The organisational and human resource challenges facing primary care trusts : protocol of a multiple case study

BACKGROUND: The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs). Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. METHODS: The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development

Verification of real-time WSA-ENLIL+Cone simulations of CME arrival-time at the CCMC from 2010-2016

The Wang-Sheeley-Arge (WSA)-ENLIL+Cone model is used extensively in space weather operations world-wide to model CME propagation. As such, it is important to assess its performance. We present validation results of the WSA-ENLIL+Cone model installed at the Community Coordinated Modeling Center (CCMC) and executed in real-time by the CCMC space weather team. CCMC uses the WSA-ENLIL+Cone model to predict CME arrivals at NASA missions throughout the inner heliosphere. In this work we compare model predicted CME arrival-times to in-situ ICME leading edge measurements at STEREO-A, STEREO-B, and Earth (Wind and ACE) for simulations completed between March 2010-December 2016 (over 1,800 CMEs). We report hit, miss, false alarm, and correct rejection statistics for all three locations. For all predicted CME arrivals, the hit rate is 0.5, and the false alarm rate is 0.1. For the 273 events where the CME was predicted to arrive at Earth, STEREO-A, or STEREO-B, and was actually observed (hit event), the mean absolute arrival-time prediction error was 10.4 +/- 0.9 hours, with a tendency to early prediction error of -4.0 hours. We show the dependence of the arrival-time error on CME input parameters. We also explore the impact of the multi-spacecraft observations used to initialize the model CME inputs by comparing model verification results before and after the STEREO-B communication loss (since September 2014) and STEREO-A sidelobe operations (August 2014-December 2015). There is an increase of 1.7 hours in the CME arrival time error during single, or limited two-viewpoint periods, compared to the three-spacecraft viewpoint period. This trend would apply to a future space weather mission at L5 or L4 as another coronagraph viewpoint to reduce CME arrival time errors compared to a single L1 viewpoint

LOSS OF PHOSPHORUS BY RUNOFF FOR AGRICULTURAL WATERSHEDS

The loss of nutrients in runoff from agricultural land is a major cause of poor surface water quality in the United State. Scientists (NRCS) developed a technique to estimate the impact of agricultural watersheds on natural water resources. The objectives of this study were to apply this technique on the Wagon Train (WT),watershed to predict (1) loss of water by surface runoff, (2) loss of phosphorus (P) from soils by runoff and P loading for WT reservoir. The annual loss of water by runoff was estimated at 4.32 million m3 . The USGS data for a 50-year period (1951 to 2000) indicated that the average annual inflow for WT reservoir was 4.25 million m3 . The predicted annual P loss by runoff was 844 kg and could be considered as the annual loading for WT reservoir. The predicted P concentration in the runoff water at field sites was 196 μg/L. Phosphorus concentration observed in major streams at the beginning of spring (March) ranged from 99 μg/L to 240 μg/L with an average of 162 μg/L (S.D..= 40 μg/L), and the average P concentration in water samples taken from different locations in the reservoir was 140 μg/L. Phosphorus uptake by algae, weeds and aquatic plants, as well as high pH in the reservoir and streams might explain the slight drop of P concentration in waters. Further, the average P concentration observed in the main stream samples for the entire rainy season (March through October), ranged between 157 and 346 μg/L with an average of 267 μg/L (S.D. = 65 μg/L). Application of P fertilizers (April/May) for summer crops might explain the increase in P concentration. When factors affecting P concentration in streams are considered, the technique could provide a reasonable estimation of P concentration in stream water

Overview of Evidence of Antimicrobial Use and Antimicrobial Resistance in the Food Chain

Antimicrobial resistance (AMR) is a global health problem. Bacteria carrying resistance genes can be transmitted between humans, animals and the environment. There are concerns that the widespread use of antimicrobials in the food chain constitutes an important source of AMR in humans, but the extent of this transmission is not well understood. The aim of this review is to examine published evidence on the links between antimicrobial use (AMU) in the food chain and AMR in people and animals. The evidence showed a link between AMU in animals and the occurrence of resistance in these animals. However, evidence of the benefits of a reduction in AMU in animals on the prevalence of resistant bacteria in humans is scarce. The presence of resistant bacteria is documented in the human food supply chain, which presents a potential exposure route and risk to public health. Microbial genome sequencing has enabled the establishment of some links between the presence of resistant bacteria in humans and animals but, for some antimicrobials, no link could be established. Research and monitoring of AMU and AMR in an integrated manner is essential for a better understanding of the biology and the dynamics of antimicrobial resistance

Spring 1970

Response of Coastal Bermudagrass to Nitrogen by D.A. Mays and G. L. Terman (page 3) Soil & Water Resources by Fred P. Miller (7) Organization Against Oil by R. B. Clark (9) 1970 Turf Conference Program (12) Principles for Any Green by Wayne Morgan (16) An Effective Technique for Recognition by Howard Gaskill (18) Ten Years of Decisions by James W. Brandt (21

Reducing Cancer Disparities through Community Engagement in Policy Development: The Role of Cancer Councils

Cancer is the second leading cause of death in the U.S and a source of large racial and ethnic disparities in population health. Policy development is a powerful but sometimes overlooked public health tool for reducing cancer burden and disparities. Along with other partners in the public health system, community-based organizations such as local cancer councils can play valuable roles in developing policies that are responsive to community needs and in mobilizing resources to support policy adoption and implementation. This paper examines the current and potential roles played by local cancer councils to reduce cancer burden and disparities. Responsive public health systems require vehicles for communities to engage in policy development. Cancer councils provide promising models of engagement. Untapped opportunities exist for enhancing policy development through cancer councils, such as expanding targets of engagement to include private-sector stakeholders and expanding methods of engagement utilizing the Affordable Care Act’s Prevention and Public Health Fund

Validation for global solar wind prediction using Ulysses comparison: Multiple coronal and heliospheric models installed at the Community Coordinated Modeling Center

The prediction of the background global solar wind is a necessary part of space weather forecasting. Several coronal and heliospheric models have been installed and/or recently upgraded at the Community Coordinated Modeling Center (CCMC), including the Wangâ Sheelyâ Arge (WSA)â Enlil model, MHDâ Aroundâ aâ Sphere (MAS)â Enlil model, Space Weather Modeling Framework (SWMF), and heliospheric tomography using interplanetary scintillation data. Ulysses recorded the last fast latitudinal scan from southern to northern poles in 2007. By comparing the modeling results with Ulysses observations over seven Carrington rotations, we have extended our thirdâ party validation from the previous nearâ Earth solar wind to middle to high latitudes, in the same late declining phase of solar cycle 23. Besides visual comparison, we have quantitatively assessed the models’ capabilities in reproducing the time series, statistics, and latitudinal variations of solar wind parameters for a specific range of model parameter settings, inputs, and grid configurations available at CCMC. The WSAâ Enlil model results vary with three different magnetogram inputs. The MASâ Enlil model captures the solar wind parameters well, despite its underestimation of the speed at middle to high latitudes. The new version of SWMF misses many solar wind variations probably because it uses lower grid resolution than other models. The interplanetary scintillationâ tomography cannot capture the latitudinal variations of solar wind well yet. Because the model performance varies with parameter settings which are optimized for different epochs or flow states, the performance metric study provided here can serve as a template that researchers can use to validate the models for the time periods and conditions of interest to them.Key PointsPerformance metrics for the global solar wind prediction are developedEight model combinations are validated with strengths and weaknesses identified for each modelEffect of model internal parameter settings and magnetogram input is discussedPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134247/1/swe20343_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134247/2/swe20343.pd

UK Large-scale Wind Power Programme from 1970 to 1990: the Carmarthen Bay experiments and the Musgrove Vertical-Axis Turbines

This article describes the development of the Musgrove Vertical Axis Wind Turbine (VAWT) concept, the UK ‘Carmarthen Bay’ wind turbine test programme, and UK government’s wind power programme to 1990. One of the most significant developments in the story of British wind power occurred during the 1970s, 1980s, and 1990s, with the development of the Musgrove vertical axis wind turbine and its inclusion within the UK Government’s wind turbine test programme. Evolving from a supervisor’s idea for an undergraduate project at Reading University, the Musgrove VAWT was once seen as an able competitor to the horizontal axis wind systems that were also being encouraged at the time by both the UK government and the Central Electricity Generating Board, the then nationalised electricity utility for England and Wales. During the 1980s and 1990s the most developed Musgrove VAWT system, along with three other commercial turbine designs was tested at Carmarthen Bay, South Wales as part of a national wind power test programme. From these developmental tests, operational data was collected and lessons learnt, which were incorporated into subsequent wind power operations.http://dx.doi.org/10.1260/03095240677860621