The cost-effectiveness of exercise referral schemes

Background Exercise referral schemes (ERS) aim to identify inactive adults in the primary care setting. The primary care professional refers the patient to a third party service, with this service taking responsibility for prescribing and monitoring an exercise programme tailored to the needs of the patient. This paper examines the cost-effectiveness of ERS in promoting physical activity compared with usual care in primary care setting. Methods A decision analytic model was developed to estimate the cost-effectiveness of ERS from a UK NHS perspective. The costs and outcomes of ERS were modelled over the patient's lifetime. Data were derived from a systematic review of the literature on the clinical and cost-effectiveness of ERS, and on parameter inputs in the modelling framework. Outcomes were expressed as incremental cost per quality-adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses investigated the impact of varying ERS cost and effectiveness assumptions. Sub-group analyses explored the cost-effectiveness of ERS in sedentary people with an underlying condition. Results Compared with usual care, the mean incremental lifetime cost per patient for ERS was £169 and the mean incremental QALY was 0.008, generating a base-case incremental cost-effectiveness ratio (ICER) for ERS at £20,876 per QALY in sedentary individuals without a diagnosed medical condition. There was a 51% probability that ERS was cost-effective at £20,000 per QALY and 88% probability that ERS was cost-effective at £30,000 per QALY. In sub-group analyses, cost per QALY for ERS in sedentary obese individuals was £14,618, and in sedentary hypertensives and sedentary individuals with depression the estimated cost per QALY was £12,834 and £8,414 respectively. Incremental lifetime costs and benefits associated with ERS were small, reflecting the preventative public health context of the intervention, with this resulting in estimates of cost-effectiveness that are sensitive to variations in the relative risk of becoming physically active and cost of ERS. Conclusions ERS is associated with modest increase in lifetime costs and benefits. The cost-effectiveness of ERS is highly sensitive to small changes in the effectiveness and cost of ERS and is subject to some significant uncertainty mainly due to limitations in the clinical effectiveness evidence base.

Shalom Schwarzbard 1917-1938

The collection consists of correspondence, newspaper clippings, manuscripts and notes that relate primarily to the Schwarzbard trial and its aftermath. Correspondence with organizations: Agudah Ateret Zion, Yidish Natsionaler Arbeter Farband, Yidisher Studentn Fareyn, Jewish Agency, *Der Tog*, *Unzer tsayt*, YIVO Institute, Ligue Internationale Contre L'antisemitisme, *Morgn zhurnal*, Federation de Societes Juives de France, Jewish Veterans Organization. Correspondence with individuals: Joseph Barondess, Alberto Bianchi, Zelig Kalmanovitch, Israel Ostroff, Noah Prylucki, Anna Schwarzbard, William Zukerman. Manuscripts: typescripts of memoirs *In krig mit zikh aleyn* (At War With Myself). Poems about Schwarzbard's assassination of Petlyura. Poems by Anna Schwarzbard. Clippings about Schwarzbard. Personal documents.

Novel photoisomerization of spirodienones

Spironaphthalenones of the type (Image ) have been demonstrated to undergo isomerization to (Image ) upon UV irradiation.

A descriptive analysis of incidents reported by community aged care workers

Little is known about the types of incidents that occur to aged care clients in the community. This limits the development of effective strategies to improve client safety. The objective of the study was to present a profile of incidents reported in Australian community aged care settings. All incident reports made by community care workers employed by one of the largest community aged care provider organizations in Australia during the period November 1, 2012, to August 8, 2013, were analyzed. A total of 356 reports were analyzed, corresponding to a 7.5% incidence rate per client year. Falls and medication incidents were the most prevalent incident types. Clients receiving high-level care and those who attended day therapy centers had the highest rate of incidents with 14% to 20% of these clients having a reported incident. The incident profile indicates that clients on higher levels of care had higher incident rates. Incident data represent an opportunity to improve client safety in community aged care.

Molecular epidemiology of human rhinoviruses

The first part of this work investigates the molecular epidemiology of a human enterovirus (HEV), echovirus 30 (E-30). This project is part of a series of studies performed in our research team analyzing the molecular epidemiology of HEV-B viruses. A total of 129 virus strains had been isolated in different parts of Europe. The sequence analysis was performed in three different genomic regions: 420 nucleotides (nt) in the VP4/VP2 capsid protein coding region, the entire VP1 capsid protein coding gene of 876 nt, and 150 nt in the VP1/2A junction region. The analysis revealed a succession of dominant sublineages within a major genotype. The temporally earlier genotypes had been replaced by a genetically homogenous lineage that has been circulating in Europe since the late 1970s. The same genotype was found by other research groups in North America and Australia. Globally, other cocirculating genetic lineages also exist. The prevalence of a dominant genotype makes E-30 different from other previously studied HEVs, such as polioviruses and coxsackieviruses B4 and B5, for which several coexisting genetic lineages have been reported. The second part of this work deals with molecular epidemiology of human rhinoviruses (HRVs). A total of 61 field isolates were studied in the 420-nt stretch in the capsid coding region of VP4/VP2. The isolates were collected from children under two years of age in Tampere, Finland. Sequences from the clinical isolates clustered in the two previously known phylogenetic clades. Seasonal clustering was found. Also, several distinct serotype-like clusters were found to co-circulate during the same epidemic season. Reappearance of a cluster after disappearing for a season was observed. The molecular epidemiology of the analyzed strains turned out to be complex, and we decided to continue our studies of HRV. Only five previously published complete genome sequences of HRV prototype strains were available for analysis. Therefore, all designated HRV prototype strains (n=102) were sequenced in the VP4/VP2 region, and the possibility of genetic typing of HRV was evaluated. Seventy-six of the 102 prototype strains clustered in HRV genetic group A (HRV-A) and 25 in group B (HRV-B). Serotype 87 clustered separately from other HRVs with HEV species D. The field strains of HRV represented as many as 19 different genotypes, as judged with an approximate demarcation of a 20% nt difference in the VP4/VP2 region. The interserotypic differences of HRV were generally similar to those reported between different HEV serotypes (i.e. about 20%), but smaller differences, less than 10%, were also observed. Because some HRV serotypes are genetically so closely related, we suggest that the genetic typing be performed using the criterion "the closest prototype strain". This study is the first systematic genetic characterization of all known HRV prototype strains, providing a further taxonomic proposal for classification of HRV. We proposed to divide the genus Human rhinoviruses into HRV-A and HRV-B. The final part of the work comprises a phylogenetic analysis of a subset (48) of HRV prototype strains and field isolates (12) in the nonstructural part of the genome coding for the RNA-dependent RNA polymerase (3D). The proposed division of the HRV strains in the species HRV-A and HRV-B was also supported by 3D region. HRV-B clustered closer to HEV species B, C, and also to polioviruses than to HRV-A. Intraspecies variation within both HRV-A and HRV-B was greater in the 3D coding region than in the VP4/VP2 coding region, in contrast to HEV. Moreover, the diversity of HRV in 3D exceeded that of HEV. One group of HRV-A, designated HRV-A', formed a separate cluster outside other HRV-A in the 3D region. It formed a cluster also in the capsid region, but located within HRV-A. This may reflect a different evolutionary history of distinct genomic regions among HRV-A. Furthermore, the tree topology within HRV-A in the 3D region differed from that in the VP4/VP2, suggesting possible recombination events in the evolution of the strains. No conflicting phylogenies were observed in any of the 12 field isolates. Possible recombination was further studied using the Similarity and Bootscanning analyses of the complete genome sequences of HRV available in public databases. Evidence for recombination among HRV-A was found, as HRV2 and HRV39 showed higher similarity in the nonstructural part of the genome. Whether HRV2 and HRV39 strains - and perhaps also some other HRV-A strains not yet completely sequenced - are recombinants remains to be determined.

Embodied energy in cement stabilised rammed earth walls

Rammed earth walls are low carbon emission and energy efficient alternatives to load bearing walls. Large numbers of rammed earth buildings have been constructed in the recent past across the globe. This paper is focused on embodied energy in cement stabilised rammed earth (CSRE) walls. Influence of soil grading, density and cement content on compaction energy input has been monitored. A comparison between energy content of cement and energy in transportation of materials, with that of the actual energy input during rammed earth compaction in the actual field conditions and the laboratory has been made. Major conclusions of the investigations are (a) compaction energy increases with increase in clay fraction of the soil mix and it is sensitive to density of the CSRE wall, (b) compaction energy varies between 0.033 MJ/m(3) and 0.36 MJ/m(3) for the range of densities and cement contents attempted, (c) energy expenditure in the compaction process is negligible when compared to energy content of the cement and (d) total embodied energy in CSRE walls increases linearly with the increase in cement content and is in the range of 0.4-0.5 GJ/m(3) for cement content in the rage of 6-8%. (C) 2009 Elsevier B.V. All rights reserved.

Microstructural stability and creep in nanocrystals

Microstructural stability is an important consideration during high temperature deformation and processing of nanomaterials. We will address issues relating to triple junctions in limiting grain growth during creep as well as densification. Although early studies on deformation have considered diffusion creep as a possible rate controlling deformation mechanism in nanocrystals, a critical inspection of available data indicates that there is no strong evidence for conventional diffusion creep in such materials. The possibility of diffusion creep by rapid diffusion along triple junctions will be analyzed, and interface controlled diffusion creep will also be discussed critically. It is shown that the critical grain size for dislocation activity is similar to that for occurrence of conventional diffusion creep.

Prevalence, codetection and seasonal distribution of upper airway viruses and bacteria in children with acute respiratory illnesses with cough as a symptom

Most studies exploring the role of upper airway viruses and bacteria in paediatric acute respiratory infections (ARI) focus on specific clinicaldiagnoses and/or do not account for virus–bacteria interactions. We aimed to describe the frequency and predictors of virus and bacteria codetection in children with ARI and cough, irrespective of clinical diagnosis. Bilateral nasal swabs, demographic, clinical and risk factor data were collected at enrollment in children aged <15 years presenting to an emergency department with an ARI and where cough was a symptom. Swabs were tested by polymerase chain reaction for 17 respiratory viruses and seven respiratory bacteria. Logistic regression was used to investigate associations between child characteristics and codetection of the organisms of interest. Between December 2011 and August 2014, swabs were collected from 817 (93.3%) of 876 enrolled children, median age 27.7 months (interquartile range13.9–60.3 months). Overall, 740 (90.6%) of 817 specimens were positive for any organism. Both viruses and bacteria were detected in 423 specimens (51.8%). Factors associated with codetection were age (adjusted odds ratio (aOR) for age <12 months = 4.9, 95% confidence interval (CI) 3.0, 7.9; age 12 to <24 months = 6.0, 95% CI 3.7, 9.8; age 24 to <60 months = 2.4, 95% CI 1.5, 3.9), male gender (aOR 1.46; 95% CI 1.1, 2.0), child care attendance (aOR 2.0; 95% CI 1.4, 2.8) and winter enrollment (aOR 2.0; 95% CI 1.3, 3.0). Haemophilus influenzae dominated the virus–bacteria pairs. Virus–H. influenzae interactions in ARI should be investigated further, especially as the contribution of nontypeable H. influenzae to acute and chronic respiratory diseases is being increasingly recognized.

Novel peptides of therapeutic promise from Indian Conidae

Highly structured small peptides are the major toxic constituents of the venom of cone snails, a family of widely distributed predatory marine molluscs. These animals use the venom for rapid prey immobilization. The peptide components in the venom target a wide variety of membrane-bound ion channels and receptors. Many have been found to be highly selective for a diverse range of mammalian ion channels and receptors associated with pain-signaling pathways. Their small size, structural stability, and target specificity make them attractive pharmacologic agents. A select number of laboratories mainly from the United States, Europe, Australia, Israel, and China have been engaged in intense drug discovery programs based on peptides from a few snail species. Coastal India has an estimated 20-30% of the known cone species; however, few serious studies have been reported so far. We have begun a comprehensive program for the identification and characterization of peptides from cone snails found in Indian Coastal waters. This presentation reviews our progress over the last 2 years. As expected from the evolutionary history of these venom components, our search has yielded novel peptides of therapeutic promise from the new species that we have studied.

Dynamic viscosity of gas mixtures

The viscosity of five binary gas mixtures - namely, oxygen-hydrogen, oxygen-nitrogen, oxygen-carbon dioxide, carbon dioxide-nitrogen, carbon dioxide-hydrogen - and two ternary mixtures - oxygen-nitrogen-carbon dioxide and oxygen-hydrogen-carbon dioxide - were determined at ambient temperature and pressure using an oscillating disk viscometer. The theoretical expressions of several investigators were in good agreement with the experimental results obtained with this viscometer. In the case of the ternary gas mixture oxygen-carbon dioxide-nitrogen, as long as the volumetric ratio of oxygen to carbon dioxide in the mixture was maintained at 11 to 8, the viscosity of the ternary mixture at ambient temperature and pressure remained constant irrespective of the percentage of nitrogen present in the mixture.

Vertical profile of aerosol single scattering albedo over west coast of India during W_ICARB

Altitude profile of aerosol Single Scattering Albedo (SSA), derived from simultaneous in-situ airborne measurements of the coefficients of aerosol absorption and scattering off the west coast of India over the Arabian Sea (AS), during January 2009 is presented. While both the absorption and scattering coefficients decreased with altitude, their vertical structure differed significantly. Consequently, the derived SSA, with a surface value of 0.94, decreased with altitude, illustrating increasing relative dominance of aerosol absorption at higher altitudes. Altitude profile of SSA, when examined in conjunction with that of hemispheric backscatter fraction, revealed that the continental influence on the aerosol properties was higher at higher altitude, rather than the effect of marine environment. During an east-west transect across the peninsular India at an altitude of similar to 2500 m (free troposphere), it was found that the aerosol scattering coefficients remained nearly the same over both east and west coasts. (C) 2010 Elsevier Ltd. All rights reserved.

Titania nanowires as substrates for sensing and photocatalysis of common textile industry effluents

Sensing and photocatalysis of textile industry effluents such as dyes using mesoporous anatase titania nanowires are discussed here.Spectroscopic investigations show that the titania nanowires preferentially sense cationic (e.g. Methylene Blue, Rhodamine B) over anionic (e.g. Orange G, Remazol Brilliant Blue R) dyes. The adsorbed dye concentration on titania nanowires increased with increase in nanowire dimensions and dye solution pH. Electrochemical sensing directly corroborated spectroscopic findings. Electrochemical detection sensitivity for Methylene Blue increased by more than two times in magnitude with tripling of nanowire average length. Photodegradation of Methylene Blue using titania nanowires is also more efficient than the commercial P25-TiO2 nanopowders. Keeping illumination protocol and observation times constant, the Methylene Blue concentration in solution decreased by only 50% in case of P25-TiO2 nanoparticles compared to a 100% decrease for titania nanowires. Photodegradation was also found to be function of exposure times and dye solution pH.Excellent sensing ability and photocatalytic activity of the titania nanowires is attributed to increased effective reaction area of the controlled nanostructured morphology. (C) 2010 Elsevier B.V. All rights reserved.

An Experimental and Numerical Study of Calliphora Wing Structure

Experiments are performed to determine the mass and stiffness variations along the wing of the blowfly Calliphora. The results are obtained for a pairs of wings of 10 male flies and fresh wings are used. The wing is divided into nine locations along the span and seven locations along the chord based on venation patterns. The length and mass of the sections is measured and the mass per unit length is calculated. The bending stiffness measurements are taken at three locations, basal (near root), medial and distal (near tip) of the fly wing. Torsional stiffness measurements are also made and the elastic axis of the wing is approximately located. The experimental data is then used for structural modeling of the wing as a stepped cantilever beam with nine spanwise sections of varying mass per unit lengths, flexural rigidity (EI) and torsional rigidity (GJ) values. Inertial values of nine sections are found to approximately vary according to an exponentially decreasing law over the nine sections from root to tip and it is used to calculate an approximate value of Young's modulus of the wing biomaterial. Shear modulus is obtained assuming the wing biomaterial to be isotropic. Natural frequencies, both in bending and torsion, are obtained by solving the homogeneous part of the respective governing differential equations using the finite element method. The results provide a complete analysis of Calliphora wing structure and also provide guidelines for the biomimetic structural design of insect-scale flapping wings.

Formale Aspekte dreier finnischsprachiger Untertitelungsversionen des Films Das Leben der Anderen und bei den Untertitelungen angewandte Übersetzungsstrategien

Työssä tutkitaan yhtäältä saksankielisen elokuvan Muiden elämä ( Das Leben der Anderen ) kolmen suomenkielisen tekstitysversion tekstityksen muotoseikkoja, kuten välimerkkien käyttöä, repliikki- ja rivijakoa, ja toisaalta tekstityksen sisältöseikkoja, joita tarkastellaan tekstityksessä käytettävien käännösstrategioiden avulla. Tutkielmassa tarkastellaan, ovatko tekstityksissä käytetyt muotoseikat konventioiden mukaisia ja minkälaisia käännösstrategioita tekstityksissä on käytetty sekä johtaako tietyn käännösstrategian käyttö merkityksen muutoksiin ja kaventumisiin tekstityksessä. Tutkielman aineistona on elokuva Muiden elämä ja sen kolme suomenkielistä tekstitystä: elokuvateattereissa esitetty versio, DVD-tekstitys ja televisiossa esitetty versio. Hypoteesina oli, että kaikkien versioiden muotoseikat ovat konventioiden mukaisia ja että versioilla on eroavuuksia ruututekstien määrässä ja repliikkijaossa. Lisäksi oletettiin, että tietyn käännösstrategian käytön ja merkityksen muutoksien välillä on yhteys, niin että merkityksen muutoksia esiintyy eniten silloin, kun kaikkea sanottua ei voida kääntää. Tutkielman teoriataustassa esitellään aluksi lyhyesti av-kääntämisen muita lajeja, kuten ns. dubbausta eli jälkiäänitystä, selostusta ja voice-overia, jonka jälkeen syvennytään tekstityksen teoriaan, tekstityksen muotoseikkoihin ja konventioihin sekä tekstityksen käännösstrategioihin. Tekstityksen sisältöseikkojen analyysin viitekehyksenä ovat Henrik Gottliebin (1994, 1997) kymmenen käännösstrategiaa: lisäys (engl. expansion), para-fraasi (paraphrase), suora käännös (transfer), imitaatio (imitation), transkriptio (transcription), siirtäminen (dislocation), tiivistäminen (condensation), lyhentäminen (decimation), poisjättäminen (deletion) ja resignaatio (resignation). Tutkielmassa analysoitiin kaikkien tekstitysversioiden muotoseikat. Tekstityksen sisältöseikkojen tutkimuksessa jokainen dialogin lause tai sivulause analysoitiin omana verbaalisena segmenttinään. Yhteensä analysoitiin 1311 verbaalista segmenttiä ja tutkittiin, mitä käännösstrategiaa missäkin tekstitysversiossa oli missäkin osakäännöksessä käytetty, sekä tarkasteltiin, muuttuuko repliikissä merkitys alkutekstiin verrattuna. Strategiat kuvataan ja niiden käyttöä valaistaan esimerkkien avulla. Tulokset ovat hypoteesia tukevia: Tutkielmassa havaittiin, että kaikkien tekstitysversioiden muotoseikat ovat suurimmalta osin konventioiden mukaisia. Eroja oli havaittavissa tavuviivan, pilkun ja kursiivin käytössä. Versiot eroavat myös ruututekstien määrässä: elokuvaversiossa on eniten ruututekstejä (1091), vaikka siinä on vähiten sanoja (3968); DVD-tekstityksessä on 876 ruututekstiä ja 4278 sanaa ja TV-tekstityksessä on 983 ruututekstiä ja 5293 sanaa. Eroavaisuudet selittyvät sillä, että elokuvatekstityksen ruututekstit ovat lyhyempiä ja nopeammin ilmestyviä kuin DVD- tai TV-tekstitysten. Tutkittu DVD-tekstitys on elokuvatekstityksen muokkaus, mistä johtuu sen vähäinen sana- ja ruututekstimäärä. Tutkielmassa havaittiin myös, että kaikissa versioissa yleisimmin käytetty käännösstrategia oli suora käännös, mutta TV-tekstityksessä sitä oli käytetty yli 50 %:ssa kaikista osakäännöksistä ja DVD- ja elokuvaversiossa yli 35 %:ssa, eli TV-tekstityksessä sitä oli käytetty huomattavasti enemmän kuin muissa versioissa. Lyhentämistä ja poisjättämistä oli DVD- ja elokuvatekstityksessä käytetty enemmän kuin TV-tekstityksessä. Nämäkin erot selit-tynevät elokuvatekstityksen pienemmällä tilalla ja tämän tekstityksen muokkaamisesta DVD-tekstitykseksi. Merkityksen muutoksia ja kaventumisia esiintyi eniten strategioiden poisjättäminen ja lyhentäminen yhteydessä, muiden strategioiden yhteydessä merkityksen muutoksia ja kaventumisia esiintyi vain marginaalisesti. Tulokset tukevat hypoteesia siitä, että merkitys muuttuu ja kaventuu eniten silloin, kun kaikkea sanottua ei voida kääntää.

Structural effects on the vaporization of high molecular weight esters

To understand the effect of molecular weight and branching on the heats of vaporization (AH,) and their flow behavior, AH, and viscosity (7) were measured at different temperatures in the high molecular weight ester series: linear flexible di-n-alkyl sebacates and compact branched triglycerides with molecular weight ranging from 300 to 900. AHv" values (AHv corrected to 298 K) have been obtained with experimental AH, and also computed according to the group additivity method; a smaller-CH,- group value of 3.8 kJ mol-' compared to the normal value of 5.0 kJ mol-' is found to give good agreement with the experimental data (within 2-5% error). Both ester series have the same AH," irrespective of their molecular features, namely,shape, flexibility, and polarity, suggesting the coiling of the molecules during vaporization. The segmental motion of these ester series during their flow and its dependence on their molecular features unlike AH,' are demonstrated by the correlation of the enthalpy of activation for viscous flow (AH*) and the ratio AE,/AH* = n (AE, is the energy of vaporization) with molecular weight.