in the control group were lost to follow-up. A sample size calculation indicated that 122 patients per arm would be needed to detect a clinically important difference in the main outcome for breathlessness, cough and fatigue. CONCLUSIONS: The study has provided evidence of the feasibility and acceptability of a new intervention in the lung cancer population and warrants a fully powered trial before we reach any conclusions. The follow-on trial will test the hypothesis that the intervention improves symptom cluster of breathlessness, cough and fatigue better than usual care alone. Full economic evaluation will be conducted in the main trial

Ferrocene-Decorated Hyperbranched Poly(aroxycarbonylphenylene)s: Synthesis, Light Refraction, Photopatterning and Precursor to Magnetic Ceramics

Ferrocene-decorated hyperbranched poly[1,3,5-tri(aroycarbonyl)phenylene]s (hb-PTACPs) are prepared in moderate yields with high molecular weights by one-pot polycyclotrimerization of 4,4'-isopropylidenediphenyl bipropiolate with 4-(ferrocenylmethyl)phenyl propiolate in reflux dimethylformamide. All the polymers are soluble and film-forming. They enjoy high thermal stability and lost little of their weight when heated to 300 °C under nitrogen. Thin solid films of the organometallic polymers shows high refractive indices (RI = 1.7038–1.6295) in the wavelength region of 400–1,700 nm. Ceramization of the organometallic hb-PTACPs at high temperature under inert atmosphere gives iron nanoparticles with high magnetizabilities. The organometallic polymers are readily cross-linked under UV irradiation and pyrolysis of the patterned polymer films produces magnetic ceramic patterns with good shape retention

The association between exaggeration in health related science news and academic press releases: retrospective observational study

Objective To identify the source (press releases or news) of distortions, exaggerations, or changes to the main conclusions drawn from research that could potentially influence a reader’s health related behaviour. Design Retrospective quantitative content analysis. Setting Journal articles, press releases, and related news, with accompanying simulations. Sample Press releases (n=462) on biomedical and health related science issued by 20 leading UK universities in 2011, alongside their associated peer reviewed research papers and news stories (n=668). Main outcome measures Advice to readers to change behaviour, causal statements drawn from correlational research, and inference to humans from animal research that went beyond those in the associated peer reviewed papers. Results 40% (95% confidence interval 33% to 46%) of the press releases contained exaggerated advice, 33% (26% to 40%) contained exaggerated causal claims, and 36% (28% to 46%) contained exaggerated inference to humans from animal research. When press releases contained such exaggeration, 58% (95% confidence interval 48% to 68%), 81% (70% to 93%), and 86% (77% to 95%) of news stories, respectively, contained similar exaggeration, compared with exaggeration rates of 17% (10% to 24%), 18% (9% to 27%), and 10% (0% to 19%) in news when the press releases were not exaggerated. Odds ratios for each category of analysis were 6.5 (95% confidence interval 3.5 to 12), 20 (7.6 to 51), and 56 (15 to 211). At the same time, there was little evidence that exaggeration in press releases increased the uptake of news. Conclusions Exaggeration in news is strongly associated with exaggeration in press releases. Improving the accuracy of academic press releases could represent a key opportunity for reducing misleading health related news

Molecular anchors in the solid state: Restriction of intramolecular rotation boosts emission efficiency of luminogen aggregates to unity

Introduction of freely rotatable tetraphenylethene (TPE) to conventional luminophors quenches their light emissions in the solutions but endows the resultant molecules (TPEArs) with aggregation-induced emission characteristics in the condensed phase due to the restriction of intramolecular rotation. High fluorescence quantum yields up to 100% have been achieved in the films of TPEArs

A mechanistic study of AIE processes of TPE luminogens: Intramolecular rotation vs. configurational isomerization

Chromophores containing olefinic double bonds are the core components of many important luminogen systems that show the novel photophysical effect of aggregation-induced emission (AIE). The role and extent of E–Z isomerization (EZI) of the double bond in affecting the solution emissions of the AIE luminogens (AIEgens), however, have not been fully understood. In this work, we verified the occurrence of EZI in the dilute solutions of TPE-cored AIEgens by NMR spectroscopy using elaborate experimental procedures. We further designed a TPE-fluorescein adduct to quantify that EZI plays a minor role whereas intramolecular rotation plays a major role in the emission quenching processes of the AIEgen solutions. This study fills the gap in the research on the restriction of the intramolecular rotation (RIR) mechanism for the AIE effect and provides a useful tool for the mechanistic investigation of photoluminescence processes

Caveats in science-based news stories communicate caution without lowering interest

Science stories in the media are strongly linked to changes in health-related behavior. Science writers (including journalists, press officers, and researchers) must therefore frame their stories to communicate scientific caution without disrupting coherence and disengaging the reader. In this study we investigate whether caveats (“Further research is needed to validate the results”) satisfy this dual requirement. In four experiments participants read news reports with and without caveats. In Experiments 1 to 3, participants judged how cautious or confident researchers were, and how interesting or comprehensible they found the reports. News reports with caveats were judged as more cautious that those without, but levels of reader interest and comprehensibility were unaffected. In a fourth experiment, we created a mock newsroom and recruited journalism students to make judgments about which press releases should be published. Here, neither caveats nor the introduction of qualifying expressions in headlines had an effect on judgments of newsworthiness, consistent with Experiments 1 to 3. The reasons participants gave for rejecting a press release rarely referred to the caveat. Our results therefore suggest that science writers should include caveats in news reporting and that they can do so without fear of disengaging their readers or losing news uptak

How readers understand causal and correlational expressions used in news headlines

[Correction Notice: An Erratum for this article was reported in Vol 23(1) of Journal of Experimental Psychology: Applied (see record 2016-59631-001). In the article, the fourth author was inadvertently omitted from the advance online version. Also, the second paragraph of the author note should have included the following: “Amy Barrington contributed to the design and data collection for Experiments 2 and 3. We thank the following undergraduate students for contributions to Experiment 1 and pilot work leading up to the project: Laura Benjamin, Cecily Donnelly, Cameron Dunlop, Rebecca Emerson, Rose Fisher, Laura Jones, Olivia Manship, Hannah McCarthy, Naomi Scott, Eliza Walwyn-Jones, Leanne Whelan, and Joe Wilton.” All versions of this article have been corrected.] Science-related news stories can have a profound impact on how the public make decisions. The current study presents 4 experiments that examine how participants understand scientific expressions used in news headlines. The expressions concerned causal and correlational relationships between variables (e.g., “being breast fed makes children behave better”). Participants rated or ranked headlines according to the extent that one variable caused the other. Our results suggest that participants differentiate between 3 distinct categories of relationship: direct cause statements (e.g., “makes,” “increases”), which were interpreted as the most causal; can cause statements (e.g., “can make,” “can increase”); and moderate cause statements (e.g., “might cause,” “linked,” “associated with”), but do not consistently distinguish within the last group despite the logical distinction between cause and association. On the basis of this evidence, we make recommendations for appropriately communicating cause and effect in news headlines