Prediction of airborne sound transmission across a timber-concrete composite floor using Statistical Energy Analysis

This paper concerns the development and experimental validation of prediction models using Statistical Energy Analysis (SEA) to calculate the airborne sound insulation of a timber–concrete composite floor. The complexity in modelling this floor is due to it having (1) a multilayer upper plate formed from concrete and Oriented Strand Board (OSB), (2) multiple types of rigid connector between the upper plate and the timber joists and (3) a resiliently suspended ceiling. A six-subsystem model treats the concrete–OSB plate as a single subsystem and three different five-subsystem models treat the combination of concrete, OSB and timber joists as a single orthotropic plate subsystem. For the orthotropic plate it is suggested that bending stiffnesses predicted using the theories of Huffington and Troitsky provide a more suitable and flexible approach than that of Kimura and Inoue. All SEA models are able to predict the weighted sound reduction index to within 2 dB of the measurement. The average difference (magnitude) between measurements and predictions in one-third octave bands is up to 4 dB. These results confirm that SEA can be used to model direct transmission across relatively complex floor constructions. However, this requires the inclusion of measured data in the SEA model, namely the dynamic stiffness of the resilient isolators and the cavity reverberation time

What is the most appropriate treatment for chronic rhinosinusitis?

Chronic rhinosinusitis (CRS) is a common, treatable disease that affects approximately 11% of British adults. It places an enormous burden on patients, with significant detriment to their quality of life, and the health service as it consumes vast numbers of both primary and secondary care resources. However, there is considerable variability in treatment strategies and prescribing practices. This review summarises the key recommendations from landmark guidelines in the treatment of CRS and critically appraises the evidence for treatment

Use of Nonmedicated Control Substances in Randomized Clinical Trials of Patients with Chronic Rhinosinusitis:A Systematic Review and Single-Arm Meta-analysis

IMPORTANCE: The effect of nonmedicated control substances in chronic rhinosinusitis remains unclear. OBJECTIVE: To assess the association of nonmedicated control substances in randomized clinical trials with disease outcomes in patients diagnosed with chronic rhinosinusitis. DATA SOURCES AND STUDY SELECTION: In this single-arm systematic review and meta-analysis, the Cochrane Library of Systematic Reviews, Ovid MEDLINE, Embase, PubMed, and ClinicalTrials.gov databases were searched for randomized clinical trials with a preintervention and postintervention design for chronic rhinosinusitis that were published between 1946 and January 23, 2019. DATA EXTRACTION AND SYNTHESIS: Paired reviewers independently extracted data. The analyses used random-effects models and the Cochrane risk of bias assessment to rate the quality of the evidence. MAIN OUTCOMES AND MEASURES: The primary outcomes were the association of nonmedicated control substances with 22-item Sinonasal Outcome Test (SNOT-22) scores or nasal symptom scores when SNOT-22 was not available. RESULTS: A total of 2305 abstracts were identified and screened, 725 articles were reviewed in full text, and 38 articles met the study criteria and were included in the meta-analysis. Among the 38 included studies, a total of 2258 adults (mean age range, 27-53 years; 20.0%-72.5% women) were randomized to receive nonmedicated control substances or sham interventions. Topical nonmedicated control substances were associated with significant reduction in SNOT-22 scores (mean difference [MD], −8.81; 95% CI, −12.60 to −5.03). A subgroup analysis of topical therapies, limited to saline irrigation and nasal spray diluents, found that topical diluents were associated with a greater reduction in SNOT-22 scores (MD, −11.45; 95% CI, −13.50 to −9.41) compared with saline irrigation (MD, −13.60; 95% CI, −19.95 to −7.25). Nonmedicated control substances were associated with a significant reduction in nasal obstruction scores (standardized MD [SMD], −0.42; 95% CI, −0.81 to −0.03). No significant change was found in rhinorrhea scores (SMD, −0.34; 95% CI, −1.37 to 0.69), postnasal drip scores (SMD, −0.96; 95% CI, −2.18 to 0.25), facial pain scores (SMD, −0.57; 95% CI, −1.68 to 0.55), or loss of smell scores (SMD, −0.18; 95% CI, −0.68 to 0.32). CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis of the use of nonmedicated control substances in randomized clinical trials of chronic rhinosinusitis outcomes suggests that the use of nonmedicated control substances is associated with limited improvements in SNOT-22 and nasal obstruction scores. These findings highlight potential areas of future research directions and the importance of randomized clinical trials to accurately estimate treatment effect

School experiences of queer youth who are deaf

Abstract: Historically, South African society has had conflicting views on the nature and nurture of Deaf people and Lesbian, Gay, Bisexual, Transgender, Intersex and Queer (LGBTIQ) people. In the context of the diverse nature of South African cultures and societies, the reality and existence of deaf and LGBTIQ people’s lives have historically remained invisible and oppressed. Consequently, this study explored how South African school youth, who are deaf or hard-of-hearing and identify as either LGBTIQ, navigate their learning and social environments in schools. In an attempt to discover ways in which the South African schooling system can respond to and accommodate deaf learners who embody queer identities. This study was based on a qualitative approach with a phenomenological paradigm and a historical narrative research design. In this study, data was collected by means of face-to-face interviews with five queer participants who are deaf. The findings from this study found that South African school youth who are deaf or hard-of-hearing and that identify as LGBTIQ are systematically disadvantaged and limited in their capacity to navigate their learning and social environments during their schooling years. The findings highlighted that owing to the institutionalisation of heteronormativity and compulsory heterosexuality within the frameworks, policies, curriculum and infrastructure of the deaf schools, the learners are systematically denied knowledge of the existence of queer sexualities and gender identities. Therefore, their school years are marked with uncertainty of sexual identities, internal conflict and homophobia owing to the compulsory heteronormative culture embedded within the deaf institutions. Thus, the findings of this study illustrated that queer learners who are deaf, only disclose and embrace their queer sexualities and gender identities once they have left school. Consequently, the findings of this study revealed the following needs: firstly, for queer youth who are deaf to receive diverse sexuality education within the classroom. Secondly, for accommodations in the school uniforms and infrastructure. Thirdly, addressing the sign language communication barriers of teachers, counsellors and parents. Lastly, the need for access to diverse sexuality resources and materials for the queer youth who are deaf.M.Ed. (Educational Psychology

A case-control study of medical, psychological and socio-economic factors influencing the severity of chronic rhinosinusitis

BACKGROUND: Chronic rhinosinusitis (CRS) is a common and debilitating disorder. Little is known about the epidemiology of this disease. The aims of the study were to identify differences in socio-economic variables and quality of life between patients with chronic rhinosinusitis and healthy controls, to identify any significant associations between CRS and other medical co-morbidities, psychiatric disease or environmental exposure and to explore the experience of CRS from the perspective of CRS sufferers. METHODS: Participants were recruited from ENT clinics from 30 centres across the UK. They completed a study-specific questionnaire considering environmental, medical and socio-economic factors, and SF-36 and SNOT-22 scores. All participants with CRS were diagnosed by a clinician and categorised as having CRS (with polyposis, without polyposis or allergic fungal rhinosinusitis (AFRS)). Controls included family and friends of those attending ENT outpatient clinics and hospital staff who had no diagnosis of nose or sinus problems and had not been admitted to hospital in the previous 12 months. RESULTS: A total of 1470 study participants (1249 patients and 221 controls) were included in the final analysis. Highly significant differences were seen in generic and disease-specific quality of life scores between CRS sufferers and controls; mean SNOT-22 score 45.0 for CRS compared with 12.1 amongst controls. There were no clear differences in socioeconomic variables including social class, index of multiple deprivation and educational attainment between cases and controls. Common comorbidities with a clear association included respiratory and psychiatric disorders, with a higher frequency of reported upper respiratory tract infections. CONCLUSIONS: CRS is associated with significant impairment in quality of life and with certain medical co-morbidities. In contrast to other common ENT disorders, no socioeconomic differences were found between patients and controls in this study

Sexual misery’ or ‘happy British Muslims’? : Contemporary depictions of Muslim sexuality

We begin this article with a close look at some contemporary pictures of sexual life in the Muslim world that have been painted in certain sections of the Western media, asking how and why these pictures matter. Across a range of mainstream print media from the New York Times to the Daily Mail, and across reported events from several countries, can be found pictures of ‘sexual misery’ (Daoud, 2016: np.). These ‘frame’ Muslim men as tyrannical, Muslim women as downtrodden or exploited, and the wider world of Islam as culpable (Morey and Yaqin, 2012). Crucially, this is not the whole story. We then consider how these negative representations are being challenged and how they can be challenged further. In doing so, we will not simply set pictures of sexual misery against their binary opposites, namely pictures replete with the promise of sexual happiness (Ahmed, 2010). Instead, we search for a more complex picture, one that unsettles stereotypes about the sexual lives of Muslims without simply idealizing its subjects. This takes us to the journalism, life writing and creative non-fiction of Shelina Zahra Janmohamed and the fiction of Ayisha Malik and Amjeed Kabil. We read this long-form work critically, attending to manifest advances in depictions of the relationships of Muslim-identified individuals over the last decade or so, while also remaining alert to lacunae and limitations in the individual representations. More broadly, we hope to signal our intention to avoid both Islamophobia and Islamophilia (Shryock, 2010) in scrutinizing literary texts

Altered smell and taste: anosmia, parosmia and the impact of long Covid-19

Background: Qualitative olfactory (smell) dysfunctions are a common side effect of post-viral illness and known to impact quality of life and health status. Evidence is emerging that taste and smell loss are common symptoms of Covid-19 that may emerge and persist long after initial infection. The aim of the present study was to document the impact of post Covid-19 alterations to taste and smell. Methods: We conducted exploratory thematic analysis of user-generated text from 9000 users of the AbScent Covid-19 Smell and Taste Loss moderated Facebook support group from March 24 to 30th September 2020. Results: Participants reported difficulty explaining and managing an altered sense of taste and smell; a lack of interpersonal and professional explanation or support; altered eating; appetite loss, weight change; loss of pleasure in food, eating and social engagement; altered intimacy and an altered relationship to self and others. Conclusions: Our findings suggest altered taste and smell with Covid-19 may lead to severe disruption to daily living that impacts on psychological well-being, physical health, relationships and sense of self. More specifically, participants reported impacts that related to reduced desire and ability to eat and prepare food; weight gain, weight loss and nutritional insufficiency; emotional wellbeing; professional practice; intimacy and social bonding; and the disruption of people’s sense of reality and themselves. Our findings should inform further research and suggest areas for the training, assessment and treatment practices of health care professionals working with long Covid

Knee joint neuromuscular activation performance during muscle damage and superimposed fatigue

This study examined the concurrent effects of exercise-induced muscle damage and superimposed acute fatigue on the neuromuscular activation performance of the knee flexors of nine males (age: 26.7 ± 6.1yrs; height 1.81 ± 0.05m; body mass 81.2 ± 11.7kg [mean ± SD]). Measures were obtained during three experimental conditions: (i) FAT-EEVID, involving acute fatiguing exercise performed on each assessment occasion plus a single episode of eccentric exercise performed on the first occasion and after the fatigue trial; (ii) FAT, involving the fatiguing exercise only and; (iii) CON consisting of no exercise. Assessments were performed prior to (pre) and at lh, 24h, 48h, 72h, and 168h relative to the eccentric exercise. Repeated-measures ANOVAs showed that muscle damage within the FAT-EEVID condition elicited reductions of up to 38%, 24%) and 65%> in volitional peak force, electromechanical delay and rate of force development compared to baseline and controls, respectively (F[io, 80] = 2.3 to 4.6; p to 30.7%>) following acute fatigue (Fp; i6] = 4.3 to 9.1; p ; Fp, iq = 3.9; p <0.05). The safeguarding of evoked muscle activation capability despite compromised volitional performance might reveal aspects of capabilities for emergency and protective responses during episodes of fatigue and antecedent muscle damaging exercise

Mass of the Southern Black Hole in NGC 6240 from Laser Guide Star Adaptive Optics

NGC 6240 is a pair of colliding disk galaxies, each with a black hole in its core. We have used laser guide star adaptive optics on the Keck II telescope to obtain high-resolution ($\sim 0.06$") near-infrared integral-field spectra of the region surrounding the supermassive black hole in the south nucleus of this galaxy merger. We use the K-band CO absorption bandheads to trace stellar kinematics. We obtain a spatial resolution of about 20 pc and thus directly resolve the sphere of gravitational influence of the massive black hole. We explore two different methods to measure the black hole mass. Using a Jeans Axisymmetric Multi-Gaussian mass model, we investigate the limit that a relaxed mass distribution produces all of the measured velocity dispersion, and find an upper limit on the black hole mass at 2.0 \pm 0.2 \times 10^9 M_{\sun}. When assuming the young stars whose spectra we observe remain in a thin disk, we compare Keplerian velocity fields to the measured two-dimensional velocity field measured and fit for a mass profile containing a black hole point mass plus a radially-varying spherical component, which suggests a lower limit for the black hole mass of 8.7 \pm 0.3 \times 10^8 M_{\sun}. Our measurements of the stellar velocity dispersion place this AGN within the scatter of the $M_{BH}$-$\sigma_{*}$ relation. As NGC 6240 is a merging system, this may indicate that the relation is preserved during a merger at least until the final coalescence of the two nuclei.Comment: 10 pages, 12 figures; accepted to Ap

Chronic rhinosinusitis:a qualitative study of patient views and experiences of current management in primary and secondary care

OBJECTIVES: To explore patient views and perspectives of current management of chronic rhinosinusitis (CRS) in primary and secondary care. DESIGN: Semistructured qualitative telephone interviews as part of the MACRO programme (Defining best Management for Adults with Chronic RhinOsinusitis). SETTING: Primary care and secondary care ear, nose and throat outpatient clinics in the UK. PARTICIPANTS: Twenty-five patients consented to in-depth telephone interviews. Transcribed recordings were managed using NVivo software and analysed using inductive thematic analysis. RESULTS: CRS has a significant impact on patients' quality of life, affecting their ability to work effectively, their social interactions and daily living. Patients seek help when symptoms become unmanageable, but can become frustrated with the primary care system with difficulties obtaining an appointment, and lack of continuity of care. Patients perceive that general practitioners can be dismissive of CRS symptoms, and patients often prioritise other concerns when they consult. Health system barriers and poor communication can result in delays in accessing appropriate treatment and referral. Adherence to intranasal steroids is a problem and patients are uncertain about correct technique. Nasal irrigation can be time-consuming and difficult for patients to use. Secondary care consultations can appear rushed, and patients would like specialists to take a more 'holistic' approach to their management. Surgery is often considered a temporary solution, appropriate when medical options have been explored. CONCLUSIONS: Patients are frustrated with the management of their CRS, and poor communication can result in delays in receiving appropriate treatment and timely referral. Patients seek better understanding of their condition and guidance to support treatments decisions in light of uncertainties around the different medical and surgical options. Better coordinated care between general practice and specialist settings and consistency of advice has the potential to increase patient satisfaction and improve outcomes