A postal survey to identify and describe nurse led clinics in genitourinary medicine services across England

Background: Nurses in genitourinary medicine (GUM) services are progressively extending their roles to conduct "comprehensive care" nurse led clinics. In such roles the nurse coordinates the first line, comprehensive care of patients presenting with sexual health conditions and issues. Objectives: To identify and describe comprehensive care nurse led clinics in GUM services across England. Methods: A postal questionnaire consisting of 17 closed response questions was sent to 209 GUM services across England. A second questionnaire was sent to non-responders to increase the response rate. Data were single entered and analysed using SPSS. Results: Of the 190 GUM clinic respondents (91% response rate), 44 (23%) reported providing some form of comprehensive care nurse led clinic, 90% of which were initiated since 1995. Key results show staff development featured as the main reason for initiating such services and there was general consistency in the aspects of care undertaken by these nurses. There was evidence of guideline development specific to nurse led care and some patient group direction use for supplying medication. The level of support from medical staff while nurse led clinics were being conducted varied between services. Few services have conducted any audit or research to monitor/evaluate nurse led care. There was little consistency in the clinical experience and educational prerequisites to undertake comprehensive care nurse led clinics. Continuing professional development opportunities also varied between services. Conclusions: The steady growth of comprehensive care nurse led clinics indicates that the skills of GUM nurses are being recognised. Nurses working in advanced practice roles now require courses and study days reflecting these changes in practice. Locally agreed practice guidelines can define nursing practice boundaries and ensure accountability, as will the development of patient group directions to supply medication. Monitoring and evaluation of nurse led clinics also require attention

Analytical fuel property effects--small combustors

The consequences of using broad-property fuels in both conventional and advanced state-of-the-art small gas turbine combustors are assessed. Eight combustor concepts were selected for initial screening, of these, four final combustor concepts were chosen for further detailed analysis. These included the dual orifice injector baseline combustor (a current production 250-C30 engine combustor) two baseline airblast injected modifications, short and piloted prechamber combustors, and an advanced airblast injected, variable geometry air staged combustor. Final predictions employed the use of the STAC-I computer code. This quasi 2-D model includes real fuel properties, effects of injector type on atomization, detailed droplet dynamics, and multistep chemical kinetics. In general, fuel property effects on various combustor concepts can be classified as chemical or physical in nature. Predictions indicate that fuel chemistry has a significant effect on flame radiation, liner wall temperature, and smoke emission. Fuel physical properties that govern atomization quality and evaporation rates are predicted to affect ignition and lean-blowout limits, combustion efficiency, unburned hydrocarbon, and carbon monoxide emissions

Evaluation of non-intrusive flow measurement techniques for a re-entry flight experiment

This study evaluates various non-intrusive techniques for the measurement of the flow field on the windward side of the Space Shuttle orbiter or a similar reentry vehicle. Included are linear (Rayleigh, Raman, Mie, Laser Doppler Velocimetry, Resonant Doppler Velocimetry) and nonlinear (Coherent Anti-Stokes Raman, Laser-Induced Fluorescence) light scattering, electron-beam fluorescence, thermal emission, and mass spectroscopy. Flow-field properties were taken from a nonequilibrium flow model by Shinn, Moss, and Simmonds at the NASA Langley Research Center. Conclusions are, when possible, based on quantitative scaling of known laboratory results to the conditions projected. Detailed discussion with researchers in the field contributed further to these conclusions and provided valuable insights regarding the experimental feasibility of each of the techniques

Non-intrusive flow measurements on a reentry vehicle

This study evaluates the utility of various non-intrusive techniques for the measurement of the flow field on the windward side of the Space Shuttle or a similar re-entry vehicle. Included are linear (Rayleigh, Raman, Mie, Laser Doppler Velocimetry, Resonant Doppler Velocimetry) and nonlinear (Coherent Anti-Stokes Raman, Laser Induced Fluorescence) light scattering, electron beam fluorescence, thermal emission and mass spectroscopy. Flow field properties are taken from a nonequilibrium flow model by Shinn, Moss and Simmonds at NASA Langley. Conclusions are, when possible, based on quantitative scaling of known laboratory results to the conditions projected. Detailed discussion with researchers in the field contributed further to these conclusions and provided valuable insights regarding the experimental feasibility of each of the techniques

Imputing Risk Tolerance from Survey Responses

Economic theory assigns a central role to risk preferences. This paper develops a measure of relative risk tolerance using responses to hypothetical income gambles in the Health and Retirement Study. In contrast to most survey measures that produce an ordinal metric, this paper shows how to construct a cardinal proxy for the risk tolerance of each survey respondent. The paper also shows how to account for measurement error in estimating this proxy and how to obtain consistent regression estimates despite the measurement error. The risk tolerance proxy is shown to explain differences in asset allocation across households.

Type II superlattices for infrared detectors and devices

Superlattices consisting of combinations of III-V semiconductors with type II band alignments are of interest for infrared applications because their energy gaps can be made smaller than those of any 'natural' III-V compounds. Specifically, it has been demonstrated that both InSb/InAsxSb1-x superlattices and Ga1-xInxSb/InAs superlattices can possess energy gaps in the 8-14 mu m range. The efforts have focused on the Ga1-xInxSb/InAs system because of its extreme broken gap band alignment, which results in narrow energy gaps for very short superlattice periods. The authors report the use of in situ chemical doping of Ga1-xInxSb/InAs superlattices to fabricate p-n photodiodes. These diodes display a clear photovoltaic response with a threshold near 12 mu m. They have also attained outstanding structural quality in Ga1-xInxSb/InAs superlattices grown on radiatively heated GaSb substrates. Cross-sectional transmission electron microscope images of these superlattices display no dislocations, while high resolution X-ray diffraction scans reveal sharp high-order superlattice satellites and strong Pendellosung fringes