5,968 research outputs found

    Digital library use: Social practice in design and evaluation

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    Nurse-identified patient care and health services research priorities in the United Arab Emirates: a Delphi study

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    Background: The need for improved research on ill health has been recognized internationally and locally in the United Arab Emirates (UAE). The UAE Nursing and Midwifery Council recently committed to enhancing the status and contributions of nursing in healthcare research across the UAE by establishing a National Committee for Research Development. This study using a Delphi method to identify research priorities from the perspective of nurses delivering frontline healthcare. Methods: A two-phase Delphi design was implemented with 1032 nurses participating in phase one of the study and 1339 in phase two. Results: The most important priority was patient safety and healthcare professionals’ awareness of international patient safety goals (including staffing levels and shift length) and potential effects on patient safety. Other important priorities were infection control practices and management of communicable diseases. Conclusions: These priorities may inform nursing research programs to improve patient care and health outcomes in the UAE and similar contexts worldwide

    Phonons of graphene and graphitic materials derived from the empirical potential LCBOPII

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    We present the interatomic force constants and phonon dispersions of graphite and graphene from the LCBOPII empirical bond order potential. We find a good agreement with experimental results, particularly in comparison to other bond order potentials. From the flexural mode we determine the bending rigidity of graphene to be 0.69 eV at zero temperature. We discuss the large increase of this constant with temperature and argue that derivation of force constants from experimental values should take this feature into account. We examine also other graphitic systems, including multilayer graphene for which we show that the splitting of the flexural mode can provide a tool for characterization

    Workforce and Professional Education

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    Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail

    Neural Decision Boundaries for Maximal Information Transmission

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    We consider here how to separate multidimensional signals into two categories, such that the binary decision transmits the maximum possible information transmitted about those signals. Our motivation comes from the nervous system, where neurons process multidimensional signals into a binary sequence of responses (spikes). In a small noise limit, we derive a general equation for the decision boundary that locally relates its curvature to the probability distribution of inputs. We show that for Gaussian inputs the optimal boundaries are planar, but for non-Gaussian inputs the curvature is nonzero. As an example, we consider exponentially distributed inputs, which are known to approximate a variety of signals from natural environment.Comment: 5 pages, 3 figure

    Follow-up of CRT-D patients downgraded to CRT-P at the time of generator exchange

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    Background: Some patients with cardiac resynchronisation therapy (CRT) experience super-response (LVEF improvements to ≥50%). At generator exchange (GE), downgrading (DG) from CRT-defibrillator (CRT-D) to CRT-pacemaker (CRT-P) could be an option for these patients on primary prevention ICD indication and no required ICD therapies. Long-term data on arrhythmic events in super-responders is scarce. Methods: CRT-D patients with LVEF improvement to ≥50% at GE were identified in four large centres for retrospective analysis. Mortality, significant ventricular tachyarrhythmia and appropriate ICD-therapy were determined, and patient analysis was split into two groups (downgraded to CRT-P or not). Results: Sixty-six patients (53% male, 26% coronary artery disease) on primary prevention were followed for a median of 129 months [IQR: 101–155] after implantation. 27 (41%) patients were downgraded to CRT-P at GE after a median of 68 [IQR: 58–98] months (LVEF 54% ± 4%). The other 39 (59%) continued with CRT-D therapy (LVEF 52% ± 6%). No cardiac death or significant arrhythmia occurred in the CRT-P group (median follow-up (FU) 38 months [IQR: 29–53]). Three appropriate ICD-therapies occurred in the CRT-D group [median FU 70 months (IQR: 39–97)]. Annualized event-rates after DG/GE were 1.5%/year and 1.0%/year in the CRT-D group and the whole cohort, respectively. Conclusions: No significant tachyarrhythmia were detected in the patients downgraded to CRT-P during follow-up. However, three events were observed in the CRT-D group. Whilst downgrading CRT-D patients is an option, a small residual risk for arrhythmic events remains and decisions regarding downgrade should be made on a case-by-case basis.</p

    Adaptive Filtering Enhances Information Transmission in Visual Cortex

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    Sensory neuroscience seeks to understand how the brain encodes natural environments. However, neural coding has largely been studied using simplified stimuli. In order to assess whether the brain's coding strategy depend on the stimulus ensemble, we apply a new information-theoretic method that allows unbiased calculation of neural filters (receptive fields) from responses to natural scenes or other complex signals with strong multipoint correlations. In the cat primary visual cortex we compare responses to natural inputs with those to noise inputs matched for luminance and contrast. We find that neural filters adaptively change with the input ensemble so as to increase the information carried by the neural response about the filtered stimulus. Adaptation affects the spatial frequency composition of the filter, enhancing sensitivity to under-represented frequencies in agreement with optimal encoding arguments. Adaptation occurs over 40 s to many minutes, longer than most previously reported forms of adaptation.Comment: 20 pages, 11 figures, includes supplementary informatio

    Lineages of the Islamic State: an international historical sociology of state (de-)formation in Iraq

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    Existing accounts of the Islamic State (IS) tend to rely on orientalist and technicist assumptions and hence insufficiently sensitive to the historical, sociological, and international conditions of the possibility of IS. The present article provides an alternative account through a conjunctural analysis that is anchored in an international historical sociology of modern Iraq informed by Leon Trotsky's idea of ‘uneven and combined development’. It foregrounds the concatenation of Iraq's contradictory (post‐)colonial nation‐state formation with the neoliberal conjuncture of 1990‐2014. It shows that the former process involved the tension‐prone fusion of governing institutions of the modern state and the intermittent but steady reproduction, valorization, and politicization of supra‐national (religious‐sectarian) and sub‐national (ethno‐tribal) collective identities, which subverted the emergence of an Iraqi nation. The international sanctions regime of the 1990s transformed sectarian and tribal difference into communitarian tension by fatally undermining the integrative efficacy of the Ba’ath party's authoritarian welfare‐state. Concurrently, the neo‐liberal demolition of the post‐colonial authoritarian welfare states in the region gave rise to the Arab Spring revolutions. The Arab Spring however elicited a successful authoritarian counter‐revolution that eliminated secular‐nationalist forms of oppositional politics. This illiberal neoliberalisation of the region's political economy valorised the religionisation of the domestic effects of the 2003 US‐led destruction of the Iraqi state and its reconstruction on a majoritarian basis favouring the Shi’as and hence transforming sectarian tension into sectarian conflict culminating in IS. Thus, IS is, the paper demonstrates, the result of neither an internal cultural pathology nor sheerly external forces. Rather, it is the novel product of an utterly historical congealment of the intrinsically interactive and multilinear dynamics of socio‐political change
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