Infection control and changing health-care delivery systems.

In the past, health care was delivered mainly in acute-care facilities. Today, health care is delivered in hospital, outpatient, transitional care, long-term care, rehabilitative care, home, and private office settings. Measures to reduce health-care costs include decreasing the number of hospitals and the length of patient stays, increasing outpatient and home care, and increasing long-term care for the elderly. The home-care industry and managed care have become major providers of health care. The role of specialists in health-care epidemiology has changed accordingly

The environment and host haloes of the brightest z~6 Lyman-break galaxies

By studying the large-scale structure of the bright high-redshift Lyman-break galaxy (LBG) population it is possible to gain an insight into the role of environment in galaxy formation physics in the early Universe. We measure the clustering of a sample of bright (-22.7<M_UV<-21.125) LBGs at z~6 and use a halo occupation distribution (HOD) model to measure their typical halo masses. We find that the clustering amplitude and corresponding HOD fits suggests that these sources are highly biased (b~8) objects in the densest regions of the high-redshift Universe. Coupled with the observed rapid evolution of the number density of these objects, our results suggest that the shape of high luminosity end of the luminosity function is related to feedback processes or dust obscuration in the early Universe - as opposed to a scenario where these sources are predominantly rare instances of the much more numerous M_UV ~ -19 population of galaxies caught in a particularly vigorous period of star formation. There is a slight tension between the number densities and clustering measurements, which we interpret this as a signal that a refinement of the model halo bias relation at high redshifts or the incorporation of quasi-linear effects may be needed for future attempts at modelling the clustering and number counts. Finally, the difference in number density between the fields (UltraVISTA has a surface density ~1.8 times greater than UDS) is shown to be consistent with the cosmic variance implied by the clustering measurements.Comment: 19 pages, 8 figures, accepted MNRAS 23rd March 201

Soil hardpans and plant growth

When farm vehicles travel over moist soils they can create hardpans which can marledly reduce crop and pasture yields. Research at Wongan Hills Research Station has shown that plant growth and nutrient uptake were affected for at least eight years after the original workings caused the hardpan

Climate-driven Shifts in Quantity and Seasonality of River Discharge over the past 1000 Years from the Hydrographic Apex of North America

Runoff generated from high elevations is the primary source of freshwater for western North America, yet this critical resource is managed on the basis of short instrumental records that capture an insufficient range of climatic conditions. Here we probe the effects of climate change over the past ~1000 years on river discharge in the upper Mackenzie River system based on paleoenvironmental information from the Peace-Athabasca Delta. The delta landscape responds to hydroclimatic changes with marked variability, while Lake Athabasca level appears to directly monitor overall water availability. The latter fluctuated systematically over the past millennium, with the highest levels occurring in concert with maximum glacier extent during the Little Ice Age, and the lowest during the 11th century, prior to medieval glacier expansion. Recent climate-driven hydrological change appears to be on a trajectory to even lower levels as high-elevation snow and glacier meltwater contributions both continue to decline

Direct Detection of Products from the Pyrolysis of 2-Phenethyl Phenyl Ether

The pyrolysis of 2-phenethyl phenyl ether (PPE, C_6H_5C_2H_4OC_6H_5) in a hyperthermal nozzle (300-1350 °C) was studied to determine the importance of concerted and homolytic unimolecular decomposition pathways. Short residence times (<100 μs) and low concentrations in this reactor allowed the direct detection of the initial reaction products from thermolysis. Reactants, radicals, and most products were detected with photoionization (10.5 eV) time-of-flight mass spectrometry (PIMS). Detection of phenoxy radical, cyclopentadienyl radical, benzyl radical, and benzene suggest the formation of product by the homolytic scission of the C_6H_5C_2H_4-OC_6H_5 and C_6H_5CH_2-CH_2OC_6H_5 bonds. The detection of phenol and styrene suggests decomposition by a concerted reaction mechanism. Phenyl ethyl ether (PEE, C_6H_5OC_2H_5) pyrolysis was also studied using PIMS and using cryogenic matrix-isolated infrared spectroscopy (matrix-IR). The results for PEE also indicate the presence of both homolytic bond breaking and concerted decomposition reactions. Quantum mechanical calculations using CBS-QB3 were conducted, and the results were used with transition state theory (TST) to estimate the rate constants for the different reaction pathways. The results are consistent with the experimental measurements and suggest that the concerted retro-ene and Maccoll reactions are dominant at low temperatures (below 1000 °C), whereas the contribution of the C_6H_5C_2H_4-OC_6H_5 homolytic bond scission reaction increases at higher temperatures (above 1000 °C)

Contact of Single Asperities with Varying Adhesion: Comparing Continuum Mechanics to Atomistic Simulations

Atomistic simulations are used to test the equations of continuum contact mechanics in nanometer scale contacts. Nominally spherical tips, made by bending crystals or cutting crystalline or amorphous solids, are pressed into a flat, elastic substrate. The normal displacement, contact radius, stress distribution, friction and lateral stiffness are examined as a function of load and adhesion. The atomic scale roughness present on any tip made of discrete atoms is shown to have profound effects on the results. Contact areas, local stresses, and the work of adhesion change by factors of two to four, and the friction and lateral stiffness vary by orders of magnitude. The microscopic factors responsible for these changes are discussed. The results are also used to test methods for analyzing experimental data with continuum theory to determine information, such as contact area, that can not be measured directly in nanometer scale contacts. Even when the data appear to be fit by continuum theory, extracted quantities can differ substantially from their true values

Expanding e-MERLIN with the Goonhilly Earth Station

A consortium of universities has recently been formed with the goal of using the decommissioned telecommunications infrastructure at the Goonhilly Earth Station in Cornwall, UK, for astronomical purposes. One particular goal is the introduction of one or more of the ~30-metre parabolic antennas into the existing e-MERLIN radio interferometer. This article introduces this scheme and presents some simulations which quantify the improvements that would be brought to the e-MERLIN system. These include an approximate doubling of the spatial resolution of the array, an increase in its N-S extent with strong implications for imaging the most well-studied equatorial fields, accessible to ESO facilities including ALMA. It also increases the overlap between the e-MERLIN array and the European VLBI Network. We also discuss briefly some niche science areas in which an e-MERLIN array which included a receptor at Goonhilly would be potentially world-leading, in addition to enhancing the existing potential of e-MERLIN in its role as a Square Kilometer Array pathfinder instrument.Comment: 7 pages, 3 figures, to appear in the proceedings of "Astronomy with megastructures: Joint science with the E-ELT and SKA", 10-14 May 2010, Crete, Greece (Eds: Isobel Hook, Dimitra Rigopoulou, Steve Rawlings and Aris Karastergiou

The value of routine histopathological examination of appendicectomy specimens

<p>Abstract</p> <p>Background</p> <p>Appendicectomy specimens removed from patients with suspected acute appendicitis often appear macroscopically normal but histopathological analysis of these cases may reveal a more sinister underlying pathology. We evaluated histopathological reports of 1225 appendicectomy specimens at the Norfolk and Norwich University Hospital (NNUH) over the past three years.</p> <p>Methods</p> <p>Histopathology reports for all appendices analysed at the NNUH between March 2003 and March 2006 were reviewed by examination of the case notes. The analysis focussed on the confirmation of acute appendicitis, incidental unexpected incidental findings other than inflammation, whether these abnormalities were suspected on gross examination at the time of surgery, and the effect on patient management and prognosis.</p> <p>Results</p> <p>The histopathology reports disclosed a variety of abnormal incidental lesions. Of the 1225 specimens, 46 (3.75%) revealed abnormal diagnoses other than inflammatory changes. Twenty-four (1.96%) of these were clinically significant and affected further patient management. Only two of these (0.16%) were suspected on macroscopic examination intra-operatively.</p> <p>Conclusion</p> <p>Twenty-four of the 1225 specimens (1.96%) had an impact on patient management or outcome and were not suspected on macroscopic examination at the time of surgery. These would have been missed had the specimens not been examined microscopically. The intra-operative diagnosis of the surgeon is therefore unreliable in detecting abnormalities of the appendix. This study supports the sending of all appendicectomy specimens for routine histopathological examination.</p

Vancomycin-resistant enterococci outside the health-care setting: prevalence, sources, and public health implications.

Although nosocomial acquisition and subsequent colonization of vancomycin-resistant enterococci (VRE), an emerging international threat to public health, has been emphasized in the United States, colonization among nonhospitalized persons has been infrequently documented. In contrast, in Europe, colonization appears to occur frequently in persons outside the health-care setting. An important factor associated with VRE in the community in Europe has been avoparcin, a glycopeptide antimicrobial drug used for years in many European nations at subtherapeutic doses as a growth promoter in food-producing animals. In Europe, evidence suggests that foodborne VRE may cause human colonization. Although avoparcin has never been approved for use in the United States, undetected community VRE transmission may be occurring at low levels. Further studies of community transmission of VRE in the United States are urgently needed. If transmission with VRE from unrecognized community sources can be identified and controlled, increased incidence of colonization and infection among hospitalized patients may be prevented

Goonhilly: a new site for e-MERLIN and the EVN

The benefits for the e-MERLIN and EVN arrays of using antennae at the satellite communication station at Goonhilly in Cornwall are discussed. The location of this site - new to astronomy - will provide an almost equal distribution of long baselines in the east-west- and north-south directions, and opens up the possibility to get significantly improved observations of equatorial fields with e-MERLIN. These additional baselines will improve the sensitivity on a set of critical spatial scales and will increase the angular resolution of e-MERLIN by a factor of two. e-MERLIN observations, including many allocated under the e-MERLIN Legacy programme, will benefit from the enhanced angular resolution and imaging capability especially for sources close to or below the celestial equator (where ESO facilities such as ALMA will operate) of including the Goonhilly telescopes. Furthermore, the baselines formed between Goonhilly and the existing stations will close the gap between the baselines of e-MERLIN and those of the European VLBI Network (EVN) and therefore enhance the legacy value of e-MERLIN datasets.Comment: 10 pages, 2 figue