21 research outputs found
The quest for the solar g modes
Solar gravity modes (or g modes) -- oscillations of the solar interior for
which buoyancy acts as the restoring force -- have the potential to provide
unprecedented inference on the structure and dynamics of the solar core,
inference that is not possible with the well observed acoustic modes (or p
modes). The high amplitude of the g-mode eigenfunctions in the core and the
evanesence of the modes in the convection zone make the modes particularly
sensitive to the physical and dynamical conditions in the core. Owing to the
existence of the convection zone, the g modes have very low amplitudes at
photospheric levels, which makes the modes extremely hard to detect. In this
paper, we review the current state of play regarding attempts to detect g
modes. We review the theory of g modes, including theoretical estimation of the
g-mode frequencies, amplitudes and damping rates. Then we go on to discuss the
techniques that have been used to try to detect g modes. We review results in
the literature, and finish by looking to the future, and the potential advances
that can be made -- from both data and data-analysis perspectives -- to give
unambiguous detections of individual g modes. The review ends by concluding
that, at the time of writing, there is indeed a consensus amongst the authors
that there is currently no undisputed detection of solar g modes.Comment: 71 pages, 18 figures, accepted by Astronomy and Astrophysics Revie
Pancreatic enzyme replacement therapy in patients with pancreatic cancer: A national prospective study
Objective: UK national guidelines recommend pancreatic enzyme replacement therapy (PERT) in pancreatic cancer. Over 80% of pancreatic cancers are unresectable and managed in non-surgical units. The aim was to assess variation in PERT prescribing, determine factors associated with its use and identify potential actions to improve prescription rates. Design: RICOCHET was a national prospective audit of malignant pancreatic, peri-ampullary lesions or malignant biliary obstruction between April and August 2018. This analysis focuses on pancreatic cancer patients and is reported to STROBE guidelines. Multivariable regression analysis was undertaken to assess factors associated with PERT prescribing. Results: Rates of PERT prescribing varied among the 1350 patients included. 74.4% of patients with potentially resectable disease were prescribed PERT compared to 45.3% with unresectable disease. PERT prescription varied across surgical hospitals but high prescribing rates did not disseminate out to the respective referring network. PERT prescription appeared to be related to the treatment aim for the patient and the amount of clinician contact a patient has. PERT prescription in potentially resectable patients was positively associated with dietitian referral (p = 0.001) and management at hepaticopancreaticobiliary (p = 0.049) or pancreatic unit (p = 0.009). Prescription in unresectable patients also had a negative association with Charlson comorbidity score 5–7 (p = 0.045) or >7 (p = 0.010) and a positive association with clinical nurse specialist review (p = 0.028). Conclusion: Despite national guidance, wide variation and under-treatment with PERT exists. Given that most patients with pancreatic cancer have unresectable disease and are treated in non-surgical hospitals, where prescribing is lowest, strategies to disseminate best practice and overcome barriers to prescribing are urgently required
Concordance between nurse-reported quality of care and quality of care as publicly reported by nurse-sensitive indicators
A inclusão da violência na agenda da saúde: trajetória histórica The inclusion of violence in the health agenda: historical trajectory
Neste texto, busco sistematizar e registrar a trajetória histórica de legitimação do tema dos acidentes e da violência na área da saúde. Mostro que se trata de um processo inconcluso, que ocorre pela pressão de atores e pela força dos acontecimentos. Inicialmente o tema se inclui de forma reduzida, por meio dos conceitos de "acidentes, lesões e traumas". Já a partir da segunda metade do século 20, há a incorporação da pauta de direitos de vários sujeitos sociais, que vai desde a entrada da observação e notificação da violência contra crianças, mulheres e idosos, até a discussão da violência social, no seu sentido mais amplo, afetando a saúde das populações. No Brasil, esse processo, sem dúvida lento e intermitente, tem alguns logros e pioneirismos encenados pelo Ministério da Saúde, com a colaboração e a pressão de movimentos sociais, acadêmicos e profissionais: um documento de diagnóstico da situação de morbimortalidade por todos os tipos de violência; documento de uma Política Nacional de Redução de Acidentes e Violências e um Plano de Ação Nacional.<br>In this article, I seek to provide a systematic record of the historical trajectory of the inclusion of accidents and violence as a legitimate issue of the health area. It will be shown that the process is not concluded, and that it is going on under the pressure of actors and by force of the circumstances. In the beginning, the issue finds a restricted space in the health agenda through the concepts "accidents, injuries and traumas". Since the second half of the 20th century, the rights of different social subjects are incorporated, ranging from observation and notification of violent acts against children,women, the elderly, to the discussion of social violence in its broadest sense, affecting the health of populations. In Brazil, this doubtlessly slow and intermittent process shows some attempts and a pioneer action of the Ministry of Health, carried out in cooperation with and under pressure of social, academic and professional movements: a diagnosis of morbidity and mortality from all kinds of violence, documenting a national policy towards reduction of accidents and violence on national level