Viscous effects on a vortex wake in ground effect

Wake vortex trajectories and strengths are altered radically by interactions with the ground plane. Prediction of vortex strength and location is especially important in the vicinity of airports. Simple potential flow methods have been found to yield reasonable estimates of vortex descent rates in an otherwise quiescent ambient background, but those techniques cannot be adjusted for more realistic ambient conditions and they fail to provide satisfactory estimates of ground-coupled behavior. The authors have been involved in a systematic study concerned with including viscous effects in a wake-vortex system which is near the ground plane. The study has employed numerical solutions to the Navier-Stokes equations, as well as perturbation techniques to study ground coupling with a descending vortex pair. Results of a two-dimensional, unsteady numerical-theoretical study are presented in this paper. A time-based perturbation procedure has been developed which permits the use of analytical solutions to an inner and outer flow domain for the initial flow field. Predictions have been compared with previously reported laminar experimental results. In addition, the influence of stratification and turbulence on vortex behavior near the ground plane has been studied

Initialization and Simulation of Three-Dimensional Aircraft Wake Vortices

This paper studies the effects of axial velocity profiles on vortex decay, in order to properly initialize and simulate three-dimensional wake vortex flow. Analytical relationships are obtained based on a single vortex model and computational simulations are performed for a rather practical vortex wake, which show that the single vortex analytical relations can still be applicable at certain streamwise sections of three-dimensional wake vortices

Qualitative study exploring the phenomenon of multiple electronic prescribing systems within single hospital organisations

BACKGROUND: A previous census of electronic prescribing (EP) systems in England showed that more than half of hospitals with EP reported more than one EP system within the same hospital. Our objectives were to describe the rationale for having multiple EP systems within a single hospital, and to explore perceptions of stakeholders about the advantages and disadvantages of multiple systems including any impact on patient safety. METHODS: Hospitals were selected from previous census respondents. A decision matrix was developed to achieve a maximum variation sample, and snowball sampling used to recruit stakeholders of different professional backgrounds. We then used an a priori framework to guide and analyse semi-structured interviews. RESULTS: Ten participants, comprising pharmacists and doctors and a nurse, were interviewed from four hospitals. The findings suggest that use of multiple EP systems was not strategically planned. Three co-existing models of EP systems adoption in hospitals were identified: organisation-led, clinician-led and clinical network-led, which may have contributed to multiple systems use. Although there were some perceived benefits of multiple EP systems, particularly in niche specialities, many disadvantages were described. These included issues related to access, staff training, workflow, work duplication, and system interfacing. Fragmentation of documentation of the patient's journey was a major safety concern. DISCUSSION: The complexity of EP systems' adoption and deficiencies in IT strategic planning may have contributed to multiple EP systems use in the NHS. In the near to mid-term, multiple EP systems may remain in place in many English hospitals, which may create challenges to quality and patient safety.Peer reviewe

Diagnosis-based risk adjustment for Medicare capitation payments

Using 1991-92 data for a 5-percent Medicare sample, we develop, estimate, and evaluate risk-adjustment models that utilize diagnostic information from both inpatient and ambulatory claims to adjust payments for aged and disabled Medicare enrollees. Hierarchical coexisting conditions (HCC) models achieve greater explanatory power than diagnostic cost group (DCG) models by taking account of multiple coexisting medical conditions. Prospective models predict average costs of individuals with chronic conditions nearly as well as concurrent models. All models predict medical costs far more accurately than the current health maintenance organization (HMO) payment formula

Seeing the smart city on Twitter: Colour and the affective territories of becoming smart

This paper pays attention to the immense and febrile field of digital image files which picture the smart city as they circulate on the social media platform Twitter. The paper considers tweeted images as an affective field in which flow and colour are especially generative. This luminescent field is territorialised into different, emergent forms of becoming ‘smart’. The paper identifies these territorialisations in two ways: firstly, by using the data visualisation software ImagePlot to create a visualisation of 9030 tweeted images related to smart cities; and secondly, by responding to the affective pushes of the image files thus visualised. It identifies two colours and three ways of affectively becoming smart: participating in smart, learning about smart, and anticipating smart, which are enacted with different distributions of mostly orange and blue images. The paper thus argues that debates about the power relations embedded in the smart city should consider the particular affective enactment of being smart that happens via social media. More generally, the paper concludes that geographers must pay more attention to the diverse and productive vitalities of social media platforms in urban life and that this will require experiment with methods that are responsive to specific digital qualities

Debilitating disease in a polyparasitised woylie (Bettongia penicillata): A diagnostic investigation

During monitoring of critically endangered woylie (Bettongia penicillata) populations within the south-west of Western Australia, an adult female woylie was euthanased after being found in extremely poor body condition with diffuse alopecia, debilitating skin lesions and severe ectoparasite infestation. Trypanosoma copemani G2 and Sarcocystis sp. were detected molecularly within tissue samples collected post-mortem. Potorostrongylus woyliei and Paraustrostrongylus sp. nematodes were present within the stomach and small intestine, respectively. Blood collected ante-mortem revealed the presence of moderate hypomagnesaemia, mild hypokalaemia, mild hyperglobulinaemia and mild hypoalbuminaemia. Diffuse megakaryocytic hypoplasia was evident within the bone marrow. We propose various hypotheses that may explain the presence of severe ectoparasite infection, skin disease and poor body condition in this woylie. Given the potential deleterious effects of parasite infection, the importance of monitoring parasites cannot be over-emphasised

Using diagnoses to describe populations and predict costs

The Diagnostic Cost Group Hierarchical Condition Category (DCG/HCC) payment models summarize the health care problems and predict the future health care costs of populations. These models use the diagnoses generated during patient encounters with the medical delivery system to infer which medical problems are present. Patient demographics and diagnostic profiles are, in turn, used to predict costs. We describe the logic, structure, coefficients and performance of DCG/HCC models, as developed and validated on three important data bases (privately insured, Medicaid, and Medicare) with more than 1 million people each

Forging Partnerships in Health Care: Process and Measuring Benefits

Universally, there is concern that much academic learning has dealt mainly in theory, removing knowledge from context with a resultant lack of practical experience. Here, the catalyst for strengthening university-community engagement, emanated from a desire to foster greater propensity within students to make connections between their academic courses and responsibility toward the community and people in need, and thus develop enhanced skills in social interaction, teamwork and effectiveness. This paper explores a variety of models of university-community engagement that aim to achieve and model good practice in policy making and planning around healthcare education and service development. Ways of integrating teaching and learning with community engagement, so there is reciprocal learning with significant benefits to the community, students, the university and industry are described. The communities of engagement for a transdisciplinary approach in healthcare are defined and the types of collaborative partnerships are outlined, including public/private partnerships, service learning approaches and regional campus engagement. The processes for initiating innovation in this field, forging sustainable partnerships, providing cooperative leadership and building shared vision are detailed. Measuring shared and sustained benefits for all participants is examined in the context of effecting changes in working relationships as well as the impact on students in terms of increased personal and social responsibility, confidence and competence. For the health professions, it is considered vital to adopt this approach in order to deliver graduates who feel aware of community needs, believe they can make a difference, and have a greater sense of community responsibility, ethic of service and more sophisticated understandings of social contexts. In the longer term, it is proposed the strategy will deliver a future healthcare workforce that is more likely to have a strengthened sense of community, social and personal responsibility and thus effect positive social change