401 research outputs found

    Healthcare use among preschool children attending GP-led urgent care centres: a descriptive, observational study

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    © 2015 Published by the BMJ Publishing Group Limited.Objective Urgent care centres (UCCs) hours were developed with the aim of reducing inappropriate emergency department (ED) attendances in England. We aimed to examine the presenting complaint and outcomes of care in 2 general practitioner (GP)-led UCCs with extended opening times. Design Retrospective observational epidemiological study using routinely collected data. Setting 2 GP-led UCCs in London, colocated with a hospital ED. Participants All children aged under 5 years, attending 2 GP-led UCCs over a 3-year period. Outcomes Outcomes of care for the children including: primary diagnosis; registration status with a GP; destination following review within the UCC; and any medication prescribed. Comparison between GP-led UCC visit rates and routine general practices was also made. Results 3% (n=7747/282 947) of all attenders at the GP-led UCCs were children aged under 5 years. The most common reason for attendance was a respiratory illness (27%), followed by infectious illness (17%). 18% (n=1428) were either upper respiratory tract infections or viral infections. The majority (91%) of children attending were registered with a GP, and over two-thirds of attendances were out of hours. Overall 79% were seen and discharged home. Preschool children were more likely to attend their GP (47.0 per 100) than a GP-led UCC (9.4 per 100; 95% CI 8.9 to 10.0). Conclusions Two-thirds of preschool children attending GP-led UCCs do so out of hours, despite the majority being registered with a GP. The case mix is comparable with those presenting to an ED setting, with the majority managed exclusively by the GPs in the UCC before discharge home. Further work is required to understand the benefits of a GP-led urgent system in influencing future use of services especially emergency care

    In silico simulation of reversible and irreversible swelling of mitochondria: The role of membrane rigidity

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    Mitochondria have been widely accepted as the main source of ATP in the cell. The inner mitochondrial membrane (IMM) is important for the maintenance of ATP production and other functions of mitochondria. The electron transport chain (ETC) generates an electrochemical gradient of protons known as the proton-motive force across the IMM and thus produces the mitochondrial membrane potential that is critical to ATP synthesis. One of the main factors regulating the structural and functional integrity of the IMM is the changes in the matrix volume. Mild (reversible) swelling regulates mitochondrial metabolism and function; however, excessive (irreversible) swelling causes mitochondrial dysfunction and cell death. The central mechanism of mitochondrial swelling includes the opening of non-selective channels known as permeability transition pores (PTPs) in the IMM by high mitochondrial Ca2+ and reactive oxygen species (ROS). The mechanisms of reversible and irreversible mitochondrial swelling and transition between these two states are still unknown. The present study elucidates an upgraded biophysical model of reversible and irreversible mitochondrial swelling dynamics. The model provides a description of the PTP regulation dynamics using an additional differential equation. The rigidity tensor was used in numerical simulations of the mitochondrial parameter dynamics with different initial conditions defined by Ca2+ concentration in the sarco/endoplasmic reticulum. We were able to estimate the values of the IMM rigidity tensor components by fitting the model to the previously reported experimental data. Overall, the model provides a better description of the reversible and irreversible mitochondrial swelling dynamics.Funding Agency USA NIGMS NIH SC1GM128210 Institute for Functional Nanomaterials (USA NSF) 1002410 PR NASA EPSCoR (USA NASA Cooperative Agreement) NNX15AK43Ainfo:eu-repo/semantics/publishedVersio

    Surface states on n-type Al0.24Ga0.76As characterized by deep-level transient spectroscopy

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    Capacitance deep-level transient spectroscopy (DLTS) was used to study surface states on aluminum compounds. Two hole-like traps were observed in pseudomorphic high-electron-mobility transistor with a multifinger gate. No hole-like signals were observed in the DLTS spectra of the fat field-effect transistor (FATFET) having negligible ratio of the ungated surface to the total area between the source and the drain. The activation energies of both surface states were measured to be 0.50??0.03 and 0.81??0.01 eV.open6

    Influence of liposomal drug entrapment on percutaneous absorption

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    Results of permeation experiments involving finite dose diffusion cells with hairless mouse skin as the membrane indicate that neither intact liposomes nor the phospholipid of which they are comprised diffuses across the skin. Lipophilic drugs like progesterone and hydrocortisone, which are intercalated within the bilayer structure of the phospholipid in multilamellar liposomes, seem to pass through the skin with comparable facility to free drug (comparable mass transfer coeficients). On the other hand, highly polar glucose entrapped in the aqueous compartments of the liposome is poorly available for transport. The results of in vitro release rate studies and theoretical calculations indicate that the very slight flux of liposomally incorporated glucose seen experimentally is attributable to a slow release rate of glucose out of the liposome followed by relatively rapid skin permeation of the free solute. On the other hand, for hydrophobic progesterone and hydrocortsone the experimental results and supportive theoretical analysis suggest direct transfer of drug from liposome to the skin. Considering this mechanism and owing to increased soluble payloads of lipophilic drugs through liposomal incorporation, n ore total drug may be delivered through skin via liposomes relative to simple aqueous solutions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/24969/1/0000396.pd

    Staff perceptions on patient motives for attending GP-led urgent care centres in London: a qualitative study

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    ABSTRACT Objectives: General practitioner (GP)-led urgent care centres were established to meet the growing demand for urgent care. Staff members working in such centres are central in influencing patients' choices about which services they use, but little is known about staff perceptions of patients' motives for attending urgent care. We hence aimed to explore their perceptions of patients' motives for attending such centres

    ‘Does My Haltung Look Big In This?”: The Use of Social Pedagogical Theory for the Development of Ethical and Value Led Practice

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    The aim of this article is to set out how the use of social pedagogical Haltung can support the exploration of values and how this informs and shapes a practitioner’s direct work. Haltung is a German concept that has no direct English translation but means ‘mind set’, ‘ethos’ or ‘attitude’ (Eichsteller, 2010) and relates to an individual’s value base. Mührel’s (2008, cited in Eichsteller, 2010), sets out that a social pedagogical Haltung is based on the two concepts of empathic understanding and regard. This paper argues that the use of a social pedagogical Haltung gives practitioners a philosophical framework to support the reflection of core values and ethics held on a personal level. It also supports an understanding of how these influence practitioners and students when using ‘self’ in relationship based practice. The understanding of Haltung is important but for social pedagogical practice to be undertaken it also has to be demonstrated by actions. The reflective activity Values Alive in Practice, set out in this article, provides a tool for social workers, practitioners and students to critically explore their own values and practice and make more meaningful connections between their Haltung and their behaviours demonstrated in their everyday work. In the UK, values and standards for social work practice are set out by British Association of Social Work and Social Work England. Arguably, these have, at times, been reduced to a checklist for students and practitioners and can lack more in depth and explicit links to practice. The analysis of practice is more likely to focus on the skills and abilities of practitioners rather than the value base that underpins these. Whilst the understanding and key application of core knowledge and skills is essential for competent social work practice (Forrester et al., 2019), this article argues that it must also be supported and shaped by ethical principles. This article seeks to explore how social workers can be supported to adopt value led approaches to complex work within an outcome focussed culture

    Isothermal Microcalorimetry to Investigate Non Specific Interactions in Biophysical Chemistry

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    Isothermal titration microcalorimetry (ITC) is mostly used to investigate the thermodynamics of “specific” host-guest interactions in biology as well as in supramolecular chemistry. The aim of this review is to demonstrate that ITC can also provide useful information about non-specific interactions, like electrostatic or hydrophobic interactions. More attention will be given in the use of ITC to investigate polyelectrolyte-polyelectrolyte (in particular DNA-polycation), polyelectrolyte-protein as well as protein-lipid interactions. We will emphasize that in most cases these “non specific” interactions, as their definition will indicate, are favoured or even driven by an increase in the entropy of the system. The origin of this entropy increase will be discussed for some particular systems. We will also show that in many cases entropy-enthalpy compensation phenomena occur

    Tracking sic FET developments with a FET simulator

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    SiC FETs promise high voltage working, high output power and a high impedance level for easy matching in applications at low gigahertz freque cies.RF SiC FETs development has bee supported by practical investigation of dispersio using a pulsed I(V)measurement system,a d by relating the multi-bias S -parameter behaviour of the devices to their material and structural features using a FET simulator.The simulator has been evolved through application i the GaAs industry. Modelling dispersion in all technologies is problematic because,whereas the origin of dispersion an be identified experimentally,the mechanism is ot know in enough detail to include other tha a ge eric model of it in the simulator. Nonetheless,the simulator is useful for interpreting practical device behaviour and for examining the likely performance benefits of any proposed changes to SiC FET structure
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