The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems

Background: Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems.

Methods: In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis.

Results: Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating role plays into behaviour change training, providing more practical information about stress management and removing self-monitoring of lifestyle change.

Conclusion: Qualitative research is integral to developing the design detail of a complex intervention and tailoring its components to address individuals' needs in different healthcare systems. The findings highlight how qualitative research may be a valuable component of the preparation for complex interventions and their evaluation.

Non-covalent hydrogels of cyclodextrins and poloxamines for the controlled release of proteins

Different types of gels were prepared by combining poloxamines (Tetronic), i.e. poly(ethylene oxide)/poly(propylene oxide) (PEO/PPO) octablock star copolymers, and cyclodextrins (CD). Two different poloxamines with the same molecular weight (ca. 7000) but different molecular architectures were used. For each of their four diblock arms, direct Tetronic 904 presents PEO outer blocks while in reverse Tetronic 90R4 the hydrophilic PEO blocks are the inner ones. These gels were prepared by combining alpha-CD and poloxamine aqueous solutions. The physicochemical properties of these systems depend on several factors such as the structure of the block copolymers and the Tetronic/alpha-CD ratio. These gels were characterized using differential scanning calorimetry (DSC), viscometry and X-ray diffraction measurements. The 90R4 gels present a consistency that makes them suitable for sustained drug delivery. The resulting gels were easily eroded: these complexes were dismantled when placed in a large amount of water, so controlled release of entrapped large molecules such as proteins (Bovine Serum Albumin, BSA) is feasible and can be tuned by varying the copolymer/CD ratio. 

Rapid Implementation and Optimisation of DSP Systems on FPGA-Centric Hetrogeneous Platforms

This paper, chosen as a best paper from the 2005 SAMOS Workshop on Computer Systems: describes the for the first time the major Abhainn project for automated system level design of embedded signal processing systems. In particular, this describes four key novelties: novel algorithm modelling techniques for DSP systems, automated implementation realisation, algorithm transformation for system optimisation and automated inter-processor communication. This is applied to two complex systems: a radar and sonar system. In both cases technology which allows non-experts to automatically create low-overhead, high performance embedded signal processing systems is exhibited.

Ligand differentiated complementary Rh-catalyst systems for the enantioselective desymmetrization of meso-cyclic anhydrides

Two distinct systems for the rhodium-catalyzed enantioselective desymmetrization of meso-cyclic anhydrides have been developed. Each system has been optimized and are compatible with the use of in situ prepared organozinc reagents. Rhodium/PHOX species efficiently catalyze the addition of alkyl nucleophiles to glutaric anhydrides, while a rhodium/phosphoramidite system is effective in the enantioselective arylation of succinic and glutaric anhydrides.

Room-temperature ionic liquids as replacements for organic solvents in multiphase bioprocess operations

Organic solvents are widely used in a range of multiphase bioprocess operations including the liquid-liquid extraction of antibiotics and two-phase biotransformation reactions. There are, however, considerable problems associated with the safe handling of these solvents which relate to their toxic and flammable nature. In this work we have shown for the first time that room-temperature ionic liquids, such as 1-butyl-3-methylimidazolium hexafluorophosphate, [bmim][PF6], can be successfully used in place of conventional solvents for the liquid-liquid extraction of erythromycin-A and for the Rhodococcus R312 catalyzed biotransformation of 1,3-dicyanobenzene (1,3-DCB) in a liquid-liquid, two-phase system. Extraction of erythromycin with either butyl acetate or [bmim][PF6] showed that values of the equilibrium partition coefficient, K, up to 20-25 could be obtained for both extractants. The variation of K with the extraction pH was also similar in the pH range 5-9 though differed significantly at higher pH values. Biotransformation of 1,3-DCB in both water-toluene and water-[bmim][PF6] systems showed similar profiles for the conversion of 1,3-DCB initially to 3-cyanobenzamide and then 3-cyanobenzoic acid. The initial rate of 3-cyanobenzamide production in the water-[bmim][PF6] system was somewhat lower, however, due to the reduced rate of 1,3-DCB mass transfer from the more viscous [bmim] [PF,] phase. it was also shown that the specific activity of the biocatalyst in the water-[bmim][PF6] system was almost an order of magnitude greater than in the water-toluene system which suggests that the rate of 3-cyanobenzamide production was limited by substrate mass transfer rather than the activity of the biocatalyst. (C) 2000 John Wiley & Sons, Inc.

Passing quantum correlations to qubits using any two-mode state

We draw an explicit connection between the statistical properties of an entangled two-mode continuous variable (CV) resource and the amount of entanglement that can be dynamically transferred to a pair of noninteracting two-level systems. More specifically, we rigorously reformulate entanglement-transfer process by making use of covariance matrix formalism. When the resource state is Gaussian, our method makes the approach to the transfer of quantum correlations much more flexible than in previously considered schemes and allows the straightforward inclusion of the effects of noise affecting the CV system. Moreover, the proposed method reveals that the use of de-Gaussified two-mode states is almost never advantageous for transferring entanglement with respect to the full Gaussian picture, despite the entanglement in the non-Gaussian resource can be much larger than in its Gaussian counterpart. We can thus conclude that the entanglement-transfer map overthrows the

On the Distribution of Signal Phase in Body Area Networks

In this letter, we investigate the distribution of the phase component of the complex received signal observed in practical experiments using body area networks. Two phase distributions, the recently proposed kappa-mu and eta-mu probability densities, which together encompass the most widely used fading models, namely Semi-Gaussian, Rayleigh, Hoyt, Rice, and Nakagami-m, have been compared with measurement data. The kappa-mu distribution has been found to provide the best fit over a range of on-body links, while the user was mobile. The experiments were carried out in two dissimilar indoor environments at opposite ends of the multipath spectrum. It has also been found that the uniform phase distribution has not arisen in anyone of the experiments.

Sensory systems and spatial memory in the fruit bat Rousettus aegyptiacus

The megachiropteran fruit bat Rousettus aegyptiacus is able to orient and navigate using both vision and echolocation. These two sensory systems have different environmental constraints however, echolocation being relatively short range when compared with vision. Despite this difference, an experiment testing their memory of a perch location demonstrates that once the location of a perch is learned R. aegyptiacus is not influenced by the movement of local landmark cues in the vicinity of the perch under either light or dark conditions. Thus despite the differing constraints of vision and echolocation, this suggests a place is remembered as a location in space and not by associations with landmarks in the vicinity. A decrease in initial performance when the task was repeated in the dark suggested the possibility that a memory of a location learned using vision does not generalize to echolocation.

A constraints-based resource discovery model for multi-provider cloud environments

Increasingly infrastructure providers are supplying the cloud marketplace with storage and on-demand compute resources to host cloud applications. From an application user's point of view, it is desirable to identify the most appropriate set of available resources on which to execute an application. Resource choice can be complex and may involve comparing available hardware specifications, operating systems, value-added services, such as network configuration or data replication, and operating costs, such as hosting cost and data throughput. Providers' cost models often change and new commodity cost models, such as spot pricing, have been introduced to offer significant savings. In this paper, a software abstraction layer is used to discover infrastructure resources for a particular application, across multiple providers, by using a two-phase constraints-based approach. In the first phase, a set of possible infrastructure resources are identified for a given application. In the second phase, a heuristic is used to select the most appropriate resources from the initial set. For some applications a cost-based heuristic is most appropriate; for others a performance-based heuristic may be used. A financial services application and a high performance computing application are used to illustrate the execution of the proposed resource discovery mechanism. The experimental result shows the proposed model could dynamically select an appropriate set of resouces that match the application's requirements.

Recoil-induced electronic excitation and ionization in one-and two-electron ions

The electronic redistribution of an ion or atom induced by a sudden recoil of the nucleus occurring during the emission or capture of a neutral particle is theoretically investigated. For one-electron systems, analytical expressions are derived for the electronic transition probabilities to bound and continuum states. The quality of a B-spline basis set approach is evaluated from a detailed comparison with the analytical results. This numerical approach is then used Io study the dynamics of two-electron systems (neutral He and Ne ) using correlated wavefunctions for both the target and daughter ions. The total transition probabilities to discrete states, autoionizing states and direct single- and double-ionization probabilities are calculated from the pseudospectra. Sum rules for transition probabilities involving an initial bound state and a complete final series are discussed.

A comparison of two measures of facial activity during pain in the newborn child

Facial activity is strikingly visible in infants reacting to noxious events. Two measures that reduce this activity to composite events, the Neonatal Facial Coding System (NFCS) and the Facial Action Coding System (FACS), were used to examine facial expressions of 56 neonates responding to routine heel lancing for blood sampling purposes. The NFCS focuses upon a limited subset of all possible facial actions that had been identified previously as responsive to painful events, whereas the FACS is a comprehensive system that is inclusive of all facial actions. Descriptions of the facial expressions obtained from the two measurement systems were very similar, supporting the convergent validity of the shorter, more readily applied system. As well, the cluster of facial activity associated with pain in this sample, using either measure, was similar to the cluster of facial activity associated with pain in adults and other newborns, both full-term and preterm, providing construct validity for the position that the face encodes painful distress in infants and adults.

Enhancing non-classicality in mechanical systems

We study the effects of post-selection measurements on both the non-classicality of the state of a mechanical oscillator and the entanglement between two mechanical systems that are part of a distributed optomechanical network. We address the cases of both Gaussian and non-Gaussian measurements, identifying in which cases simple photon counting and Geiger-like measurements are effective in distilling a strongly non-classical mechanical state and enhancing the purely mechanical entanglement between two elements of the network.

RU Peg and AE Aqr: two contrasting CVs with one thing in common

Roche tomography is a powerful tool for imaging the surfaces of stars. We have applied it to two contrasting systems, a normal dwarf nova, RU Peg, and the peculiar intermediate polar AE Aqr. Despite these differences, the Roche tomograms of the cool stars in the two systems are remarkably similar. We compare them with tomograms of two other stars, and discuss the differences and similarities. The rotation speed may be critical in determining the surface appearance, and it is strongly recommended that a Roche tomogram be obtained for the bright CV SS Cygni, which would be the fastest-rotating secondary to be studied. In addition, V426 Oph should be re-observed.