The validity and reliability of the Parent Fever Management Scale: A study from Palestine

Background Parental fever phobia and overuse of antipyretics to control fever is increasing. Little is known about childhood fever management among Arab parents. No scales to measure parents’ fever management practices in Palestine are available. Aims The aims of this study were to translate and examine the psychometric properties of the Arabic version of the Parent Fever Management Scale (PFMS). Methods A standard “forward–backward” procedure was used to translate PFMS into Arabic language. It was then validated on a convenience sample of 402 parents between July and October 2012. Descriptive statistics were used, and instrument reliability was assessed for internal consistency using Cronbach's alpha coefficient. Validity was confirmed using convergent and known group validation. Results Applying the recommended scoring method, the median (interquartile range) score of the PFMS was 26 (23-30). Acceptable internal consistency was found (Cronbach’s alpha = 0.733) and the test–retest reliability value was 0.92 (P < 0.001). The chi-squared (χ2) test showed a significant relationship between PFMS groups and frequent daily administration of antipyretic groups (χ2 = 52.86; P < 0.001). The PFMS sensitivity and specificity were 77.67% and 57.75%, respectively. The positive and negative predictive values were 67.89% and 32.11%, respectively. Conclusions The findings of this validation study indicate that the Arabic version of the PFMS is a reliable and valid measure which can be used as a useful tool for health professionals to identify parents’ fever management practices and thus provide targeted education to reduce the unnecessary burden of care they place on themselves when concerned for a febrile child.

A review on solar assisted heat pump systems in Singapore

A solar assisted heat pump is used for different applications, such as, water heating, drying and air conditioning. The unglazed evaporator-collector enables to absorb both solar energy and ambient energy due to low operating temperature. Three different systems are described: solar assisted heat pump system for hot water using an unglazed evaporator collector; solar assisted heat pump for hot water and drying, where evaporator collector and air collector are used; an integrated solar heat pump system making use of solar and ambient energy, and air-con waste heat. Unlike conventional collector, evaporator collector was found to have higher efficiency, 80% to 90%, and the coefficient of performance attained a value as high as 8.0. The integrated system leads to a reduction of global warming, as it uses solar energy, ambient energy and air-con waste heat.

Desalination with a solar-assisted heat pump : an economic optimization

The solar-assisted heat pump (SAHP) desalination, based on the Rankin cycle, operates in low temperature and utilizes both solar and ambient energy. An experimental SAHP desalination system has been constructed at the National University of Singapore, Singapore. The system consisted of two main sections: an SAHP and a water distillation section. Experiments were carried out under the different meteorological condition of Singapore and results showed that the system had a performance ratio close to 1.3. The heat pump has a coefficient of performance of about 8, with solar collector efficiencies of 80% and 60% for evaporator and liquid collectors, respectively. Economic analysis showed that at a production rate of 900 L/day and an evaporator collector area of around 70m2 will have a payback period of about 3.5 years.

Desalination of seawater using solar, ambient energy and waste heat from air conditioning

Desalination is considered one of the most suitable areas for the utilization of solar energy, as there are many places in the world where abundant supply of solar energy is available and also there is a great demand for fresh water. An integrated solar heat pump desalination system has been developed at the National University of Singapore. The system also offers the opportunity of water heating and drying utilizing solar, ambient energy and waste heat from air conditioning system, which is conventionally dumped into the environment causing global warming. Desalination is carried out by making use of a single effect of Multi-Effect Distillation (MED) system. Within the desalination chamber, both fl ashing and evaporation of saline water take place. The maximum Coefficient of Performance (COP) of the heat pump system was around 5.8. In the integrated system, the maximum fresh water production rate was 9.6 l h−1 and a Performance Ratio (PR) of 1.2. For only desalination, the system has the potential to produce a maximum of 30 l h−1 of fresh water.

Modelling of a magnetocaloric system for cooling in the kilowatt range

A numerical time-dependent model of an active magnetic regenerator (AMR) was developed for cooling in the kilowatt range. Earlier numerical models have been mostly developed for cooling power in the 0.4 kW range. In contrast, this paper reports the applicability of magnetic refrigeration to the 50 kW range. A packed bed active magnetic regenerator was modelled and the influence of parameters such as geometry and operating parameters were studied for different geometries. The pressure drop for AMR bed length and particle diameter was also studied. High cooling power and coefficient of performance (COP) were achieved by optimization of the diameter of the magnetocaloric powder particles and operating frequency. The optimum operating conditions of the AMR for a cooling capacity of 50 kW was determined for a temperature span of 15 K. The predicted coefficient of performance (COP) was found to be ∼6, making it an attractive alternative to vapour compression systems.

Development of a Solar Assisted Heat Pump Desalination System

In view of the growing global demand for energy and concern expressed for environmental degradation, a clean and "free" energy source, such as solar energy, has been receiving greater attention in recent years for various applications using different techniques. The Direct Expansion Solar Assisted Heat Pump (DX-SAHP) principle is one of the most promising techniques as it makes use of both solar and ambient energy. As the system has capability to function at low temperatures, it has the potential to operate at night in the tropics. The system utilizes multi-effect distillation (MED) principle for the conversion of seawater to fresh water. An experimental setup of the DX-SAHP desalination system has been built at the Department of Mechanical Engineering, National University of Singapore (NUS). This system uses two types of flat-plate solar collectors. One is called evaporator-collector, where no glazing is used, and the efficiency varies between 80 and 90%. The other type of collector is single-glazed, where the maximum efficiency is about 60%, and it is used for feed water heating. For the heat pump cycle, refrigerant R134a is used. The present study provides a comprehensive analyses and performance evaluation of this system under different operating and meteorological conditions of Singapore. The Coefficient of Performance (COP) of the heat pump system reached a maximum value of 10. For a single effect of desalination, the system shows a Performance Ratio (PR) of around 1.3.

Zinc oxide quantum dot nanostructures

Zinc oxide (ZnO) is one of the most intensely studied wide band gap semiconductors due to its many desirable properties. This project established new techniques for investigating the hydrodynamic properties of ZnO nanoparticles, their assembly into useful photonic structures, and their multiphoton absorption coefficients for excitation with visible or infrared light rather than ultraviolet light. The methods developed are also applicable to a wide range of nanoparticle samples.

Experimental investigation and design of lipped channel beams in shear

Cold-formed high strength steel members are increasingly used as primary load bearing components in low rise buildings. Lipped channel beam (LCB) is one of the most commonly used flexural members in these applications. In this research an experimental study was undertaken to investigate the shear behaviour and strengths of LCB sections. Simply supported test specimens of back to back LCBs with aspect ratios of 1.0 and 1.5 were loaded at mid-span until failure. Test specimens were chosen such that all three types of shear failure (shear yielding, inelastic and elastic shear buckling) occurred in the tests. The ultimate shear capacity results obtained from the tests were compared with the predictions from the current design rules in Australian/NewZealand and American cold-formed steel design standards. This comparison showed that these shear design rules are very conservative as they did not include the post-buckling strength observed in the shear tests and the higher shear buckling coefficient due to the additional fixity along the web-flange juncture. Improved shear design equations are proposed in this paper by including the above beneficial effects. Suitable lower bound design rules were also developed under the direct strength method format. This paper presents the details of this experimental study and the results including the improved design rules for the shear capacity of LCBs. It also includes the details of tests of LCBs subject to combined shear and flange distortion, and combined bending and shear actions, and proposes suitable design rules to predict the capacities in these cases.

STAR : Predicting recombination sites from amino acid sequence

Background Designing novel proteins with site-directed recombination has enormous prospects. By locating effective recombination sites for swapping sequence parts, the probability that hybrid sequences have the desired properties is increased dramatically. The prohibitive requirements for applying current tools led us to investigate machine learning to assist in finding useful recombination sites from amino acid sequence alone. Results We present STAR, Site Targeted Amino acid Recombination predictor, which produces a score indicating the structural disruption caused by recombination, for each position in an amino acid sequence. Example predictions contrasted with those of alternative tools, illustrate STAR'S utility to assist in determining useful recombination sites. Overall, the correlation coefficient between the output of the experimentally validated protein design algorithm SCHEMA and the prediction of STAR is very high (0.89). Conclusion STAR allows the user to explore useful recombination sites in amino acid sequences with unknown structure and unknown evolutionary origin. The predictor service is available from http://pprowler.itee.uq.edu.au/star.

Predicting structural disruption of proteins caused by crossover

We present a machine learning model that predicts a structural disruption score from a protein s primary structure. SCHEMA was introduced by Frances Arnold and colleagues as a method for determining putative recombination sites of a protein on the basis of the full (PDB) description of its structure. The present method provides an alternative to SCHEMA that is able to determine the same score from sequence data only. Circumventing the need for resolving the full structure enables the exploration of yet unresolved and even hypothetical sequences for protein design efforts. Deriving the SCHEMA score from a primary structure is achieved using a two step approach: first predicting a secondary structure from the sequence and then predicting the SCHEMA score from the predicted secondary structure. The correlation coefficient for the prediction is 0.88 and indicates the feasibility of replacing SCHEMA with little loss of precision.

Improving national hospice/palliative care service symptom outcomes systematically through point-of-care data collection, structured feedback and benchmarking

PURPOSE Every health care sector including hospice/palliative care needs to systematically improve services using patient-defined outcomes. Data from the national Australian Palliative Care Outcomes Collaboration aims to define whether hospice/palliative care patients' outcomes and the consistency of these outcomes have improved in the last 3 years. METHODS Data were analysed by clinical phase (stable, unstable, deteriorating, terminal). Patient-level data included the Symptom Assessment Scale and the Palliative Care Problem Severity Score. Nationally collected point-of-care data were anchored for the period July-December 2008 and subsequently compared to this baseline in six 6-month reporting cycles for all services that submitted data in every time period (n = 30) using individual longitudinal multi-level random coefficient models. RESULTS Data were analysed for 19,747 patients (46 % female; 85 % cancer; 27,928 episodes of care; 65,463 phases). There were significant improvements across all domains (symptom control, family care, psychological and spiritual care) except pain. Simultaneously, the interquartile ranges decreased, jointly indicating that better and more consistent patient outcomes were being achieved. CONCLUSION These are the first national hospice/palliative care symptom control performance data to demonstrate improvements in clinical outcomes at a service level as a result of routine data collection and systematic feedback.

Food insecurity and physical activity among U.S. populations

Objectives: Examine the association between food insecurity (FI) and physical activity (PA) in the U.S. population. Methods: Accelerometry (PAM) and self-report PA (PAQ) data from NHANES 2003-2006 were used. Those aged less than six years or were older than 65 years, pregnant, with physical limitations, or with family income above 350% of the poverty line were excluded. FI was measured by the USDA Household Food Security Survey Module. Crude and adjusted odd ratios were calculated from logistic regression to identify the association between FI and adherence to the PA recommendation. Crude and adjusted coefficients were calculated from linear regression to identify the association between FI and both sedentary and activity minutes. Results: In children, FI was not associated with adherence to PA recommendation measured via PAM or PAQ (p>0.05) but was significantly associated with sedentary minutes (adjusted coefficient=10.74, one-sided p<0.05). Food-insecure children did less moderate-to-vigorous PA than did food-secure children (adjusted coefficient = -5.31, p = 0.032). In adults, FI was significantly associated with PA (adjusted OR=0.722 for PAM and OR=0.839 for PAQ, one-sided p<0.05) but not associated with sedentary minutes (p>0.05) Conclusions: FI children were more sedentary and FI adults were less likely to adhere to the PA recommendation than those without FI.

Household food insecurity is associated with less physical activity among children and adults in the U.S. population

Background Household food insecurity and physical activity are each important public-health concerns in the United States, but the relation between them was not investigated thoroughly. Objective We wanted to examine the association between food insecurity and physical activity in the U.S. population. Methods Physical activity measured by accelerometry (PAM) and physical activity measured by questionnaire (PAQ) data from the NHANES 2003–2006 were used. Individuals aged <6 y or >65 y, pregnant, with physical limitations, or with family income >350% of the poverty line were excluded. Food insecurity was measured by the USDA Household Food Security Survey Module. Adjusted ORs were calculated from logistic regression to identify the association between food insecurity and adherence to the physical-activity guidelines. Adjusted coefficients were obtained from linear regression to identify the association between food insecurity with sedentary/physical-activity minutes. Results In children, food insecurity was not associated with adherence to physical-activity guidelines measured via PAM or PAQ and with sedentary minutes (P > 0.05). Food-insecure children did less moderate to vigorous physical activity than food-secure children (adjusted coefficient = −5.24, P = 0.02). In adults, food insecurity was significantly associated with adherence to physical-activity guidelines (adjusted OR = 0.72, P = 0.03 for PAM; and OR = 0.84, P < 0.01 for PAQ) but was not associated with sedentary minutes (P > 0.05). Conclusion Food-insecure children did less moderate to vigorous physical activity, and food-insecure adults were less likely to adhere to the physical-activity guidelines than those without food insecurity.

Available evidence does not support serosorting as an HIV risk reduction strategy

Recent data highlighted the association between penetration of antiretrovirals in the central nervous system (CNS) and neurocognitive impairment in HIVpositive patients. Existing antiretrovirals have been ranked according to a score of neuropenetration, which was shown to be a predictor of anti-HIVactivity in the CNS and improvement of neurocognitive disorders [1]. Main factors affecting drug penetration are known to be protein binding, lipophilicity and molecular weight [2]. Moreover, active translation by membrane transporters (such as p-glycoprotein) could be a key mechanism of passage [3]. The use of raltegravir (RGV), a novel antiretroviral drug targeted to inhibit the HIV preintegrase complex, is increasing worldwide due to its efficacy and tolerability. However, penetration of RGV in the CNS has not been yet elucidated. In fact, prediction of RGV neuropenetration according to molecular characteristics is controversial. Intermediate protein binding (83%) and large volume of distribution (273 l) could suggest a high distribution beyond extracellular spaces [4]. On the contrary, low lipophilicity (oil/water partition coefficient at pH 7.4 of 2.80) and intermediate molecular weight (482.51 Da) suggest a limited diffusion. Furthermore, in-vitro studies suggest that RGV is substrate of p-glycoprotein, although this efflux pump has not been identified to significantly affect plasma pharmacokinetics [5]. In any case, no data concerning RGV passage into cerebrospinal fluid of animals or humans have yet been published.