32 research outputs found
HVOF-Deposited WCCoCr as Replacement for Hard Cr in Landing Gear Actuators
WCCoCr coatings deposited by HVOF can replace hard Cr on landing gear components. Powders with two different WC particle sizes (micro and nano-) and geometries have been employed to study the effects on the coatingâs properties. Moreover, coatings produced employing two sets of parameters resulting in high and low flame temperatures have been evaluated. Minor differences in microstructure and morphology were observed for the two powders employing the same spraying parameters, but the nano-sized powder exhibited a higher spraying efficiency. However, more significant microstructural changes result when the low- and high-energy spray parameters are used. Moreover, results of various tests which include adhesion, wear, salt fog corrosion resistance, liquid immersion, and axial fatigue strength, indicate that the coatings produced with high-energy flame are similar in behavior. On the other hand, the nanostructured low-energy flame coating exhibited a significantly lower salt fog corrosion resistanc
Self-management support interventions for stroke survivors: a systematic meta-review
There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients.Systematic meta-review of the evidence for self-management support interventions with stroke survivors to inform provision of healthcare services.We searched MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, BNI, Database of Abstracts of Reviews for Effectiveness, and Cochrane Database of Systematic Reviews for systematic reviews of self-management support interventions for stroke survivors. Quality was assessed using the R-AMSTAR tool, and data extracted using a customised data extraction form. We undertook a narrative synthesis of the reviews' findings.From 12,400 titles we selected 13 systematic reviews (published 2003-2012) representing 101 individual trials. Although the term 'self-management' was rarely used, key elements of self-management support such as goal setting, action planning, and problem solving were core components of therapy rehabilitation interventions. We found high quality evidence that supported self-management in the context of therapy rehabilitation delivered soon after the stroke event resulted in short-term (< 1 year) improvements in basic and extended activities of daily living, and a reduction in poor outcomes (dependence/death). There is some evidence that rehabilitation and problem solving interventions facilitated reintegration into the community.Self-management terminology is rarely used in the context of stroke. However, therapy rehabilitation currently successfully delivers elements of self-management support to stroke survivors and their caregivers with improved outcomes. Future research should focus on managing the emotional, medical and social tasks of long-term survivorship
Chronic Diseases in North-West Tanzania and Southern Uganda. Public Perceptions of Terminologies, Aetiologies, Symptoms and Preferred Management
Research outputs produced to support a quantitative population survey, quantitative health facility survey, focus groups and in-depth interviews performed by the projec
A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions. (PRISMS Practical systematic RevIew of Self-Management Support for long-term conditions)
Background: Despite robust evidence concerning self-management for some long-term conditions (LTCs), others lack research explicitly on self-management and, consequently, some patient groups may be overlooked. Aim: To undertake a rapid, systematic overview of the evidence on self-management support for LTCs to inform health-care commissioners and providers about what works, for whom, and in what contexts. Methods: Self-management is âthe tasks .â.â. individuals must undertake to live with one or more chronic conditions .â.â.â[including] .â.â.âhaving the confidence to deal with medical management, role management and emotional management of their conditionsâ. We convened an expert workshop and identified characteristics of LTCs potentially of relevance to self-management and 14 diverse exemplar LTCs (stroke, asthma, type 2 diabetes mellitus, depression, chronic obstructive pulmonary disease, chronic kidney disease, dementia, epilepsy, hypertension, inflammatory arthropathies, irritable bowel syndrome, low back pain, progressive neurological disorders and type 1 diabetes mellitus). For each LTC we conducted systematic overviews of systematic reviews of randomised controlled trials (RCTs) of self-management support interventions (âquantitative meta-reviewsâ); and systematic overviews of systematic reviews of qualitative studies of patientsâ experiences relating to self-management (âqualitative meta-reviewsâ). We also conducted an original systematic review of implementation studies of self-management support in the LTCs. We synthesised all our data considering the different characteristics of LTCs. In parallel, we developed a taxonomy of the potential components of self-management support. Results: We included 30 qualitative systematic reviews (including 515 unique studies), 102 quantitative systematic reviews (including 969 RCTs), and 61 studies in the implementation systematic review. Effective self-management support interventions are multifaceted, should be tailored to the individual, their culture and beliefs, a specific LTC and position on the disease trajectory, and underpinned by a collaborative/communicative relationship between the patient and health-care professional (HCP) within the context of a health-care organisation that actively promotes self-management. Self-management support is a complex intervention and although many components were described and trialled in the studies no single component stood out as more important than any other. Core components include (1) provision of education about the LTC, recognising the importance of understanding patientsâ pre-existing knowledge and beliefs about their LTC; (2) psychological strategies to support adjustment to life with a LTC; (3) strategies specifically to support adherence to treatments; (4) practical support tailored to the specific LTC, including support around activities of daily living for disabling conditions, action plans in conditions subject to marked exacerbations, intensive disease-specific training to enable self-management of specific clinical tasks; and (5) social support as appropriate. Implementation requires a whole-systems approach which intervenes at the level of the patient, the HCP and the organisation. The health-care organisation is responsible for providing the means (both training and time/material resources) to enable HCPs to implement, and patients to benefit from, self-management support, regularly evaluating self-management processes and clinical outcomes. More widely there is a societal need to address public understanding of LTCs. The lack of public story for many conditions impacted on patient help-seeking behaviour and public perceptions of need. Conclusions: Supporting self-management is inseparable from the high-quality care for LTCs. Commissioners and health-care providers should promote a culture of actively supporting self-management as a normal, expected, monitored and rewarded aspect of care. Further research is needed to understand how health service managers and staff can achieve this culture change in their health-care organisations. Study registration: This study is registered as PROSPERO CRD42012002898. Funding: The National Institute for Health Research Health Services and Delivery Research programme
The formation and fate of internal waves in the South China Sea
Internal gravity waves, the subsurface analogue of the familiar surface gravity waves that break on beaches, are ubiquitous in the ocean. Because of their strong vertical and horizontal currents, and the turbulent mixing caused by their breaking, they affect a panoply of ocean processes, such as the supply of nutrients for photosynthesis1, sediment and pollutant transport2 and acoustic transmission3; they also pose hazards for man-made structures in the ocean4. Generated primarily by the wind and the tides, internal waves can travel thousands of kilometres from their sources before breaking5, making it challenging to observe them and to include them in numerical climate models, which are sensitive to their effects6,7. For over a decade, studies8-11 have targeted the South China Sea, where the oceans' most powerful known internal waves are generated in the Luzon Strait and steepen dramatically as they propagate west. Confusion has persisted regarding their mechanism of generation, variability and energy budget, however, owing to the lack of in situ data from the Luzon Strait, where extreme flow conditions make measurements difficult. Here we use new observations and numerical models to (1) show that the waves begin as sinusoidal disturbances rather than arising from sharp hydraulic phenomena, (2) reveal the existence of >200-metre-high breaking internal waves in the region of generation that give rise to turbulence levels >10,000 times that in the open ocean, (3) determine that the Kuroshio western boundary current noticeably refracts the internal wave field emanating from the Luzon Strait, and (4) demonstrate a factor-of-two agreement between modelled and observed energy fluxes, which allows us to produce an observationally supported energy budget of the region. Together, these findings give a cradle-to-grave picture of internal waves on a basin scale, which will support further improvements of their representation in numerical climate predictions
The formation and fate of internal waves in the South China Sea
Author Posting. © The Author(s), 2015. This is the author's version of the work. It is posted here by permission of Nature Publishing Group for personal use, not for redistribution. The definitive version was published in Nature 521 (2015): 65-69, doi:10.1038/nature14399.Internal gravity waves, the subsurface analogue of the familiar surface gravity
waves that break on beaches, are ubiquitous in the ocean. Because of their strong vertical and horizontal currents, and the turbulent mixing caused by their
breaking, they impact a panoply of ocean processes, such as the supply of nutrients
for photosynthesis1, sediment and pollutant transport2 and acoustic transmission3;
they also pose hazards for manmade structures in the ocean4. Generated primarily
by the wind and the tides, internal waves can travel thousands of kilometres from
their sources before breaking5, posing severe challenges for their observation and
their inclusion in numerical climate models, which are sensitive to their effects6-7.
Over a decade of studies8-11 have targeted the South China Sea, where the oceansâ
most powerful internal waves are generated in the Luzon Strait and steepen
dramatically as they propagate west. Confusion has persisted regarding their
generation mechanism, variability and energy budget, however, due to the lack of
in-situ data from the Luzon Strait, where extreme flow conditions make
measurements challenging. Here we employ new observations and numerical
models to (i) show that the waves begin as sinusoidal disturbances rather than
from sharp hydraulic phenomena, (ii) reveal the existence of >200-m-high
breaking internal waves in the generation region that give rise to turbulence levels
>10,000 times that in the open ocean, (iii) determine that the Kuroshio western
boundary current significantly refracts the internal wave field emanating from the
Luzon Strait, and (iv) demonstrate a factor-of-two agreement between modelled
and observed energy fluxes that enables the first observationally-supported energy
budget of the region. Together, these findings give a cradle-to-grave picture of
internal waves on a basin scale, which will support further improvements of their
representation in numerical climate predictions.Our work was supported by the U.S. Office of Naval Research and
the Taiwan National Science Council.2015-10-2
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The formation and fate of internal waves in the South China Sea
Internal gravity waves, the subsurface analogue of the familiar
surface gravity waves that break on beaches, are ubiquitous in
the ocean. Because of their strong vertical and horizontal currents,
and the turbulent mixing caused by their breaking, they affect a
panoply of ocean processes, such as the supply of nutrients for
photosynthesisÂč, sediment and pollutant transportÂČ and acoustic
transmissionÂł; they also pose hazards for man-made structures in
the oceanâŽ. Generated primarily by the wind and the tides, internal
waves can travel thousands of kilometres from their sources before
breakingâ”, making it challenging to observe them and to include
them in numerical climate models, which are sensitive to their
effects[superscript 6,7]. For over a decade, studies[superscript 8â11] have targeted the South
China Sea, where the oceansâ most powerful known internal waves
are generated in the Luzon Strait and steepen dramatically as they
propagate west. Confusion has persisted regarding their mechanism
of generation, variability and energy budget, however,
owing to the lack of in situ data from the Luzon Strait, where
extreme flow conditions make measurements difficult. Here we
use new observations and numerical models to (1) show that the
waves begin as sinusoidal disturbances rather than arising from
sharp hydraulic phenomena, (2) reveal the existence of >200-metre-high breaking internal waves in the region of generation
that give rise to turbulence levels >10,000 times that in the open
ocean, (3) determine that the Kuroshio western boundary current
noticeably refracts the internal wave field emanating from the
Luzon Strait, and (4) demonstrate a factor-of-two agreement
between modelled and observed energy fluxes, which allows us to
produce an observationally supported energy budget of the region.
Together, these findings give a cradle-to-grave picture of internal
waves on a basin scale, which will support further improvements of
their representation in numerical climate predictions