Interfacial areas and gas hold-ups in bubble columns and packed bubble columns at elevated pressures

Interfacial areas and gas hold-ups have been determined at pressures up to 1.85 MPa in a bubble column with a diameter of 85.5 mm and for superficial gas velocities between 1 and 10 cm s−1. In some experiments the bubble column was packed with glass cylinders of length 5.0 mm and diameter 4.0 mm. The interfacial areas were determined by the chemical method using the model reaction between CO2 and aqueous diethanolamine (DEA) and hold-ups by observation of height differences.\ud \ud The interfacial areas in the packed bubble column are unaffected by pressure. The gas hold-ups as well as the interfacial areas in the bubble column increase with increasing operating pressure. The magnitude of the pressure influence depends on the superficial gas velocity. The positive influence of pressure on the gas hold-ups and the interfacial in the bubble column originates from the formation of smaller bubbles at the gas distributor

Determinants of three-year change in children’s objectively measured sedentary time

Background Sedentary behaviours (SB) are highly prevalent in young people and may be adversely associated with physical and mental health. Understanding of the modifiable determinants of SB is necessary to inform the design of behaviour change interventions but much of the existing research is cross-sectional and focussed upon screen-based behaviours. Purpose To examine the social, psychological and environmental determinants of change in children’s objectively measured sedentary time from age 11 to 14 years. Methods Data are from the second (2008) and third (2011) waves of assessment in the Sport, Physical Activity, and Eating Behaviour: Environmental Determinants in Young People (SPEEDY) study, conducted in the county of Norfolk, United Kingdom. Longitudinal data on accelerometer assessed sedentary time were available for 316 (53.5% female, 11.2±0.3 years at baseline) and 264 children after-school and at the weekend respectively. Information on 14 candidate determinants, including school travel mode and electronic media ownership, was self-reported. Change in the proportion of registered time spent sedentary was used as the outcome variable in cross-classified linear regression models, adjusted for age, sex, body mass index and baseline sedentary time. Simple and multiple models were run and interactions with sex explored. Results Daily sedentary time increased by 30-40 minutes after-school and at the weekend from baseline to follow-up. Participants who travelled to school by cycle exhibited smaller increases in after-school sedentary time (beta; 95%CI for change in % time spent sedentary: -3.3;-6.7,-0.07). No significant determinants of change in weekend sedentary time were identified. Conclusions Time spent sedentary increased during the three-year duration of follow-up but few of the variables examined were significantly associated with changes in sedentary time. Children’s mode of school travel may influence changes in their sedentary time over this period and should be examined further, alongside broader efforts to identify modifiable determinants of SB during childhood.The work was supported by the Centre for Diet and Activity Research (CEDAR), a UK Clinical Research Collaboration Public Health Research Centre of Excellence (RES-590-28-0002). Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The SPEEDY study was funded by the Medical Research Council (Unit Programme number MC_UU_12015/7, MC_UU_12015/3, MC_UU_12015/4) and the National Prevention Research Initiative, consisting of the following funding partners: British Heart Foundation; Cancer Research United Kingdom; Department of Health; Diabetes United Kingdom; Economic and Social Research Council; Medical Research Council; Health and Social Care Research and Development Office for Northern Ireland; Chief Scientist Office, Scottish Government Health Directorates; Welsh Assembly Government; and World Cancer Research Fund

The implementation of quality management systems in hospitals: a comparison between three countries

BACKGROUND: Is the implementation of Quality Management (QM) in health care proceeding satisfactorily and can national health care policies influence the implementation process? Policymakers and researchers in a country need to know the answer to this question. Cross country comparisons can reveal whether sufficient progress is being made and how this can be stimulated. The objective of the study was to investigate agreement and disparities in the implementation of QMS between The Netherlands, Hungary and Finland with respect to the evaluation model used and the national policy strategy of the three countries. METHODS: The study has a cross sectional design, based on measurements in 2000. Empirical data about QM-activities in hospitals were gathered by a self-administered questionnaire. The questionnaires were answered by the directors of the hospitals or the quality coordinators. The analyses are based on data from 101 hospitals in the Netherlands, 116 hospitals in Hungary and 59 hospitals in Finland. Outcome measures are the developmental stage of the Quality Management System (QMS), the development within five focal areas, and distinct QM-activities which were listed in the questionnaire. RESULTS: A mean of 22 QM-activities per hospital was found in the Netherlands and Finland versus 20 QM-activities in Hungarian hospitals. Only a small number of hospitals has already implemented a QMS (4% in The Netherlands,0% in Hungary and 3% in Finland). More hospitals in the Netherlands are concentrating on quality documents, whereas Finnish hospitals are concentrating on training in QM and guidelines. Cyclic quality improvement activities have been developed in the three countries, but in most hospitals the results were not used for improvements. All three countries pay hardly any attention to patient participation. CONCLUSION: The study demonstrates that the implementation of QM-activities can be measured at national level and that differences between countries can be assessed. The hypothesis that governmental legislation or financial reimbursement can stimulate the implementation of QM-activities, more than voluntary recommendations, could not be confirmed. However, the results show that specific obligations can stimulate the implementation of QM-activities more than general, framework legislation

Evidence for weathering and volcanism during the PETM from Arctic Ocean and Peri-Tethys osmium isotope records

Sudden global warming during the Paleocene–Eocene Thermal Maximum (PETM, 55.9 Ma) occurred because of the rapid release of several thousand gigatonnes of isotopically light carbon into the oceans and atmosphere; however, the cause of this release is not well understood. Some studies have linked carbon injection to volcanic activity associated with the North Atlantic Igneous Province (NAIP), while others have emphasised carbon cycle feedbacks associated with orbital forcing. This study presents the osmium isotope compositions of mudrocks that were deposited during the PETM at four locations (one from the Arctic Ocean, and three from the Peri-Tethys). The Os-isotope records all exhibit a shift of similar magnitude towards relatively radiogenic values across the PETM. This observation confirms that there was a transient, global increase in the flux of radiogenic Os from the weathering of continental rocks in response to elevated temperatures at that time. The tectonic effects of NAIP volcanic emplacement near the onset of the PETM is recorded by anomalously radiogenic Os-isotope compositions of PETM-age Arctic Ocean samples, which indicate an interval of hydrographic restriction that can be linked tectonic uplift due to hotspot volcanism in the North Atlantic seaway. The Peri-Tethys data also document a transient, higher flux of unradiogenic osmium into the ocean near the beginning of the PETM, most likely from the weathering of young mafic rocks associated with the NAIP. These observations support the hypothesis that volcanism played a major role in triggering the cascade of environmental changes during the PETM, and highlight the influence of paleogeography on the Os isotope characteristics of marine water masses

Effective and resource-efficient strategies for recruiting families in physical activity, sedentary behavior, nutrition, and obesity prevention research: A systematic review with expert opinion.

We systematically identified effective and resource-efficient strategies for recruiting families into health promoting intervention research. Four databases were searched for reviews. Interventions were extracted from included reviews. Additionally, a Delphi study was conducted with 35 experts in family-based research. We assessed extracted data from our review and Delphi participants' opinions by collating responses into overarching themes based on recruitment setting then recruitment strategies to identify effective and resource-efficient strategies for recruiting families into intervention research. A total of 64 articles (n = 49 studies) were included. Data regarding recruitment duration (33%), target sample size (32%), reach (18%), expressions of interest (33%), and enrollment rate (22%) were scarcely reported. Recruitment settings (84%) and strategies (73%) used were available for most studies. However, the details were vague, particularly regarding who was responsible for recruitment or how recruitment strategies were implemented. The Delphi showed recruitment settings, and strategies fell under six themes: school-based, print/electronic media, community settings-based, primary care-based, employer-based, and referral-based strategies. Underrecruitment in family-based trials is a major issue. Reporting on recruitment can be improved by better adherence to existing guidelines. Our findings suggest a multifaceted recruitment approach targeting adults and children with multiple exposures to study information.This work was supported by the National Institute for Health Research Public Health 16 Research Programme (project number 15/01/19). Funding was also received from the Medical 17 Research Council (project number MC_UU_12015/7) and National Institute for Health Research 18 Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme (Grant IS19 BRC-1215-20014)

Quality of life, developmental milestones, and self-esteem of young adults with congenital hypothyroidism diagnosed by neonatal screening

Contains fulltext : 71281.pdf (publisher's version ) (Closed access)CONTEXT: With advances in the treatment of congenital hypothyroidism (CH), the neuropsychological functioning of CH patients is considerably improved. Although much is written about cognitive and motor development, little is known about emotional and social consequences for patients growing up with CH, diagnosed by neonatal screening. OBJECTIVES: The objectives of the study were to: 1) compare health-related quality of life (HRQoL), developmental milestones also called course of life (CoL), sociodemographical outcomes, and self-esteem of CH patients with the general population; and 2) explore whether severity of CH was related to these outcomes. DESIGN/SETTING/PATIENTS: A total of 69 young adults with CH, born in The Netherlands in 1981-1982, completed the "TNO-AZL Questionnaire for Adult's Health related Quality of Life" questionnaire, the CoL survey (developmental milestones and sociodemographical outcomes), and a self-esteem questionnaire. MAIN OUTCOME MEASURES: HRQoL, CoL, social demographical outcomes, and self-esteem in young adults with CH were determined. RESULTS: CH patients are more often at risk for HRQoL impairment and reported lower HRQoL on several domains (cognitive functioning, P < 0.0001; sleeping, P < 0.004; pain, P < 0.0001; daily activities, P < 0.004; vitality, P < 0.0001; aggressiveness, P < 0.0001; and depressive moods, P < 0.0001) compared with healthy adults. Patients reported a lower self-esteem (P < 0.005) and had a delayed CoL on the domain of social development (P < 0.016). There were no significant within-group differences between the severity groups for HRQoL, CoL, and self-esteem. CONCLUSIONS: Negative consequences in terms of HRQoL, development, and self-esteem are prevalent in young adults with CH. Health care physicians should be attentive to these consequences and provide additional support (emotional and educational guidance) if necessary

Social and Cultural Factors Affecting Complementary and Alternative Medicine (CAM) Use during Menopause in Sydney and Bologna

Background. Previous surveys found CAM use during menopause to be popular. This paper compares the results from two surveys (Sydney and Bologna) to examine factors that determine the extent and pattern of CAM use to alleviate menopausal symptoms. Methods. Women, aged 45–65 years, who were symptomatic when transitioning through menopause or asymptomatic but taking menopause-specific treatments, were recruited in Sydney (n=1,296) and Bologna (n=1,106) to complete the same voluntary, anonymous, and self-administered questionnaire. The results were reanalysed using stratified analyses to determine similarities and differences. Results. Demographics of the two cohorts differed significantly. CAM was more popular in Sydney. The most significant determinants of CAM use were the use of CAM for other conditions besides menopause and the severity of vasomotor symptoms. Occupational status was a determinant of CAM use amongst Bologna respondents only. In order to relieve symptoms, Australian and Italian women used different CAM modalities whose effectiveness was generally perceived as good. Conclusion. CAM use is popular amongst menopausal women from Sydney and Bologna. Differences in the patterns of CAM use seem to depend on CAM availability and on the educational level and professional status of users. The complex interaction between market, social, and cultural factors of CAM use seems to be more influential on women’s choice of CAM than the available evidence of their effectiveness

Feasibility of the debris ring transit method for the solar-like star HD 107146 by an occulted galaxy

Occulting galaxy pairs have been used to determine the transmission and dust composition within the foreground galaxy. Observations of the nearly face-on ring-like debris disc around the solar-like star HD 107146 by HST/ACS in 2004 and HST/STIS in 2011 reveal that the debris ring is occulting an extended background galaxy over the subsequent decades. Our aim is to use 2004 Hubble Space Telescope (HST) observations of this system to model the galaxy and apply this to the 2011 observation in order to measure the transmission of the galaxy through the outer regions of the debris disc. We model the galaxy with an exponential disc and a Sérsic pseudo-bulge in the V and I bands, but irregularities due to small-scale structure from star-forming regions limits accurate determination of the foreground dust distribution. We show that debris ring transit photometry is feasible for optical depth increases of Δτ ≥ 0.04 (1σ) on tens of au scales - the width of the background galaxy - when the 2011 STIS data are compared directly with new HST/STIS observations, instead of the use of a smoothed model as a reference

Patient expectations of fair complaint handling in hospitals: empirical data

BACKGROUND: A common finding in several studies is patients' dissatisfaction with complaint handling in health care. The reasons why are for the greater part unknown. The key to an answer may be found in a better understanding of patients' expectations. We investigated patients' expectations of complaint handling in hospitals. METHODS: Subjects were patients who had lodged a complaint at the complaint committees of 74 hospitals in the Netherlands. A total of 424 patients (response 75%) completed a written questionnaire at the start of the complaint procedures. Derived from justice theory, we asked what they expected from fair procedures, fair communication and fair outcome of complaint handling. RESULTS: The predominant reason for complainants to lodge a complaint was to prevent the incident from happening again. Complainants expected fair procedures from the complaint committee, in particular an impartial position. This was most important to 87% of the complainants. They also expected to be treated respectfully. Furthermore, they expected the hospital and the professional involved to respond to their complaint. A change in hospital performances was the most wanted outcome of complaint handling, according to 79% of the complainants. They also expected disclosure from the professionals. Professionals should admit a mistake when it had occurred. More complainants (65%) considered it most important to get an explanation than an apology (41%). Only 32% of complainants expected the professional to make an effort to restore the doctor-patient relationship. A minority of complainants (7%) wanted financial compensation. CONCLUSION: Nearly all complainants want to prevent the incident from happening again, not out of pure altruism, but in order to restore their sense of justice. We conclude that complaint handling that does not allow for change is unlikely to meet patients' expectations. Secondly, complaint handling should not be left exclusively to complaint committees, the responses of hospital and professionals are indispensable

Health- related quality of life and self-worth in 10-year old children with congenital hypothyroidism diagnosed by neonatal screening

Contains fulltext : 108082.pdf (publisher's version ) (Open Access)ABSTRACT: BACKGROUND: Much is written about cognitive and motor development; less is known about social and emotional consequences of growing up with congenital hypothyroidism (CH).The objectives of the study were: (1) to compare health related quality of life (HRQoL) and self-worth of 10 year old patients with CH with the general population; (2) to explore associations of disease factors, IQ and motor skills with the outcomes. METHODS: Children with CH and their parents completed several questionnaires. Patients were classified to 'severe CH, n = 41' or 'moderate/mild CH, n = 41' based on pre-treatment FT4 concentration.Differences between CH and the general population were tested by analysis of covariance and one sample t-tests (mean scale scores HRQoL and self-worth), chi-square tests and binomial tests (% at risk of impaired HRQoL and self-worth). Linear regression analyses corrected for gender were conducted to explore associations of the outcomes with disease factors, IQ and motor skills. RESULTS: Patients with CH reported lower mean HRQoL on motor, cognitive and social functioning, and on autonomy and positive emotions (p < 0.0001). Patients were also more often at risk for impaired HRQoL and self-worth. No differences were found between the severity groups. Lower IQ was only significant associated with worse cognitive HRQoL. Initial FT4 plasma, age at onset of therapy, initial T4 dose and motor skills were not significantly associated with HRQoL and self-worth. CONCLUSIONS: Negative consequences in terms of HRQoL and self-worth are prevalent in children with CH, independent of disease factors, IQ and motor skills. Physicians should to be attentive to these consequences and provide attention and supportive care