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We investigate the effects of heterogeneity and incomplete information on aggregate contributions to a public good using the voluntary contribution mechanism. The non-linear laboratory environment has three-person groups as partners under varying conditions of information and communication. Bergstrom, Blum and Varian predict that increasing heterogeneity will have no effect on aggregate contributions in a no-communication environment. Ledyard conjectures a positive effect of incomplete information, a negative effect of heterogeneity, and a positive interaction of heterogeneity and incomplete information. We find that incomplete information has a small but significant negative effect. Heterogeneity has a positive effect on aggregate contributions, but its effects interact unexpectedly with communication. In a no-communication environment, heterogeneity in two dimensions (endowment and preferences) increases contributions substantially while heterogeneity in a single dimension (endowment or preferences) has little effect. In the communication environment we find the reverse. We also find a positive interaction between heterogeneity and incomplete information. Thus we reject the Bergstrom, Blume and Varian invariance result and provide mixed evidence on Ledyard's conjectures.
Data created in a controlled laboratory setting are a relatively new phenomenon to economists. Traditional data analysis methods using either parametric or nonparametric tests are not necessarily the best option available to economists analyzing laboratory data. In 1935, Fisher proposed the randomization technique as an alternative data analysis method when examining treatment effects. The observed data are used to create a test statistic. Then treatment labels are shuffled across the data and the test statistic is recalculated. The original statistic can be ranked against all possible test statistics that can be generated by these data, and a p-value can be obtained. A Monte Carlo analysis of t-test, the Mann-Whitney U-test, and the exact randomization t-test is conducted. The exact randomization t-test compares favorably to the other two tests both in terms of size and power. Given the limited distributional assumptions necessary for implementation of the exact randomization test, these results suggest that experimental economists should consider using the exact randomization test more often.
Variation in observed global generic richness over the Phanerozoic must be partly explained by changes in the numbers of fossils and their geographic spread over time. The influence of sampling intensity (i.e., the number of samples) has been well addressed, but the extent to which the geographic distribution of samples might influence recovered biodiversity is comparatively unknown. To investigate this question, we create models of genus richness through time by resampling the same occurrence dataset of modern global biodiversity using spatially explicit sampling intensities defined by the paleo-coordinates of fossil occurrences from successive time intervals. Our steady-state null model explains about half of observed change in uncorrected fossil diversity and a quarter of variation in sampling-standardized diversity estimates. The inclusion in linear models of two additional explanatory variables associated with the spatial array of fossil data (absolute latitudinal range of occurrences, percentage of occurrences from shallow environments) and a Cenozoic step increases the accuracy of steady-state models, accounting for 67% of variation in sampling-standardized estimates and more than one-third of the variation in first differences. Our results make clear that the spatial distribution of samples is at least as important as numerical sampling intensity in determining the trajectory of recovered fossil biodiversity through time and caution against the overinterpretation of both the variation and the trend that emerge from analyses of global Phanerozoic diversity.
Biodiversity is in rapid decline, but the extent of loss is not well resolved for poorly known groups. We estimate the number of extinctions for Australian non-marine invertebrates since the European colonisation of the continent. Our analyses use a range of approaches, incorporate stated uncertainties and recognise explicit caveats. We use plausible bounds for the number of species, two approaches for estimating extinction rate, and Monte Carlo simulations to select combinations of projected distributions from these variables. We conclude that 9,111 (plausible bounds of 1,465 to 56,828) Australian species have become extinct over this 236-year period. These estimates dwarf the number of formally recognised extinctions of Australian invertebrates (10 species) and of the single invertebrate species listed as extinct under Australian legislation. We predict that 39–148 species will become extinct in 2024. This is inconsistent with a recent pledge by the Australian government to prevent all extinctions. This high rate of loss is largely a consequence of pervasive taxonomic biases in community concern and conservation investment. Those characteristics also make it challenging to reduce that rate of loss, as there is uncertainty about which invertebrate species are at the most risk. We outline conservation responses to reduce the likelihood of further extinctions.
The grant of a patent for a genuinely new chemical entity (NCE) provides for 20 to 25 years protection from generic competition, allowing the patent owner to set prices to recoup the cost of the invention. Evergreening is a strategy by which patent owners extend the life of a patent monopoly, surrounding an original inventive patent with numerous additional patents for modifications or variations to the original invention (secondary patents). The sub-set of secondary patents owned by the originator company are known as ‘evergreening patents’, that is, patents designed to further delay generic entry to the market. Only a small number of evergreening patents achieve this effect. Numerous articles on pharmaceutical marketing consider such patenting an important part of ‘lifecycle management’, ensuring continuing high profits from the original invention are kept ‘evergreen’.
Lewy Body Dementia (LBD) is predicted to be under-diagnosed in the general population. RBD is one of the four core clinical criteria for the diagnosis of LBD. Longitudinal studies of RBD show strong association with LBD, so there is potential for early identification of LBD and subsequent management. We aimed to screen 100% of patients referred to Trafford MATS for RBD.
Methods
We performed three Plan-Do-Study-Act (PDSA) cycles; in the first cycle we introduced a validated RBD screening question, from the DIAMOND-Lewy study, to the initial memory assessment proforma. This asked ‘Have you ever been told that you “act out your dreams” while sleeping (punched or flailed arms in the air, shouted or screamed)?’
In the second PDSA cycle, we delivered a RBD and LBD educational package to the specialist memory nurses who undertake the initial assessments. In the third PDSA cycle reminders were sent to the team to use the new assessment proforma.
We collated data from patients who had undergone an initial memory assessment between 06/04/21- 22/06/21 from the trusts electronic database.
Results
Initial baseline data showed that 0% of initial assessments screened for RBD; at the end of PDSA one this was 100% and 75% at the end of PDSA two. This increased to 100% at the end of the last PDSA cycle. The main reason for non-completion of the screening question was use of the old proforma.
4/152 patients screened positive; patients were diagnosed with Alzheimer's disease, delirium, vascular dementia and mixed Alzheimer‘s disease and vascular dementia, respectively.
Conclusion
The introduction of a RBD screening question into the MATS initial assessment proforma improved screening for RBD. We think the variation in screening compliance rates was likely due to practitioners using old assessment proformas, hence sending reminders of the new proforma.
A limitation of the project was that some patients did not have a bed partner, which makes identification of the disorder more difficult.
Since the completion of the project, we have circulated a news bulletin through the Dementia United charity to raise awareness of our QI project nationally and also discussed the project with the Lewy Body society. Whilst our project has not yet identified a patient with LBD, we feel that introducing this screening question is a very easy and reproducible change to implement and RBD should be screened for in all memory patients.
This QIP aims to improve communication and information sharing between the community LD team, administration team, service providers and wider stakeholders, to ensure patient safety. The primary objective is to evaluate local initiatives to improve communication between MDT professionals and wider stakeholders. The secondary objective is to improve patient safety and staff satisfaction.
Methods
The COVID-19 pandemic created unprecedented communication challenges within the workforce and highlighted areas requiring review; this included information sharing among internal and external teams, collaborative teamworking, support in absence of senior clinical leadership and transition pathways from Child and Adolescent Mental Health Services to adult LD services. The QIP was initiated in March 2021.
The discovery process included an initial consultation exploring practitioners’ experiences, areas for development and to share ideas for good practice.
We used QI methodology, following ‘plan-do-study-action’ cycles, to analyse change. Change ideas included a single point of contact for internal and external queries, regular complex case management meetings, development of a referral process and clinical review for complex cases along with teaching sessions.
Qualitative feedback from the team pre- and post-intervention, at baseline and regular follow-up intervals, in the form of monthly team meetings, emails, focus-groups and semi-structured interviews.
Results
A full thematic map was created after initial consultation; themes included communication improvement between teams and external agencies, timely support for complex case management, improving transition processes and development of robust clinical review processes.
Qualitative feedback has been collated, analysed and final recommendations to be shared with the MDT professionals
Conclusion
Preliminary results have shown improvements in communication among the MDT, stakeholders, and external agencies.
The consultation process highlighted that there is a substantial need for standardisation and consistency within communicative practices to promote enhanced care delivery and improved patient outcomes.
To investigate nutrition knowledge (NK) in university students, potential factors affecting knowledge and predictors of good NK.
Design:
A cross-sectional study was conducted in 2017–2018. The revised General Nutrition Knowledge Questionnaire was administered online to assess overall NK and subsections of knowledge (dietary recommendations, nutrient sources of foods, healthy food choices and diet–disease relationships). The Kruskal–Wallis test was used to compare overall NK scores according to sex, age, ethnicity, field of study, studying status, living arrangement, being on a special diet and perceived health. Logistic regression was performed to identify which of these factors were associated with a good level of NK (defined as having an overall NK score above the median score of the sample population).
Setting:
Two London-based universities.
Participants:
One hundred and ninety students from various academic disciplines.
Results:
The highest NK scores were found in the healthy food choices (10 out of 13 points) and the lowest in the nutrient sources of foods section (25 out of 36 points). Overall NK score was 64 out of 88 points, with 46·8 % students reaching a good level of knowledge. Knowledge scores significantly differed according to age, field of study, ethnicity and perceived health. Having good NK was positively associated with age (OR = 1·05, (95 % CI 1·00, 1·1), P < 0·05), White ethnicity (OR = 3·27, (95 % CI 1·68, 6·35), P < 0·001) and health rating as very good or excellent (OR = 4·71, (95 % CI 1·95, 11·4), P < 0·05).
Conclusions:
Future health-promoting interventions should focus on increasing knowledge of specific nutrition areas and consider the personal and academic factors affecting NK in university students.
When the coronavirus disease 2019 pandemic hit the UK, clinicians within Pennine Care NHS Foundation Trust (a five-borough mental health trust) were faced with the challenge of rapidly switching to a novel way of assessing patients remotely.
The idea for a QI project on trainees’ experience with remote consultations was conceived in April 2020. We present our February 2021 results here.
We aimed to improve trainee confidence in conducting remote psychiatric assessments by at least 40%, to ensure effective and safe patient care during their 6 months placement.
Method
Our discovery process included surveying trainees in April 2020 to explore experiences with remote psychiatric consultations, a literature search of current UK guidance and a local audit. The audit reviewed documentation of consent to remote consultations, with reference to standards as per NHS England remote consultation guidance. Key change ideas included publication of an article, ‘Remote consultations – top tips for clinical practitioners’, video-simulated remote consultations and a session on remote consultations in the trainee induction.
In the first ‘plan-do-study-act’ (PDSA) cycle, we presented key findings from the article in a video presentation, which was sent trust-wide. We measured confidence in conducting remote assessments pre- and post-presentation via a feedback survey. Unfortunately, response rates were low and in the second PDSA cycle we targeted a smaller cohort of trainees at the August 2020 induction, although encountered similar difficulties. In the third PDSA cycle, we collected real-time data using an interactive app at the February 2021 trainee induction, and measured pre- and post- confidence following a presentation and a video-simulated remote consultation.
Result
2/34 respondents had accessed previous remote psychiatric consultation training and12/35 had some telepsychiatry experience. Pre-induction trainee confidence results revealed: extremely uncomfortable (16%), not confident (31%), neutral (47%), confident (6%) and very confident (0%) and post-induction confidence was 0%, 22%, 52%, 26% and 0%, respectively.
Conclusion
Our project started during the first peak of the pandemic, which may be a reason for initial limited response rates. Our results suggest that the remote psychiatric consultation trainee induction session has shown some improvement in trainee confidence; the ‘confident’ cohort improved from 6% to 26%.
Our next steps include collecting similar real-time data, mid-rotation and uploading video-simulated remote consultations to the Trust Intranet. We plan to complete the local audit cycle. We also plan to incorporate patient experience (from an ongoing systematic review) to inform a potential triage process post-pandemic, choosing between face-to-face versus remote consultations.
The degree of distortion of the calcite endotherm on differential thermal analysis (DTA) curves for kaolinite-calcite mixtures depends on the kaolinite sample used as well as on the factors previously established. Although no two of the ten kaolinite samples employed, even if from the same general locality, produced identical effects under all experimental conditions, a general relationship between locality of origin and degree of distortion was noted. The crystalline species detected in the products of heating, after standing in air at room temperature, included portlandite, calcite, aragonite, vaterite and the high-temperature phases gehlenite, α′-Ca2SiO4, and 12CaO. 7Al2O3. The actual species present again depended on the kaolinite sample. Although the results cannot be directly related to the volatiles evolved along with water on dehydroxylation of the different kaolinites, a tentative explanation is offered on the basis of the effects of the volatiles on the surfaces of the particles present.
The field of computational science is concerned with generating feasible algorithms to solve mathematical problems, usually those that are important in scientific applications. An important difference between such feasible algorithms and traditional algorithms considered in computability theory is that, in general, they involve various forms of approximation. We will see that there is a common strategy in computational science that can take a problem that is not feasibly computable, and then generate a (more) feasible algorithm to a slightly modified problem. We will see how one, more general, version of this strategy underlies numerical computing, which uses approximations, and how a more restricted version underlies symbolic computing, which is exact. The nature of this feasible computation strategy in these two branches of computational science has some consequences for computability theory. We will also consider its roots in the history of science. It emerges, therefore, that feasible computing is a fundamental part of a great deal of scientific inference, as well as at the core of advanced algorithms for solving problems in computational science.
Measurements of δ34S covering the years 1935–76 and including the 1963 Agung (Indonesia) eruption were made on a West Antarctic firn core, RIDSA (78.73˚ S, 116.33˚ W; 1740ma.s.l.), and results are used to unravel potential source functions in the sulfur cycle over West Antarctica. The δ34S values of SO42– range from 3.1‰ to 9.9‰. These values are lower than those reported for central Antarctica, from near South Pole station, of 9.3–18.1‰ (Patris and others, 2000). While the Agung period is isotopically distinct at South Pole, it is not in the RIDSA dataset, suggesting differences in the source associations for the sulfur cycle between these two regions. Given the relatively large input of marine aerosols at RIDSA (determined from Na+ data and the seasonal SO42– cycle), there is likely a large marine biogenic SO42– influence. The δ34S values indicate, however, that this marine biogenic SO42–, with a well-established δ34S of 18‰, is mixing with SO42– that has extremely negative δ34S values to produce the measured isotope values in the RIDSA core. We suggest that the transport and deposition of stratospheric SO42– in West Antarctica, combined with local volcanic input, accounts for the observed variance in δ34S values.
This article challenges the restrictive association of critical theory with the Frankfurt School by exploring the differential reception of Hegel by German critical thinkers on both sides of the Iron Curtain after 1945. In the West, Theodor Adorno held Hegelian ‘identity thinking’ partly responsible for the atrocities of National Socialism. Meanwhile in the East, Ernst Bloch turned Hegel into a weapon against the communist regime. The difference between Adorno and Bloch’s positions is shown to turn on the relationship between speculation, dialectics and critique. Whereas for Adorno Hegelian speculation was the root of dangerous identity thinking, Bloch saw the repression of speculative thought as a cornerstone of totalitarianism. However, it is argued that ultimately Bloch and Adorno were united in their reception of Hegel by a shared understanding that the goal of critical theory, namely the transformation of the social totality, could not be achieved without utopian speculation.
Epidemiological evidence indicates that high consumption of tomatoes and tomato-based products reduces the risk of chronic diseases such as CVD and cancer. Such potential benefits are often ascribed to high concentrations of lycopene present in tomato products. Mainly from the results of in vitro studies, potential biological mechanisms by which carotenoids could protect against heart disease and cancer have been suggested. These include cholesterol reduction, inhibition of oxidation processes, modulation of inflammatory markers, enhanced intercellular communication, inhibition of tumourigenesis and induction of apoptosis, metabolism to retinoids and antiangiogenic effects. However, with regard to CVD, results from intervention studies gave mixed results. Over fifty human intervention trials with lycopene supplements or tomato-based products have been conducted to date, the majority being underpowered. Many showed some beneficial effects but mostly on non-established cardiovascular risk markers such as lipid peroxidation, DNA oxidative damage, platelet activation and inflammatory markers. Only a few studies showed improvement in lipid profiles, C reactive protein and blood pressure. However, recent findings indicate that lycopene could exert cardiovascular protection by lowering HDL-associated inflammation, as well as by modulating HDL functionality towards an antiatherogenic phenotype. Furthermore, in vitro studies indicate that lycopene could modulate T lymphocyte activity, which would also inhibit atherogenic processes and confer cardiovascular protection. These findings also suggest that HDL functionality deserves further consideration as a potential early marker for CVD risk, modifiable by dietary factors such as lycopene.
The objective of this article was to explore the extent of the scientific literature and evidence base about the psychosocial needs of students conducting research in the fields of advanced cancer and palliative care.
Method:
A scoping review was conducted in major scientific databases. English-language articles on the topic of interest were retained if they were published in peer-reviewed journals between 1995 and 2013.
Results:
A total of 3,161 references were screened, and 7 were retained for analysis. Only two articles were empirical studies involving the collection of primary empirical data. The remaining ones were commentaries and personal reflections. While there is a near absence of empirical research about the psychosocial needs of students, several commentaries suggest that students in this field have a high need for support. Three themes were identified in the limited literature retrieved: (1) the importance of proper training and supervision; (2) the availability of emotional support structures; and (3) the use of effective and deliberate self-care strategies.
Significance of results:
This scoping review demonstrates that little is known about the psychosocial needs of students conducting research in advanced cancer and palliative care. However, what is clear is that there is a large emotional impact on student researchers engaged in this type of work. Adequate training and support is needed to promote students' health and well-being, encourage retention of students, and foster high-quality studies. More empirical data are needed to better understand the experiences of students conducting this type of research and to ensure the sustainability of training and research in this field.
Details of a visual method for indicating boundary layer transition are given, with particular reference to tests at high Reynolds number in the RAE 5 metre pressurised low-speed wind tunnel on a slender-body model. The method is compared with other techniques on the basis of ease of use and quality of the indication.
Digital data transmission techniques enable various elements within a system to communicate in an efficient manner. Multiplexing techniques permit this data to be transferred rapidly, accurately and reliably, without the constraints imposed by conventional wiring systems which employ heavy and costly cable runs and expensive connectors. In today’s cost conscious aviation world, both military and civil users are anxious to capitalise upon savings in cost and weight while gaining substantial benefits in terms of performance and reliability.
Smiths Industries has been involved for over a decade in the application of multiplexed data transmission systems. The military Tornado serial data transmission system and the civil ARINC data transmission systems are areas where specific expertise has been established. More recently the weapon systems unit of the company’s Cheltenham Division together with Micro Circuit Engineering, an SI subsidiary, has established a world lead in the development and the application of the widely accepted data bus standard, MIL-STD-1553B.