Association behavior of binary polymer mixtures under elongational flow

The influence of elongational flow on the association behavior of binary mixtures of functionalized polymers capable of forming single reversible orientationally dependent bonds, such as hydrogen bonds, is studied analytically. Applying a mean-field approach with an external potential representing the effect of the elongational flow, the orientation distribution functions for the dumbbell model and the freely jointed model of a polymer chain were obtained. Two opposite factors determine the association of “linear” diblock copolymerlike chains: the unfavorable extra stretching under flow of associated polymer chains and the favorable orientation of the chains (segments) along the flow direction. The former dominates and the fraction of associated “linear” chains decreases with increasing flow rate. For mixtures of polymers which are capable of forming associated T-chains, the association also decreases, however, more slowly, and this time due to unfavorable orientational effects. If the formation of associated linear and T-polymers as well as complex linear/T-polymers is possible, a strong preference for the formation of associated T-chains is found. At high flow rates any type of association becomes unfavorable

Measurement Properties and Implementation of a Checklist to Assess Leadership Skills during Interdisciplinary Rounds in the Intensive Care Unit

The implementation of interdisciplinary teams in the intensive care unit (ICU) has focused attention on leadership behavior. A daily recurrent situation in ICUs in which both leadership behavior and interdisciplinary teamwork are integrated concerns the interdisciplinary rounds (IDRs). Although IDRs are recommended to provide optimal interdisciplinary and patient-centered care, there are no checklists available for leading physicians. We tested the measurement properties and implementation of a checklist to assess the quality of leadership skills in interdisciplinary rounds. The measurement properties of the checklist, which included 10 essential quality indicators, were tested for interrater reliability and internal consistency and by factor analysis. The interrater reliability among 3 raters was good (κ, 0.85) and the internal consistency was acceptable (α, 0.74). Factor analysis showed all factor loadings on 1 domain (>0.65). The checklist was further implemented during videotaped IDRs which were led by senior physicians and in which 99 patients were discussed. Implementation of the checklist showed a wide range of “no” and “yes” scores among the senior physicians. These results may underline the need for such a checklist to ensure tasks are synchronized within the team

Strain-induced kinetics of intergrain defects as the mechanism of slow dynamics in the nonlinear resonant response of humid sandstone bars

A closed-form description is proposed to explain nonlinear and slow dynamics effects exhibited by sandstone bars in longitudinal resonance experiments. Along with the fast subsystem of longitudinal nonlinear displacements we examine the strain-dependent slow subsystem of broken intergrain and interlamina cohesive bonds. We show that even the simplest but phenomenologically correct modelling of their mutual feedback elucidates the main experimental findings typical for forced longitudinal oscillations of sandstone bars, namely, (i) hysteretic behavior of a resonance curve on both its up- and down-slopes, (ii) linear softening of resonant frequency with increase of driving level, and (iii) gradual recovery (increase) of resonant frequency at low dynamical strains after the sample was conditioned by high strains. In order to reproduce the highly nonlinear elastic features of sandstone grained structure a realistic non-perturbative form of strain potential energy was adopted. In our theory slow dynamics associated with the experimentally observed memory of peak strain history is attributed to strain-induced kinetic changes in concentration of ruptured inter-grain and inter-lamina cohesive bonds causing a net hysteretic effect on the elastic Young's modulus. Finally, we explain how enhancement of hysteretic phenomena originates from an increase in equilibrium concentration of ruptured cohesive bonds that are due to water saturation.Comment: 5 pages, 3 figure

Practitioners’ perspectives on quality of life in aphasia rehabilitation in Denmark

Objective: This study reports on Danish speech and language therapists’ knowledge and understanding of quality of life (QOL) in aphasia, including therapists’ views on education and training in relation to preparedness for working on QOL, use of measures, and barriers to applying QOL in practice. Methods: 14 Danish clinicians completed a 48-item online questionnaire regarding their views, perspectives and practices that included multiple-choice questions, rating scales, and boxes permitting free text responses. Descriptive statistics were used to characterize the numerical data, and content analysis was applied to text responses. Results: The clinicians interpreted QOL as subjective wellbeing and participation, and explored it with most clients and relatives using informal methods, primarily conversation, for the purposes of identifying relevant goals to direct treatment. Clinicians perceived a need for greater theoretical, practical and experiential knowledge regarding QOL. They also identified a need for translated QOL instruments and training in these measures in practice. Conclusion: Despite a reported lack of knowledge about and tools for measuring QOL, Danish clinicians are applying QOL issues in their practice and perceive these issues as valuable and important in assessment and therapy. The findings have clear implications for tool development, and workforce education

Interactive prototypes in the participatory development of product-service systems

Stakeholders who are part of the development process of a new Product-Service System (PSS) could use interactive prototypes during meetings to exchange different point of views. Based on the findings of a conversation analyst and the reflections of a design researcher we compared three explication techniques of how a prototype was involved during such a meeting (for pointing and manipulating, for demonstrating its function and for imitating and/or demonstration through body movement and gesture) with the phases of a co-reflection session (exploration, ideation and confrontation). We found that the prototype was especially useful during the exploration and confrontation phases. Pointing and manipulating helped to make reflections concrete, made it easier to propose small design changes and helped the participants to reach common goals. Interactive prototypes do have their limits, during the ideation phase the prototype did not play an important role

Economic inequalities in the effectiveness of a primary care intervention for depression and suicidal ideation.

BACKGROUND: Economic disadvantage is associated with depression and suicide. We sought to determine whether economic disadvantage reduces the effectiveness of depression treatments received in primary care. METHODS: We conducted differential-effects analyses of the Prevention of Suicide in Primary Care Elderly: Collaborative Trial, a primary-care-based randomized, controlled trial for late-life depression and suicidal ideation conducted between 1999 and 2001, which included 514 patients with major depression or clinically significant minor depression. RESULTS: The intervention effect, defined as change in depressive symptoms from baseline, was stronger among persons reporting financial strain at baseline (differential effect size = -4.5 Hamilton Depression Rating Scale points across the study period [95% confidence interval = -8.6 to -0.3]). We found similar evidence for effect modification by neighborhood poverty, although the intervention effect weakened after the initial 4 months of the trial for participants residing in poor neighborhoods. There was no evidence of substantial differences in the effectiveness of the intervention on suicidal ideation and depression remission by economic disadvantage. CONCLUSIONS: Economic conditions moderated the effectiveness of primary-care-based treatment for late-life depression. Financially strained individuals benefited more from the intervention; we speculate this was because of the enhanced treatment management protocol, which led to a greater improvement in the care received by these persons. People living in poor neighborhoods experienced only temporary benefit from the intervention. Thus, multiple aspects of economic disadvantage affect depression treatment outcomes; additional work is needed to understand the underlying mechanisms