Generation and transport of a low energy intense ion beam

The paper describes experiments on the generation and transport of a low energy (70-120 keV), high intensity (10-30 A/cm(2)) microsecond duration H+ ion beam (IB) in vacuum and plasma. The IB was generated in a magnetically insulated diode (MID) with an applied radial B field and an active hydrogen-puff ion source. The annular IB, with an initial density of j(i)similar to10-20 A/cm(2) at the anode surface, was ballistically focused to a current density in the focal plane of 50-80 A/cm(2). The postcathode collimation and transport of the converging IB were provided by the combination of a "concave" toroidal magnetic lens followed by a straight transport solenoid section. With optimized MID parameters and magnetic fields in the lens/solenoid system, the overall efficiency of IB transport at the exit of the solenoid 1 m from the anode was similar to 50% with an IB current density of 20 A/cm(2). Two-dimensional computer simulations of post-MID IB transport supported the optimization of system parameters. (C) 2004 American Institute of Physics

Development and testing of a composite index to monitor the continuum of maternal health service delivery at provincial and district level in South Africa

The continuum of care is a recommended framework for comprehensive health service delivery for maternal health, and it integrates health system and social determinants of health. There is a current lack of knowledge on a measurement approach to monitor performance on the framework. In this study we aim to develop and test a composite index for assessing the maternal health continuum in a province in South Africa with the possibility of nationwide use

Sustainable rural physician training: leadership in a fragile environment

Chapter 1: Characterising Australia’s rural specialist physician workforce: the professional profile and professional satisfaction of junior doctors and consultants: Objective: To assess differences in the demographic characteristics, professional profile and professional satisfaction of rural and metropolitan junior physicians and physician consultants in Australia. Design, setting and participants: Cross-sectional, population level national survey of the Medicine in Australia: Balancing Employment and Life longitudinal cohort study (collected 2008–2016). Participants were specialist physicians from four career stage groups: pre-registrars (physician intent); registrars; new consultants (< 5 years since Fellowship); and consultants. Main outcome measures: Level of professional satisfaction across various job aspects, such as hours worked, working conditions, support networks and educational opportunities, comparing rural and metropolitan based physicians. Results: Participants included 1587 pre-registrars (15% rural), 1745 physician registrars (9% rural), 421 new consultants (20% rural) and 1143 consultants (13% rural). Rural physicians of all career stages demonstrated equivalent professional satisfaction across most job aspects, compared with metropolitan physician counterparts. Some examples of differences in satisfaction included rural pre-registrars being less likely to agree they had good access to support and supervision from qualified consultants (odds ratio [OR], 0.6; 95% CI, 0.3–0.9) and rural consultants being more likely to agree they had a poorer professional support network (OR, 1.9; 95% CI, 1.2–2.9). In terms of demographics, relatively more rural physicians had a rural background or were trained overseas. Although most junior physicians were women, female consultants were less likely to be working in a rural location (OR, 0.6; 95% CI, 0.4–0.8). Conclusion: Junior physicians in metropolitan or rural settings have a similar professional experience, which is important in attracting future trainees. Increased opportunities for rural training should be prioritised, along with addressing concerns about the professional isolation and poorer support network of those in rural areas, not only among junior doctors but also consultants. Finally, making rural practice more attractive to female junior physicians could greatly improve the consultant physician distribution. Chapter 2: General physicians and paediatricians in rural Australia: the social construction of professional identity: Objective: To explore the construction of professional identity among general physicians and paediatricians working in non-metropolitan areas. Design, setting and participants: In-depth qualitative interviews were conducted with general physicians and paediatricians, plus informants from specialist colleges, government agencies and academia who were involved in policy and programs for the training and recruitment of specialists in rural locations across three states and two territories. This research is part of the Training Pathways and Professional Support for Building a Rural Physician Workforce Study, 2018–19. Main outcome measures: Individual and collective descriptors of professional identity. Results: We interviewed 36 key informants. Professional identity for general physicians and paediatricians working in regional, rural and remote Australia is grounded in the breadth of their training, but qualified by location — geographic location, population served or specific location, where social and cultural context specifically shapes practice. General physicians and paediatricians were deeply engaged with their local community and its economic vulnerability, and they described the population size and dynamics of local economies as determinants of viable practice. They often complemented their practice with formal or informal training in areas of special interest, but balanced their practice against subspecialist availability, also dependent on demographics. While valuing their professional roles, they showed limited inclination for industrial organisation. Conclusion: Despite limited consensus on identity descriptors, rural general physicians and paediatricians highly value generalism and their rural engagement. The structural and geographic bias that preferences urban areas will need to be addressed to further develop coordinated strategies for advanced training in rural contexts, for which collective identity is integral. Chapter 3: Sustainable rural physician training: leadership in a fragile environment: Objectives: To understand Royal Australasian College of Physicians (RACP) training contexts, including supervisor and trainee perspectives, and to identify contributors to the sustainability of training sites, including training quality. Design, setting and participants: A cross-sectional mixed-methods design was used. A national sample of RACP trainees and Fellows completed online surveys. Survey respondents who indicated willingness to participate in interviews were purposively recruited to cover perspectives from a range of geographic, demographic and training context parameters. Main outcome measures: Fellows’ and trainees’ work and life satisfaction, and their experiences of supervision and training, respectively, by geographic location. Results: Fellows and trainees reported high levels of satisfaction, with one exception — inner regional Fellows reported lower satisfaction regarding opportunities to use their abilities. Not having a good support network was associated with lower satisfaction. Our qualitative findings indicate that a culture of undermining rural practice is prevalent and that good leadership at all levels is important to reduce negative impacts on supervisor and trainee availability, site accreditation and viability. Trainees described challenges in navigating training pathways, ensuring career development, and having the flexibility to meet family needs. The small number of Fellows in some sites poses challenges for supervisors and trainees and results in a blurring of roles; accreditation is an obstacle to provision of training at rural sites; and the overlap between service and training roles can be difficult for supervisors. Conclusion: Our qualitative findings emphasise the distinctive nature of regional specialist training, which can make it a fragile environment. Leadership at all levels is critical to sustaining accreditation and support for supervisors and trainees. Chapter 4: Principles to guide training and professional support for a sustainable rural specialist physician workforce: Objective: To draw on research conducted in the Building a Rural Physician Workforce project, the first national study on rural specialist physicians, to define a set of principles applicable to guiding training and professional support action. Design: We used elements of the Delphi approach for systematic data collection and codesign, and applied a hybrid participatory action planning approach to achieve consensus on a set of principles. Results: Eight interconnected foundational principles built around rural regions and rural people were identified: FP1, grow your own “connected to” place; FP2, select trainees invested in rural practice; FP3, ground training in community need; FP4, rural immersion — not exposure; FP5, optimise and invest in general medicine; FP6, include service and academic learning components; FP7, join up the steps in rural training; and FP8, plan sustainable specialist roles. Conclusion: These eight principles can guide training and professional support to build a sustainable rural physician workforce. Application of the principles, and coordinated action by stakeholders and the responsible organisations, are needed at national, state and local levels to achieve a sustainable rural physician workforce.</p

A photodiode-based neutral particle bolometer for characterizing charge-exchanged fast-ion behavior.

A neutral particle bolometer (NPB) has been designed and implemented on Tri Alpha Energy's C-2 device in order to spatially and temporally resolve the charge-exchange losses of fast-ion populations originating from neutral beam injection into field-reversed configuration plasmas. This instrument employs a silicon photodiode as the detection device with an integrated tungsten filter coating to reduce sensitivity to light radiation. Here we discuss the technical aspects and calibration of the NPB, and report typical NPB measurement results of wall recycling effects on fast-ion losses

A photodiode-based neutral particle bolometer for characterizing charge-exchanged fast-ion behavior.

A neutral particle bolometer (NPB) has been designed and implemented on Tri Alpha Energy's C-2 device in order to spatially and temporally resolve the charge-exchange losses of fast-ion populations originating from neutral beam injection into field-reversed configuration plasmas. This instrument employs a silicon photodiode as the detection device with an integrated tungsten filter coating to reduce sensitivity to light radiation. Here we discuss the technical aspects and calibration of the NPB, and report typical NPB measurement results of wall recycling effects on fast-ion losses

Determinants of women's satisfaction with maternal health care: a review of literature from developing countries.

BACKGROUND: Developing countries account for 99 percent of maternal deaths annually. While increasing service availability and maintaining acceptable quality standards, it is important to assess maternal satisfaction with care in order to make it more responsive and culturally acceptable, ultimately leading to enhanced utilization and improved outcomes. At a time when global efforts to reduce maternal mortality have been stepped up, maternal satisfaction and its determinants also need to be addressed by developing country governments. This review seeks to identify determinants of women's satisfaction with maternity care in developing countries. METHODS: The review followed the methodology of systematic reviews. Public health and social science databases were searched. English articles covering antenatal, intrapartum or postpartum care, for either home or institutional deliveries, reporting maternal satisfaction from developing countries (World Bank list) were included, with no year limit. Out of 154 shortlisted abstracts, 54 were included and 100 excluded. Studies were extracted onto structured formats and analyzed using the narrative synthesis approach. RESULTS: Determinants of maternal satisfaction covered all dimensions of care across structure, process and outcome. Structural elements included good physical environment, cleanliness, and availability of adequate human resources, medicines and supplies. Process determinants included interpersonal behavior, privacy, promptness, cognitive care, perceived provider competency and emotional support. Outcome related determinants were health status of the mother and newborn. Access, cost, socio-economic status and reproductive history also influenced perceived maternal satisfaction. Process of care dominated the determinants of maternal satisfaction in developing countries. Interpersonal behavior was the most widely reported determinant, with the largest body of evidence generated around provider behavior in terms of courtesy and non-abuse. Other aspects of interpersonal behavior included therapeutic communication, staff confidence and competence and encouragement to laboring women. CONCLUSIONS: Quality improvement efforts in developing countries could focus on strengthening the process of care. Special attention is needed to improve interpersonal behavior, as evidence from the review points to the importance women attach to being treated respectfully, irrespective of socio-cultural or economic context. Further research on maternal satisfaction is required on home deliveries and relative strength of various determinants in influencing maternal satisfaction

Generation and transport of a low energy intense ion beam

The paper describes experiments on the generation and transport of a low energy (70-120 keV), high intensity (10-30 A/cm(2)) microsecond duration H+ ion beam (IB) in vacuum and plasma. The IB was generated in a magnetically insulated diode (MID) with an applied radial B field and an active hydrogen-puff ion source. The annular IB, with an initial density of j(i)similar to10-20 A/cm(2) at the anode surface, was ballistically focused to a current density in the focal plane of 50-80 A/cm(2). The postcathode collimation and transport of the converging IB were provided by the combination of a "concave" toroidal magnetic lens followed by a straight transport solenoid section. With optimized MID parameters and magnetic fields in the lens/solenoid system, the overall efficiency of IB transport at the exit of the solenoid 1 m from the anode was similar to 50% with an IB current density of 20 A/cm(2). Two-dimensional computer simulations of post-MID IB transport supported the optimization of system parameters. (C) 2004 American Institute of Physics