Effectiveness of a programme of exercise on physical function in survivors of critical illness following discharge from the ICU: study protocol for a randomised controlled trial (REVIVE)

Background: Following discharge home from the ICU, patients often suffer from reduced physical function, exercise capacity, health-related quality of life and social functioning. There is usually no support to address these longer term problems, and there has been limited research carried out into interventions which could improve patient outcomes. The aim of this study is to investigate the effectiveness and cost-effectiveness of a 6-week programme of exercise on physical function in patients discharged from hospital following critical illness compared to standard care.

Methods/Design: The study design is a multicentre prospective phase II, allocation-concealed, assessor-blinded, randomised controlled clinical trial. Participants randomised to the intervention group will complete three exercise sessions per week (two sessions of supervised exercise and one unsupervised session) for 6 weeks. Supervised sessions will take place in a hospital gymnasium or, if this is not possible, in the participants home and the unsupervised session will take place at home. Blinded outcome assessment will be conducted at baseline after hospital discharge, following the exercise intervention, and at 6 months following baseline assessment (or equivalent time points for the standard care group). The primary outcome measure is physical function as measured by the physical functioning subscale of the Short-Form-36 health survey following the exercise programme. Secondary outcomes are health-related quality of life, exercise capacity, anxiety and depression, self efficacy to exercise and healthcare resource use. In addition, semi-structured interviews will be conducted to explore participants’ perceptions of the exercise programme, and the feasibility (safety, practicality and acceptability) of providing the exercise programme will be assessed. A within-trial cost-utility analysis to assess the cost-effectiveness of the intervention compared to standard care will also be conducted.

Discussion: If the exercise programme is found to be effective, this study will improve outcomes that are meaningful to patients and their families. It will inform the design of a future multicentre phase III clinical trial of exercise following recovery from critical illness. It will provide useful information which will help the development of services for patients after critical illness.

Secure Communication in Cellular Networks: The Benefits of Millimeter Wave Mobile Broadband

This paper proposes millimeter wave (mmWave) mobile broadband for achieving secure communication in downlink cellular network. Analog beamforming with phase shifters is adopted for the mmWave transmission. The secrecy throughput is analyzed based on two different transmission modes, namely delay-tolerant transmission and delay-limited transmission. The impact of large antenna arrays at the mmWave frequencies on the secrecy throughput is examined. Numerical results corroborate our analysis and show that mmWave systems can enable significant secrecy improvement. Moreover, it is indicated that with large antenna arrays, multi-gigabit per second secure link at the mmWave frequencies can be reached in the delay-tolerant transmission mode and the adverse effect of secrecy outage vanishes in the delay-limited transmission mode.

Secure Multiuser Multiple Amplify-and-Forward Relay Networks in Presence of Multiple Eavesdroppers

In this paper, we study the information-theoretical security of a downlink multiuser cooperative relaying network with multiple intermediate amplify-and-forward (AF) relays, where there exist multiple eavesdroppers which can overhear the message. To prevent the wiretap and strength the network security, we select one best relay and user pair, so that the selected user can receive the message from the base station assisted by the selected relay. The relay and user selection is performed by maximizing the ratio of the received signal-to-noise ratio (SNR) at the user to the eavesdroppers, which is based on both the main and eavesdropper links. For the considered system, we derive the closed-form expression of the secrecy outage probability, and provide the asymptotic expression in high main-to-eavesdropper ratio (MER) region. From the asymptotic analysis, we can find that the system diversity order is equivalent to the number of relays regardless of the number of users and eavesdroppers.

Investigation of secure wireless regions using configurable beamforming on WARP

In this paper, we examine a novel approach to network security against passive eavesdroppers in a ray-tracing model and implement it on a hardware platform. By configuring antenna array beam patterns to transmit the data to specific regions, it is possible to create defined regions of coverage for targeted users. By adapting the antenna configuration according to the intended user’s channel state information, this allows the vulnerability of the physical regions to eavesdropping to be reduced. We present the application of our concept to 802.11n networks where an antenna array is employed at the access point. A range of antenna array configurations are examined by simulation and then realized using the Wireless Open-Access Research Platform(WARP)

Creating secure wireless regions using configurable beamforming

We present a novel approach to network security against passive eavesdroppers by employing a configurable beam-forming technique to create tightly defined regions of coverage for targeted users. In contrast to conventional encryption methods, our security scheme is developed at the physical layer by configuring antenna array beam patterns to transmit the data to specific regions. It is shown that this technique can effectively reduce vulnerability of the physical regions to eavesdropping by adapting the antenna configuration according to the intended user's channel state information. In this paper we present the application of our concept to 802.11n networks where an antenna array is employed at the access point, and consider the issue of minimizing the coverage area of the region surrounding the targeted user. A metric termed the exposure region is formally defined and used to evaluate the level of security offered by this technique. A range of antenna array configurations are examined through analysis and simulation, and these are subsequently used to obtain the optimum array configuration for a user traversing a coverage area.

Secure Multiuser Communications in Multiple Amplify-and-Forward Relay Networks

This paper proposes relay selection in order to increase the physical layer security in multiuser cooperative relay networks with multiple amplify-and-forward (AF) relays, in the presence of multiple eavesdroppers. To strengthen the network security against eavesdropping attack, we present three criteria to select the best relay and user pair. Specifically, criterion I and II study the received signal-to-noise ratio (SNR) at the receivers, and perform the selection by maximizing the SNR ratio of the user to the eavesdroppers. To this end, criterion I relies on both the main and eavesdropper links, while criterion II relies on the main links only. Criterion III is the standard max-min selection criterion,
which maximizes the minimum of the dual-hop channel gains of main links. For the three selection criteria, we examine the system secrecy performance by deriving the analytical expressions for the secrecy outage probability. We also derive the asymptotic analysis for the secrecy outage probability with high main-to eavesdropper ratio (MER). From the asymptotic analysis, an interesting observation is reached: for each criterion, the system diversity order is equivalent to the number of relays regardless of the number of users and eavesdroppers.

Feasibility trial of a film-based educational intervention for increasing boy's and girl's intentions to avoid teenage pregnancy: study protocol

The World Health Organisation, amongst others, recognises that adolescent men have a vital yet neglected role in reducing teenage pregnancies and that there is a pressing need for educational interventions designed especially for them. This study seeks to fill this gap by determining the feasibility of conducting an effectiveness trial of the If I Were Jack intervention in post-primary schools. This 4-week intervention aims to increase teenagers' intentions to avoid unintended pregnancy and addresses gender inequalities in sex education by explicitly focusing on young men. A cluster randomised feasibility trial with embedded process evaluation will determine: recruitment, participation and retention rates; quality of implementation; acceptability and feasibility of the intervention and trial procedures; and costs. (C) 2014 The Authors. Published by Elsevier Ltd.

How secure is a Newtonian paradigm for psychological and educational measurement?

From the early 1900s, some psychologists have attempted to establish their discipline as a quantitative science. In using quantitative methods to investigate their theories, they adopted their own special definition of measurement of attributes such as cognitive abilities, as though they were quantities of the type encountered in Newtonian science. Joel Michell has presented a carefully reasoned argument that psychological attributes lack additivity, and therefore cannot be quantities in the same way as the attributes of classical Newtonian physics. In the early decades of the 20th century, quantum theory superseded Newtonian mechanics as the best model of physical reality. This paper gives a brief, critical overview of the evolution of current measurement practices in psychology, and suggests the need for a transition from a Newtonian to a quantum theoretical paradigm for psychological measurement. Finally, a case study is presented that considers the implications of a quantum theoretical model for educational measurement. In particular, it is argued that, since the OECD’s Programme for International Student Assessment (PISA) is predicated on a Newtonian conception of measurement, this may constrain the extent to which it can make accurate comparisons of the achievements of different education systems.