609 research outputs found
Singularity formation in the strongly nonlinear wide-vortex/Tollmien-Schlichting-wave interaction equations
Published versio
Vortex/tollmien-schlichting wave interaction states in the asymptotic suction boundary layer
A self-sustaining interaction between a roll/streak structure and a three-dimensional Tollmien–Schlichting wave is considered at high-Reynolds-number within the asymptotic suction boundary layer. Strongly nonlinear governing equations, taking the form of a vortex–wave interaction (VWI) are derived and solved numerically. Finite amplitude travelling wave states, bifurcating from the lower branch of the linear neutral curve, are obtained. These states exhibit spanwise focusing, developing steep wall-shear gradients at specific spanwise locations as the wave amplitude rises. A spanwise-local analytic analysis reveals explicitly how the solution gradually loses regularity as the nonlinearity of the VWI system is increased
How are patients with rare diseases and their carers in the UK impacted by the way care is coordinated? An exploratory qualitative interview study
BACKGROUND: Care coordination is considered important for patients with rare conditions, yet research addressing the impact of care coordination is limited. This study aimed to explore how care coordination (or lack of) impacts on patients and carers. Semi-structured interviews were conducted with 15 patients and carers/parents in the UK, representing a range of rare conditions (including undiagnosed conditions). Transcripts were analysed thematically in an iterative process. RESULTS: Participants described a range of experiences and views in relation to care coordination. Reports of uncoordinated care emerged: appointments were uncoordinated, communication between key stakeholders was ineffective, patients and carers were required to coordinate their own care, and care was not coordinated to meet the changing needs of patients in different scenarios. As a result, participants experienced an additional burden and barriers/delays to accessing care. The impacts described by patients and carers, either attributed to or exacerbated by uncoordinated care, included: impact on physical health (including fatigue), financial impact (including loss of earnings and travel costs), and psychosocial impact (including disruption to school, work and emotional burden). Overall data highlight the importance of flexible care, which meets individual needs throughout patients'/carers' journeys. Specifically, study participants suggested that the impacts may be addressed by: having support from a professional to coordinate care, changing the approach of clinics and appointments (where they take place, which professionals/services are available and how they are scheduled), and improving communication through the use of technology, care plans, accessible points of contact and multi-disciplinary team working. CONCLUSION: This study provides further evidence of impacts of uncoordinated care; these may be complex and influenced by a number of factors. Approaches to coordination which improve access to care and lessen the time and burden placed on patients and carers may be particularly beneficial. Findings should influence future service developments (and the evaluation of such developments). This will be achieved, in the first instance, by informing the CONCORD Study in the UK
A review of the law surrounding Female Genital Mutilation Protection Orders
Performing Female Genital Mutilation (FGM) is prohibited within the United Kingdom
by the FGM Act 2003. A mandatory reporting duty for FGM requires regulated health
and social care professionals and teachers in England and Wales to report known
cases of FGM in under 18-year-olds to the police. An Application to the Court for an
FGM Protection Order (FGMPO) can be made to keep individual women and girls safe
from FGM. This paper reveals the significant disconnect between the number of
FGMPO applications and known recorded cases of FGM. The introduction of FGMPOs
requires critical exploration as there is insufficient evidence to show that FGMPOs are
effective in protecting women and girls from FGM. It is therefore unclear what impact,
if any, FGMPOs are having upon the protection of women and girls at risk of FGM.
The barriers to the implementation of FGMPOs and possible solutions are discussed
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