Physicians' perspectives on the treatment of patients with eating disorders in the acute setting

Abstract Background Hospitalisation for an eating disorder is rare, however treatment in the acute medical setting can be a life-saving admission. While the multidisciplinary team delivers overall patient care, medical decisions are the responsibility of the treating physicians. Treatment decisions directly impact on patient care and outcomes. This study aimed to explore the considerations that influence the medical decisions of physicians when treating patients with eating disorders in the acute setting. Method Semi-structured interviews were conducted with ten medical physicians who had previously treated eating disorders on a general medical unit in two Australian tertiary hospitals. An interview schedule, based on the literature and four relevant domains from the Consolidated Framework for Implementation Research, was developed. Interviews were audio recorded, transcribed verbatim and analyzed thematically. Coding and interim themes and sub-themes were developed by two dietitian researchers; these were further refined through researcher discussion and triangulation with two additional dietitian researchers. Results Ten doctors were interviewed (3 consultants (1 adult general medical and 2 paediatricians: 13–16 years medical experience), 2 registrars (4–7 years experience), 1 resident (1 year experience), and 4 interns (< 1 year experience). Doctors described memorable patient cases, related to hospital stays over several weeks. Interviews ranged in length from 58 min to 91 min. Four themes (with five sub-themes) were developed: 1) navigating uncertainty (focusing on processes and goals and seeking information), 2) being “the good doctor” (doing the right thing), 3) seeing the big picture (depending on key players and considering short and long-term), and 4) involving family and patient. Conclusions Non-specialist physicians described challenges in the treatment of eating disorders in the inpatient setting. They take a holistic approach that considers both short and longer-term goals, relying on specialist colleagues, the wider multidisciplinary team and sometimes family members to guide treatment decisions during admissions on general medical wards. Additional support, education and training centered on the key themes may increase physicians’ confidence and ability to make effective treatment decisions for this patient group. The results are relevant to all health professionals working in this field to better understand the priorities of medical physicians and to support them to achieve positive outcomes in the inpatient treatment of patients with eating disorders

Wake Vortex Field Measurement Program at Memphis, Tennessee: Data Guide

Eliminating or reducing current restrictions in the air traffic control system due to wake vortex considerations would yield increased capacity, decreased delays, and cost savings. Current wake vortex separation standards are widely viewed as very conservative under most conditions. However, scientific uncertainty about wake vortex behavior under different atmospheric conditions remains a barrier to development of an adaptive vortex spacing system. The objective of the wake vortex field measurement efforts during December, 1994 and August, 1995 at Memphis, TN were to record wake vortex behavior for varying atmospheric conditions and types of aircraft. This effort is part of a larger effort by the NASA Langley Research Center to develop an Aircraft Vortex Spacing System (AVOSS) as an element of the Terminal Area Productivity (TAP) program. The TAP program is being performed in concert with the FAA Terminal Air Traffic Control Automation (TATCA) program and ATC Automation. Wake vortex behavior was observed using a mobile continuous-wave (CW) coherent laser Doppler radar (lidar) developed at Lincoln Laboratory. This lidar features a number of improvements over previous systems, including the first-ever demonstration of an automatic wake vortex detection and tracking algorithm

Geophysical and hydrogeological assessment of the interaction of saline and fresh groundwater near a tidal creek

Through the application of downhole logging techniques an innovative assessment of density dependent groundwater flow has been undertaken that highlights the limitations of water level measurements for assessing groundwater flow in coastal environments. The method utilises an EM39 bulk conductivity log to calculate fluid conductivity/fluid density that was then used to convert measured point water head to freshwater head/environmental head to improve the understanding of groundwater flow at the creek. This method of assessing density dependent flow is unique and has not previously been demonstrated. The converted water levels showed that interpretation of groundwater flow is critically dependent on a detailed knowledge of both head and density. An assessment of the potential error in the conversion process indicated that, for the low gradients at the study site, misinterpretation of flow could occur due to errors inherent in the process. As a result, it is recommended that pressure transducers and loggers be used to monitor pressure in variable density systems so that Darcy&#146;s equation can be used directly to calculate groundwater flow and direction. The thesis also presents the results of high-resolution geophysical mapping of the distribution of saline groundwater beneath a tidal creek. The mapping was used to develop a detailed conceptual model of the salinity distribution at a tidal creek that included: the presence of saline intrusion beneath the creek; saline groundwater overlying fresh groundwater due to surface flooding in extreme tide events; concentrated discharge of groundwater (comprised of brackish water due to mixing in the aquifer) at the creek banks; and, significant changes in the distribution of saline groundwater according to rainfall events and only minor changes over a tidal cycle. The conceptual model, geophysical site assessment, water level analysis and numerical modelling represents a multi-disciplinary approach to the assessment of the interaction of saline and fresh groundwater that has not previously been undertaken. Significant anisotropy was inferred from geophysical observations that indicated vertical flow in the borehole annulus. This observation is particularly significant and implies that even relatively short (1.0 to 2.0 m) screened wells may not yield accurate fluid conductivity and head values in variable density systems

Information fusion for CB defense applications: Challenge and opportunity

Information fusion aims at a synergistic exploitation of multiple information sources, to enable decision-making or to enhance its performance. The sources include sensors of various modalities and characteristics, as well as sources which are not sensors. We discuss the challenges of information fusion, technical directions and approaches that can cope with those challenges, and the opportunities those approaches enable. Several research and development efforts conducted at MIT Lincoln Laboratory over the recent years in the area of information fusion for chemical-biological defense serve as the backdrop for that discussion.National Science Foundation (Grant No. 0329901)United States. Dept. of the Air Force (Air Force Contract FA8721-05-C-0002

The Grey Album:

In the field of digital sampling, disk jockeys have shown a recent enthusiasm for 'mash-ups' - new compositions created by combining the rhythm tracks of one song and the vocal track of another. Most famously of all, DJ Danger Mouse remixed the vocals from Jay-Z's The Black Album and the Beatles' White Album and called his creation The Grey Album. The Grey Album poses a number of difficult issues regarding copyright law and digital sampling. Does such a 'mash-up' go beyond the de minimis use of a copyright work? Is The Grey Album protected by the defence of fair use under copyright law because it provides a transformative use of copyright works? Can such remixes be compulsorily licensed? Does a 'mash-up' raise issues concerning the moral rights of attribution and integrity, which are recognised in Europe and Australia