598 research outputs found

    Modelling the impact of extreme weather events on healthcare infrastructure using rich picture diagrams

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    Healthcare infrastructure for a community comprises not only its hospital but also many other related facilities such as primary care clinics, community health centres, rural nursing posts, aged care centres, etc. These facilities form a complex set of relationships which need to work collectively for an effective response to climatechange related extreme weather events such as floods and storms. The aim of this research is to develop a conceptual understanding of the dynamic relationships of hospital facilities before, during and after an extreme weather event. This is an essential step in framing a systems model that will assist facility managers to maintain critical healthcare infrastructure during an emergency. Rich Picture Diagrams (RPDs) were used to map relationships between critical healthcare infrastructure components such as the base hospital; access roads; aged care facilities and remotely located supplies. The rich information on the inter-organisational, system and governance complexities associated with responding to extreme weather events was obtained from three hospital case studies (two in Australia and one in New Zealand). The main finding of this research is that RPDs have considerable potential in the development of soft systems models which will assist decision takers involved in the design and management of healthcare infrastructure particularly in the context of extreme weather events. The soft systems methodology which underpins this research challenges the conventional view of what constitutes a ‘facility’ and consequently has important implications for those constructing and managing facilities

    The adaptive capacity of hospital facilities to cope with the risk of disasters caused by extreme weather events: a case study approach.

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    A three-year study is currently being conducted to determine the adaptive capacity of hospitals in Australia and New Zealand to cope with climate change-related extreme weather events. The primary objective of this research is to develop strategies that can be employed to improve the resilience of hospital facilities to these events. A case study approach was adopted to collect data through focus groups comprising participants who had experienced extreme weather events. Using risk and opportunity management methods, focus group workshop sessions were used as a structured approach to identify, assess and control the risks and opportunities associated with an extreme weather event scenario. The research findings indicate that there is considerable scope for clinical and non-clinical staff to work cooperatively in developing preventative as well as response and recovery strategies. The findings reinforce the view that the relationship between building users and building facilities needs to operate in an integrated fashion if any adaptive strategy is to be effective. This raises interesting governance issues which will be explored in future research

    Occupational Therapy in HomEcare Re-ablement Services (OTHERS): results of a feasibility randomised controlled trial

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    Objectives: The objective of this study was to test the feasibility of conducting a randomised controlled trial (RCT) of an intervention targeted at activities of daily living (ADL), delivered by an occupational therapist, in homecare reablement. Design: Feasibility parallel group RCT. Setting: Single-site local authority homecare reablement service. Participants: People referred for homecare reablement with ability to consent. Exclusion criteria were as follows: inability to speak English, receiving other community therapy services, needing two or more to assist transfer and receiving end-of-life care. Control: ‘Usual care’ was 6 weeks of homecare reablement delivered by social care workers (no routine health professional input). Intervention: A targeted ADL programme, delivered by an occupational therapist incorporating goal setting, teaching/practising techniques, equipment/adaptations and provision of advice/support. This was in addition to usual care. Outcome measures: Aspects of feasibility including eligibility, recruitment, intervention delivery, attrition and suitability and sensitivity of outcome measures. Participant outcomes were personal and extended ADL, quality of life, falls and use of health and social care services. Results: 30 participants were recruited, 15 to each arm, which was 60% of those eligible. Data from 22 (73%) were analysed at 6 months. Of the 15 participants, 13 (86%) received the intervention and were able to set one or more ADL goals. There were improvements from baseline in both groups, although overall improvements were greater in the occupational therapy (OT) intervention group. The biggest threat to feasibility was a change in service configuration during the trial, involving additional occupational therapy input, affecting usual care and recruitment. Conclusions: Despite the service reconfiguration, it was feasible to recruit and retain participants, deliver the intervention and collect outcome data that were responsive to change. The choice of primary outcome measure remains unclear. A further powered study is feasible and warranted; however, the design will require careful consideration because of ongoing national changes in service configurations

    Quasi-free Compton Scattering and the Polarizabilities of the Neutron

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    Differential cross sections for quasi-free Compton scattering from the proton and neutron bound in the deuteron have been measured using the Glasgow/Mainz tagging spectrometer at the Mainz MAMI accelerator together with the Mainz 48 cm ⊘\oslash ×\times 64 cm NaI(Tl) photon detector and the G\"ottingen SENECA recoil detector. The data cover photon energies ranging from 200 MeV to 400 MeV at θγLAB=136.2∘\theta^{LAB}_\gamma=136.2^\circ. Liquid deuterium and hydrogen targets allowed direct comparison of free and quasi-free scattering from the proton. The neutron detection efficiency of the SENECA detector was measured via the reaction p(γ,π+n)p(\gamma,\pi^+ n). The "free" proton Compton scattering cross sections extracted from the bound proton data are in reasonable agreement with those for the free proton which gives confidence in the method to extract the differential cross section for free scattering from quasi-free data. Differential cross sections on the free neutron have been extracted and the difference of the electromagnetic polarizabilities of the neutron have been obtained to be α−β=9.8±3.6(stat)12.1.1(syst)±2.2(model)\alpha-\beta= 9.8\pm 3.6(stat){}^{2.1}_1.1(syst)\pm 2.2(model) in units 10−4fm310^{-4}fm^3. In combination with the polarizability sum α+β=15.2±0.5\alpha +\beta=15.2\pm 0.5 deduced from photoabsorption data, the neutron electric and magnetic polarizabilities, αn=12.5±1.8(stat)−0.6+1.1±1.1(model)\alpha_n=12.5\pm 1.8(stat){}^{+1.1}_{-0.6}\pm 1.1(model) and βn=2.7∓1.8(stat)−1.1+0.6(syst)∓1.1(model)\beta_n=2.7\mp 1.8(stat){}^{+0.6}_{-1.1}(syst)\mp 1.1(model) are obtained. The backward spin polarizability of the neutron was determined to be γπ(n)=(58.6±4.0)×10−4fm4\gamma^{(n)}_\pi=(58.6\pm 4.0)\times 10^{-4}fm^4

    The reaction γp→π∘γ′p\gamma p \to \pi^\circ \gamma^\prime p and the magnetic dipole moment of the Δ+(1232)\Delta^+(1232) resonance

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    The reaction γp→π∘γ′p\gamma p \to \pi^\circ \gamma^\prime p has been measured with the TAPS calorimeter at the Mainz Microtron accelerator facility MAMI for energies between s\sqrt{s} = 1221--1331 MeV. Cross sections differential in angle and energy have been determined for all particles in the final state in three bins of the excitation energy. This reaction channel provides access to the magnetic dipole moment of the Δ+(1232)\Delta^{+}(1232) resonance and, for the first time, a value of μΔ+=(2.7−1.3+1.0(stat.)±1.5(syst.)±3(theo.))μN\mu_{\Delta^+} = (2.7_{-1.3}^{+1.0}(stat.) \pm 1.5 (syst.) \pm 3(theo.)) \mu_N has been extracted

    Photoproduction of eta-mesic 3He

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    The photoproduction of eta-mesic 3He has been investigated using the TAPS calorimeter at the Mainz Microtron accelerator facility MAMI. The total inclusive cross section for the reaction gamma+3He->eta+X has been measured for photon energies from threshold to 820 MeV. The total and angular differential coherent eta cross sections have been extracted up to energies of 745 MeV. A resonance-like structure just above the eta production threshold with an isotropic angular distribution suggests the existence of a resonant quasi-bound state. This is supported by studies of a competing decay channel of such a quasi-bound eta-mesic nucleus into pi^0+p+X. A binding energy of (-4.4+-4.2) MeV and a width of (25.6+-6.1) MeV is deduced for the quasi-bound eta-mesic state in 3He.Comment: v1: 4 pages, 4 figures, submitted to PRL; v2: minor revisions and corrections, new figure added, 4 pages, 5 figs; v3: minor change

    Upgrade of the Glasgow photon tagging spectrometer for Mainz MAMI-C

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    The Glasgow photon tagging spectrometer at Mainz has been upgraded so that it can be used with the 1500 MeV electron beam now available from the Mainz microtron MAMI-C. The changes made and the resulting properties of the spectrometer are discussed.Comment: 20 pages, 12 figure

    Excitations in the Halo Nucleus He-6 Following The Li-7(gamma,p)He-6 Reaction

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    A broad excited state was observed in 6-He with energy E_x = 5 +/- 1 MeV and width Gamma = 3 +/- 1 MeV, following the reaction Li-7(gamma,p)He-6. The state is consistent with a number of broad resonances predicted by recent cluster model calculations. The well-established reaction mechanism, combined with a simple and transparent analysis procedure confers considerable validity to this observation.Comment: 3 pages of LaTeX, 3 figures in PostScript, approved for publication in Phys. Rev. C, August, 200

    In-medium modifications of the ππ\pi\pi interaction in photon-induced reactions

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    Differential cross sections of the reactions (γ,π∘π∘)(\gamma,\pi^\circ\pi^\circ) and (γ,π∘π++π∘π−)(\gamma,\pi^\circ\pi^++\pi^\circ\pi^-) have been measured for several nuclei (1^1H,12^{12}C, and nat^{\rm nat}Pb) at an incident-photon energy of EγE_{\gamma}=400-460 MeV at the tagged-photon facility at MAMI-B using the TAPS spectrometer. A significant nuclear-mass dependence of the ππ\pi\pi invariant-mass distribution is found in the π∘π∘\pi^\circ\pi^\circ channel. This dependence is not observed in the π∘π+/−\pi^\circ\pi^{+/-} channel and is consistent with an in-medium modification of the ππ\pi\pi interaction in the II=JJ=0 channel. The data are compared to π\pi-induced measurements and to calculations within a chiral-unitary approach
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