Realist evaluation of the impact of paediatric nurse practitioner clinics, specialist paediatric nurses, and a children’s community nursing team in deflecting attendance at emergency departments and urgent care centres by children with long-term conditions

In 2018, the Greater Manchester Children’s Health and Wellbeing Board developed a 10-point strategy to achieve its objectives, the sixth of which was to reduce unnecessary hospital attendances and admissions for children with long term conditions such as asthma, diabetes and epilepsy. Funding was secured from Manchester Academic Health Science Centre to commission an exploration of the impact of the Paediatric Nurse Practitioner Clinic within the context of the Family Services Model and the impact that the service was having on reducing attendance at urgent care centres or admission to hospital. Alternatives to taking children to the ED/UCC can be a preference. An integrated system, with elements able to book directly into others, with rapid access, information, health promotion, and follow-up were essential to success. Extra consultation time for proactive intervention, with sufficient nurses to provide a seven-days service were valued. Advertisement of the service to the public and to professionals is vital for uptake by professionals and the public

Recent progress towards a chiral effective field theory for the NN system

Since Weinberg's proposal two decades ago, chiral effective field theory in the NN sector has been developed and applied up to order $O((Q/M_{hi})^4)$. In principle it could provide a model-independent description of nuclear force from QCD. However, in spite of its huge success, some open issues such as the renormalization group invariance and power counting, still remain to be solved. In this talk we refine the chiral effective field theory approach to the NN system based on a renormalization group analysis. Our results show that a truly model-independent description of NN system can be obtained by a new power counting which treats the subleading order corrections perturbatively.Comment: Contribution to the proceedings of the Seventh International Symposium on Chiral Symmetry in Hadrons and Nuclei, Beijing, October 2013. 4 pages, 1 figur

Exercises to develop skill in map reading in grade four

Thesis (Ed.M.)--Boston Universit

Technique for extending the frequency range of digital dividers

A technique for extending the frequency range of a presettable digital divider is described. The conventional digital divider consists of several counter stages with the count of each stage compared to a preselected number. When the counts for all stages are equal to the preselected numbers, an output pulse is generated and all stages are reset. For high input frequencies, the least significant stage of the divider has to be reset in a very short time. This limits the frequency that can be handled by the conventional digital divider. This invention provides a technique in which the second least significant and higher stages are reset and the least significant stage is permitted to free-run. Hence, the time in which the reset operation can be performed is increased thereby extending the frequency range of the divider

The Mayflies (Ephemeroptera) of Tennessee, With a Review of the Possibly Threatened Species Occurring Within the State

One hundred and forty-three species of mayflies are reported from the state of Tennessee. Sixteen species (Ameletus cryptostimulus, Choroterpes basalis, Baetis virile, Ephemera blanda, E. simulans, Ephemerella berneri, Heterocloeon curiosum, H. petersi, Labiobaetis ephippiatus, Leptophlebia bradleyi, Macdunnoa brunnea, Paraleptophlebia assimilis, P. debilis, P. mollis, Rhithrogenia pellucida and Siphlonurus mirus) are reported for the first time. Rare and vulnerable species occurring in the state are also discussed. This represents the first comprehensive statewide list of mayflies for Tennessee

Estimation of Sorting Time for Arthropod Samples Collected with Tullgren Funnels

Arthropods were sorted from samples obtained with Tullgren funnels. Each sorter maintained a log of time per session and arthropods removed per session. Five individuals removed all arthropods from 12 separate samples and sorted them into previously designated class or ordinal taxa. Each sample was sorted by a single student. Students were allowed to develop their own approaches to sorting and do it as time permitted. Mean sorting rate per sample was 2.43 arthropods per minute, with a range of 1.42-5.64, while mean sorting rate for a sorting session was 3.41 specimens per minute. Specimen density was only weakly correlated with sort time. Fatigue did not appear to be a major factor in sorting rate, as indicated by the similarity of the linear and quadratic coefficients of determination for each sample

Non-destructive method for applying and removing instrumentation on helicopter rotor blades

A nondestructive method of applying and removing instrumentation on airfoils

Taber Vibration Isolator for Vacuum and Cryogenic Applications

We present a procedure for the design and construction of a passive, multipole, mechanical high-stop vibration isolator. The isolator, consisting of a stack of metal disks connected by thin wires, attenuates frequencies in the kilohertz range, and is suited to both vacuum and cryogenic environments. We derive an approximate analytical model and compare its predictions for the frequencies of the normal modes to those of a finite element analysis. The analytical model is exact for the modes involving only motion along and rotation about the longitudinal axis, and it gives a good approximate description of the transverse modes. These results show that the high-frequency behavior of a multi-stage isolator is well characterized by the natural frequencies of a single stage. From the single-stage frequency formulae, we derive relationships among the various geometrical parameters of the isolator to guarantee equal attenuation in all degrees of freedom. We then derive expressions for the attenuation attainable with a given isolator length, and find that the most important limiting factor is the elastic limit of the spring wire material. For our application, which requires attenuations of 250 dB at 1 kHz, our model specifies a six-stage design using brass disks of approximately 2 cm in both radius and thickness, connected by 3 cm steel wires of diameters ranging from 25 to 75 microns. We describe the construction of this isolator in detail, and compare measurements of the natural frequencies of a single stage with calculations from the analytical model and the finite element package. For translations along and rotations about the longitudinal axes, all three results are in agreement to within 10% accuracy.Comment: 11 pages, 13 figures, REVTe