1,048 research outputs found

    The Parker Magnetostatic Theorem

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    We demonstrate the Parker Magnetostatic Theorem in terms of a small neighborhood in solution space containing continuous force-free magnetic fields in small deviations from the uniform field. These fields are embedded in a perfectly conducting fluid bounded by a pair of rigid plates where each field is anchored, taking the plates perpendicular to the uniform field. Those force-free fields obtainable from the uniform field by continuous magnetic footpoint displacements at the plates have field topologies that are shown to be a restricted subset of the field topologies similarly created without imposing the force-free equilibirum condition. The theorem then follows from the deduction that a continuous nonequilibrum field with a topology not in that subset must find a force-free state containing tangential discontinuities.Comment: 13 pages, no figur

    Great Expectations of Integrated Care : an Investigation of Assumptions Regarding the Impacts of Integrated Care for Frail Elderly People on Formal and Informal Caregivers

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    Frail elderly people are increasingly being cared for in their own homes by both formal and informal caregivers. Integrated care models are therefore being developed to better coordinate formal and informal care for frail elderly people in communities. However, much remains unclear regarding the impacts of integrated care delivery on formal and informal caregivers. The aim of this dissertation was therefore to investigate the three main assumptions regarding the benefits of integrated care on formal and informal caregivers, i.e., that integrated care for the frail elderly (1) safeguards informal caregivers against the negative impacts of caregiving; (2) improves the work processes and experiences of formal caregivers; and (3) improves the interaction between formal and informal care over time. These assumptions were investigated in the real-life setting of an integrated care intervention for community-dwelling frail elderly people in the Walcheren region of the Netherlands. This intervention, the ‘Walcheren Integrated Care Model’ (WICM), consisted of the following evidence-based elements: a single entry-point, proactive frailty screening, comprehensive needs assessments, case management, multidisciplinary team meetings, protocols and treatment plans, a shared information and communication system, task specialization and tasks delegation, and the creation of a geriatric care network with a formal steering group. The results show that integrated care for the frail elderly can be expected to safeguard informal caregivers against some negative impacts of caregiving, but also that improvements for formal caregivers and formal-informal care interaction should not be readily expected. It is concluded that, as yet, most expectations regarding the benefits of integrated care for formal and informal caregivers remain unjustified

    A conserved U-rich RNA region implicated in regulation of translation in Plasmodium female gametocytes.

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    Translational repression (TR) plays an important role in post-transcriptional regulation of gene expression and embryonic development in metazoans. TR also regulates the expression of a subset of the cytoplasmic mRNA population during development of fertilized female gametes of the unicellular malaria parasite, Plasmodium spp. which results in the formation of a polar and motile form, the ookinete. We report the conserved and sex-specific regulatory role of either the 3’- or 5’-UTR of a subset of translationally repressed mRNA species as shown by almost complete inhibition of expression of a GFP reporter protein in the female gametocyte. A U-rich, TR-associated element, identified previously in the 3’-UTR of TR-associated transcripts, played an essential role in mediating TR and a similar region could be found in the 5’-UTR shown in this study to be active in TR. The silencing effect of this 5’-UTR was shown to be independent of its position relative to its ORF, as transposition to a location 3’ of the ORF did not affect TR. These results demonstrate for the first time in a unicellular organism that the 5’ or the 3’-UTR of TR-associated transcripts play an important and conserved role in mediating TR in female gametocytes

    Clinical profile of acutely ill psychiatric patients admitted to a general hospital psychiatric unit

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    Objectives: Helen Joseph Hospital in southern Gauteng Province is one of five specialist hospitals on the academic circuit of the University of theWitwatersrand. Against a background of new mental health legislation, implemented in South Africa during December 2004 with no formal mechanisms in place to monitor mental health services on different levels of care or in regions, a study with three objectives was undertaken, namely: (I) to provide a baseline on psychiatric morbidity and treatment outcome; (II) to establish the state of affairs analysis for mental health care and (III) to establish a framework for cost centre management. The current study focuses on objective one. Method: A retrospective clinical audit was undertaken of mental health service delivery, teaching and research at Helen Joseph Hospital over a one-year period from September 2003 to August 2004. This article reports on the two service delivery datasets identified: the “Inpatient Discharge Summary Report” and the “Consultation/Liaison Report”. Results: A total number of 438 service users were admitted and a monthly average of 80 consultation/liaison assessments was conducted during the study period. Persistent unfavourable nursing staff ratios continued, while the number of service users from other African countries was generally underrated. Non-compliance and substance abuse contributed significantly to the admission of service users. Schizophrenia was indicated as the most likely diagnosis in almost a quarter of cases. Conclusion: Morbidity and treatment outcome at Helen Joseph Hospital will only be contextualized after the implementation of a regular clinical audit process in all the facilities of its referral network. Keywords: Psychiatric morbidity; Treatment outcome; Referral network; Clinical profile; Service delivery; Clinical audit African Journal of Psychiatry Vol. 10 (3) 2007: pp. 159-16

    A framework for current public mental health care practice in South Africa

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    One of the main aims of the new Mental Health Care Act, Act No. 17 of 2002 (MHCA) is to promote the human rights of people with mental disabilities in South Africa. However, the upholding of these rights seems to be subject to the availability of resources. Chapter 2 of the MHCA clarifies the responsibility of the State to provide infrastructure and systems. Chapters 5, 6 and 7 of the Act define and regulate the different categories of mental health care users, clarify the procedures around these categories and spell out mental health practitioners' roles and responsibilities in this regard. Also according to the National Health Act No. 61 of 2003, the State remains the key role player in mental health care provision, being responsible for adequate mental health infrastructure and resource allocation. Due to “limited resources” practitioners however often work in environments where staff ratios may be fractional of what should be expected and in units of which the physical structure and security is totally inadequate. The interface between professional responsibility of clinical workers versus the inadequacy of clinical interventions resulting from infrastructure and staffing constraints needs to be defined. This paper considered recent legislation currently relevant to mental health care practice in order to delineate the legal, ethical and labour framework in which public sector mental health practitioners operate as state employees. These included the Mental Health Care Act, No.17 of 2002; the National Health Act, No. 61 of 2003 and the proposed Traditional Health Practitioners Act, No. 35 of 2004. Formal legal review of and advice on this legislation as it pertains to public sector mental health practitioners as state employees, is necessary and should form the basis of the principles and standards for care endorsed by organized mental health care practitioner groups such as the South African Society of Psychiatrists (SASOP).African Journal of Psychiatry Vol. 10 (4) 2007: pp. 205-20

    Acute psychiatric in-patients tested for HIV status: a clinical profile

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    No Abstract.South African Psychiatry Review Vol. 10 (2) 2007: pp.83-8

    Collapsing lattice animals and lattice trees in two dimensions

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    We present high statistics simulations of weighted lattice bond animals and lattice trees on the square lattice, with fugacities for each non-bonded contact and for each bond between two neighbouring monomers. The simulations are performed using a newly developed sequential sampling method with resampling, very similar to the pruned-enriched Rosenbluth method (PERM) used for linear chain polymers. We determine with high precision the line of second order transitions from an extended to a collapsed phase in the resulting 2-dimensional phase diagram. This line includes critical bond percolation as a multicritical point, and we verify that this point divides the line into two different universality classes. One of them corresponds to the collapse driven by contacts and includes the collapse of (weakly embeddable) trees, but the other is {\it not yet} bond driven and does not contain the Derrida-Herrmann model as special point. Instead it ends at a multicritical point PP^* where a transition line between two collapsed phases (one bond-driven and the other contact-driven) sparks off. The Derrida-Herrmann model is representative for the bond driven collapse, which then forms the fourth universality class on the transition line (collapsing trees, critical percolation, intermediate regime, and Derrida-Herrmann). We obtain very precise estimates for all critical exponents for collapsing trees. It is already harder to estimate the critical exponents for the intermediate regime. Finally, it is very difficult to obtain with our method good estimates of the critical parameters of the Derrida-Herrmann universality class. As regards the bond-driven to contact-driven transition in the collapsed phase, we have some evidence for its existence and rough location, but no precise estimates of critical exponents.Comment: 11 pages, 16 figures, 1 tabl

    Effects of an integrated care intervention on informal caregivers: Baseline and One Year Post-implementation

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    __Abstract__ __Introduction:__ In order to face the challenges associated with an aging population, traditional health care models are increasingly being replaced with integrated care models [1]. However, while evidence exists that these models benefit older people, there is a lack of knowledge about how integrated care affects the informal caregiver [2]. In this study, effects of a new integrated model on the caregivers of frail elderly have been investigated. The model is characterized by an umbrella organizational structure involving case management, multidisciplinary teams, protocols, consultations, and patient files. The aim of this study was to investigate the effects of this model on caregivers in terms of perceived health, quality of life, objective and subjective burden. __Theory and Methods:__ A quasi-experimental design with before/after study and control group was used. Data was gathered using questionnaires (instruments: 2 items of the RAND-36 [3], short form objective burden informal care [4], SRB [5], CarerQoL [6] ,Cantril’s Ladder [7]). Analysis encompassed group comparison using paired and unpaired tests and regression analyses with baseline measurements, control variables (sex, age, relation to care-receiver, living together with care-receiver, income, education, having a life partner, employment, durance of care giving) and the intervention as independent variables. Additionally, analyses of subgroups and interaction effects will be performed. __Preliminary results:__ Within and between group differences were found and indicated significant reductions in health (P<0.1) and life ratings (P<0.1) and more financial problems (P<0.05) for the control group. Regression analysis revealed that caregivers in the intervention group were more likely to take on HDL type tasks (P<0.05) and experienced less financial problems (P<0.05). __Conclusion:__ The integrated care intervention increased the likelihood of caregivers performing HDL tasks and reduced their financial problems
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