Supporting research and development in ambulance services: research for better healthcare in prehospital settings

Background This paper discusses recent developments in research support for ambulance trusts in England and Wales and how this could be designed to lead to better implementation, collaboration in and initiation of high-quality research to support a truly evidence-based service. Method The National Ambulance Research Steering Group was set up in 2007 to establish the strategic direction for involvement of regional ambulance services in developing relevant and well-designed research for improving the quality of services to patients. Results Ambulance services have been working together and with academic partners to implement research and to participate, collaborate and lead the design of research that is relevant for patients and ambulance services. Conclusion New structures to support the strategic development of ambulance and prehospital research will help address gaps in the evidence for health interventions and service delivery in prehospital and ambulance care and ensure that ambulance services can increase their capacity and capability for high-quality research

The degradation of alzak by short wavelength ultraviolet radiation

The changes in reflectance of thermal aluminum coating samples exposed to different irradiating utraviolet wavelengths are discussed. It is shown that the coating is damaged faster and further by 180 to 210 in radiation than by Lyman alpha radiation. On an equivalent incident energy basis, Lyman alpha does less damage than 180 to 210 nm radiation. Above 300 nm no degradation is observed for long exposures and below 300 nm increasing degradation with decreasing wavelength is found. It is concluded that Lyman alpha radiation need not be included in laboratory testing of this thermal coating for spacecraft structures

Evaluating the Methodology and Clinical Utility of Spatial Access to Health Care Measures in Appalachia.

The Appalachia region of the U.S. has noted socioeconomic disparities, elevated rates and mortality for many cancers, and substandard cancer treatment patterns. These disparities, combined with Appalachia’s largely rural population, suggest that the region has reduced access to health care. This research investigated the methodology behind spatial access to healthcare using population-based clinical data and geographic information systems (GIS) software. The dissertation’s goal was to provide a guide of the latest spatial access methods in Appalachia and to demonstrate how those methods can be incorporated into models studying cancer disparities in the region. Accredited mammography centers and primary care physicians in 2008 from Pennsylvania, Ohio, Kentucky, and North Carolina, along with U.S. Census population data, were geocoded into GIS software. Methods compared included ratios of mammography centers and physicians to county populations, travel time to closest mammography centers and physicians, and several versions of the newer two-step floating catchment area (2SFCA) method, which has never been evaluated in Appalachia. As a measure of predictive validity, spatial access methods were then used to predict two important breast cancer clinical indicators: stage at diagnosis and receipt of adjuvant hormonal therapy after a qualifying surgery. Urban and non-Appalachia areas had consistently shorter travel times than the rural and Appalachia areas of the same states, across both travel times to mammography centers and primary care physicians. The 2SFCA measures that included variable catchment sizes appeared distinct from the original 2SFCA method and 2SFCA methods that included distance decay weights but no variable catchments. Predictors of late-stage breast cancer diagnosis included age, insurance status, county primary care to population ratio, and primary care 2SFCA score. Geographically weighted logistic regression revealed that the effect of the predictor variables varied throughout the study region. Predictors of adjuvant hormonal therapy included the presence of multiple diseases, county economic status, and mammography center 2SFCA score. Overall, the 2SFCA method with variable catchment sizes offered the greatest predictive validity of the access measures and offers theoretical improvements over the other access to care measures. Nonetheless, further research is needed to validate the 2SFCA method parameters with patient healthcare utilization data.PhDBioinformaticsUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111545/1/joedonoh_1.pd

Travelling to and attending major sporting events: determinants of total spend and trip duration decisions

The global growth of sport and major sporting events as tourism and mass entertainment in both single and multi sport formats has prompted the desire for a greater understanding of event attendees and the implications of their motivations and decisions to travel and attend major sporting events. However, research into major sporting events has generally focused on the Olympic Games and/or attendance of a single major sporting event. Currently, the major sporting event community sees the value of measuring the economic impact of major sporting events but do not understand the decisions taken by individuals that travel to and attend major sporting events due to the lack of research in the area. Thus, more robust and comprehensive research needs to be carried out to improve the understanding of individuals that travel to and attend a range of major sporting events. The purpose of this research was to develop a better understanding of the total spend and trip duration decisions of individuals that travel to and attend major sporting events with commercial companies. The research used a positivist quantitative strategy to empirically assess research questions surrounding repeat major sporting event attendance, motivations for major sporting event attendance, variables affecting total spending and trip duration decisions and relationships the between motivations, trip duration and total spending, and to econometrically model findings. Independent variables for analysis were identified through a review of literature, which informed the construction of both a conceptual model and online survey focusing on demographics, event related motivations, major sporting event profile and sporting involvement. Variable-based data collected from individual respondents on nine different major sporting events then underwent a two stage descriptive and statistical analysis. The descriptive analysis consisted of a quantitative breakdown of survey results and the statistical analysis allowed the data to be econometrically modeled and assessed through regression analysis. The research provided significant findings towards understanding the decisions taken by individuals that travel to and attend major sporting events and in doing so led to a greater understanding of total spend and trip duration decisions. Findings indicated that the demographic variables and event related motivations determined total spend decisions whilst demographic variables, event related motivations and major sporting event profile variables determined trip duration decisions. Directly implicated in these findings were relevant key variables for commercial companies to consider in the packaging and sale of major event sport travel to an existing and committed customer base. Furthermore, the results can be extended and applied to populations within a broader sport event community such as managers, planners and evaluators to enhance the economic impact of major sporting events through a better understanding of event attendees

Controls on the width of tropical precipitation and its contraction under global warming

AD and ARA were funded by the National Science Foundation Paleo Perspective on Climate Change (P2C2) Grant number AGS-1702827.Climate models robustly and unanimously simulate narrowing of the intense tropical precipitation under greenhouse gas forcing. We argue that the meridional width of tropical precipitation is controlled by the seasonal meridional range of the intertropical convergence zone (ITCZ). The contraction of tropical precipitation under greenhouse forcing results from a reduced seasonal range of ITCZ migration. An energetic theory -- similar to the energetic theory for ITCZ shifts based on the hemispheric contrast of energy input to the atmosphere-- is developed. The meridional width of tropical precipitation is proportional to the seasonal range of the inter-hemispheric contrast in atmospheric heating divided by the efficiency of atmospheric cross-equatorial heat transport. Climate models are biased toward overly expansive tropical precipitation resulting from an exaggerated seasonal atmospheric heating. The robust contraction of tropical precipitation under global warming results from increased efficiency of inter-hemispheric energy transport consistent with enhanced gross moist stability of the tropical atmosphere.Publisher PDFPeer reviewe

Dynamics of Vortex Core Switching in Ferromagnetic Nanodisks

Dynamics of magnetic vortex core switching in nanometer-scale permalloy disk, having a single vortex ground state, was investigated by micromagnetic modeling. When an in-plane magnetic field pulse with an appropriate strength and duration is applied to the vortex structure, additional two vortices, i.e., a circular- and an anti-vortex, are created near the original vortex core. Sequentially, the vortex-antivortex pair annihilates. A spin wave is created at the annihilation point and propagated through the entire element; the relaxed state for the system is the single vortex state with a switched vortex core.Comment: to appear in Appl. Phys. Let

A method of mounting multiple otoliths for beam-based microchemical analyses

Beam-based analytical methods are widely used to measure the concentrations of elements and isotopes in otoliths. These methods usually require that otoliths be individually mounted and prepared to properly expose the desired growth region to the analytical beam. Most analytical instruments, such as LA-ICPMS and ion and electron microprobes, have sample holders that will accept only one to six slides or mounts at a time. We describe a method of mounting otoliths that allows for easy transfer of many otoliths to a single mount after they have been prepared. Such an approach increases the number of otoliths that can be analyzed in a single session by reducing the need open the sample chamber to exchange slides—a particularly time consuming step on instruments that operate under vacuum. For ion and electron microprobes, the method also greatly reduces the number of slides that must be coated with an electrical conductor prior to analysis. In this method, a narrow strip of cover glass is first glued at one end to a standard microscope slide. The otolith is then mounted in thermoplastic resin on the opposite, free end of the strip. The otolith can then be ground and flipped, if needed, by reheating the mounting medium. After otolith preparation is complete, the cover glass is cut with a scribe to free the otolith and up to 20 small otoliths can be arranged on a single petrographic slide

Pressure Tuning of the Charge Density Wave in the Halogen-Bridged Transition-Metal (MX) Solid Pt2Br6(NH3)4Pt_2Br_6(NH_3)_4

We report the pressure dependence up to 95 kbar of Raman active stretching modes in the quasi-one-dimensional MX chain solid $Pt_2Br_6(NH_3)_4$. The data indicate that a predicted pressure-induced insulator-to-metal transition does not occur, but are consistent with the solid undergoing either a three-dimensional structural distortion, or a transition from a charge-density wave to another broken-symmetry ground state. We show that such a transition cacan be well-modeled within a Peierls-Hubbard Hamiltonian. 1993 PACS: 71.30.+h, 71.45.Lr, 75.30.Fv, 78.30.-j, 81.40.VwComment: 4 pages, ReVTeX 3.0, figures available from the authors on request (Gary Kanner, [email protected]), to be published in Phys Rev B Rapid Commun, REVISION: minor typos corrected, LA-UR-94-246