Post discharge medicines use review service for older patients: recruitment issues in a feasibility study

Background The community pharmacy medicines use review (MUR) service in England has been identified as a way of providing support with medication to recently discharged patients; however initial uptake of post-discharge MUR has been low. Objective To identify barriers to recruitment into a randomised controlled feasibility study of a hospital referral system to older patients’ regular community pharmacists. Method Ward pharmacists at Southport District General Hospital identified patients aged over 65 to be approached by a researcher to assess eligibility and discuss involvement in the trial. Participants were randomised to referral for a post discharge MUR with their regular community pharmacist, or to standard discharge care. Reasons for patients not participating were collected. Results Over a 9-month period 337 potential participants were identified by ward pharmacists. Of these, 132 were eligible and 60 were recruited. Barriers to recruitment included competing priorities among ward pharmacists, and national restrictions placed on MURs e.g. housebound patients and those requiring carer support with medication. Lack of expected benefit resulted in a high proportion of patient refusals. Conclusion The current provisions for post discharge MURs exclude many older people from participation, including those possibly in greatest need. Unfamiliarity with the role of the pharmacist in transitional care may have affected patients’ perceived ‘cost-benefit’ of taking part in this study

The Deep Space Network: A Radio Communications Instrument for Deep Space Exploration

The primary purpose of the Deep Space Network (DSN) is to serve as a communications instrument for deep space exploration, providing communications between the spacecraft and the ground facilities. The uplink communications channel provides instructions or commands to the spacecraft. The downlink communications channel provides command verification and spacecraft engineering and science instrument payload data

A COMPARATIVE RISK ANALYSIS OF FUELWOOD USE IN THE PACIFIC NORTHWEST

Abstract-A risk impact analysis is performed for residential space heating derived from fuelwood in the Pacific Northwest. Direct risks associated with the collection and use of fuelwood in homes are characterized and computed per 1012Btu of fuelwood harvested. The hazards identified are then compared to similar risks associated with the generation of electricity using four different fuels: coal, oil, natural gas, and uranium. The resulting comparison indicates that the acquisition and use of fuelwood in residences is several times more costly in terms of loss of life and injury incurred, than electricity derived from the conventional fuels compared

G band atmospheric radars: new frontiers in cloud physics

Clouds and associated precipitation are the largest source of uncertainty in current weather and future climate simulations. Observations of the microphysical, dynamical and radiative processes that act at cloud scales are needed to improve our understanding of clouds. The rapid expansion of ground-based super-sites and the availability of continuous profiling and scanning multi-frequency radar observations at 35 and 94 GHz have significantly improved our ability to probe the internal structure of clouds in high temporal-spatial resolution, and to retrieve quantitative cloud and precipitation properties. However, there are still gaps in our ability to probe clouds due to large uncertainties in the retrievals. The present work discusses the potential of G band (frequency between 110 and 300 GHz) Doppler radars in combination with lower frequencies to further improve the retrievals of microphysical properties. Our results show that, thanks to a larger dynamic range in dual-wavelength reflectivity, dual-wavelength attenuation and dual-wavelength Doppler velocity (with respect to a Rayleigh reference), the inclusion of frequencies in the G band can significantly improve current profiling capabilities in three key areas: boundary layer clouds, cirrus and mid-level ice clouds, and precipitating snow

G band atmospheric radars: New frontiers in cloud physics

Clouds and associated precipitation are the largest source of uncertainty in current weather and future climate simulations. Observations of the microphysical, dynamical and radiative processes that act at cloud scales are needed to improve our understanding of clouds. The rapid expansion of ground-based super-sites and the availability of continuous profiling and scanning multi-frequency radar observations at 35 and 94 GHz have significantly improved our ability to probe the internal structure of clouds in high temporal-spatial resolution, and to retrieve quantitative cloud and precipitation properties. However, there are still gaps in our ability to probe clouds due to large uncertainties in the retrievals. The present work discusses the potential of G band (frequency between 110 and 300 GHz) Doppler radars in combination with lower frequencies to further improve the retrievals of microphysical properties. Our results show that, thanks to a larger dynamic range in dual-wavelength reflectivity, dual-wavelength attenuation and dual-wavelength Doppler velocity (with respect to a Rayleigh reference), the inclusion of frequencies in the G band can significantly improve current profiling capabilities in three key areas: boundary layer clouds, cirrus and mid-level ice clouds, and precipitating snow. © 2014 Author(s)

Association between duration of symptoms and severity of disease at first presentation to paediatric rheumatology: results from the Childhood Arthritis Prospective Study

Objectives. To study the association between disease severity at first presentation to paediatric rheumatology (PRh) and length of time since symptom onset in children recruited to the Childhood Arthritis Prospective Study

A Very Sensitive 21cm Survey for Galactic High-Velocity HI

Very sensitive HI 21cm observations have been made in 860 directions at dec >= -43deg in search of weak, Galactic, high-velocity HI emission lines at moderate and high Galactic latitudes. One-third of the observations were made toward extragalactic objects. The median 4-sigma detection level is NHI = 8x10^{17} cm^-2 over the 21' telescope beam. High-velocity HI emission is detected in 37% of the directions; about half of the lines could not have been seen in previous surveys. The median FWHM of detected lines is 30.3 km/s. High- velocity HI lines are seen down to the sensitivity limit of the survey implying that there are likely lines at still lower values of NHI. The weakest lines have a kinematics and distribution on the sky similar to that of the strong lines, and thus do not appear to be a new population. Most of the emission originates from objects which are extended over several degrees; few appear to be compact sources. At least 75%, and possibly as many as 90%, of the lines are associated with one of the major high-velocity complexes. The Magellanic Stream extends at least 10 deg to higher Galactic latitude than previously thought and is more extended in longitude as well. Although there are many lines with low column density, their numbers do not increase as rapidly as NHI^-1, so most of the HI mass in the high-velocity cloud phenomenon likely resides in the more prominent clouds. The bright HI features may be mere clumps within larger structures, and not independent objects.Comment: 88 pages includes 22 figures Accepted for Publication in ApJ Suppl. June 200

Experiments on Ion Cyclotron Damping at the Deuterium Fourth Harmonic in DIII-D

Absorption of fast Alfven waves by the energetic ions of an injected beam is evaluated in the DIII-D tokamak. Ion cyclotron resonance absorption at the fourth harmonic of the deuteron cyclotron frequency is observed with deuterium neutral beam injection (f = 60 MHz, B{sub T} = 1.9 T). Enhanced D-D neutron rates are evidence of absorption at the Doppler-shifted cyclotron resonance. Characteristics of global energy confinement provide further proof of substantial beam acceleration by the rf. In many cases, the accelerated deuterons cause temporary stabilization of the sawtooth (monster sawteeth), at relatively low rf power levels of {approximately}1 MW