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A Cost-Effective Semi Ab-initio Approach to Model Relaxation in Rare-Earth Single-Molecule Magnets
No full textWe discuss a cost-eective approach to understand magnetic relaxation in the newgeneration of rare-earth single-molecule magnets. It combines ab-initio calculations ofthe crystal field parameters, of the magneto-elastic coupling with local modes and of thephonon density of states with fitting of only three microscopic parameters. Althoughmuch less demanding than a fully ab-initio approach, the method gives important phys-ical insights into the origin of the observed relaxation. By applying it to high-anisotropycompounds with very different relaxation, we demonstrate the power of the approachand we pinpoint ingredients for improving the performance of single-molecule magnets
Hospital admissions and place of death of residents of care homes receiving specialist healthcare services: A systematic review without meta-analysis
No full textAim: To synthesize evidence on the ability of specialist care home support services to prevent hospital admission of older care home residents, including at end-of-life. Design: Systematic review, without meta-analysis, with vote counting based on direction of effect. Data sources: Fourteen electronic databases were searched from January 2010 to January 2019. Reference lists of identified reviews, study protocols and included documents were scrutinised for further studies. Review methods: Papers on the provision of specialist care home support that addressed older, long-term care home residents’ physical health needs and provided comparative data on hospital admissions were included. Two reviewers undertook study selection and quality appraisal independently. Vote counting by direction of effect and binomial tests determined service effectiveness. Results: Electronic searches identified 79 relevant references. Combined with 19 citations from an earlier review, this gave 98 individual references relating to 92 studies. Most were from the UK (22), US (22) and Australia (19). Twenty studies were randomised controlled trials and six clinical controlled trials. The review suggested interventions addressing residents’ general health needs (p<0.001), assessment and management services (p<0.0001) and non-training initiatives involving medical staff (p<0.0001) can reduce hospital admissions, whilst there was also promising evidence for services targeting residents at imminent risk of hospital entry or post-hospital discharge and training only initiatives. End-of-life care services may enable residents to remain in the home at end-of-life (p<0.001), but the high number of weak-rated studies undermined confidence in this result. Conclusion: This review suggests specialist care home support services can reduce hospital admissions. More robust studies of services for residents at end-of-life are urgently needed. Impact: The review addressed the policy imperative to reduce the avoidable hospital admission of older care home residents and provides important evidence to inform service design. The findings are of relevance to commissioners, providers and residents
Youth loneliness and academic outcomes
No full textLoneliness has previously been linked to cognitive and attentional bias, and such biases may have a detrimental impact on perceived scholastic self-beliefs. Little is known about the relationship in school-aged adolescents. The current study examined the association between loneliness and scholastic self-beliefs in a nationally representative Danish sample of adolescents (aged 11-, 13- and 15 years, n = 3815, collected by the Health Behaviour in School-aged Children study (HBSC, 2014). Through binary logistic regressions, results demonstrated that higher levels of loneliness, measured by a single item and a composite score, were associated with poorer self-reported achievement perception, higher feelings of school dissatisfaction, and greater feelings of school pressure. Results also suggested gender played a moderating role. The current study highlights the importance of loneliness for scholastic self-beliefs, and provides a novel insight by utilising distinct loneliness measures. The implications, in relation to research and practise, are discussed
A compact fission detector for fission-tagging neutron capture experiments with radioactive fissile isotopes
No full textIn the measurement of neutron capture cross-sections of fissile isotopes, the fission channel is a source of background which can be removed efficiently using the so-called fission-tagging or fission-veto technique. For this purpose a new compact and fast fission chamber has been developed. The design criteria and technical description of the chamber are given within the context of a measurement of the 233U(n,γ) cross-section at the n TOF facility at CERN, where it was coupled to the n TOF Total Absorption Calorimeter. For this measurement the fission detector was optimized for time resolution, minimization of material in the neutron beam and for alpha-fission discrimination. The performance of the fission chamber and its application as a fission tagging detector are discussed
The Need for Clean Air: the Way Air Pollution and Climate Change Affect Allergic Rhinitis and Asthma
No full textDecision-Making Models based on Incomplete Hesitant Fuzzy Linguistic Preference Relation with Application to Site Selection of Hydropower Stations
No full textThe paper proposes two decision-making models in an incomplete fuzzy hesitant linguistic environment and applies them to address the site selection problems for hydropower stations. For better depicting a decision maker’s judgements under uncertainty, based on the concept of incomplete hesitant fuzzy linguistic preference relation, the paper firstly defines its consistency measures from the perspective of additive consistency and multiplicative consistency, respectively. By introducing decision maker’s satisfaction degree to measure the differences between the incomplete hesitant fuzzy linguistic preference relation and its corresponding weight vector, two decision-making models, which aim to achieve the maximum satisfaction degree are established for determining the optimal weight vector. The paper further designs experiments to make decision support by evaluating the proposed models from the correlation and time complexity point of view and providing sensitivity analysis. A case study concerning the site selection for a hydropower station at Yalong River is given to illustrate the decision-making process and the effectiveness of the proposed models
A traumatic past in the far distance: narrating children’s survival in the immediate aftermath of the Holocaust
No full textThis article explores the history of a group of approximately 1000 young Holocaust survivors that were resettled in Canada in the late 1940s as part of a project sponsored by the Canadian Jewish Congress (CJC). It seeks to interrogate the main material of this research, the case files that were filled by humanitarian workers in Europe to assist the young survivors in their Canadian visa application. Through a close reading of this material, it has the ambition to examine the discourses and practices of the adults – in other words to “observe the observer” – and highlight how they wrote about the Holocaust and about the individual and collective experiences of its survivors. It also asks if one can grasp the voices of the children themselves and highlight the specificity of their experience of persecution
Institutional use of National Clinical Audits by healthcare providers
No full textRationale, aims and objectives: Healthcare systems worldwide devote significantresources towards collecting data to support care quality assurance andimprovement. In the United Kingdom, National Clinical Audits are intended tocontribute to these objectives by providing public reports of data on healthcaretreatment and outcomes, but their potential for quality improvement in particular isnot realised fully among healthcare providers. Here, we aim to explore thisoutcome from the perspective of hospital boards and their quality committees: anunder-studied area, given the emphasis in previous research on the audits’ use byclinical teams.Methods: We carried out semi-structured, qualitative interviews with 54 staff indifferent clinical and management settings in five English National Health Servicehospitals about their use of NCA data, and the circumstances that supported orconstrained such use. We used Framework Analysis to identify themes within theirresponses.Results: We found that members and officers of hospitals’ governing bodiesperceived an imbalance between the benefits to their institutions from NationalClinical Audits and the substantial resources consumed by participating in them.This led some to question the audits’ legitimacy, which could limit scope forimprovements based on audit data, proposed by clinical teams.Conclusions: Measures to enhance the audits’ perceived legitimacy could helpaddress these limitations. These include audit suppliers moving from an emphasison cumulative, retrospective reports to real-time reporting, clearly presenting the‘headline’ outcomes important to institutional bodies and staff. Measures may alsoinclude further negotiation between hospitals, suppliers and their commissionersabout the nature and volume of data the latter are expected to collect; wider use byhospitals of routine clinical data to populate audit data fields; and furtherdevelopment of interactive digital technologies to help staff explore and report auditdata in meaningful ways
Understanding Refractory Rheumatoid Arthritis:Implications for a Therapeutic Approach
No full textRefractory rheumatoid arthritis (RA) has emerged as an area of unmet need in a landscape of generally well-controlled disease. Whilst most patients are adequately treated on methotrexate and other first-line disease-modifying anti-rheumatic drugs (DMARDs), a proportion requires biologic (b) and targeted synthetic (ts) DMARDs, with a further subsection failing multiple agents. Recent observational studies have adopted working definitions of refractory RA based on number of failed DMARDs, with prevalence estimates of 6–21% depending on threshold and study population. Risk factors include treatment delay, baseline disease activity and function, female gender, smoking, obesity and lower socioeconomic status. Practical and conceptual challenges in defining refractory RA arise from limitations of disease activity scores used to assess response, with attendant misclassification risk of co-existent non-inflammatory pathology, and failure to capture additional outcomes, such as fatigue, that have variable treatment response. Time is an important factor in defining refractory disease; registry studies show that growing treatment options have resulted in rapid b/tsDMARD cycling and earlier refractory status, and refractory RA is itself a dynamic concept, evolving with each new therapeutic class. Whilst the biology underpinning refractory RA remains largely unknown, a general overview of biomarker studies and clinical trials old and new offers insights into prediction of response and treatment failure. Whilst the future holds promise, current data are insufficient to personalise or meaningfully sequence b/tsDMARDs. Therefore, avoidance of a refractory course is best achieved by following proven management paradigms (e.g. early diagnosis and treat-to-target), addressing modifiable risk factors, and considering enrolment in novel trials.</p
