Density-functional studies of tungsten trioxide, tungsten bronzes, and related systems

Tungsten trioxide adopts a variety of structures which can be intercalated with charged species to alter the electronic properties, thus forming `tungsten bronzes'. Similar optical effects are observed upon removing oxygen from WO_3, although the electronic properties are slightly different. Here we present a computational study of cubic and hexagonal alkali bronzes and examine the effects on cell size and band structure as the size of the intercalated ion is increased. With the exception of hydrogen (which is predicted to be unstable as an intercalate), the behaviour of the bronzes are relatively consistent. NaWO_3 is the most stable of the cubic systems, although in the hexagonal system the larger ions are more stable. The band structures are identical, with the intercalated atom donating its single electron to the tungsten 5d valence band. Next, this was extended to a study of fractional doping in the Na_xWO_3 system (0 < x < 1). A linear variation in cell parameter, and a systematic change in the position of the Fermi level up into the valence band was observed with increasing x. In the underdoped WO_3-x system however, the Fermi level undergoes a sudden jump into the conduction band at around x = 0.2. Lastly, three compounds of a layered WO_4&#215;a,wdiaminoalkane hybrid series were studied and found to be insulating, with features in the band structure similar to those of the parent WO_3 compound which relate well to experimental UV-visible spectroscopy results.Comment: 12 pages, 16 figure

Modelling the tongue-of-ionisation using CTIP with SuperDARN electric potential input: verification by radiotomography

Electric potential patterns obtained by the SuperDARN radar network are used as input to the Coupled Thermosphere-Ionosphere-Plasmasphere model, in an attempt to improve the modelling of the spatial distribution of the ionospheric plasma at high latitudes. Two case studies are considered, one under conditions of stable IMF &lt;I&gt;B&lt;sub&gt;z&lt;/sub&gt;&lt;/I&gt; negative and the other under stable IMF &lt;I&gt;B&lt;sub&gt;z&lt;/sub&gt;&lt;/I&gt; positive. The modelled plasma distributions are compared with sets of well-established tomographic reconstructions, which have been interpreted previously in multi-instrument studies. For IMF &lt;I&gt;B&lt;sub&gt;z&lt;/sub&gt;&lt;/I&gt; negative both the model and observations show a tongue-of-ionisation on the nightside, with good agreement between the electron density and location of the tongue. Under &lt;I&gt;B&lt;sub&gt;z&lt;/sub&gt;&lt;/I&gt; positive, the SuperDARN input allows the model to reproduce a spatial plasma distribution akin to that observed. In this case plasma, unable to penetrate the polar cap boundary into the polar cap, is drawn by the convective flow in a tongue-of-ionisation around the periphery of the polar cap

Understanding why primary care doctors leave direct patient care: a systematic review of qualitative research

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordData availability statement: All data relevant to the study are included in the article or uploaded as supplementary information. No additional data available.Background UK general practitioners (GPs) are leaving direct patient care in significant numbers. We undertook a systematic review of qualitative research to identify factors affecting GPs’ leaving behaviour in the workforce as part of a wider mixed methods study (ReGROUP). Objective To identify factors that affect GPs’ decisions to leave direct patient care. Methods Qualitative interview-based studies were identified and their quality was assessed. A thematic analysis was performed and an explanatory model was constructed providing an overview of factors affecting UK GPs. Non-UK studies were considered separately. Results Six UK interview-based studies and one Australian interview-based study were identified. Three central dynamics that are key to understanding UK GP leaving behaviour were identified: factors associated with low job satisfaction, high job satisfaction and those linked to the doctor–patient relationship. The importance of contextual influence on job satisfaction emerged. GPs with high job satisfaction described feeling supported by good practice relationships, while GPs with poor job satisfaction described feeling overworked and unsupported with negatively impacted doctor–patient relationships. Conclusions Many GPs report that job satisfaction directly relates to the quality of the doctor–patient relationship. Combined with changing relationships with patients and interfaces with secondary care, and the gradual sense of loss of autonomy within the workplace, many GPs report a reduction in job satisfaction. Once job satisfaction has become negatively impacted, the combined pressure of increased patient demand and workload, together with other stress factors, has left many feeling unsupported and vulnerable to burn-out and ill health, and ultimately to the decision to leave general practice

Scope and mortality of adult medical ICU patients in an Eastern Cape tertiary hospital

Background. The characteristics and mortality outcomes of patients admitted to South African intensive care units (ICUs) owing to medical conditions are unknown. Available literature is derived from studies based on data from high-income countries. Objectives. To determine ICU utilisation by medical patients and evaluate the scope of admissions and clinical associations with hospital mortality in ICU patients 12 years and older admitted to an Eastern Cape tertiary ICU, particularly in the subset with HIV disease. Methods. A retrospective descriptive one-year cohort study. Data were obtained from the LivAKI study database and demographic data, comorbidities, diagnosis, and mortality outcomes and associations were determined. Results. There were 261 (29.8%) medical ICU admissions. The mean age of the cohort was 40.2 years; 51.7% were female. When compared with the surgical emergencies, the medical subgroup had higher sequential organ failure assessment (SOFA) scores (median score 5 v. 4, respectively) and simplified acute physiology score III (SAPS 3) scores (median 52.7 v. 48.5), a higher incidence of acute respiratory distress syndrome (ARDS) (7.7% v. 2.9%) and required more frequent dialysis (20.3% v. 5.5%). Of the medical admissions, sepsis accounted for 32.4% of admission diagnoses. The HIV seroprevalence rate was 34.0%, of whom 57.4% were on antiretroviral therapy. ICU and hospital mortality rates were 11.1% and 21.5% respectively, while only acute kidney injury (AKI) and sepsis were independently associated with mortality. The HIV-positive subgroup had a higher burden of tuberculosis (TB), higher admission SOFA and SAPS 3 scores and required more organ support. Conclusion. Among medical patients admitted to ICU, there was a high HIV seroprevalence with low uptake of antiretroviral therapy. Sepsis was the most frequently identified ICU admission diagnosis. Sepsis and AKI (not HIV) were independent predictors of mortality. Co-infection with HIV and TB was associated with increased mortality

Reviews

The following publications have been reviewed by the mentioned authors;Welsh Crafts by Mary Eirwen Jones, reviewed by Roy NashA Source Book of Picture Making by Henry Pluckrose, reviewed by R. HartApproaches to Drawing by Leo Walmsley, reviewed by John EgglestonMoulded and Slip Cast Pottery and Ceramics by David Cowley, reviewed by Michael PaffardPainting by John Lancaster, reviewed by R. N. MacGregorDesign Resource Sheets by R. N. Billington and J. R. Jeffrey, reviewed by Dick SuttonEnamelling on Metal, Oppi. Intracht, reviewed by J. N. AtkinsProcesses by Jack Bainbridge, reviewed by Michael SayerArtists and People by Su Braden, reviewed by Roy ShawMake Your Own Musical Instrument by Stuart Dalby, reviewed by Eric DecorteDesign in General Education by John Harahan, reviewed by Bernard AylwardPainting Without a Brush by Roy Sparkes, reviewed by John LancasterBuilding Craft Equipment by A. Jay and Carol W. Abrams, reviewed by S. R. BlundellPyrography by Berhand Havez and Jean-Claude Varlet, reviewed by Paul Kin

Safety and efficacy of antenatal milk expressing for women with diabetes in pregnancy: protocol for a randomised controlled trial

Many maternity providers recommend that women with diabetes in pregnancy express and store breast milk in late pregnancy so breast milk is available after birth, given (1) infants of these women are at increased risk of hypoglycaemia in the first 24 h of life; and (2) the delay in lactogenesis II compared with women without diabetes that increases their infant\u27s risk of receiving infant formula. The Diabetes and Antenatal Milk Expressing (DAME) trial will establish whether advising women with diabetes in pregnancy (pre-existing or gestational) to express breast milk from 36 weeks gestation increases the proportion of infants who require admission to special or neonatal intensive care units (SCN/NICU) compared with infants of women receiving standard care. Secondary outcomes include birth gestation, breastfeeding outcomes and economic impact

Identifying policies and strategies for general practitioner retention in direct patient care in the United Kingdom: a RAND/UCLA appropriateness method panel study

Background The United Kingdom (UK) is experiencing a general practitioner (GP) workforce retention crisis. Research has focused on investigating why GPs intend to quit, but less is known about the acceptability and effectiveness of policies and strategies to improve GP retention. Using evidence from research and key stakeholder organisations, we generated a set of potential policies and strategies aimed at maximising GP retention and tested their appropriateness for implementation by systematically consulting with GPs. Methods 28 GP Partners and GPs working in national stakeholder organisations from South West England and London were purposively sampled, and asked to take part in a RAND/UCLA Appropriateness Method panel. Panellists were asked to read an evidence briefing summary, and then complete an online survey on two occasions. During each round, participants rated the appropriateness of policies and strategies aimed at improving GP retention using a nine point scale (1 ‘extremely inappropriate’ to 9 ‘extremely appropriate’). Fifty-four potential policies and strategies (equating to 100 statements) were tested, focusing on factors influencing job satisfaction (e.g. well-being, workload, incentives and remuneration, flexible working, human resources systems). Ratings were analysed for panel consensus and categorised based on appropriateness (‘appropriate’, ‘uncertain’, ‘inappropriate’). Results 12/28 GPs approached agreed to take part, 9/28 completed two rounds of the online survey between February and June 2018. Panellists identified 24/54 policy and strategy areas (41/100 statements) as ‘appropriate’. Examples included providing GP practices ‘at risk’ of experiencing GP shortages with a toolkit for managing recruitment and retention, and interventions to facilitate peer support to enhance health and wellbeing, or support portfolio careers. Strategies to limit GP workload, and manage patient demand were also endorsed. Conclusions The panel of experienced GPs identified a number of practical ways to improve GP retention through interventions that might enhance job satisfaction and work-life balance. Future research should evaluate the impact of implementing these recommendations

Methane in the atmosphere of the transiting hot Neptune GJ436b?

We present an analysis of seven primary transit observations of the hot Neptune GJ436b at 3.6, 4.5 and $8~\mu$m obtained with the Infrared Array Camera (IRAC) on the Spitzer Space Telescope. After correcting for systematic effects, we fitted the light curves using the Markov Chain Monte Carlo technique. Combining these new data with the EPOXI, HST and ground-based $V, I, H$ and $K_s$ published observations, the range $0.5-10~\mu$m can be covered. Due to the low level of activity of GJ436, the effect of starspots on the combination of transits at different epochs is negligible at the accuracy of the dataset. Representative climate models were calculated by using a three-dimensional, pseudo-spectral general circulation model with idealised thermal forcing. Simulated transit spectra of GJ436b were generated using line-by-line radiative transfer models including the opacities of the molecular species expected to be present in such a planetary atmosphere. A new, ab-initio calculated, linelist for hot ammonia has been used for the first time. The photometric data observed at multiple wavelengths can be interpreted with methane being the dominant absorption after molecular hydrogen, possibly with minor contributions from ammonia, water and other molecules. No clear evidence of carbon monoxide and dioxide is found from transit photometry. We discuss this result in the light of a recent paper where photochemical disequilibrium is hypothesised to interpret secondary transit photometric data. We show that the emission photometric data are not incompatible with the presence of abundant methane, but further spectroscopic data are desirable to confirm this scenario.Comment: 19 pages, 10 figures, 1 table, Astrophysical Journal in pres

Comparative Network Analysis of Preterm vs. Full-Term Infant-Mother Interactions

Several studies have reported that interactions of mothers with preterm infants show differential characteristics compared to that of mothers with full-term infants. Interaction of preterm dyads is often reported as less harmonious. However, observations and explanations concerning the underlying mechanisms are inconsistent. In this work 30 preterm and 42 full-term mother-infant dyads were observed at one year of age. Free play interactions were videotaped and coded using a micro-analytic coding system. The video records were coded at one second resolution and studied by a novel approach using network analysis tools. The advantage of our approach is that it reveals the patterns of behavioral transitions in the interactions. We found that the most frequent behavioral transitions are the same in the two groups. However, we have identified several high and lower frequency transitions which occur significantly more often in the preterm or full-term group. Our analysis also suggests that the variability of behavioral transitions is significantly higher in the preterm group. This higher variability is mostly resulted from the diversity of transitions involving non-harmonious behaviors. We have identified a maladaptive pattern in the maternal behavior in the preterm group, involving intrusiveness and disengagement. Application of the approach reported in this paper to longitudinal data could elucidate whether these maladaptive maternal behavioral changes place the infant at risk for later emotional, cognitive and behavioral disturbance