121 research outputs found

    Preventing transition to turbulence: a viscosity stratification does not always help

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    In channel flows a step on the route to turbulence is the formation of streaks, often due to algebraic growth of disturbances. While a variation of viscosity in the gradient direction often plays a large role in laminar-turbulent transition in shear flows, we show that it has, surprisingly, little effect on the algebraic growth. Non-uniform viscosity therefore may not always work as a flow-control strategy for maintaining the flow as laminar.Comment: 9 pages, 8 figure

    Oral medicine acceptance in infants and toddlers: measurement properties of the caregiver-administered Children’s acceptance tool (CareCAT)

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    BACKGROUND: Developing age-appropriate medications remains a challenge in particular for the population of infants and toddlers, as they are not able to reliably self-report if they would accept and consequently take an oral medicine. Therefore, it is common to use caregivers as proxies when assessing medicine acceptance. The outcome measures used in this research field differ and most importantly lack validation, implying a persisting gap in knowledge and controversy in the field. The newly developed Caregiver-administered Children’s Acceptance Tool (CareCAT) is based on a 5-point nominal scale, with descriptors of medication acceptance behavior. This crosssectional study assessed the measurement properties of the tool with regards to the user’s understanding and its intra- and inter-rater reliability. METHODS: Participating caregivers were enrolled at a primary healthcare facility where their children (median age 6 months) had been prescribed oral antibiotics. Caregivers, trained observers and the tool developer observed and scored on the CareCAT tool what behavior children exhibited when receiving the medicine (n = 104). The videorecords of this process served as replicate observations (n = 69). After using the tool caregivers were asked to explain their observations and the tool descriptors in their own words. The tool’s reliability was assessed by percentage agreement and Cohen’s unweighted kappa coefficients of agreement for nominal scales. RESULTS: The study found that caregivers using CareCAT had a satisfactory understanding of the tool’s descriptors. Using its dichotomized scores the tool reliably was strong for acceptance behavior (agreement inter-rater 84–88%, kappa 0.66–0.76; intra-rater 87–89%, kappa 0.68–0.72) and completeness of medicine ingestion (agreement inter-rater 82–86%, kappa 0.59–0.67; intra-rater 85–93%, kappa 0.50–0.70). CONCLUSIONS: The CareCAT is a low-cost, easy-to-use and reliable instrument, which is relevant to assess acceptance behavior and completeness of medicine ingestion, both of which are of significant importance for developing age-appropriate medications in infants and toddlers

    Pharmacotherapeutic management of paediatric heart failure and ACE-I use patterns: A European survey

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    Objective To characterise heart failure (HF) maintenance pharmacotherapy for children across Europe and investigate how angiotensin-converting enzyme inhibitors (ACE-I) are used in this setting. Methods A Europe-wide web-based survey was conducted between January and May 2015 among European paediatricians dedicated to cardiology. Results Out of 200-eligible, 100 physicians representing 100 hospitals in 27 European countries participated. All participants reported prescribing ACE-I to treat dilated cardiomyopathy-related HF and 97% in the context of congenital heart defects; 87% for single ventricle physiology. Twenty-six per cent avoid ACE-I i

    Toward a Regulatory Pathway for the Use of in Silico Trials in The Ce Marking of Medical Devices

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    In Silico Trials methodologies will play a growing and fundamental role in the development and de-risking of new medical devices in the future. While the regulatory pathway for Digital Patient and Personal Health Forecasting solutions is clear, it is more complex for In Silico Trials solutions, and therefore deserves a deeper analysis. In this position paper, we investigate the current state of the art towards the regulatory system for in silico trials applied to medical devices while exploring the European regulatory system toward this topic. We suggest that the European regulatory system should start a process of innovation: in principle to limit distorted quality by different internal processes within notified bodies, hence avoiding that the more innovative and competitive companies focus their attention on the needs of other large markets, like the USA, where the use of such radical innovations is already rapidly developing

    From Fan Parks to Live Sites: Mega events and the territorialisation of urban space

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    This article draws on the work of Gilles Deleuze and Felix Guattari to consider the phenomenon of Live Sites and Fan Parks which are now enshrined within the viewing experience of mega sports events. Empirically, the article draws upon primary research on Live Sites generated during the London 2012 Olympic Games. Live Sites are represented as new spaces within which to critically locate and conceptually explore the shifting dynamics of urban space, subjectivity and its performative politic. The authors argue that the first, or primary, spaces of mega sporting events (the official venues) and their secondary counterparts (Live Sites) simply extend brandscaping tendencies but that corporate striation is always incomplete, opening up possibilities for disruption and dislocation

    Symbolism in bank marketing and architecture: the headquarters of National Provincial Bank of England

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    This article undertakes an analysis of the symbolism present in the architecture and design in nineteenth century British banking. It focuses upon the headquarters of National Provincial Bank of England, which was built in the 1860s. It explores the symbols and messages that those at the bank wished to communicate to those that viewed the building. The analysis finds that those at the bank impressed its national identity, achieved through its extensive branch network, as its key message which differentiated it from its rivals. Other symbols emphasized that it had adapted to the local market and was equal in terms of competency and richness in comparison to its competitors. We argue that these messages became part of the organization’s identity and its brand, as well as the culture of the City of London more broadly. The article provides a new explanation for symbolic meanings represented by bank architecture. It integrates the existing discussion of bank architecture in historical research with the theoretical frameworks and literature being developed in organizational identity and branding

    Effectiveness of a single-session early psychological intervention for children after road traffic accidents: a randomised controlled trial

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    BACKGROUND: Road traffic accidents (RTAs) are the leading health threat to children in Europe, resulting in 355,000 injuries annually. Because children can suffer significant and long-term mental health problems following RTAs, there is considerable interest in the development of early psychological interventions. To date, the research in this field is scarce, and currently no evidence-based recommendations can be made. METHODS: To evaluate the effectiveness of a single-session early psychological intervention, 99 children age 7-16 were randomly assigned to an intervention or control group. The manualised intervention was provided to the child and at least one parent around 10 days after the child's involvement in an RTA. It included reconstruction of the accident using drawings and accident-related toys, and psychoeducation. All of the children were interviewed at 10 days, 2 months and 6 months after the accident. Parents filled in questionnaires. Standardised instruments were used to assess acute stress disorder (ASD), posttraumatic stress disorder (PTSD), depressive symptoms and behavioural problems. RESULTS: The children of the two study groups showed no significant differences concerning posttraumatic symptoms and other outcome variables at 2 or at 6 months. Interestingly, analyses showed a significant intervention x age-group effect, indicating that for preadolescent children the intervention was effective in decreasing depressive symptoms and behavioural problems. CONCLUSIONS: This study is the first to show a beneficial effect of a single-session early psychological intervention after RTA in preadolescent children. Therefore, an age-specific approach in an early stage after RTAs may be a promising way for further research. Younger children can benefit from the intervention evaluated here. However, these results have to be interpreted with caution, because of small subgroup sizes. Future studies are needed to examine specific approaches for children and adolescents. Also, the intervention evaluated here needs to be studied in other groups of traumatised children. TRIAL REGISTRATION: Clinical Trial Registry: ClinicalTrials.gov: NCT00296842
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