An ageing nursing workforce

There are well documented workforce shortages in nursing. Many strategies have been suggested to resolve the issue, including increasing migration or training places, changing skill mix or nurses' roles, redesigning nursing work, and greater use of unregulated or unlicensed workers. One of the contributing and growing factors is the ageing of the workforce, but methods of retaining older employees have been given very little attention. This paper examines the impact of ageing on individuals, the ageing nursing workforce and the implications for government policy given its current status. © 2010 AHHA

THE ROLE OF TIP LEAKAGE FLOW IN SPIKE-TYPE ROTATING STALL INCEPTION

This paper describes the role of tip leakage flow in creating the leading edge separation necessary for onset of spike-type compressor rotating stall. A series of unsteady multi-passage simulations, supported by experimental data, are used to define and illustrate the two competing mechanisms that cause the high incidence responsible for this separation: blockage from a casing-suction-surface corner separation and forward spillage of the tip leakage jet. The axial momentum flux in the tip leakage flow determines which mechanism dominates. At zero tip clearance, corner separation blockage dominates. As clearance is increased, the leakage flow reduces blockage, moving the stall flow coefficient to lower flow, i.e. giving a larger unstalled flow range. Increased clearance, however, means increased leakage jet momentum and contribution to leakage jet spillage. There is thus a clearance above which jet spillage dominates in creating incidence, so the stall flow coefficient increases and flow range decreases with clearance. As a consequence there is a clearance for maximum flow range; for the two rotors in this study, the value was approximately 0.5% chord. The chord-wise distribution of the leakage axial momentum is also important in determining stall onset. Shifting the distribution towards the trailing edge increases flow range for a leakage jet dominated geometry and reduces flow range for a corner separation dominated geometry. Guidelines are developed for flow range enhancement through control of tip leakage flow axial momentum magnitude and distribution. An example is given of how this might be achieved.Mitsubishi Heavy Industries, Ltd

A note on the use of sensitivity analysis to explore the potential impact of declining institutional care utilisation on disability prevalence

Many health and disability surveys are conducted using the non-institutionalised population as a sampling frame. Consequently, it is possible that changes in the utilisation of institutional care could account for all or part of any change in the observed prevalence of functional limitation, disability or other health state, based on samples from the non-institutionalised population. Using conditional probability arguments, I present an adjustment formula for computing health state prevalences for the non-institutionalised population under a scenario in which health state prevalences are held constant except for movement into the non-institutionalised population of individuals who would formerly have been in institutional care. By comparing the adjusted prevalence with observed non-institutionalised health state prevalences the contribution of changes in institutionalisation to observed changes in the non-institutionalised health state prevalence can be assessed

A new species of Dermopristis Kearn, Whittington & Evans-Gowing, 2010 (Monogenea: Microbothriidae), with observations on associations between the gut diverticula and reproductive system and on the presence of denticles in the nasal fossae of the host Glaucostegus typus (Bennett) (Elasmobranchii: Rhinobatidae)

Dermopristis cairae n. sp. (Microbothriidae) is described from the skin and possibly from the nasal fossae of the giant shovelnosed ray Glaucostegus typus (Bennett). The new species is distinguished from D. paradoxus Kearn, Whittington & Evans-Gowing, 2010 by its larger size, body shape, lack of transverse ridges on the ventral surface and absence of a seminal receptacle. Extensive short gut branches lie dorsal to the testes and adjacent to the coiled region of the vas deferens and the oo¨type, possibly reflecting high metabolic demand in these areas. Denticles are present in the lining of the nasal fossae of G. typus, providing a firm substrate for the cement-based attachment of a microbothriid. However, confirmation that D. cairae inhabits the nasal fossae of G. typus is required

Potential use of oxygen as a metabolic biosensor in combination with T2*-weighted MRI to define the ischemic penumbra

We describe a novel magnetic resonance imaging technique for detecting metabolism indirectly through changes in oxyhemoglobin:deoxyhemoglobin ratios and T2* signal change during ‘oxygen challenge’ (OC, 5 mins 100% O2). During OC, T2* increase reflects O2 binding to deoxyhemoglobin, which is formed when metabolizing tissues take up oxygen. Here OC has been applied to identify tissue metabolism within the ischemic brain. Permanent middle cerebral artery occlusion was induced in rats. In series 1 scanning (n=5), diffusion-weighted imaging (DWI) was performed, followed by echo-planar T2* acquired during OC and perfusion-weighted imaging (PWI, arterial spin labeling). Oxygen challenge induced a T2* signal increase of 1.8%, 3.7%, and 0.24% in the contralateral cortex, ipsilateral cortex within the PWI/DWI mismatch zone, and ischemic core, respectively. T2* and apparent diffusion coefficient (ADC) map coregistration revealed that the T2* signal increase extended into the ADC lesion (3.4%). In series 2 (n=5), FLASH T2* and ADC maps coregistered with histology revealed a T2* signal increase of 4.9% in the histologically defined border zone (55% normal neuronal morphology, located within the ADC lesion boundary) compared with a 0.7% increase in the cortical ischemic core (92% neuronal ischemic cell change, core ADC lesion). Oxygen challenge has potential clinical utility and, by distinguishing metabolically active and inactive tissues within hypoperfused regions, could provide a more precise assessment of penumbra

Nanoencapsulation of phase change materials for advanced thermal energy storage systems

A review focusing on phase change materials for thermal energy storage, particularly their nanoencapsulation, and insight into future research possibilities.</p

Disease flare of ankylosing spondylitis presenting as reactive arthritis with seropositivity: a case report

<p>Abstract</p> <p>Introduction</p> <p>Concurrent rheumatoid factor seropositivity is occasionally detected in ankylosing spondylitis and often causes confusion in clinical routine. Overlap between various seronegative arthritides is a known but uncommon association. Differentiation of spondyloarthropathy from rheumatoid arthritis is important, since the natural history, complications, treatments and prognosis of the two diseases differ significantly.</p> <p>Case presentation</p> <p>Here, we report the case of a 47-year-old Sri Lankan man who had a long history of intermittent joint pains worsening following a recent episode of self-resolving non-bloody diarrhea. Subsequently, he developed a skin rash suggestive of keratoderma blenorrhagica and circinate balanitis. He had classical radiological evidence of ankylosing spondylosis (previously undiagnosed) associated with human leukocyte antigen B27 antigen, but was positive for rheumatoid factor.</p> <p>Conclusions</p> <p>A disease flare of ankylosing spondylitis prompted by a minor diarrheal illness showing well documented features of reactive arthritis is remarkable. The prognostic implications of seropositivity in spondyloarthritis are discussed.</p