Pericarditis—A Five Year Study In The African

A CAJM article on pericarditis in African patients at the Harare Referral Hospital.A retrospective study of cases of pericarditis presenting to Harare African Hospital during the five year period 1967-1971 was carried out. This study excludes cases of pericarditis due to rheumatic heart disease and uraemia. During the five year period there were 85 patients in whom a diagnosis of pericarditis or pericardial effusion was made (Table 1). Ten of these would appear on subsequent investigation or post-mortem findings to have been inaccurately diagnosed, and in 18 cases the diagnosis Of pericarditis was established solely on clinical examination with no 'confirmatory investigations. These 28 cases have been excluded from this study. The report deals with the remaining 57 cases of pericarditis or pericardial effusion in whom the clinical diagnosis was confirmed by radiology, aspiration, surgery or 'postmortem findings

Dimpling process in cold roll metal forming by finite element modelling and experimental validation

The dimpling process is a novel cold-roll forming process that involves dimpling of a rolled flat strip prior to the roll forming operation. This is a process undertaken to enhance the material properties and subsequent products’ structural performance while maintaining a minimum strip thickness. In order to understand the complex and interrelated nonlinear changes in contact, geometry and material properties that occur in the process, it is necessary to accurately simulate the process and validate through physical tests. In this paper, 3D non-linear finite element analysis was employed to simulate the dimpling process and mechanical testing of the subsequent dimpled sheets, in which the dimple geometry and material properties data were directly transferred from the dimpling process. Physical measurements, tensile and bending tests on dimpled sheet steel were conducted to evaluate the simulation results. Simulation of the dimpling process identified the amount of non-uniform plastic strain introduced and the manner in which this was distributed through the sheet. The plastic strain resulted in strain hardening which could correlate to the increase in the strength of the dimpled steel when compared to plain steel originating from the same coil material. A parametric study revealed that the amount of plastic strain depends upon on the process parameters such as friction and overlapping gap between the two forming rolls. The results derived from simulations of the tensile and bending tests were in good agreement with the experimental ones. The validation indicates that the finite element analysis was able to successfully simulate the dimpling process and mechanical properties of the subsequent dimpled steel products

Patient-reported outcome measures v. clinician-measured outcomes in community psychiatric practice

Aims and method We examine the feasibility of the routine use of three patient-reported and one clinician-rated outcome measures (patient-identified problem, EuroQol-5D questionnaire, EuroQol Visual Analogue Scale and Health of the Nation Outcome Scales (HoNOS)) in an out-patient community psychiatric service, and discuss the associations between these variables. Results The routine collection of outcome measures was feasible in the out-patient setting. There was a general improvement in the health status from the initial assessment to the first follow-up. Subsequent scores remained stable. Clinical implications The study encourages the practical use of scales in routine community psychiatric practice. As there was correlation between HoNOS and EQ-5D index, both need not be used in routine practice

Acoustic performance of cold-formed steel buildings

This chapter introduces the requirements associated with acoustic performance in buildings and sound insulation properties of building partitions composed of cold-formed steel sections. Developments in experimental tests, analytical and numerical methods for determining acoustic performance of cold-formed steel buildings are presented. Design and construction methods for walls and floors using cold-formed steel sections to achieve desired acoustic performance are included. Recent research on cold-formed steel acoustic studs is highlighted. Typical acoustic performance values of building partitions using cold-formed steel sections are provided. Finally, acoustic design examples of a wall and a floor are described for reference

GPs' use of problem solving therapy for depression: a qualitative study of barriers to and enablers of evidence based care

BACKGROUND: Depression is a major health concern, predominantly treated by general practitioners (GPs). Problem solving therapy (PST) is recognised as an effective treatment for depression that is not widely used by GPs. This research aims to explore barriers and enablers that may influence GPs use of this treatment. METHOD: Qualitative methodology was used including individual and focus group interviews of GPs, PST experts and consumers. Analysis was undertaken using the Theory of Planned Behaviour (TPB) as a framework. RESULTS: A spectrum of potential influences, on GPs' use of PST emerged. Both barriers and enablers were identified. PST was perceived as being close to current practice approaches and potentially beneficial to both doctor and patient. In addition to a broadly positive attitude to PST, expressed by those with previous experience of its use, potential solutions to perceived barriers emerged. By contrast some GPs expressed fear that the use of PST would result in loss of doctor control of consultations and associated potential adverse patient outcomes. Patient expectations, which emerged as not always coinciding with GPs' perception of those expectations, were identified as a potential influence on GPs' decision concerning adoption of PST. In addition specific factors, including GP skill and confidence, consultation time constraints and technical issues related to PST were noted as potential concerns. CONCLUSION: This research contributes to our knowledge of the factors that may influence GPs' decisions regarding use of PST as a treatment for depression. It recognises both barriers and enablers. It suggests that for many GPs, PST is viewed in a positive light, providing encouragement to those seeking to increase the provision of PST by GPs. In identifying a number of potential barriers, along with associated options to address many of these barriers, it provides insights which may assist in the planning of GP training in PST

Compressive Strength Tests and Design of Cold-formed Plain and Dimpled Steel Columns

This paper presents the experiments and design formulae of cold-formed plain and dimpled steel columns. A series of compression tests on plain and dimpled channel columns were conducted over a range of different geometries and the strength of the columns were investigated. The change in strength of the dimpled columns resulting from the cold working associated with the dimpling process was considered. The results showed that the buckling and ultimate strengths of dimpled steel columns were up to 33% and 26% greater than plain steel columns, respectively. The test results were evaluated by comparing buckling and ultimate loads of plain and dimpled channel columns with the values predicted by theoretical and semi-empirical methods. It was found that the predicted buckling and ultimate loads correlated well with the experimental results. Based on the experimental results, expressions for determining buckling and ultimate strengths of component plate elements of plain and dimpled channel columns were formulated

Problem-Solving Treatment for People Recently Diagnosed with Visual Impairment: Pilot Randomised Controlled Trial

BACKGROUND: Problem-Solving Treatment (PST) has been used to treat and prevent depression in a variety of settings. However, the impact of PST on improving psychological well-being in those with recent vision loss remains unknown. The aim of this study was to evaluate whether PST may lead to better psychological well-being in people with recent vision loss through a pilot parallel-group randomised controlled trial. METHODS: Participants who were diagnosed with visual impairment during the previous 3 months were randomly allocated to either an 8-week PST or treatment as usual (N = 61). Outcome measures were administered at baseline, 3, 6, and 9-months. RESULTS: A linear mixed model demonstrated that PST significantly improved psychological well-being (measured by the Warwick Edinburgh Mental Well-being Scale) (treatment effect = 2.44; 95% CI = 0.40-4.47; p = 0.019). Significant improvements in the PST group for symptoms of distress, quality of life and self-efficacy were also observed. There was no significant difference in mobility. The treatment effect was consistent at all follow-ups. Attrition rate was low (13%). CONCLUSIONS: PST was associated with a significant and sustained improvement in a range of outcomes in people with recent vision loss. Further large scale RCT is now required

Access to and use of clinical services and disease-modifying therapies by people with progressive multiple sclerosis in the United Kingdom

Background: According to current UK guidelines everyone with progressive MS should have access to an MS Specialist but levels of access and use of clinical services is unknown. Our objective was to investigate access to MS Specialists, use of clinical services and disease-modifying therapies (DMTs) by people with progressive MS in the United Kingdom. Methods: A UK wide, online survey was conducted via the UK MS Register. Inclusion criteria: age over 18 years, primary or secondary progressive MS and a member of the UK MS Register. Participants were asked about access to MS Specialists; recent clinical service use; receipt of regular review and current and previous DMT use. Participant demographics; quality of life and disease impact measures were supplied from the UK MS Register. Results: In total 1298 participants responded: 5% were currently taking DMT; 23% had previously taken DMT; and 95% reported access to an MS Specialist. Most utilised services were: MS Doctor/Nurse (50%), General Practitioner (45%), and Physiotherapist (40%). Seventy-four percent received a regular review although 37% received theirs less than annually. Current DMT use was associated with better quality of life but past DMT use was associated with poorer quality of life and higher impact of disease. Conclusions: Access to, and use of, MS Specialists was high. However a gap in service provision was highlighted in both receiving and frequency of regular reviews

Explicit dynamics finite element analysis of energy absorption characteristics of thin-walled UltraSTEEL columns

UltraSTEEL material has been reported to have higher yield and ultimate strengths than plain mild steel under quasi-static loads. This project aims to study the energy absorption characteristics of UltraSTEEL thin-walled structures when subjected to axial impact loads. The numerical modelling starts from duplicating the UltraSTEEL dimpling process and defining the resultant material properties by taking strain hardening and strain rate sensitivity into consideration. Features including element type, mesh density, symmetric boundary conditions and imperfections are then studied. The responses of 1mm gauge plain and UltraSTEEL columns to the same impact load are compared by conducting explicit dynamics finite element simulations. Comparing to the plain columns, the effect of gauge on the UltraSTEEL columns’ failure mode and specific energy absorption (SEA) are analysed through a parametric study.Hadley Industries Holdings Limite

Optimal Design Method for Static Precision of Heavy-Duty Vertical Machining Center Based on Gravity Deformation Error Modelling

Due to the large size and large span of heavy-duty machine tools, the structural deformation errors caused by gravity account for a large proportion of the static errors, and the influence of gravity deformation must thus be considered in the machine tool precision design. This paper proposes a precision design method for heavy-duty vertical machining centers based on gravity deformation error modelling. By abstracting the machine tool into a multibody system topology, the static error model of the machine tool is established based on the multibody system theory and a homogeneous coordinate transformation. Assuming that the static error of each motion axis is composed of two parts, i.e., the manufacturing-induced geometric error and the gravity deformation error, the machine tool stiffness model of the relationship between gravity and deformation error is developed using the spatial beam elements. In the modelling process, the stiffness coefficients and volume coefficients of the components are introduced to fully consider the influences of structural parameters on machine tool precision. Taking the machine tool static precision, the component stiffness coefficients and the volume coefficients as the design variables, based on the use of the worst condition method, error sensitivity analysis and global optimization algorithm, the optimal allocation of the static error budget of the machine tool and the structural design requirements of each component are determined, providing a valuable guide for the detailed structure design and manufacture processing of the machine tool components