Patients' perceptions of the potential of breathing training for asthma: a qualitative study.

Poor symptom control is common in asthma. Breathing training exercises may be an effective adjunct to medication; it is therefore important to understand facilitators and barriers to uptake of breathing training exercises

Improving distress in dialysis (iDiD): a feasibility two-arm parallel randomised controlled trial of an online cognitive behavioural therapy intervention with and without therapist led telephone support for psychological distress in patients undergoing haemodialysis

Introduction: Psychological distress is common in end-stage kidney disease (ESKD) and is associated with poorer health outcomes. Cognitive behavioural therapy (CBT) is recommended in UK clinical guidelines for the management of depression in people with long-term conditions. Access to skilled therapists competent in managing the competing mental and physical health demands of ESKD is limited. Online CBT treatments tailored to the needs of the ESKD population offers a pragmatic solution for under-resourced services. This study examines the feasibility and acceptability of implementing a two-arm parallel randomised controlled trial of online CBT with (intervention arm) and without (control arm) therapist support to improve psychological distress in patients undergoing haemodialysis. Methods: Patients will be screened for depression and anxiety while attending for their haemodialysis treatments. We aim to recruit 60 adult patients undergoing haemodialysis who meet criteria for mild to moderately severe symptoms of depression and/or anxiety. Patients will be randomised individually (using a 1:1 computerised sequence ratio) to either online CBT with therapist telephone support (intervention arm), or online CBT with no therapist (control arm). Outcomes include feasibility and acceptability descriptive data on rates of recruitment, randomisation, retention and treatment adherence. Self-report outcomes include measures of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), quality of life (Euro-QoL), service use (client service receipt inventory) and illness cognitions (brief illness perception questionnaire). A qualitative process evaluation will also be conducted. The statistician will be blinded to treatment allocation. Ethics and dissemination: A National Health Service (NHS) research ethics committee approved the study. Data from this study will provide essential information for the design and testing of further interventions to ameliorate distress in patients undergoing dialysis. Any amendments to the protocol will be submitted to the NHS committee and study sponsor<br/

Status Update of the Parkes Pulsar Timing Array

The Parkes Pulsar Timing Array project aims to make a direct detection of a gravitational-wave background through timing of millisecond pulsars. In this article, the main requirements for that endeavour are described and recent and ongoing progress is outlined. We demonstrate that the timing properties of millisecond pulsars are adequate and that technological progress is timely to expect a successful detection of gravitational waves within a decade, or alternatively to rule out all current predictions for gravitational wave backgrounds formed by supermassive black-hole mergers.Comment: 10 pages, 3 figures, Amaldi 8 conference proceedings, accepted by Classical & Quantum Gravit

Development of a pulsar-based timescale

Using observations of pulsars from the Parkes Pulsar Timing Array (PPTA) project we develop the first pulsar-based timescale that has a precision comparable to the uncertainties in international atomic timescales. Our ensemble of pulsars provides an Ensemble Pulsar Scale (EPS) analogous to the free atomic timescale Echelle Atomique Libre (EAL). The EPS can be used to detect fluctuations in atomic timescales and therefore can lead to a new realisation of Terrestrial Time, TT(PPTA11). We successfully follow features known to affect the frequency of the International Atomic Timescale (TAI) and we find marginally significant differences between TT(PPTA11) and TT(BIPM11). We discuss the various phenomena that lead to a correlated signal in the pulsar timing residuals and therefore limit the stability of the pulsar timescale.Comment: Accepted for publication in MNRA

Fetal body MRI and its application to fetal and neonatal treatment: an illustrative review

This Review depicts the evolving role of MRI in the diagnosis and prognostication of anomalies of the fetal body, here including head and neck, thorax, abdomen and spine. A review of the current literature on the latest developments in antenatal imaging for diagnosis and prognostication of congenital anomalies is coupled with illustrative cases in true radiological planes with viewable three-dimensional video models that show the potential of post-acquisition reconstruction protocols. We discuss the benefits and limitations of fetal MRI, from anomaly detection, to classification and prognostication, and defines the role of imaging in the decision to proceed to fetal intervention, across the breadth of included conditions. We also consider the current capabilities of ultrasound and explore how MRI and ultrasound can complement each other in the future of fetal imaging

Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review

Background: To offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both womens and mens views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older peoples views or preferences regarding uptake and adherence to exercise to prevent falls. Methods: A review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach. Results: Nine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of mens and womens views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies. Conclusion: Although there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older womens and mens views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.Funding Agencies|Swedish Research Council [2015-03481]; Strategic Research Programme in Care Sciences, Umea University; Karolinska Institute, Sweden; Umea University</p

Gravitational wave detection using pulsars: status of the Parkes Pulsar Timing Array project

The first direct detection of gravitational waves may be made through observations of pulsars. The principal aim of pulsar timing array projects being carried out worldwide is to detect ultra-low frequency gravitational waves (f ~ 10^-9 to 10^-8 Hz). Such waves are expected to be caused by coalescing supermassive binary black holes in the cores of merged galaxies. It is also possible that a detectable signal could have been produced in the inflationary era or by cosmic strings. In this paper we review the current status of the Parkes Pulsar Timing Array project (the only such project in the Southern hemisphere) and compare the pulsar timing technique with other forms of gravitational-wave detection such as ground- and space-based interferometer systems.Comment: Accepted for publication in PAS

On detection of the stochastic gravitational-wave background using the Parkes pulsar timing array

We search for the signature of an isotropic stochastic gravitational-wave background in pulsar timing observations using a frequency-domain correlation technique. These observations, which span roughly 12 yr, were obtained with the 64-m Parkes radio telescope augmented by public domain observations from the Arecibo Observatory. A wide range of signal processing issues unique to pulsar timing and not previously presented in the literature are discussed. These include the effects of quadratic removal, irregular sampling, and variable errors which exacerbate the spectral leakage inherent in estimating the steep red spectrum of the gravitational-wave background. These observations are found to be consistent with the null hypothesis, that no gravitational-wave background is present, with 76 percent confidence. We show that the detection statistic is dominated by the contributions of only a few pulsars because of the inhomogeneity of this data set. The issues of detecting the signature of a gravitational-wave background with future observations are discussed.Comment: 12 pages, 8 figures, 7 tables, accepted for publication in MNRA