A case study of asthma care in school age children using nurse-coordinated multidisciplinary collaborative practices

Aim: To describe the role of school nursing in leading and coordinating a multidisciplinary networked system of support for children with asthma, and to analyze the strengths and challenges of undertaking and supporting multiagency interprofessional practice. Background: The growth of networked and interprofessional collaborations arises from the recognition that a number of the most pressing public health problems cannot be addressed by single-discipline or -agency interventions. This paper identifies the potential of school nursing to provide the vision and multiagency leadership required to coordinate multidisciplinary collaboration. Method: A mixed-method single-case study design using Yin’s approach, including focus groups, interviews, and analysis of policy documents and public health reports. Results: A model that explains the integrated population approach to managing school-age asthma is described; the role of the lead school nurse coordinator was seen as critical to the development and sustainability of the model. Conclusion: School nurses can provide strategic multidisciplinary leadership to address pressing public health issues. Health service managers and commissioners need to understand how to support clinicians working across multiagency boundaries and to identify how to develop leadership skills for collaborative interprofessional practice so that the capacity for nursing and other health care professionals to address public health issues does not rely on individual motivation. In England, this will be of particular importance to the commissioning of public health services by local authorities from 2015

Study of radar pulse compression for high resolution satellite altimetry

Pulse compression techniques are studied which are applicable to a satellite altimeter having a topographic resolution of + 10 cm. A systematic design procedure is used to determine the system parameters. The performance of an optimum, maximum likelihood processor is analysed, which provides the basis for modifying the standard split-gate tracker to achieve improved performance. Bandwidth considerations lead to the recommendation of a full deramp STRETCH pulse compression technique followed by an analog filter bank to separate range returns. The implementation of the recommended technique is examined

Analysis and test evaluation of the dynamic response and stability of three advanced turboprop models

Results of dynamic response and stability wind tunnel tests of three 62.2 cm (24.5 in) diameter models of the Prop-Fan, advanced turboprop, are presented. Measurements of dynamic response were made with the rotors mounted on an isolated nacelle, with varying tilt for nonuniform inflow. One model was also tested using a semi-span wing and fuselage configuration for response to realistic aircraft inflow. Stability tests were performed using tunnel turbulence or a nitrogen jet for excitation. Measurements are compared with predictions made using beam analysis methods for the model with straight blades, and finite element analysis methods for the models with swept blades. Correlations between measured and predicted rotating blade natural frequencies for all the models are very good. The IP dynamic response of the straight blade model is reasonably well predicted. The IP response of the swept blades is underpredicted and the wing induced response of the straight blade is overpredicted. Two models did not flutter, as predicted. One swept blade model encountered an instability at a higher RPM than predicted, showing predictions to be conservative

Entanglement versus Quantum Discord in Two Coupled Double Quantum Dots

We study the dynamics of quantum correlations of two coupled double quantum dots containing two excess electrons. The dissipation is included through the contact with an oscillator bath. We solve the Redfield master equation in order to determine the dynamics of the quantum discord and the entanglement of formation. Based on our results, we find that the quantum discord is more resistant to dissipation than the entanglement of formation for such a system. We observe that this characteristic is related to whether the oscillator bath is common to both qubits or not and to the form of the interaction Hamiltonian. Moreover, our results show that the quantum discord might be finite even for higher temperatures in the asymptotic limit.Comment: 14 pages, 8 figures (new version is the final version to appear in NJP

Integrating Community-Based Interventions to Reverse the Convergent TB/HIV Epidemics in Rural South Africa.

The WHO recommends integrating interventions to address the devastating TB/HIV co-epidemics in South Africa, yet integration has been poorly implemented and TB/HIV control efforts need strengthening. Identifying infected individuals is particularly difficult in rural settings. We used mathematical modeling to predict the impact of community-based, integrated TB/HIV case finding and additional control strategies on South Africa's TB/HIV epidemics. We developed a model incorporating TB and HIV transmission to evaluate the effectiveness of integrating TB and HIV interventions in rural South Africa over 10 years. We modeled the impact of a novel screening program that integrates case finding for TB and HIV in the community, comparing it to status quo and recommended TB/HIV control strategies, including GeneXpert, MDR-TB treatment decentralization, improved first-line TB treatment cure rate, isoniazid preventive therapy, and expanded ART. Combining recommended interventions averted 27% of expected TB cases (95% CI 18-40%) 18% HIV (95% CI 13-24%), 60% MDR-TB (95% CI 34-83%), 69% XDR-TB (95% CI 34-90%), and 16% TB/HIV deaths (95% CI 12-29). Supplementing these interventions with annual community-based TB/HIV case finding averted a further 17% of TB cases (44% total; 95% CI 31-56%), 5% HIV (23% total; 95% CI 17-29%), 8% MDR-TB (68% total; 95% CI 40-88%), 4% XDR-TB (73% total; 95% CI 38-91%), and 8% TB/HIV deaths (24% total; 95% CI 16-39%). In addition to increasing screening frequency, we found that improving TB symptom questionnaire sensitivity, second-line TB treatment delays, default before initiating TB treatment or ART, and second-line TB drug efficacy were significantly associated with even greater reductions in TB and HIV cases. TB/HIV epidemics in South Africa were most effectively curtailed by simultaneously implementing interventions that integrated community-based TB/HIV control strategies and targeted drug-resistant TB. Strengthening existing TB and HIV treatment programs is needed to further reduce disease incidence

A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.

Non-motor symptoms are present in Parkinson's disease (PD) and a key determinant of quality of life. The Non-motor Symptoms Scale (NMSS) is a validated scale that allows quantifying frequency and severity (burden) of NMS. We report a proposal for using NMSS scores to determine levels of NMS burden (NMSB) and to complete PD patient classification

Nine percent nickel steel heavy forging weld repair study

The feasibility of making weld repairs on heavy section 9% nickel steel forgings such as those being manufactured for the National Transonic Facility fan disk and fan drive shaft components was evaluated. Results indicate that 9% nickel steel in heavy forgings has very good weldability characteristics for the particular weld rod and weld procedures used. A comparison of data for known similar work is included

Medium Modifications of Hadron Properties and Partonic Processes

Chiral symmetry is one of the most fundamental symmetries in QCD. It is closely connected to hadron properties in the nuclear medium via the reduction of the quark condensate , manifesting the partial restoration of chiral symmetry. To better understand this important issue, a number of Jefferson Lab experiments over the past decade have focused on understanding properties of mesons and nucleons in the nuclear medium, often benefiting from the high polarization and luminosity of the CEBAF accelerator. In particular, a novel, accurate, polarization transfer measurement technique revealed for the first time a strong indication that the bound proton electromagnetic form factors in 4He may be modified compared to those in the vacuum. Second, the photoproduction of vector mesons on various nuclei has been measured via their decay to e+e- to study possible in-medium effects on the properties of the rho meson. In this experiment, no significant mass shift and some broadening consistent with expected collisional broadening for the rho meson has been observed, providing tight constraints on model calculations. Finally, processes involving in-medium parton propagation have been studied. The medium modifications of the quark fragmentation functions have been extracted with much higher statistical accuracy than previously possible.Comment: to appear in J. Phys.: Conf. Proc. "New Insights into the Structure of Matter: The First Decade of Science at Jefferson Lab", eds. D. Higinbotham, W. Melnitchouk, A. Thomas; added reference

Charge transfer complexes and radical cation salts of chiral methylated organosulfur donors

The single crystal X-ray structure of the all-axial conformer of the (R,R,R,R) enantiomer of the chiral donor tetramethyl-BEDT-TTF (TM-BEDT-TTF) was described and compared to the all-equatorial conformer. (S,S,S,S)-Tetramethyl-BEDT-TTF formed crystalline 1 : 1 complexes with TCNQ and TCNQ-F4, as well as a THF solvate of the TCNQ complex. Donors bis((2S,4S)-pentane-2,4-dithio)tetrathiafulvalene and (ethylenedithio)((2S,4S)-pentane-2,4-dithio)tetrathiafulvalene, which contain seven-membered rings bearing chirally oriented methyl groups, only formed complexes with TCNQ-F4. The TCNQ-F4 complexes contain planar organosulfur systems, in contrast to the TCNQ complexes in which there is minimal charge transfer. A variety of crystal packing modes were observed. Electrocrystallization experiments with both enantiomers and the racemic form of tetramethyl-BEDT-TTF afforded mixed valence radical cation salts with the AsF6 and SbF6 anions formulated as (TM-BEDT-TTF)2XF6 (X = As, Sb). Electrical conductivity was only found in one charge transfer complex, while the radical cation salts are all semiconducting

Thermodynamic and magnetic properties of the layered triangular magnet NaNiO2

We report muon-spin rotation, heat capacity, magnetization, and ac magnetic susceptibility measurements of the layered spin-1/2 antiferromagnet NaNiO2. These show the onset of long-range magnetic order below T_N = 19.5K. Rapid muon depolarization persisting to about 5K above T_N is consistent with the presence of short-range magnetic order. The temperature and frequency dependence of the ac susceptibility suggests that magnetic clusters persist above 25K in the paramagnetic state and that their volume fraction decreases with increasing temperature. A frequency dependent peak in the ac magnetic susceptibility at T_sf = 3K is observed, consistent with a slowing of spin fluctuations at this temperature. A partial magnetic phase diagram is deduced.Comment: 4 pages, 4 figure