General practitioners' perceptions of effective health care

Objectives: To explore general practitioners' perceptions of effective health care and its application in their own practice; to examine how these perceptions relate to assumptions about clinicians' values and behaviour implicit in the evidence based medicine approach. Design: A qualitative study using semistructured interviews. Setting: Eight general practices in North Thames region that were part of the Medical Research Council General Practice Research Framework. Participants: 24 general practitioners, three from each practice. Main outcome measures: Respondents' definitions of effective health care, reasons for not practising effectively according to their own criteria, sources of information used to answer clinical questions about patients, reasons for making changes in clinical practice. Results: Three categories of definitions emerged: clinical, patient related, and resource related. Patient factors were the main reason given for not practising effectively; others were lack of time, doctors' lack of knowledge and skills, lack of resources, and "human failings." Main sources of information used in situations of clinical uncertainty were general practitioner partners and hospital doctors. Contact with hospital doctors and observation of hospital practice were just as likely as information from medical and scientific literature to bring about changes in clinical practice. Conclusions: The findings suggest that the central assumptions of the evidence based medicine paradigm may not be shared by many general practitioners, making its application in general practice problematic. The promotion of effective care in general practice requires a broader vision and a more pragmatic approach which takes account of practitioners' concerns and is compatible with the complex nature of their work

The dynamic phenomena of a tethered satellite: NASA's first Tethered Satellite Mission, TSS-1

The tethered satellite system (TSS) was envisioned as a means of extending a satellite from its base (space shuttle, space station, space platform) into a lower or higher altitude in order to more efficiently acquire data and perform science experiments. This is accomplished by attaching the satellite to a tether, deploying it, then reeling it in. When its mission is completed, the satellite can be returned to its base for reuse. If the tether contains a conductor, it can also be used as a means to generate and flow current to and from the satellite to the base. When current is flowed, the tether interacts with the Earth's magnetic field, deflecting the tether. When the current flows in one direction, the system becomes a propulsive system that can be used to boost the orbiting system. In the other direction, it is a power generating system. Pulsing the current sets up a dynamic oscillation in the tether, which can upset the satellite attitude and preclude docking. A basic problem occurs around 400-m tether length, during satellite retrieval when the satellite's pendulous (rotational) mode gets in resonance with the first lateral tether string mode. The problem's magnitude is determined by the amount of skiprope present coming into this resonance condition. This paper deals with the tethered satellite, its dynamic phenomena, and how the resulting problems were solved for the first tethered satellite mission (TSS-1). Proposals for improvements for future tethered satellite missions are included. Results from the first tethered satellite flight are summarized

On the anomalous afterglow seen in a chameleon afterglow search

We present data from our investigation of the anomalous orange-colored afterglow that was seen in the GammeV Chameleon Afterglow Search (CHASE). These data includes information about the broad band color of the observed glow, the relationship between the glow and the temperature of the apparatus, and other data taken prior to and during the science operations of CHASE. While differing in several details, the generic properties of the afterglow from CHASE are similar to luminescence seen in some vacuum compounds. Contamination from this, or similar, luminescent signatures will likely impact the design of implementation of future experiments involving single photon detectors and high intensity light sources in a cryogenic environment.Comment: 6 pages, 5 figures, submitted to PR

Propfan test assessment testbed aircraft stability and control/performance 1/9-scale wind tunnel tests

One-ninth scale wind tunnel model tests of the Propfan Test Assessment (PTA) aircraft were performed in three different NASA facilities. Wing and propfan nacelle static pressures, model forces and moments, and flow field at the propfan plane were measured in these tests. Tests started in June 1985 and were completed in January 1987. These data were needed to assure PTA safety of flight, predict PTA performance, and validate analytical codes that will be used to predict flow fields in which the propfan will operate