Adoption of Telemedicine in Scottish Remote and Rural General Practices: A Qualitative Study

In the past decade there has been increasing use of information technology in Scottish primary care. The majority of general practitioners (GPs) now accept that computing is part of their everyday practice. Some GPs in Scotland have used telemedicine for the referral of patients for specialist opinion or for access to educational resources. However, although the potential benefits of telemedicine to primary care are arguably greatest in the remote and rural context, the few existing studies suggest that uptake is slow and piecemeal. There have been a number of studies of the knowledge, experience and attitudes of health-care professionals to telemedicine. These have indicated that although there is general satisfaction with the experience of using telemedicine, health professionals have concerns about the negative effect on the consultation, establishing the infrastructure and adopting telemedicine systems into existing organizational systems

Remote working: survey of attitudes to eHealth of doctors and nurses in rural general practices in the United Kingdom.

BACKGROUND: Health professionals in rural primary care could gain more from eHealth initiatives than their urban counterparts, yet little is known about eHealth in geographically isolated areas of the UK. OBJECTIVE: To elicit current use of, and attitudes towards eHealth of professionals in primary care in remote areas of Scotland. METHODS: In 2002, a questionnaire was sent to all general practitioners (n=154) in Scotland's 82 inducement practices, and to 67 nurses. Outcome measures included reported experience of computer use; access to, and experience of eHealth and quality of that experience; views of the potential usefulness of eHealth and perceived barriers to the uptake of eHealth. RESULTS: Response rate was 87%. Ninety-five percent of respondents had used either the Internet or email. The proportions of respondents who reported access to ISDN line, scanner, digital camera, and videoconferencing unit were 71%, 48%, 40% and 36%, respectively. Use of eHealth was lower among nurses than GPs. Aspects of experience that were rated positively were 'clinical usefulness', 'functioning of equipment' and 'ease of use of equipment' (76%, 74%, and 74%, respectively). The most important barriers were 'lack of suitable training' (55%), 'high cost of buying telemedicine equipment' (54%), and 'increase in GP/nurse workload' (43%). Professionals were concerned about the impact of tele-consulting on patient privacy and on the consultation itself. CONCLUSIONS: Although primary healthcare professionals recognize the general benefits of eHealth, uptake is low. By acknowledging barriers to the uptake of eHealth in geographically isolated settings, broader policies on its implementation in primary care may be informed

Detection and isolation of exotic Newcastle disease virus from field-collected flies.

Flies were collected by sweep net from the vicinity of two small groups of "backyard" poultry (10-20 chickens per group) that had been identified as infected with exotic Newcastle disease virus (family Paramyxoviridae, genus avulavirus, ENDV) in Los Angeles County, CA, during the 2002-2003 END outbreak. Collected flies were subdivided into pools and homogenized in brain-heart infusion broth with antibiotics. The separated supernatant was tested for the presence of ENDV by inoculation into embryonated chicken eggs. Exotic Newcastle disease virus was isolated from pools of Phaenicia cuprina (Wiedemann), Fannia canicularis (L.), and Musca domestica L., and it was identified by hemagglutination inhibition with Newcastle disease virus antiserum. Viral concentration in positive pools was low (<1 egg infectious dose50 per fly). Isolated virus demonstrated identical monoclonal antibody binding profiles as well as 99% sequence homology in the 635-bp fusion gene sequence compared with ENDV recovered from infected commercial egg layer poultry during the 2002 outbreak

An efficient scheme for the deterministic maximal entanglement of N trapped ions

We propose a method for generating maximally entangled states of N two-level trapped ions. The method is deterministic and independent of the number of ions in the trap. It involves a controlled-NOT acting simultaneously on all the ions through a dispersive interaction. We explore the potential application of our scheme for high precision frequency standards.Comment: 4 pages, no figures, submitted to PRL, under review, Revised Version: Incorporated referee comment

Three-Stage InP Submillimeter-Wave MMIC Amplifier

A submillimeter-wave monolithic integrated- circuit (S-MMIC) amplifier has been designed and fabricated using an indium phosphide (InP) 35-nm gate-length high electron mobility transistor (HEMT) device, developed at Northrop Grumman Corporation. The HEMT device employs two fingers each 15 micrometers wide. The HEMT wafers are grown by molecular beam epitaxy (MBE) and make use of a pseudomorphic In0.75Ga0.25As channel, a silicon delta-doping layer as the electron supply, an In0.52Al0.48As buffer layer, and an InP substrate. The three-stage design uses coplanar waveguide topology with a very narrow ground-to-ground spacing of 14 micrometers. Quarter-wave matching transmission lines, on-chip metal-insulator-metal shunt capacitors, series thin-film resistors, and matching stubs were used in the design. Series resistors in the shunt branch arm provide the basic circuit stabilization. The S-MMIC amplifier was measured for S-parameters and found to be centered at 320 GHz with 13-15-dB gain from 300-345 GHz. This chip was developed as part of the DARPA Submillimeter Wave Imaging Focal Plane Technology (SWIFT) program (see figure). Submillimeter-wave amplifiers could enable more sensitive receivers for earth science, planetary remote sensing, and astrophysics telescopes, particularly in radio astronomy, both from the ground and in space. A small atmospheric window at 340 GHz exists and could enable ground-based observations. However, the submillimeter-wave regime (above 300 GHz) is best used for space telescopes as Earth s atmosphere attenuates most of the signal through water and oxygen absorption. Future radio telescopes could make use of S-MMIC amplifiers for wideband, low noise, instantaneous frequency coverage, particularly in the case of heterodyne array receivers

Heatwaves and mortality in Queensland 2010–2019: implications for a homogenous state-wide approach

Heatwaves are a significant cause of adverse health outcomes and mortality in Australia, worsening with climate change. In Queensland, the northeastern-most state, little is known about the impact of heatwaves outside of the capital city of Brisbane. This study aims to explore the impact of heatwaves on mortality across various demographic and environmental conditions within Queensland from 2010 to 2019. The Excess Heat Factor was used to indicate heatwave periods at the Statistical Area 2 (SA2) level. Registered deaths data from the Australian Bureau of Statistics and heatwave data from the Bureau of Meteorology were matched using a case-crossover approach. Relative risk and 95% confidence intervals were calculated across years, regions, age, sex, rurality, socioeconomic status, and cause of death. Heatwaves were associated with a 5% increase in all-cause mortality compared to deaths on non-heatwave days, with variability across the state. The risk of death on a heatwave day versus a non-heatwave day varied by heatwave severity. Individuals living in urban centers, the elderly, and those living in regions of lower socioeconomic status were most impacted by heatwave mortality. The relative risk of dying from neoplasms, nervous system conditions, respiratory conditions, and mental and behavioral conditions increased during heatwaves. As heatwaves increase in Queensland due to climate change, understanding the impact of heatwaves on mortality across Queensland is important to tailor public health messages. There is considerable variability across communities, demographic groups, and medical conditions, and as such messages need to be tailored to risk

Generation of arbitrary two dimensional motional state of a trapped ion

We present a scheme to generate an arbitrary two-dimensional quantum state of motion of a trapped ion. This proposal is based on a sequence of laser pulses, which are tuned appropriately to control transitions on the sidebands of two modes of vibration. Not more than $(M+1)(N+1)$ laser pulses are needed to generate a pure state with upper phonon number $M$ and $N$ in the $x$ and $y$ direction respectively.Comment: to appear in PR

Compact, Single-Stage MMIC InP HEMT Amplifier

A monolithic micro - wave integrated-circuit (MMIC) singlestage amplifier containing an InP-based high-electron-mobility transistor (HEMT) plus coplanar-waveguide (CPW) transmission lines for impedance matching and input and output coupling, all in a highly miniaturized layout as needed for high performance at operating frequencies of hundreds of gigahertz is described

Submillimeter-Wave Amplifier Module with Integrated Waveguide Transitions

To increase the usefulness of monolithic millimeter-wave integrated circuit (MMIC) components at submillimeter-wave frequencies, a chip has been designed that incorporates two integrated, radial E-plane probes with an MMIC amplifier in between, thus creating a fully integrated waveguide module. The integrated amplifier chip has been fabricated in 35-nm gate length InP high-electron-mobility-transistor (HEMT) technology. The radial probes were mated to grounded coplanar waveguide input and output lines in the internal amplifier. The total length of the internal HEMT amplifier is 550 m, while the total integrated chip length is 1,085 m. The chip thickness is 50 m with the chip width being 320 m. The internal MMIC amplifier is biased through wire-bond connections to the gates and drains of the chip. The chip has 3 stages, employing 35-nm gate length transistors in each stage. Wire bonds from the DC drain and gate pads are connected to off-chip shunt 51-pF capacitors, and additional off-chip capacitors and resistors are added to the gate and drain bias lines for low-frequency stability of the amplifier. Additionally, bond wires to the grounded coplanar waveguide pads at the RF input and output of the internal amplifier are added to ensure good ground connections to the waveguide package. The S-parameters of the module, not corrected for input or output waveguide loss, are measured at the waveguide flange edges. The amplifier module has over 10 dB of gain from 290 to 330 GHz, with a peak gain of over 14 dB at 307 GHz. The WR2.2 waveguide cutoff is again observed at 268 GHz. The module is biased at a drain current of 27 mA, a drain voltage of 1.24 V, and a gate voltage of +0.21 V. Return loss of the module is very good between 5 to 25 dB. This result illustrates the usefulness of the integrated radial probe transition, and the wide (over 10-percent) bandwidth that one can expect for amplifier modules with integrated radial probes in the submillimeter-regime (>300 GHz)