9,458 research outputs found

    Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors

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    OBJECTIVES: Informal carers, often family members, play a vital role in supporting stroke survivors with post-stroke disability. As populations age, numbers of carers overall and those from minority ethnic groups in particular, are rising. Carers from all ethnic groups, but especially those from black and minority ethnic groups frequently fail to access support services, making understanding their experiences important. The study therefore explored the experiences of carers of stroke survivors aged 45+ years from 5 ethnic groups in accessing and receiving social care services after hospital discharge. DESIGN: This qualitative study used 7 recorded focus groups with informal carers of stroke survivors. Data were analysed thematically focusing on similarities and differences between ethnic groups. SETTING: Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK. PARTICIPANTS: 41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups. RESULTS: Several interconnected themes were identified including: the service gap between hospital discharge and home; carers as the best person to care and cultural aspects of caring and using services. Many themes were common to all the included ethnic groups but some related to specific groups. CONCLUSIONS: Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers' part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face

    A novel method of supplying nutrients permits predictable shoot growth and root: shoot ratios of pre-transplant bedding plants

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    BACKGROUND AND AIMS: Growth of bedding plants, in small peat plugs, relies on nutrients in the irrigation solution. The object of the study was to find a way of modifying the nutrient supply so that good-quality seedlings can be grown rapidly and yet have the high root : shoot ratios essential for efficient transplanting. METHODS: A new procedure was devised in which the concentrations of nutrients in the irrigation solution were modified during growth according to changing plant demand, instead of maintaining the same concentrations throughout growth. The new procedure depends on published algorithms for the dependence of growth rate and optimal plant nutrient concentrations on shoot dry weight Ws (g m–2), and on measuring evapotranspiration rates and shoot dry weights at weekly intervals. Pansy, Viola tricola ‘Universal plus yellow’ and petunia, Petunia hybrida ‘Multiflora light salmon vein’ were grown in four independent experiments with the expected optimum nutrient concentration and fractions of the optimum. Root and shoot weights were measured during growth. KEY RESULTS: For each level of nutrient supply Ws increased with time (t) in days, according to the equation {Delta}Ws/{Delta}t=K2Ws/(100+Ws) in which the growth rate coefficient (K2) remained approximately constant throughout growth. The value of K2 for the optimum treatment was defined by incoming radiation and temperature. The value of K2 for each sub-optimum treatment relative to that for the optimum treatment was logarithmically related to the sub-optimal nutrient supply. Provided the aerial environment was optimal, Rsb/Ro{approx}Wo/Wsb where R is the root : shoot ratio, W is the shoot dry weight, and sb and o indicate sub-optimum and optimum nutrient supplies, respectively. Sub-optimal nutrient concentrations also depressed shoot growth without appreciably affecting root growth when the aerial environment was non-limiting. CONCLUSION: The new procedure can predict the effects of nutrient supply, incoming radiation and temperature on the time course of shoot growth and the root : shoot ratio for a range of growing conditions

    Assessing satisfaction with social care services among black and minority ethnic and white British carers of stroke survivors in England

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    Overall satisfaction levels with social care are usually high but lower levels have been reported among black and minority ethnic (BME) service users in England. Reasons for this are poorly understood. This qualitative study therefore explored satisfaction with services among informal carer participants from five different ethnic groups. Fifty-seven carers (black Caribbean, black African, Asian Indian, Asian Pakistani and white British) were recruited from voluntary sector organisations and a local hospital in England, and took part in semi-structured interviews using cognitive interviewing and the critical incident technique. Interviews took place from summer 2013 to spring 2014. Thematic analysis of the interviews showed that participants often struggled to identify specific ‘incidents’, especially satisfactory ones. When describing satisfactory services, participants talked mostly about specific individuals and relationships. Unsatisfactory experiences centred on services overall. When rating services using cognitive interviewing, explicit comparisons with expectations or experiences with other services were common. Highest satisfaction ratings tended to be justified by positive personal characteristics among practitioners, trust and relationships. Lower level ratings were mostly explained by inconsistency in services, insufficient or poor care. Lowest level ratings were rare. Overall, few differences between ethnic groups were identified, although white British participants rated services higher overall giving more top ratings. White British participants also frequently took a more overall view of services, highlighting some concerns but still giving top ratings, while South Asian carers in particular focused on negative aspects of services. Together these methods provide insight into what participants mean by satisfactory and unsatisfactory services. Cognitive interviewing was more challenging for some BME participants, possibly a reflection of the meaningfulness of the concept of service satisfaction to them. Future research should include comparisons between BME and white participants’ understanding of the most positive parts of satisfaction scales and should focus on dissatisfied participants

    Adhesive Contact to a Coated Elastic Substrate

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    We show how the quasi-analytic method developed to solve linear elastic contacts to coated substrates (Perriot A. and Barthel E. {\em J. Mat. Res.}, {\bf 2004}, {\em 19}, 600) may be extended to adhesive contacts. Substrate inhomogeneity lifts accidental degeneracies and highlights the general structure of the adhesive contact theory. We explicit the variation of the contact variables due to substrate inhomogeneity. The relation to other approaches based on Finite Element analysis is discussed

    General dynamical equations of motion for elastic body systems

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    Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/76290/1/AIAA-11407-643.pd

    A computational scheme to evaluate Hamaker constants of molecules with practical size and anisotropy

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    We propose a computational scheme to evaluate Hamaker constants, AA, of molecules with practical sizes and anisotropies. Upon the increasing feasibility of diffusion Monte Carlo (DMC) methods to evaluate binding curves for such molecules to extract the constants, we discussed how to treat the averaging over anisotropy and how to correct the bias due to the non-additivity. We have developed a computational procedure for dealing with the anisotropy and reducing statistical errors and biases in DMC valuations, based on possible validations on predicted AA. We applied the scheme to cyclohexasilane molecule, Si6_6H12_{12}, used in 'printed electronics' fabrications, getting A∼105±2A \sim 105 \pm 2 [zJ], being in plausible range supported even by other possible extrapolations. The scheme provided here would open a way to use handy {\it ab initio} evaluations to predict wettabilities as in the form of materials informatics over broader molecules.Comment: The manuscript was revised according to review comment

    The effect of distance on observed mortality, childhood pneumonia and vaccine efficacy in rural Gambia.

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    We investigated whether straight-line distance from residential compounds to healthcare facilities influenced mortality, the incidence of pneumonia and vaccine efficacy against pneumonia in rural Gambia. Clinical surveillance for pneumonia was conducted on 6938 children living in the catchment areas of the two largest healthcare facilities. Deaths were monitored by three-monthly home visits. Children living >5 km from the two largest healthcare facilities had a 2·78 [95% confidence interval (CI) 1·74-4·43] times higher risk of all-cause mortality compared to children living within 2 km of these facilities. The observed rate of clinical and radiological pneumonia was lower in children living >5 km from these facilities compared to those living within 2 km [rate ratios 0·65 (95% CI 0·57-0·73) and 0·74 (95% CI 0·55-0·98), respectively]. There was no association between distance and estimated pneumococcal vaccine efficacy. Geographical access to healthcare services is an important determinant of survival and pneumonia in children in rural Gambia

    Parametric optimization study of a lithium-ion cell

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    Lithium-ion cell technology is well known for its high power and energy density in the automotive application. This paper presents development of a 1D electrochemical model which can be used to predict 18650 lithium-ion cell performance under different operating conditions. COMSOL Multiphysics 5.2a software has been utilized to develop the electrochemical model to predict the cell behaviour under various discharge rates. This tool uses the finite element method (FEM) to solve the conservation equations of charge and species in solid and electrolyte phase. And Butler-Volmer equation for reaction rates of lithium insertion and extraction. In an event that the electrochemical parameters of the cell are not known, determination of these parameters by measurements or experiments is a difficult and challenging task. An attempt has been made in this paper to estimate unknown cell parameters by two methods, first by performing a parametric study on cell parameters such as particle radius, diffusion coefficient, porosity etc. within a known range from literature studies and analyse the sensitivity of these parameters on the model results. Secondly, to improve the accuracy of the simulation results, COMSOL optimization module is used and the simulation results are validated against the experimental data. Apart from the discharge profiles, the proposed model can also be used to study the time dependent distribution of lithium-ion concentration, electrolyte concentration, lithium diffusivity and ionic conductivity in the cell

    Derivation of Internally-Consistent Thermodynamic Data by the Technique of Mathematical Programming: a Review with Application the System MgO-SiO2-H2O

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    The problem of deriving an optimal set of thermodynamic properties of minerals from a diverse experimental data base is reviewed and a preferred methodology proposed. Mathematical pro-gramming(MAP) methods extend the linear programming (LIP) approach first presented by Gordon (1973), and make it possible to account for the type of information conveyed, and the uncertainties attending both phase equilibrium data and direct measurements of phase properties. For phase equilibrium data which are (in most cases) characterized by non-normal error distributions across experimental brackets, the midpoint of a bracket is no more probable than other points, and the data are best treated by considering the inequality in the change in Gibbs free energy of reaction at each half-bracket. Direct measurements of phase properties can be assumed to have approximately normal error distributions, and the MAP technique optimizes agreement with these values by using the principles of least squares in the definition of an objective function. The structure of this problem, treatment of uncertainties in various types of experimental data, and method of optimizing final solutions are discussed in some detail. The method is applied to experimental data in the MgO-SiO2-H2O system, where inconsistencies among the data are resolved and an optimal set of thermodynamic properties is presented. The derived standard state entropies and volumes agree with all direct measurements (within their uncertainties), as do enthalpies of formation from the elements except for those of talc (+16 kJ mol−1), anthophyllite (+ 14 kJ mol−1), and brucite (−1 kJ mol−1). Stable phase relations in the system have the topology predicted by Greenwood (1963, 1971), with quartz- and forsterite-absent invariant points at 683 °C-6-4 kb and 797 °C-12 kb respectively, repeating at 552 °C-120 b and 550 °C-55 b. The thermodynamic analysis indicates little remaining flexibility in the phase relations, which, when combined with suitable activity models for solid solution, should allow for accurate determination of the conditions of metamorphism of ultramafic rock
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