Magnetic stars from a FEROS cool Ap star survey

New magnetic Ap stars with split Zeeman components are presented. These stars were discovered from observations with the Fibre-fed Extended Range Optical Spectrograph (FEROS) spectrograph at the European Southern Observatory (ESO) 2.2-m telescope. 15 new magnetic stars are analysed here. Several stars with very strong magnetic fields were found, including HD 70702 with a 15-kG magnetic field strength, and HD 168767 with a 16.5-kG magnetic field strength measured using split Zeeman components of spectral lines and by comparison with synthetic calculations. The physical parameters of the stars were estimated from photometric and spectroscopic data. Together with previously published results for stars with strong magnetic fields, the relationship between magnetic field strength and rotation period is discussed

Identifying the challenges and facilitators of implementing a COPD care bundle.

BACKGROUND: Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. METHODS: An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. RESULTS: Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. CONCLUSIONS: Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges

The Role of Landscape‐Dependent Disturbance and Dispersal in Metapopulation Persistence.

The fundamental processes that influence metapopulation dynamics (extinction and recolonization) will often depend on landscape structure. Disturbances that increase patch extinction rates will frequently be landscape dependent such that they are spatially aggregated and have an increased likelihood of occurring in some areas. Similarly, landscape structure can influence organism movement, producing asymmetric dispersal between patches. Using a stochastic, spatially explicit model, we examine how landscape‐dependent correlations between dispersal and disturbance rates influence metapopulation dynamics. Habitat patches that are situated in areas where the likelihood of disturbance is low will experience lower extinction rates and will function as partial refuges. We discovered that the presence of partial refuges increases metapopulation viability and that the value of partial refuges was contingent on whether dispersal was also landscape dependent. Somewhat counterintuitively, metapopulation viability was reduced when individuals had a preponderance to disperse away from refuges and was highest when there was biased dispersal toward refuges. Our work demonstrates that landscape structure needs to be incorporated into metapopulation models when there is either empirical data or ecological rationale for extinction and/or dispersal rates being landscape dependent

Influence of the first wave of COVID-19 on asthma inhaler prescriptions

In the beginning of the COVID-19 pandemic there were major concerns regarding the huge demand for asthma inhalers. Using primary care medical records for 614,700 asthma patients between January and June 2020, we found that there was a substantial increase in inhalers solely in March 2020. Patients significantly associated with receiving higher inhaled corticosteroid prescriptions were younger, of higher socioeconomic status and had milder asthma

On the understanding of pulsations in the atmosphere of roAp stars: phase diversity and false nodes

Studies based on high-resolution spectroscopic data of rapidly oscillating Ap stars show a surprising diversity of pulsation behavior in the atmospheric layers, pointing, in particular, to the co-existence of running and standing waves. The correct interpretation of these data requires a careful modelling of pulsations in these magnetic stars. In light of this, in this work we present a theoretical analysis of pulsations in roAp stars, taking into account the direct influence of the magnetic field. We derive approximate analytical solutions for the displacement components parallel and perpendicular to the direction of the magnetic field, that are appropriate to the outermost layer. From these, we determine the expression for the theoretical radial velocity for an observer at a general position, and compute the corresponding pulsation amplitude and phase as function of height in the atmosphere. We show that the integral for the radial velocity has contributions from three different types of wave solutions, namely, running waves, evanescent waves, and standing waves of nearly constant amplitude. We then consider a number of case studies to illustrate the origin of the different pulsational behaviour that is found in the observations. Concerning pulsation amplitude, we find that it generally increases with atmospheric height. Pulsation phase, however, shows a diversity of behaviours, including phases that are constant, increasing, or decreasing with atmospheric height. Finally, we show that there are situations in which the pulsation amplitude goes through a zero, accompanied by a phase jumps of $\pi$, and argue that such behaviour does not correspond to a pulsation node in the outermost layers of the star, but rather to a visual effect, resulting from the observers inability to resolve the stellar surface.Comment: 21 pages, 25 figure

Differences in radionuclide and heavy metal concentrations found in the kidneys of barren-ground caribou from the western Northwest Territories 1994/95 to 2000/01

Aluminum, nickel, cadmium, mercury, and lead concentrations were measured in the kidney tissue of known aged barren-ground caribou wintering in the western Northwest Territories harvested during winter 1994/1995 and during winters 2000/2001 and 2001/2002. 40K, 137Cs, and 210Pb concentrations were measured in the kidney tissue of known aged barren-ground caribou during winter 2000/2001 and compared to concentrations in winter 1993/1994 reported in Macdonald et al. (1996). Renal concentrations of aluminum were higher (P<0.001)in winter 2000/2001 than winter 1994/1995. Contrastingly renal concentrations of mercury were lower (P<0.001) in winter 2000/2001 than 1994/1995. 137Cs (P<0.02), 40K (P=0.01), 210Pb (P<0.01) had lower renal concentrations in winter 2000/2001 than 1993/1994. Renal concentrations of cadmium (P<0.001) and 137Cs (P<0.04) had a positive relationship with caribou age. We also document renal concentrations of arsenic, copper, selenium, zinc, 232Th, 226Ra, and 235U in the kidneys of caribou harvested in winters 2000/2001 and 2001/2002. Renal zinc concentrations were positively correlated with the age of caribou

The supply of information in an emotional setting

Advances in the field of economics and psychology have contributed greatly to the understanding of the supply of information when it affects the emotions and consequently the decisions made by two parties. Yet, these studies assume the parties have identical utilities. In this paper, focusing on the doctor-patient interaction, we relax the perfect agency assumption, introduce the agent’s effort in supplying information, and analyse the two parties' interdependent decisions under asymmetric information. We show that when the supplier of information fails to understand the receiver’s preferences the latter will disregard completely the recommendation. We consider the policy recommendations and welfare implications of the model

Efectividad de un programa de promoción de la salud en la disminución de costos médicos asistenciales

Objetivo La práctica regular de actividad física sería capaz de reducir la frecuencia de enfermedades y podría repercutir en la reducción de costos médicos asistenciales. Explorar la posible reducción de costos asistenciales en personas activas. Métodos En una institución prestadora de servicios de salud, se contrastan los costos médicos de un grupo de personas activas con un grupo control de personas tomadas aleatoriamente del resto de la población afiliada. Resultados Los costos médicos son más bajos en las personas activas en aspectos como urgencias, hospitalizaciones y medicamentos. Se observa reducción en la frecuencia de los casos y en el costo promedio por paciente y por servicio. Conclusión La actividad física practicada en forma regular reduce los requerimientos de atención médica y con ello se genera un ahorro significativo en los costos asistenciales. Se abren perspectivas promisorias para la implementación de programas de promoción de la salud a nivel poblacional y para la racionalización de los recursos económicos en el sector salud

Impact of a COPD Discharge Care Bundle on Readmissions following Admission with Acute Exacerbation: Interrupted Time Series Analysis.

We evaluated the impact of a COPD discharge care bundle on readmission rates following hospitalisation with an acute exacerbation.Interrupted time series analysis, comparing readmission rates for COPD exacerbations at nine trusts that introduced the bundle, to two comparison groups; (1) other NHS trusts in London and (2) all other NHS trusts in England. Care bundles were implemented at different times for different NHS trusts, ranging from October 2009 to April 2011.Nine NHS acute trusts in the London, England.Patients aged 45 years and older admitted to an NHS acute hospital in England for acute exacerbation of COPD. Data come from Hospital Episode Statistics, April 2002 to March 2012.Annual trend readmission rates (and in total bed days) within 7, 28 and 90 days, before and after implementation.In hospitals introducing the bundle readmission rates were rising before implementation and falling afterwards (e.g. readmissions within 28 days +2.13% per annum (pa) pre and -5.32% pa post (p for difference in trends = 0.012)). Following implementation, readmission rates within 7 and 28 day were falling faster than among other trusts in London, although this was not statistically significant (e.g. readmissions within 28 days -4.6% pa vs. -3.2% pa, p = 0.44). Comparisons with a national control group were similar.The COPD discharge care bundle appeared to be associated with a reduction in readmission rate among hospitals using it. The significance of this is unclear because of changes to background trends in London and nationally