Randomisation before consent : avoiding delay to time-critical intervention and ensuring informed consent

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Scenarios for the development of smart grids in the UK: synthesis report

‘Smart grid’ is a catch-all term for the smart options that could transform the ways society produces, delivers and consumes energy, and potentially the way we conceive of these services. Delivering energy more intelligently will be fundamental to decarbonising the UK electricity system at least possible cost, while maintaining security and reliability of supply. Smarter energy delivery is expected to allow the integration of more low carbon technologies and to be much more cost effective than traditional methods, as well as contributing to economic growth by opening up new business and innovation opportunities. Innovating new options for energy system management could lead to cost savings of up to £10bn, even if low carbon technologies do not emerge. This saving will be much higher if UK renewable energy targets are achieved. Building on extensive expert feedback and input, this report describes four smart grid scenarios which consider how the UK’s electricity system might develop to 2050. The scenarios outline how political decisions, as well as those made in regulation, finance, technology, consumer and social behaviour, market design or response, might affect the decisions of other actors and limit or allow the availability of future options. The project aims to explore the degree of uncertainty around the current direction of the electricity system and the complex interactions of a whole host of factors that may lead to any one of a wide range of outcomes. Our addition to this discussion will help decision makers to understand the implications of possible actions and better plan for the future, whilst recognising that it may take any one of a number of forms

Investigation of cyclist and pedestian impacts with motor vehicles using experimentation and simulation

Physical tests were performed with a bicycle and a dummy in a controlled laboratory environment to reproduce cyclist accidents. The kinematics of 13 sled tests were used to identify the cyclist head impact location, understand the interaction between the cyclist and bicycle and to validate a mathematical model. The finite element software code LS-DYNA was used to simulate 70 cyclist and pedestrian accidents with motor vehicles with four different vehicle shapes which supplemented the physical testing. The study has shown that when cyclists and pedestrians were struck by any of the vehicles their whole body kinematics can be distinguished into two phases, initially a rotation followed by a sliding action. The Sports Utility Vehicle (SUV) vehicle produced more of a rotation action rather than sliding, whereas the other vehicles produced a combination of the two. The current pedestrian legislation does not cover all head impact locations for cyclists and therefore needs to be extended to encompass the windscreen and A-Pillar regions of the vehicles. The wrap around distance (WAD) for all the vehicles, apart from the SUV, should be extended to encompass a larger region. For the SUV the current WAD region is adequate in protecting cyclists and pedestrians and does not need to change. The predicted head impactor angle for cyclists is 40 degrees which is lower than the current legislative value of 65 degrees and the predicted pedestrian head impact angle is higher at a value of 80 degrees for the MPV, SM and LFC. For the SUV the proposed impactor angle increased to 100 degrees for cyclists and pedestrians. This research has demonstrated significant differences in terms of input variables and outcomes between cyclist and pedestrian accidents involving vehicles. It has used mathematical models to obtain injury data from a human mathematical model and physical testing to replicate real world cyclist accident scenarios. Recommendations have been proposed for future legislative testing techniques for cyclists, based on existing pedestrian legislation. These recommendations to alter legislation will improve vehicle design and make future vehicles more cyclist-friendly.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Urinary nandrolone metabolite detection after ingestion of a nandrolone precursor

Introduction: Quantities of various anabolic/ androgenic steroids have been found in dietary supplements without their presence being disclosed on the label. The aim of this study was to quantify the excretion patterns of the diagnostic metabolites, 19-norandrosterone (19-NA) and 19-noretiocholanolone (19-NE), after ingestion of small doses of 19-nor-4-androstene-3,17- dione (19-norandrostenedione). Methods: Eleven males and nine females entered the laboratory in the morning following an overnight fast. An initial urine sample was collected and volunteers then ingested 500 mL of water containing 5 g of creatine monohydrate and either 1.0 μg, 2.5 μg or 5.0 μg of 19-norandrostendione. The volume of each urine void was measured and an aliquot taken. Samples were analysed for the metabolites 19-NA and 19-NE by GCMS. Results Baseline urinary 19-NA concentrations were 0.19±0.14 ng/mL. Ingestion of the supplement resulted in peak mean urinary 19-NA concentrations of 0.68±0.36 ng/mL, 1.56±0.86 ng/mL, and 3.89±3.11 ng/mL in the 1.0μg, 2.5μg or 5.0μg trials respectively. Under current WADA regulations, ingestion of the 1.0 μg dose produced 0 positive doping tests, 5 subjects (20%) tested positive in the 2.5 μg trial and 15 subjects (75%) had urinary 19- NA concentrations exceeding 2 ng/mL after ingesting creatine containing 5.0 μg of the steroid. The recovery of the ingested dose was highly variable between individuals, with values ranging from 11 - 84 % (mean±SD = 47 ± 18%). Conclusions: Ingestion of trace amounts of 19-norandrostendione can result in transient elevations of urinary 19-NA and 19- NE concentrations. The addition of as little as 2.5 μg of 19-norandrostendione to a supplement (0.00005% contamination) appears sufficient to result in a doping violation in some individuals

The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review.

BACKGROUND: Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. METHODS AND FINDINGS: We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72-0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47-1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77-2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. CONCLUSIONS: Text messaging interventions increased adherence to ART and smoking cessation and should be considered for inclusion in services. Although there is suggestive evidence of benefit in some other areas, high quality adequately powered trials of optimised interventions are required to evaluate effects on objective outcomes

Effect of exercise and heat-induced hypohydration on brain volume

Purpose: The aim of the present study was to quantify changes in brain volume following exercise/heat-induced hypohydration in man. Methods: Eight active men completed intermittent exercise in a warm environment, until 2.9 ± 0.1 % of body mass was lost. Subjects remained hypohydrated for two hours following the end of exercise. Brain volume was measured before, immediately following, and 1h and 2h after exercise using MRI (Philips 3T Achieva). Measures of subjective feelings and core body temperature were also monitored. Blood samples were drawn to determine serum electrolyte concentrations and osmolality and to allow calculation of changes in blood and plasma volumes. Results: Brain volume was not influenced by hypohydration (0.2 ± 0.4 %; ES 0.2; P = 0.310). Reductions in ventricular (4.0 ± 1.8 %; ES 4.6; P < 0.001) and CSF (3.1 ± 1.9%; ES 3.3; P = 0.003) volumes were observed following exercise. Compared with pre-exercise levels, serum osmolality was elevated throughout the 2h post-exercise period (+10 ± 2 mosmol/kg; P < 0.001). Core temperature increased from 37.1 ± 0.3oC at rest to 39.3 ± 0.5oC at the end of exercise (P = 0.001). Conclusions: These data demonstrate that brain volume remains unchanged in response to moderate hypohydration and the presence of serum hyperosmolality, suggesting that mechanisms are in place to defend brain volume

Monitoring rock freezing and thawing by novel geoelectrical and acoustic techniques

Automated monitoring of freeze-thaw cycles and fracture propagation in mountain rockwalls is 23 needed to provide early warning about rockfall hazards. Conventional geoelectrical methods 24 such as electrical resistivity tomography (ERT) are limited by large and variable ohmic contact 25 resistances, requiring galvanic coupling with metal electrodes inserted into holes drilled into 26 rock, and which can be loosened by rock weathering. We report a novel experimental 27 methodology that combined capacitive resistivity imaging (CRI), ERT and microseismic event 28 recording to monitor freeze-thaw of six blocks of hard and soft limestones under conditions 29 simulating an active layer above permafrost and seasonally frozen rock in a non-permafrost 30 environment. Our results demonstrate that the CRI method is highly sensitive to freeze-thaw 31 processes; it yields property information equivalent to that obtained with conventional ERT and 32 offers a viable route for non-galvanic long-term geoelectrical monitoring, extending the benefits 33 of the methodology to soft/hard rock environments. Contact impedances achieved with CRI are 34 less affected by seasonal temperature changes, the aggregate state of the pore water (liquid or 35 frozen), and the presence of low-porosity rock with high matrix resistivities than those achieved 36 with ERT. Microseismic monitoring has the advantage over acoustic emissions that events were 37 recorded in relevant field distances of meters to decameters from cracking events. For the first 38 time we recorded about 1000 microcracking events and clustered them in four groups according 39 to frequency and waveform. Compared to previous studies, mainly on ice-cracking in glaciers, 40 the groups are attributed to single- or multiple-stage cracking events such as crack coalescence

Partnership approaches to the evaluation of complex policy initiatives : qualitative research as key to building effective relationships

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Development and assessment of a bone scanning device to enhance restraint performance

The objective of the BOSCOS (BOne Scanning for Occupant Safety) project was the development of a system that can make an assessment of the bone characteristics of each vehicle occupant in order to estimate their skeletal strengths. The seatbelt and airbag characteristics can then be adjusted to deliver optimum levels of protection specifically for each occupant. A system introduced into every vehicle has the capacity to save lives and reduce injury levels across the whole spectrum of vehicle occupants. This paper describes the contributions from academic and industrial partners to this UK Department for Transport funded project.Commercial pressure focuses restraint design on meeting legal requirements for vehicle approval, but legal requirements use dummies which do not represent the range of car occupant shapes, sizes, and driving positions. A person with lower skeletal characteristics may not be able to withstand the current fixed levels of restraint without sustaining injuries. Conversely, a person with greater skeletal characteristics may be capable of withstanding greater levels of restraint.Possible technologies that are available have been assessed for their suitability for an in-vehicle monitoring system. Accident studies have been conducted to create a baseline of statistics in terms of casualties and their injuries. Initial bone scanning studies have utilised different types of equipment and a new prototype scanner has been developed for use in a vehicle environment using ultrasound technology.Computer based occupant mathematical modelling has been used to establish the potential gains from a working system and also the requirements needed of the restraint systems toachieve these gains. In addition, bone scanning has been conducted, to determine a method to read across from scan values to skeletal condition to provide data for the optimisation of the restraint system