Measurements of fluctuating pressure and velocity, together with instantaneous smoke-flow visualizations, are presented in order to reveal the unsteady structure of a separated and reattaching flow. It is shown that throughout the separation bubble a low-frequency motion can be detected which appears to be similar to that found in other studies of separation. This effect is most significant close to separation, where it leads to a weak flapping of the shear layer. Lateral correlation scales of this low-frequency motion are less than the reattachment length, however; it appears that its timescale is about equal to the characteristic timescale for the shear layer and bubble to change between various shedding phases. These phases were defined by the following observations: shedding of pseudoperiodic trains of vortical structures from the reattachment zone, with a characteristic spacing between structures of typically 60% to 80% of the bubble length; a large-scale but irregular shedding of vorticity; and a relatively quiescent phase with the absence of any large-scale shedding structures and a significant ‘necking’ of the shear layer downstream of reattachment.Spanwise correlations of velocity in the shear layer show on average an almost linear growth of spanwise scale up to reattachment. It appears that the shear layer reaches a fully three-dimensional state soon after separation. The reattachment process does not itself appear to impose an immediate extra three-dimensionalizing effect upon the large-scale structures.

The literature suggests that health professionals working in palliative care have developed an idealised concept of dying which has been labelled the 'good' death. This paper reports the results of a preliminary qualitative study which compared the concepts of a 'good' death used by patients and staff in a palliative care unit. Semistructured interviews designed to elicit perceptions of 'good' and 'bad' deaths were conducted with 18 patients and 20 health professionals. The transcribed interviews were content analysed. There were major differences between the views of patients and staff. The patients' descriptions of a "good' death were diverse and included: dying in one's sleep, dying quietly, with dignity, being pain free and dying suddenly. In comparison, staff characterised a "good' death in terms of adequate symptom control, family involvement, peacefulness and lack of distress, while a "bad' death was described as involving uncontrolled symptoms, lack of acceptance and being young. The findings suggest that patients and staff differ in their conceptualisations of a "good' death.

Background:People with Down syndrome (DS) are an ultra-high risk population for Alzheimer’s disease (AD). Understanding the factors associated with age of onset and survival in this population could highlight factors associated with modulation of the amyloid cascade.Objective:This study aimed to establish the typical age at diagnosis and survival associated with AD in DS and the risk factors associated with these.Methods:Data was obtained from the Aging with Down Syndrome and Intellectual Disabilities (ADSID) research database, consisting of data extracted from clinical records of patients seen by Community Intellectual Disability Services (CIDS) in England. Survival times when considering different risk factors were calculated.Results:The mean age of diagnosis was 55.80 years, SD 6.29. Median survival time after diagnosis was 3.78 years, and median age at death was approximately 60 years. Survival time was associated with age of diagnosis, severity of intellectual disability, living status, anti-dementia medication status, and history of epilepsy. Age at diagnosis and treatment status remained predictive of survival time following adjustment.Conclusion:This study provides the best estimate of survival in dementia within the DS population to date, and is in keeping with previous estimates from smaller studies in the DS population. This study provides important estimates and insights into possible predictors of survival and age of diagnosis of AD in adults with DS, which will inform selection of participants for treatment trials in the future.

Interventions for noisy breathing in patients near to death (Review)