High purity silica reflective heat shield development

Measurements were made of reflectance in the vacuum ultraviolet down to 0.15 micron. Scattering coefficients (S) and absorption coefficients (K) were also measured. These coefficients express the optical properties and are used directly in a thermodynamic analysis for sizing a heat shield. The effect of the thin silica melt layer formed during entry was also studied from the standpoint of trapped radiant energy

Effect of an agri-environmental measure on nitrate leaching from a beef farming system in Ireland

peer-reviewedAgricultural nitrogen (N) management remains a key environmental challenge. Improving N management is a matter of urgency to reduce the serious ecological consequences of the reactive N. Nitrate (NO3−–N) leaching was measured under suckler beef production systems stocked at two intensities: (1) intensive, 210 kg organic N ha−1 with two cut silage harvests; and (2) rural environmental protection scheme (REPS), 170 kg organic N ha−1 with one cut silage harvest. Three replicate plots of each treatment were instrumented with ceramic cups (8 per plot), randomly placed within each plot at a depth of 1 m to collect soil solution for NO3−–N at 50 kPa suction to collecting vessels one week prior to sampling. Samples were taken on a total of 53 sampling dates over 3 winter drainage periods (2002/03, 2003/04 and 2004/05). Over the course of the experiment the mean annual soil solution NO3−–N concentration exceeded the MAC twice out of 15 means (5 treatments over 3 years). The REPS grazing and silage sub treatments had significantly lower mean annual soil solution total oxidized N (TON) concentrations than the respective intensive treatments in years 2 and 3. Annual total NO3−–N losses over the three years in intensive and REPS systems ranged from 55 to 71 and 15 to 20 kg N ha−1, respectively. Mean N surpluses in intensive and REPS systems were 210 and 95 kg ha−1, respectively with the corresponding mean N inputs of 272 and 124 kg N ha−1. The reduction in N inputs under the REPS system results in lower N leaching losses and contributed to a significant reduction in pressures on water quality

HRTEM study of orthorhombic zirconia in MgO-PSZ

High-resolution transmission electron microscopy (HRTEM) was used to study the phase of orthorhombic ZrO2 formed in magnesia partially stabilized zirconia (MgO-PSZ) during HRTEM specimen preparation. Based on the three reported crystal structures of orthorhombic ZrO2, with the space groups Pbcm, Pbc2(1) and Pbca, here it is shown that orthorhombic ZrO2 formed in MgO-PSZ has the Pbcm structure

What is the contribution of physician associates in hospital care in England? A mixed methods, multiple case study.

OBJECTIVES: To investigate the deployment of physician associates (PAs); the factors supporting and inhibiting their employment and their contribution and impact on patients' experience and outcomes and the organisation of services. DESIGN: Mixed methods within a case study design, using interviews, observations, work diaries and documentary analysis. SETTING: Six acute care hospitals in three regions of England in 2016-2017. PARTICIPANTS: 43 PAs, 77 other health professionals, 28 managers, 28 patients and relatives. RESULTS: A key influencing factor supporting the employment of PAs in all settings was a shortage of doctors. PAs were found to be acceptable, appropriate and safe members of the medical/surgical teams by the majority of doctors, managers and nurses. They were mainly deployed to undertake inpatient ward work in the medical/surgical team during core weekday hours. They were reported to positively contribute to: continuity within their medical/surgical team, patient experience and flow, inducting new junior doctors, supporting the medical/surgical teams' workload, which released doctors for more complex patients and their training. The lack of regulation and attendant lack of authority to prescribe was seen as a problem in many but not all specialties. The contribution of PAs to productivity and patient outcomes was not quantifiable separately from other members of the team and wider service organisation. Patients and relatives described PAs positively but most did not understand who and what a PA was, often mistaking them for doctors. CONCLUSIONS: This study offers new insights concerning the deployment and contribution of PAs in medical and surgical specialties in English hospitals. PAs provided a flexible addition to the secondary care workforce without drawing from existing professions. Their utility in the hospital setting is unlikely to be completely realised without the appropriate level of regulation and authority to prescribe medicines and order ionising radiation within their scope of practice

Examining the role of wine brand love on brand loyalty: a multi-country comparison

This study develops and tests a model through a multi-country study that considers consumer wine knowledge and wine experience, wine brand trust and wine brand satisfaction as antecedents of wine brand love, and wine brand loyalty as a consequence of wine brand love. Data were collected in five wine-producing countries (Australia, Chile, France, Mexico and Portugal) with a final sample of 3462 completed surveys. Hypotheses were tested with structural equation modeling and the findings confirm the importance of brand love as both a mediator and direct influence on brand loyalty for wine consumers. Furthermore, brand satisfaction was positively and significantly related to brand love. In addition, wine experience, rather than wine knowledge, positively influenced brand trust and satisfaction. Finally, results also identify differences between countries thereby providing insights into how companies should focus their marketing strategies internationally.info:eu-repo/semantics/acceptedVersio

Physician associates in England's hospitals: a survey of medical directors exploring current usage and factors affecting recruitment.

In the UK secondary care setting, the case for physician associates is based on the cover and stability they might offer to medical teams. We assessed the extent of their adoption and deployment - that is, their current usage and the factors supporting or inhibiting their inclusion in medical teams - using an electronic, self-report survey of medical directors of acute and mental health NHS trusts in England. Physician associates - employed in small numbers, in a range of specialties, in 20 of the responding trusts - were reported to have been employed to fill gaps in medical staffing and support medical specialty trainees. Inhibiting factors were commonly a shortage of physician associates to recruit and lack of authority to prescribe, as well as a lack of evidence and colleague resistance. Our data suggest there is an appetite for employment of physician associates while practical and attitudinal barriers are yet to be fully overcome

Nurse staffing and patient outcomes: strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence safe staffing guideline development

A large and increasing number of studies have reported a relationship between low nurse staffing levels and adverse outcomes, including higher mortality rates. Despite the evidence being extensive in size, and having been sometimes described as “compelling” and “overwhelming”, there are limitations that existing studies have not yet been able to address. One result of these weaknesses can be observed in the guidelines on safe staffing in acute hospital wards issued by the influential body that sets standards for the National Health Service in England, the National Institute for Health and Care Excellence (NICE), which concluded there is insufficient good quality evidence available to fully inform practice. In this paper we explore this apparent contradiction. After summarising the evidence review that informed the NICE guideline on safe staffing and related evidence, we move on to discussing the complex challenges that arise when attempting to apply this evidence to practice. Among these, we introduce the concept of endogeneity, a form of bias in the estimation of causal effects. Although current evidence is broadly consistent with a cause and effect relationship, endogeneity means that estimates of the size of effect, essential for building an economic case, may be biased and in some cases qualitatively wrong. We expand on three limitations that are likely to lead to endogeneity in many previous studies: omitted variables, which refers to the absence of control for variables such as medical staffing and patient case mix; simultaneity, which occurs when the outcome can influence the level of staffing just as staffing influences outcome; and common-method variance, which may be present when both outcomes and staffing levels variables are derived from the same survey. Thus while current evidence is important and has influenced policy because it illustrates the potential risks and benefits associated with changes in nurse staffing, it may not provide operational solutions. We conclude by posing a series of questions about design and methods for future researchers who intend to further explore this complex relationship between nurse staffing levels and outcomes. These questions are intended to reflect on the potential added value of new research given what is already known, and to encourage those conducting research to take opportunities to produce research that fills gaps in the existing knowledge for practice. By doing this we hope that future studies can better quantify both the benefits and costs of changes in nurse staffing levels and, therefore, serve as a more useful tool for those delivering services. <br/

Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews.

Background: Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine. Objective: We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies. Method: We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis. Results: Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion. Conclusion: We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required

Drosophila Activated Cdc42 Kinase Has an Anti-Apoptotic Function

Activated Cdc42 kinases (Acks) are evolutionarily conserved non-receptor tyrosine kinases. Activating somatic mutations and increased ACK1 protein levels have been found in many types of human cancers and correlate with a poor prognosis. ACK1 is activated by epidermal growth factor (EGF) receptor signaling and functions to regulate EGF receptor turnover. ACK1 has additionally been found to propagate downstream signals through the phosphorylation of cancer relevant substrates. Using Drosophila as a model organism, we have determined that Drosophila Ack possesses potent anti-apoptotic activity that is dependent on Ack kinase activity and is further activated by EGF receptor/Ras signaling. Ack anti-apoptotic signaling does not function through enhancement of EGF stimulated MAP kinase signaling, suggesting that it must function through phosphorylation of some unknown effector. We isolated several putative Drosophila Ack interacting proteins, many being orthologs of previously identified human ACK1 interacting proteins. Two of these interacting proteins, Drk and yorkie, were found to influence Ack signaling. Drk is the Drosophila homolog of GRB2, which is required to couple ACK1 binding to receptor tyrosine kinases. Drk knockdown blocks Ack survival activity, suggesting that Ack localization is important for its pro-survival activity. Yorkie is a transcriptional co-activator that is downstream of the Salvador-Hippo-Warts pathway and promotes transcription of proliferative and anti-apoptotic genes. We find that yorkie and Ack synergistically interact to produce tissue overgrowth and that yorkie loss of function interferes with Ack anti-apoptotic signaling. Our results demonstrate how increased Ack signaling could contribute to cancer when coupled to proliferative signals