What implications will Brexit have for integrated care provision?

A move towards integrated health and social care provision has been a key policy driver in the UK since 2010, underpinned by a belief that this is essential to provide holistic, person-centred care while transforming service provision. Progress towards achieving integrated care has been slow, and now Brexit poses a further challenge, as attention is focused on preparations for a ‘no-deal’ scenario. Ensuring that the NHS and social care systems are able to continue to function after March 2019 is now a key concern for those leading and managing frontline services, and measures are being put in place to deal with potential disruptions caused by a no-deal Brexit. This includes dealing with issues related to the recruitment and retention of European economic area (EEA) staff into the NHS, disruptions in the supply of medicines across European Union (EU) borders, challenges to the recognition of professional qualifications and patient safety, and health protection and health security within the UK post-Brexit. The imperative to prepare for a worse-case scenario diverts attention away from other key policy drivers, such as integrated care provision. It may also serve to reinforce a view of integration as a cost-cutting exercise, rather than as an approach to promote better care for patients. A move towards the transformation of care through integrated provision offers real potential for improved patient outcomes in the future, and a revitalised health service. However, Brexit has the potential to disrupt the integration agenda as financial resources and staff time become focused on dealing with the fall-out from Brexit, rather than on frontline patient care. Community and practice-based nurses and staff are in the frontline of integrated service provision, and in the next few months may be some of the first staff to witness the negative impact of Brexit preparations on the provision of integrated care

The Method of Moments and the Energy Levels of Molecules and Solids

The method of moments is used to derive the energy levels of a representative series of molecules, crystalline and noncrysta-1- line solids. It provides a direct link between the density of states of the eigenvalue spectrum and the connectivity and topology of the molecular or solid state network

Efficiency of 2D Photonic Crystal Emitters in Thermophotovoltaic Systems

Thermophotovoltaic (TPV) systems have the potential to convert energy in a very efficient way by using 2D photonic crystal (PhC) emitters. Recent advancements in TPV technology have developed many methods for effectively generating power. These recent advancements propose that emitters can suppress low energy photon emissions while increasing higher energy photon emissions. This can be achieved by utilising new 2D photonic crystal (PhC) structures on the surface of the emitter with varying diameter and shape.In this meta study we consider the multiple design fabrications of photonic crystal emitters and compare the efficiencies, power densities, and their potential use for converting different wavelengths into heat and power. This is done by analysing the thermodynamic factors present in the system that could potentially reduce the efficiency, and therefore power generation, of the thermophotovoltaic cell. This study found that certain shapes and materials can impact on the PhC structure and its ability to emit energy.

Brexit: the impact on health and social care and the role of community nurses

Brexit poses seismic challenges for health and social care provision in the United Kingdom concerning the on-going financial support available to fund health and social care within a post Brexit economy. Alongside funding issues there are potential concerns linked to the continued access to medical supplies and equipment which are linked to trading relationships within the European Union. Changes to the context of legal frameworks and funding for research which result from Brexit are also serious concerns. Although many of these areas may have potential detrimental impacts on patient care there is a particular concern about the loss of migrant health and social care workers which may exacerbate the recruitment issues currently facing the UK health and social care workforce. Reflections from those who work within health and social care can create insider perspectives about what Brexit means to individuals and their families. This can help organisations consider the challenges that their current EU migrant workers experience and explore ways of mitigating these impacts on both the individual and wider organisation to ensure patient care is not diluted but instead enhanced. Community and practice-based nurses and staff have a central role in providing integrated person-centred care and have an important role in advocating for their frail patients whose care may be compromised as a result of challenges created by Brexit

Divorce and the Option Value of Marital Search

This work tests whether the introduction of divorce law changes the timing of marital search. Rational agents should adjust to the divorce risk by increasing the average search spell, whereas option value theory stresses the role of irreversible investments: in this case, the new exit option should result in shorter spells. Using a dynamic model of marital search, a new data set of retrospective individual Italian data, and two robust statistical specifications, we find strong evidence that the legal innovation actually lowered the age at marriage, thereby worsening the level of marital matching, and possibly reinforcing self-fulfilling prophecies of divorce

Photolytic and thermolytic decomposition products from iron pentacarbonyl adsorbed on Y zeolite

Zeolite supported iron systems obtained by photolysis and thermolysis of Fe(CO)5/Na---Y adducts are characterized via evaluation of the respective magnetic isotherms taken with a FONER magnetometer at T = 4.2 K. Thermolysis under fast heating in inert gas and under fluidized shallow bed conditions completes within a few minutes at not, vert, similar 500 K, and gives iron clusters of which at least 70 to 90 wt% is smaller than 1 nm. Prolonged photolysis at 290 K in the same fluidized bed conditions does not result in the formation of ‘naked’ iron(O) clusters, but gives a limited fraction of magnetically coupled Fex(CO)y entities. Photodimerization cannot be excluded to be the main reaction path

Electronic Structure, Electron-Phonon Coupling, and Multiband Effects in MgB2

We review the current situation in the theory of superconducting and transport properties of MgB2. First principle calculations of of the electronic structure and electron-phonon coupling are discussed and compared with the experiment. We also present a brief description of the multiband effects in superconductivity and transport, and how these manifest themselves in MgB2. We also mention some yet open questions.Comment: Physica C, in pres

Influences of salinity on the physiology and distribution of the Arctic coralline algae, Lithothamnion glaciale (Corallinales, Rhodophyta)

In Greenland, free-living red coralline algae contribute to and dominate marine habitats along the coastline. Lithothamnion glaciale dominates coralline algae beds in many regions of the Arctic, but never in Godthåbsfjord, Greenland, where Clathromorphum sp. is dominant. To investigate environmental impacts on coralline algae distribution, calcification and primary productivity were measured in situ during summers of 2015 and 2016, and annual patterns of productivity in L. glaciale were monitored in laboratory-based mesocosm experiments where temperature and salinity were manipulated to mimic high glacial melt. The results of field and cold-room measurements indicate that both L. glaciale and Clathromorphum sp. had low calcification and photosynthetic rates during the Greenland summer (2015 and 2016), with maximum of 1.225 ± 0.17 or 0.002 ± 0.023 μmol CaCO3 · g-1 · h-1 and -0.007 ±0.003 or -0.004 ± 0.001 mg O2 · L-1 · h-1 in each species respectively. Mesocosm experiments indicate L. glaciale is a seasonal responder; photosynthetic and calcification rates increase with annual light cycles. Furthermore, metabolic processes in L. glaciale were negatively influenced by low salinity; positive growth rates only occurred in marine treatments where individuals accumulated an average of 1.85 ± 1.73 mg · d-1 of biomass through summer. These results indicate high freshwater input to the Godthåbsfjord region may drive the low abundance of L. glaciale, and could decrease species distribution as climate change increases freshwater input to the Arctic marine system via enhanced ice sheet runoff and glacier calving.Peer reviewedFinal Accepted Versio

Drug-induced metabolic acidosis

Summary: Drug causes of metabolic acidosis are numerous and their mechanisms are diverse. Broadly, they can cause metabolic acidosis with either a normal anion gap (e.g. drug-induced renal tubular acidosis) or an elevated anion gap (e.g. drug-induced lactic acidosis or pyroglutamic acidosis). This review describes the drugs that can cause or contribute to metabolic acidosis during therapeutic use, the mechanisms by which this occurs, and how they may be identified in practice