Progress toward a MEMS fabricated 100 GHz oscillator.

This report summarizes an LDRD effort which looked at the feasibility of building a MEMS (Micro-Electro-Mechanical Systems) fabricated 100 GHz micro vacuum tube. PIC Simulations proved to be a very useful tool in investigating various device designs. Scaling parameters were identified. This in turn allowed predictions of oscillator growth based on beam parameters, cavity geometry, and cavity loading. The electron beam source was identified as a critical element of the design. FEA's (Field Emission Arrays) were purchased to be built into the micro device. Laboratory testing of the FEA's was also performed which pointed out care and handling issues along with maximum current capabilities. Progress was made toward MEMS fabrication of the device. Techniques were developed and successfully employed to build up several of the subassemblies of the device. However, the lower wall fabrication proved to be difficult and a successful build was not completed. Alternative approaches to building this structure have been identified. Although these alternatives look like good solutions for building the device, it was not possible to complete a redesign and build during the timeframe of this effort

We are all one together : peer educators\u27 views about falls prevention education for community-dwelling older adults - a qualitative study

Background: Falls are common in older people. Despite strong evidence for effective falls prevention strategies, there appears to be limited translation of these strategies from research to clinical practice. Use of peers in delivering falls prevention education messages has been proposed to improve uptake of falls prevention strategies and facilitate translation to practice. Volunteer peer educators often deliver educational presentations on falls prevention to community-dwelling older adults. However, research evaluating the effectiveness of peer-led education approaches in falls prevention has been limited and no known study has evaluated such a program from the perspective of peer educators involved in delivering the message. The purpose of this study was to explore peer educators’ perspective about their role in delivering peer-led falls prevention education for community-dwelling older adults. Methods: A two-stage qualitative inductive constant comparative design was used.In stage one (core component) focus group interviews involving a total of eleven participants were conducted. During stage two (supplementary component) semi-structured interviews with two participants were conducted. Data were analysed thematically by two researchers independently. Key themes were identified and findings were displayed in a conceptual framework. Results: Peer educators were motivated to deliver educational presentations and importantly, to reach an optimal peer connection with their audience. Key themes identified included both personal and organisational factors that impact on educators’ capacity to facilitate their peers’ engagement with the message. Personal factors that facilitated message delivery and engagement included peer-to-peer connection and perceived credibility, while barriers included a reluctance to accept the message that they were at risk of falling by some members in the audience. Organisational factors, including ongoing training for peer educators and formative feedback following presentations, were perceived as essential because they affect successful message delivery. Conclusions: Peer educators have the potential to effectively deliver falls prevention education to older adults and influence acceptance of the message as they possess the peer-to-peer connection that facilitates optimal engagement. There is a need to consider incorporating learnings from this research into a formal large scale evaluation of the effectiveness of the peer education approach in reducing falls in older adults

Design of a 7-MV Linear Transformer Driver (LTD) for down-hole flash x-ray radiography.

Pulsed power driven flash x-ray radiography is a valuable diagnostic for subcritical experiments at the Nevada Test Site. The existing dual-axis Cygnus system produces images using a 2.25 MV electron beam diode to produce intense x-rays from a small source. Future hydrodynamic experiments will likely use objects with higher areal mass, requiring increased x-ray dose and higher voltages while maintaining small source spot size. A linear transformer driver (LTD) is a compact pulsed power technology with applications ranging from pulsed power flash x-ray radiography to high current Z-pinch accelerators. This report describes the design of a 7-MV dual-axis system that occupies the same lab space as the Cygnus accelerators. The work builds on a design proposed in a previous report [1]. This new design provides increased diode voltage from a lower impedance accelerator to improve coupling to low impedance diodes such as the self magnetic pinch (SMP) diode. The design also improves the predicted reliability by operating at a lower charge voltage and removing components that have proven vulnerable to failure. Simulations of the new design and experimental results of the 1-MV prototype are presented

Towards integration of general practitioner posts and accident and emergency departments: a case study of two integrated emergency posts in the Netherlands

<p>Abstract</p> <p>Background</p> <p>Accident and emergency (A&E) departments and general practitioner (GP) posts are often used inappropriately, leading to overcrowding. In the Netherlands, increasingly more integrated emergency posts (IEPs) are being created, integrating the care provided by GP posts and A&E departments, in order to improve the provision of the emergency care.</p> <p>Methods</p> <p>This explorative study compares the efficiency and patient and employee satisfaction in IEPs with those in two GP posts and two A&E departments. To this end, information was retrieved from hospital and GP patient records for the first quarter of the year before and of the year after the creation of IEPs. Patients and employees were sent a questionnaire to measure their satisfaction. Lastly, groups of hospital doctors, GPs, GP assistants, and nurses were interviewed.</p> <p>Results</p> <p>After the creation of IEPs, there was a shift of more than fifteen percent from secondary care to primary care for emergency consultations and waiting/consultation times were shortened by more than ten percent. Compared with the control settings, patients were more satisfied about telephone contact with an IEP, but professionals working at the IEP were less satisfied with several aspects of their work.</p> <p>Conclusion</p> <p>IEPs could be a promising innovation to organize emergency care more efficiently; however, it might take time to convince professionals of the possible advantages. Studies involving more IEPs and longer follow-up times are needed to determine whether such integration should be stimulated.</p

Simulations of the interaction of intense petawatt laser pulses with dense Z-pinch plasmas : final report LDRD 39670.

We have studied the feasibility of using the 3D fully electromagnetic implicit hybrid particle code LSP (Large Scale Plasma) to study laser plasma interactions with dense, compressed plasmas like those created with Z, and which might be created with the planned ZR. We have determined that with the proper additional physics and numerical algorithms developed during the LDRD period, LSP was transformed into a unique platform for studying such interactions. Its uniqueness stems from its ability to consider realistic compressed densities and low initial target temperatures (if required), an ability that conventional PIC codes do not possess. Through several test cases, validations, and applications to next generation machines described in this report, we have established the suitability of the code to look at fast ignition issues for ZR, as well as other high-density laser plasma interaction problems relevant to the HEDP program at Sandia (e.g. backlighting)

A prospective study of chemotherapy-induced febrile neutropenia in the South West London Cancer Network. Interpretation of study results in light of NCAG/NCEPOD findings

BACKGROUND: Chemotherapy-induced febrile neutropenia is a medical emergency complicating the treatment of many cancer patients. It is associated with considerable morbidity and mortality, as well as impacting on healthcare resources. METHODS: A prospective study of all cases of chemotherapy-induced febrile neutropenia in the South West London Cancer Network was conducted over a 4-month period. Factors including demographics, treatment history, management of febrile neutropenia and outcome were recorded. RESULTS AND CONCLUSION: Our results reflect those of the recent National Chemotherapy Advisory Group (NCEPOD, 2008)/National Confidential Enquiry into Patient Outcomes and Death reports (NCAG, 2009) and highlight the need for network-wide c inical care pathways to improve outcomes in this area, British Journal of Cancer (2011) 104, 407-412. doi:10.1038/sj.bjc.6606059 www.bjcancer.com Published online 21 December 2010 (C) 2011 Cancer Research U

Progression from new methicillin-resistant Staphylococcus aureus colonisation to infection: An observational study in a hospital cohort

10.1186/1471-2334-13-491BMC Infectious Diseases131-BIDM