Early changes in gradation styles and rates on Mars

The wide annulus of massifs and knobs of Isidis and Argyre provided sufficiently large areas for meaningful crater statistics of large craters. Counts were made over adjacent and nested areas in order to test consistency and to derive relative age of each basin. Within the Isidis annulus, charateristic terrains provided counting areas for dating contrasting surface process: channeled hummocky terrain, etched terrains, and intermassif channeled plains. The channeled hummocky terrain contains a high channel density of narrow valley networks cutting both primary Isidis features and old craters. The etched terrains represent a broad region outside the inner high relief massifs of southwestern Isidis where numerous irregular plateaus, mesas, and relict craters indicate a different style of erosion. The intermassif channeled plains occur along the inner mountainous ring. Shallow meandering channels form a large integrated drainage system that is linked to numerous smaller intermountainous basins. These ponds and interconnected tributaries extend beyond the primary inner massif ring through broad canyons

Aerothermodynamic Assessment of Corrugated Panel Thermal Protection Systems

The feasibility of using corrugated panels as a thermal protection system for an advanced space transportation vehicle was investigated. The study consisted of two major tasks: development of improved correlations for wind tunnel heat transfer and pressure data to yield design techniques, and application of the design techniques to determine if corrugated panels have application future aerospace vehicles. A single-stage-to-orbit vehicle was used to assess advantages and aerothermodynamic penalties associated with use of such panels. In the correlation task, experimental turbulent heat transfer and pressure data obtained on corrugation roughened surfaces during wind tunnel testing were analyzed and compared with flat plate data. The correlations and data comparisons included the effects of a large range of geometric, inviscid flow, internal boundary layer, and bulk boundary layer parameters in supersonic and hypersonic flow

Source of the optical red-slope in iron-rich meteorites

The relationship between ordinary chondrites and S-type asteroids is an unresolved issue in meteorite science. S-type asteroids exhibit a positively red-sloped spectrum that is interpreted to indicate the presence of elemental iron on the surfaces. The characteristic red-sloped spectrum of iron-rich meteorites is produced by only the specular component of the reflectance. Complex metallic surfaces can be modeled as linear mixtures of specular and nonspecular components. It is the geometry of the metal on a surface and its interaction with surrounding material, rather than the absolute amount of metal, that determine the redness of resulting spectra. In order to distinguish between ordinary chondrite and differentiated parent bodies it is important to understand how regolith processes affect the nature and form of metal on asteroid surfaces

To what extent do therapists in adult psychiatry involve the children of mentally ill patients?

The aim and scope of this study was to examine to what extent the mentally ills’ therapists involve children. Nine therapists from the psychiatric policlinic at the hospital in Namsos, Norway were interviewed. The selection of interviewees was done in order to ensure representation across the complete range of professions involved. An interview guide consisting of 12 pertinent questions was developed and employed. The results show that the informants claimed there were no known procedures for exploring the children’s situation. All of the therapists reported that the sick parent(s) had brought up their personal concerns for their children in the course of treatment. Five of the informants confirmed that they had at times invited the children to participate in conversations with their parents. Only two of these had done this more than once. The explanation for why children are so seldom involved can be stringent environmental control factors, uncertainties, fear of generated increased workload, or of undertaking a more complex treatment process. Perhaps treatment in adult psychiatry is primarily focused on the mentally ill target person alone. It seems that it’s socially unacceptable to examine children’s circumstances in the course of treatment

Video Consultation Use by Australian General Practitioners: Video Vignette Study

Background: There is unequal access to health care in Australia, particularly for the one-third of the population living in remote and rural areas. Video consultations delivered via the Internet present an opportunity to provide medical services to those who are underserviced, but this is not currently routine practice in Australia. There are advantages and shortcomings to using video consultations for diagnosis, and general practitioners (GPs) have varying opinions regarding their efficacy. Objective: The aim of this Internet-based study was to explore the attitudes of Australian GPs toward video consultation by using a range of patient scenarios presenting different clinical problems. Methods: Overall, 102 GPs were invited to view 6 video vignettes featuring patients presenting with acute and chronic illnesses. For each vignette, they were asked to offer a differential diagnosis and to complete a survey based on the theory of planned behavior documenting their views on the value of a video consultation.Results: A total of 47 GPs participated in the study. The participants were younger than Australian GPs based on national data, and more likely to be working in a larger practice. Most participants (72%-100%) agreed on the differential diagnosis in all video scenarios. Approximately one-third of the study participants were positive about video consultations, one-third were ambivalent, and one-third were against them. In all, 91% opposed conducting a video consultation for the patient with symptoms of an acute myocardial infarction. Inability to examine the patient was most frequently cited as the reason for not conducting a video consultation. Australian GPs who were favorably inclined toward video consultations were more likely to work in larger practices, and were more established GPs, especially in rural areas. The survey results also suggest that the deployment of video technology will need to focus on follow-up consultations. Conclusions: Patients with minor self-limiting illnesses and those with medical emergencies are unlikely to be offered access to a GP by video. The process of establishing video consultations as routine practice will need to be endorsed by senior members of the profession and funding organizations. Video consultation techniques will also need to be taught in medical schools

The Surgical Nosology In Primary-care Settings (SNIPS): a simple bridging classification for the interface between primary and specialist care

BACKGROUND: The interface between primary care and specialist medical services is an important domain for health services research and policy. Of particular concern is optimising specialist services and the organisation of the specialist workforce to meet the needs and demands for specialist care, particularly those generated by referral from primary care. However, differences in the disease classification and reporting of the work of primary and specialist surgical sectors hamper such research. This paper describes the development of a bridging classification for use in the study of potential surgical problems in primary care settings, and for classifying referrals to surgical specialties. METHODS: A three stage process was undertaken, which involved: (1) defining the categories of surgical disorders from a specialist perspective that were relevant to the specialist-primary care interface; (2) classifying the 'terms' in the International Classification of Primary Care Version 2-Plus (ICPC-2 Plus) to the surgical categories; and (3) using referral data from 303,000 patient encounters in the BEACH study of general practice activity in Australia to define a core set of surgical conditions. Inclusion of terms was based on the probability of specialist referral of patients with such problems, and specialists' perception that they constitute part of normal surgical practice. RESULTS: A four-level hierarchy was developed, containing 8, 27 and 79 categories in the first, second and third levels, respectively. These categories classified 2050 ICPC-2 Plus terms that constituted the fourth level, and which covered the spectrum of problems that were managed in primary care and referred to surgical specialists. CONCLUSION: Our method of classifying terms from a primary care classification system to categories delineated by specialists should be applicable to research addressing the interface between primary and specialist care. By describing the process and putting the bridging classification system in the public domain, we invite comment and application in other settings where similar problems might be faced

Children´s Forum: an Interview with Eight Children

Objective. Childrens forum (CF) is a session for information and inquiry for children between the ages of 2 and 18 whose parents are in-patients at the psychiatric ward. The aim and scope of this study was to investigate the usefulness of CF for the children, six to eight months after participating. Method. Eight children, ages 10 – 16 were interviewed. All of the interviews (semi-structured and theme-oriented) were done in the family’s home without the parent (s) being present. Results. The results showed considerable improvement in the areas of communication and relational skills between parent and child. Conclusion. The improvements that have taken place can be directly linked to the CF program content: the acquisition of knowledge, vocabulary, and concepts along with skills in the ability to apply their new insights in communication about taboo-laden topics

S = 3 Ground State for a Tetranuclear Mn^(IV)₄O₄ Complex Mimicking the S₃ State of the Oxygen Evolving Complex

The S₃ state is currently the last observable intermediate prior to O–O bond formation at the oxygen-evolving complex (OEC) of Photosystem II, and its electronic structure has been assigned to a homovalent Mn^(IV)₄ core with an S = 3 ground state. While structural interpretations based on the EPR spectroscopic features of the S₃ state provide valuable mechanistic insight, corresponding synthetic and spectroscopic studies on tetranuclear complexes mirroring the Mn oxidation states of the S₃ state remain rare. Herein, we report the synthesis and characterization by XAS and multifrequency EPR spectroscopy of a Mn^(IV)₄O₄ cuboidal complex as a spectroscopic model of the S₃ state. Results show that this Mn^(IV)₄O₄ complex has an S = 3 ground state with isotropic ⁵⁵Mn hyperfine coupling constants of −75, −88, −91, and 66 MHz. These parameters are consistent with an αααβ spin topology approaching the trimer–monomer magnetic coupling model of pseudo-octahedral Mn^(IV) centers. Importantly, the spin ground state changes from S = 1/2 to S = 3 as the OEC is oxidized from the S₂ state to the S₃ state. This same spin state change is observed following oxidation of the previously reported Mn^(III)Mn^(IV)₃O₄ cuboidal complex to the Mn^(IV)₄O₄ complex described here. This sets a synthetic precedent for the observed low-spin to high-spin conversion in the OEC

Where there is no surgeon: the effect of specialist proximity on general practitioners' referral rates

Objective: To determine the effect of proximity of surgical specialists on general practitioners' (GPs') rates of referral of surgical problems to specialist care (ie, are surgical referral rates of GPs in rural or remote areas similar to those of GPs in urban centres?). Design: A cross-sectional survey of GPpatient encounters. Setting: The Bettering the Evaluation and Care of Health (BEACH) program, which involves all active registered GPs in Australia. Participants: A random sample of 3030 GPs, each providing details of 100 consecutive patient encounters. Main outcome measures: Proportion of surgical problems (including ophthalmological and obstetric and gynaecological) referred to surgical specialists (surgeons' rooms, hospital outpatient departments or hospital emergency departments). Results: Absence of a local specialist did not significantly influence the proportion of surgical problems referred by GPs overall, but the proportion referred was significantly lower for obstetric (odds ratio [OR], 0.56; 95% CI, 0.440.70) and ophthalmological (OR, 0.60; 95% CI, 0.490.73) problems. Other factors independently associated with referral of a lower proportion of problems included male GPs, female and younger patients, holders of a Health Care Card, injury-related and non-cancer-related problems, follow-up presentations, and more than one problem managed at an encounter. Conclusions: Our findings confirm that rural and remote GPs undertake much of their patients' antenatal care, and are less likely to use specialists when managing ophthalmological problems. Absence of local specialists in other surgical specialties is not a barrier to referral of patients with surgical disorders