Realist evaluation of the impact of paediatric nurse practitioner clinics, specialist paediatric nurses, and a children’s community nursing team in deflecting attendance at emergency departments and urgent care centres by children with long-term conditions

In 2018, the Greater Manchester Children’s Health and Wellbeing Board developed a 10-point strategy to achieve its objectives, the sixth of which was to reduce unnecessary hospital attendances and admissions for children with long term conditions such as asthma, diabetes and epilepsy. Funding was secured from Manchester Academic Health Science Centre to commission an exploration of the impact of the Paediatric Nurse Practitioner Clinic within the context of the Family Services Model and the impact that the service was having on reducing attendance at urgent care centres or admission to hospital. Alternatives to taking children to the ED/UCC can be a preference. An integrated system, with elements able to book directly into others, with rapid access, information, health promotion, and follow-up were essential to success. Extra consultation time for proactive intervention, with sufficient nurses to provide a seven-days service were valued. Advertisement of the service to the public and to professionals is vital for uptake by professionals and the public

Exercises to develop skill in map reading in grade four

Thesis (Ed.M.)--Boston Universit

The Mayflies (Ephemeroptera) of Tennessee, With a Review of the Possibly Threatened Species Occurring Within the State

One hundred and forty-three species of mayflies are reported from the state of Tennessee. Sixteen species (Ameletus cryptostimulus, Choroterpes basalis, Baetis virile, Ephemera blanda, E. simulans, Ephemerella berneri, Heterocloeon curiosum, H. petersi, Labiobaetis ephippiatus, Leptophlebia bradleyi, Macdunnoa brunnea, Paraleptophlebia assimilis, P. debilis, P. mollis, Rhithrogenia pellucida and Siphlonurus mirus) are reported for the first time. Rare and vulnerable species occurring in the state are also discussed. This represents the first comprehensive statewide list of mayflies for Tennessee

Photoabsorption and photodissociation of molecules important in the interstellar medium

The photo absorption, photo dissociation, and fluorescence cross sections of interstellar molecules and radicals were measured in the vacuum ultraviolet region. These quantitative optical data are useful for understanding of the formation and destruction processes of molecules under the intense interstellar W radiation field. Infrared (IR) emissions from W excitation of aromatic molecules were also observed in this research program. The research results are useful for studying the sources of the 'unidentified' interstellar infrared (UIR) emission bands

Measurement of HO2 chemical kinetics with a new detection method

Reaction rate constants of HO2+O3 were measured at various temperatures using a newly developed HO2 detection method. HO2 was detected by the OH(A-X) emission produced from photodissociative excitation of HO2 at 147 nm. In order to examine the possible interference of other emitting species with the HO2 detection, the photoexcitation processes of all the chemical species existing in the discharge flow tube were also investigated. The results are summarized

Photoabsorption and photodissociation of molecules important in the interstellar medium

Photoabsorption and fluorescence cross sections of molecules important in the interstellar medium were measured in the 90 to 200 nm region using synchrotron radiation, excimer laser, and condensed discharge lamps as light sources. The quantitative spectroscopic data are currently needed for the modeling of formation and destruction rates of molecules by the interstellar radiation field. Fluorescences from excited photofragments produced by vacuum ultraviolet radiation of molecules are dispersed to identify the emitting species. The fluorescence data are useful for the identification of emission sources in interstellar clouds

Photoabsorption and photodissociation of molecules important in the interstellar medium

The photoabsorption, photodissociation, and fluorescence cross sections of interstellar molecules are measured at 90 to 250 nm. These quantitative optical data are needed for the understanding of the formation and destruction processes of molecules under the intense interstellar UV radiation field. Research covering the following topics is presented: (1) fluorescences from photoexcitation of CH4, CH3OH, and CH3SH; (2) NO gamma emission from photoexcitation of NO; (3) photoexcitation cross sections of aromatic molecules; (4) IR emission from UV excitation of HONO2; (5) IR emission from UV excitation of benzene and methyl-derivitives; and (6) IR emission from UV excitation of polycyclic aromatic hydrocarbon molecules

Planckian Axions in String Theory

We argue that super-Planckian diameters of axion fundamental domains can naturally arise in Calabi-Yau compactifications of string theory. In a theory with $N$ axions $\theta^i$, the fundamental domain is a polytope defined by the periodicities of the axions, via constraints of the form $-\pi<Q^{i}_{j} \theta^j<\pi$. We compute the diameter of the fundamental domain in terms of the eigenvalues $f_1^2\le\...\le f_N^2$ of the metric on field space, and also, crucially, the largest eigenvalue of $(QQ^{\top})^{-1}$. At large $N$, $QQ^{\top}$ approaches a Wishart matrix, due to universality, and we show that the diameter is at least $N f_{N}$, exceeding the naive Pythagorean range by a factor $>\sqrt{N}$. This result is robust in the presence of $P>N$ constraints, while for $P=N$ the diameter is further enhanced by eigenvector delocalization to $N^{3/2}f_N$. We directly verify our results in explicit Calabi-Yau compactifications of type IIB string theory. In the classic example with $h^{1,1}=51$ where parametrically controlled moduli stabilization was demonstrated by Denef et al. in [1], the largest metric eigenvalue obeys $f_N \approx 0.013 M_{pl}$. The random matrix analysis then predicts, and we exhibit, axion diameters $>M_{pl}$ for the precise vacuum parameters found in [1]. Our results provide a framework for achieving large-field axion inflation in well-understood flux vacua.Comment: 42 pages, 4 figure

Photoabsorption and photodissociation of molecules important in the interstellar medium

A windowless apparatus was constructed and used to measure the photoabsorption and fluorescence cross sections of molecules in the extreme ultraviolet region. Photoabsorption and fluorescence cross sections of H2O, D2O, H2S, D2s, and Co were measured in the 50 to 200 nm region. These quantitative data are currently needed for the determination of the formulation and destruction rates of molecules in the interstellar medium