Accuracy of discharge determinations

June 1967.Includes bibliographical references (pages 51-54)

Self-management support for chronic disease in primary care: frequency of patient self-management problems and patient reported priorities, and alignment with ultimate behavior goal selection.

BackgroundTo enable delivery of high quality patient-centered care, as well as to allow primary care health systems to allocate appropriate resources that align with patients' identified self-management problems (SM-Problems) and priorities (SM-Priorities), a practical, systematic method for assessing self-management needs and priorities is needed. In the current report, we present patient reported data generated from Connection to Health (CTH), to identify the frequency of patients' reported SM-Problems and SM-Priorities; and examine the degree of alignment between patient SM-Priorities and the ultimate Patient-Healthcare team member selected Behavioral Goal.MethodsCTH, an electronic self-management support system, was embedded into the flow of existing primary care visits in 25 primary care clinics and was used to assess patient-reported SM-Problems across 12 areas, patient identified SM-Priorities, and guide the selection of a Patient-Healthcare team member selected Behavioral Goal. SM-Problems included: BMI, diet (fruits and vegetables, salt, fat, sugar sweetened beverages), physical activity, missed medications, tobacco and alcohol use, health-related distress, general life stress, and depression symptoms. Descriptive analyses documented SM-Problems and SM-Priorities, and alignment between SM-Priorities and Goal Selection, followed by mixed models adjusting for clinic.Results446 participants with ≥ one chronic diseases (mean age 55.4 ± 12.6; 58.5% female) participated. On average, participants reported experiencing challenges in 7 out of the 12 SM-Problems areas; with the most frequent problems including: BMI, aspects of diet, and physical activity. Patient SM-Priorities were variable across the self-management areas. Patient- Healthcare team member Goal selection aligned well with patient SM-Priorities when patients prioritized weight loss or physical activity, but not in other self-management areas.ConclusionParticipants reported experiencing multiple SM-Problems. While patients show great variability in their SM-Priorities, the resulting action plan goals that patients create with their healthcare team member show a lack of diversity, with a disproportionate focus on weight loss and physical activity with missed opportunities for using goal setting to create targeted patient-centered plans focused in other SM-Priority areas. Aggregated results can assist with the identification of high frequency patient SM-Problems and SM-Priority areas, and in turn inform resource allocation to meet patient needs.Trial registrationClinicalTrials.gov ID: NCT01945918

AFB/open cycle gas turbine conceptual design study

Applications of coal fired atmospheric fluidized bed gas turbine systems in industrial cogeneration are identified. Based on site-specific conceptual designs, the potential benefits of the AFB/gas turbine system were compared with an atmospheric fluidized design steam boiler/steam turbine system. The application of these cogeneration systems at four industrial plant sites is reviewed. A performance and benefit analysis was made along with a study of the representativeness of the sites both in regard to their own industry and compared to industry as a whole. A site was selected for the conceptual design, which included detailed site definition, AFB/gas turbine and AFB/steam turbine cogeneration system designs, detailed cost estimates, and comparative performance and benefit analysis. Market and benefit analyses identified the potential market penetration for the cogeneration technologies and quantified the potential benefits

Plasma Electron Beam Welder for Space Vehicles Final Report

Feasibility of developing plasma electron beam welding system for earth orbiting vehicl

ALMA observations of 99 GHz free-free and H40α\alpha line emission from star formation in the centre of NGC 253

We present Atacama Large Millimeter/submillimeter Array observations of 99.02 GHz free-free and H40$\alpha$ emission from the centre of the nearby starburst galaxy NGC 253. We calculate electron temperatures of 3700-4500 K for the photoionized gas, which agrees with previous measurements. We measure a photoionizing photon production rate of $(3.2\pm0.2)\times10^{53}$ s$^{-1}$ and a star formation rate of $1.73\pm0.12$ M$_\odot$ yr$^{-1}$ within the central 20$\times$10 arcsec, which fall within the broad range of measurements from previous millimetre and radio observations but which are better constrained. We also demonstrate that the dust opacities are ~3 dex higher than inferred from previous near-infrared data, which illustrates the benefits of using millimetre star formation tracers in very dusty sources.Comment: 5 pages, 3 figures, accepted for publication in MNRAS Letter

Multi-wavelength constraints on cosmic-ray leptons in the Galaxy

Cosmic rays (CRs) interact with the gas, the radiation field and the magnetic field in the Milky Way, producing diffuse emission from radio to gamma rays. Observations of this diffuse emission and comparison with detailed predictions are powerful tools to unveil the CR properties and to study CR propagation. We present various GALPROP CR propagation scenarios based on current CR measurements. The predicted synchrotron emission is compared to radio surveys, and synchrotron temperature maps from WMAP and Planck, while the predicted interstellar gamma-ray emission is compared to Fermi-LAT observations. We show how multi-wavelength observations of the Galactic diffuse emission can be used to help constrain the CR lepton spectrum and propagation. Finally we discuss how radio and microwave data could be used in understanding the diffuse Galactic gamma-ray emission observed with Fermi-LAT, especially at low energies.Comment: 8 pages, 5 figures; in Proceedings of the 34th International Cosmic Ray Conference (ICRC 2015), The Hague (The Netherlands); Oral contributio

Studies in the Lake Ontario Basin using ERTS-1 and high altitude data

Studies in the Lake Ontario Basin are designed to provide input for models of river basin discharge and macro-scale features of lake circulation. Lake studies appear to require high altitude imagery to record the dynamic features of Lake Ontario so that ERTS-1 data may be interpreted. Land area studies require input of soil moisture, land use and soil-sediment-geomorphology measurements some of which appear to be available, on a regional scale from ERTS-1 products

AGN and starbursts at high redshift: High resolution EVN radio observations of the Hubble Deep Field

We present deep, wide-field European VLBI Network (EVN) 1.6 GHz observations of the Hubble Deep Field (HDF) region with a resolution of 0.025 arcseconds. Above the 210 microJy/beam (5sigma) detection level, the EVN clearly detects two radio sources in a field that encompasses the HDF and part of the Hubble Flanking Fields (HFF). The sources detected are: VLA J123644+621133 (a z=1.013, low-luminosity FR-I radio source located within the HDF itself) and VLA J123642+621331 (a dust enshrouded, optically faint, z=4.424 starburst system). A third radio source, J123646+621404, is detected at the 4sigma level. The VLBI detections of all three sources suggest that most of the radio emission of these particular sources (including the dusty starburst) is generated by an embedded AGN.Comment: 4 pages, 1 figure; Accepted by Astron. & Astrophys Letters ... See http://www.nfra.nl/~mag/hdf_evn.htm