The family practitioner family : the use of metaphor in understanding changes in primary health care organizations

Current UK health policy guidance locates primary care at the frontiers of health care modernization. New organizational structures have resulted in general practitioner (GP) practices being brought together in Primary Care Groups (PCGs) and Primary Care Trusts (PCTs) each serving a much larger population group than the traditional GP practice. These changes have been accompanied with a need to explore new ways of working and thinking. This paper draws upon the experiences of nurses and GPs participating in an evaluation of workforce planning issues in primary health care. It explores how practitioners working in PCGs across one geographical area were able to gain a better understanding of what these changes, to both the structure and process of practice, might involve. During this developmental process the respondents used ‘the family’ metaphor, as a form of ‘shorthand’ to orientate themselves to the new responsibilities, challenges and opportunities presented by these changes to primary health care. It was in the use of terms and constructs that were familiar to their ‘everyday life’ experiences that made taking the first tentative steps in the change process easier. This paper suggests that using metaphors may be a powerful tool for policy makers, practitioners,managers and for researchers as they seek to communicate a plan for change and in understanding what these changes might mean

Collisionless distribution function for the relativistic force-free Harris sheet

A self-consistent collisionless distribution function for the relativistic analogue of the force-free Harris sheet is presented. This distribution function is the relativistic generalization of the distribution function for the non-relativistic collisionless force-free Harris sheet recently found by Harrison and Neukirch [Phys. Rev. Lett. 102, 135003 (2009)], as it has the same dependence on the particle energy and canonical momenta. We present a detailed calculation which shows that the proposed distribution function generates the required current density profile (and thus magnetic field profile) in a frame of reference in which the electric potential vanishes identically. The connection between the parameters of the distribution function and the macroscopic parameters such as the current sheet thickness is discussed. (C) 2012 American Institute of Physics. [doi: 10.1063/1.3677268]PostprintPeer reviewe

Physical properties of concrete made with Apollo 16 lunar soil sample

This paper describes the first phase of the long-term investigation for the construction of concrete lunar bases. In this phase, petrographic and scanning electron microscope examinations showed that the morphology and elemental composition of the lunar soil made it suitable for use as a fine aggregate for concrete. Based on this finding, calcium aluminate cement and distilled water were mixed with the lunar soil to fabricate test specimens. The test specimens consisted of a 1-in cube, a 1/2-in cube, and three 0.12 x 0.58 x 3.15-in beam specimens. Tests were performed on these specimens to determine compressive strength, modulus of rupture, modulus of elasticity, and thermal coefficient of expansion. Based on examination of the material and test results, it is concluded that lunar soil can be used as a fine aggregate for concrete

Differences between the Two Anomalous X-Ray Pulsars: Variations in the Spin Down Rate of 1E 1048.1-5937 and An Extended Interval of Quiet Spin Down in 1E 2259+586

We analysed the RXTE archival data of 1E 1048.1-5937 covering a time span of more than one year. The spin down rate of this source decreases by 30 percent during the observation. We could not resolve the X-ray flux variations because of contamination by Eta Carinae. We find that the level of pulse frequency fluctuations of 1E 1048.1-5937 is consistent with typical noise levels of accretion powered pulsars. Recent RXTE observations of 1E 2259+586 have shown a constant spin down with a very low upper limit on timing noise. We used the RXTE archival X-ray observations of 1E 2259+586 to show that the intrinsic X-ray luminosity times series is also stable, with an rms fractional variation of less than 15 percent. The source could have been in a quiet phase of accretion with a constant X-ray luminosity and spin down rate.Comment: MNRAS in pres