Managing multiple morbidity in mid-life: a qualitative study of attitudes to drug use

OBJECTIVE: To examine attitudes towards drug use among middle aged respondents with high levels of chronic morbidity. DESIGN: Qualitative study with detailed interviews. SETTING: West of Scotland. PARTICIPANTS: 23 men and women aged about 50 years with four or more chronic illnesses. MAIN OUTCOME MEASURE: Participants' feelings about long term use of drugs to manage chronic multiple morbidity. RESULTS: Drugs occupied a central place in the way people managed their comorbidities. Respondents expressed an aversion to taking drugs, despite acknowledging that they depended on drugs to live as "normal" a life as possible. Respondents expressed ambivalence to their drugs in various ways. Firstly, they adopted both regular and more flexible regimens and might adhere to a regular regimen in treating one condition (such as hypertension) while adopting a flexible regimen in relation to others, in response to their experience of symptoms or varying demands of their daily life. Secondly, they expressed reluctance to take drugs, but an inability to be free of them. Thirdly, drugs both facilitated performance of social roles and served as evidence of an inability to perform such roles. CONCLUSIONS: Insight into the considerable tension experienced by people managing complex drug regimens to manage multiple chronic illness may help medical carers to support self care practices among patients and to optimise concordance in their use of prescribed drugs

Study of lubricant jet flow phenomena in spur gears: Out of mesh condition

The penetration depth onto the tooth flank of a jet of oil at different velocities pointed at the pitch line on the outgoing side of mesh was determined. The analysis determines the impingement depth for both the gear and the pinion. It includes the cases for speed increasers and decreasers as well as for one to one gear ratio. In some cases the jet will strike the loaded side of the teeth, and in others it will strike the unloaded side of the teeth. In nearly all cases the top land will be cooled regardless of the penetration depth, and postimpingement oil spray will usually provide adequate amounts of oil for lubrication but is marginal or inadequate for cooling

Accelerating Cosmologies from S-Branes

We point out that the recently proposed model of a flat 4-dimensional universe with accelerated expansion in string/M-theory is a special case of time-dependent solutions that the author found under the name of ``S-branes.'' We also show that similar accelerating models can be obtained from S-branes if the internal space is chosen to be hyperbolic or flat spaces.Comment: 8 pages, 4 figures, comments added, a typo corrected, final version to appear in Phys. Rev. Let

Wear consideration in gear design for space applications

A procedure is described that was developed for evaluating the wear in a set of gears in mesh under high load and low rotational speed. The method can be used for any low-speed gear application, with nearly negligible oil film thickness, and is especially useful in space stepping mechanism applications where determination of pointing error due to wear is important, such as in long life sensor antenna drives. A method is developed for total wear depth at the ends of the line of action using a very simple formula with the slide to roll ratio V sub s/V sub r. A method is also developed that uses the wear results to calculate the transmission error also known as pointing error of a gear mesh

Characterizing the uncertainty in holddown post load measurements

In order to understand unexpectedly erratic load measurements in the launch-pad supports for the space shuttle, the sensitivities of the load cells in the supports were analyzed using simple probabilistic techniques. NASA engineers use the loads in the shuttle's supports to calculate critical stresses in the shuttle vehicle just before lift-off. The support loads are measured with 'load cells' which are actually structural components of the mobile launch platform which have been instrumented with strain gauges. Although these load cells adequately measure vertical loads, the horizontal load measurements have been erratic. The load measurements were simulated in this study using Monte Carlo simulation procedures. The simulation studies showed that the support loads are sensitive to small deviations in strain and calibration. In their current configuration, the load cells will not measure loads with sufficient accuracy to reliably calculate stresses in the shuttle vehicle. A simplified model of the holddown post (HDP) load measurement system was used to study the effect on load measurement accuracy for several factors, including load point deviations, gauge heights, and HDP geometry

The development of cases for teaching administration of the nursing services by the case method.

Thesis (M.S.)--Boston Universit

Into Mesh Lubrication of Spur Gears with Arbitrary Offset Oil Jet. 2: for Jet Velocities Equal to or Greater than Great Velocity

An analysis was conducted for into mesh oil jet lubrication with an arbitrary offset and inclination angle from the pitch point for the case where the oil jet velocity is equal to or greater than gear pitch line velocity. Equations were developed for minimum and maximum oil jet impingement depth. The analysis also included the minimum oil jet velocity required to impinge on the gear or pinion and the optimum oil jet velocity required to obtain the best lubrication condition of maximum impingement depth and gear cooling. It was shown that the optimum oil jet velocity for best lubrication and cooling is when the oil jet velocity equals the gear pitch line velocity. When the oil jet velocity is slightly greater than the pitch line velocity the loaded side of the driven gear and the unloaded side of the pinion receive the best lubrication and cooling with slightly less impingement depth. As the jet velocity becomes much greater than the pitch line velocity the impingement depth is considerably reduced and may completely miss the pinion

Into Mesh Lubrication of Spur Gears with Arbitrary Offset Oil Jet. I: For Jet Velocity Less than or Equal to Gear Velocity

An analysis was conducted for into mesh oil jet lubrication with an arbitrary offset and inclination angle from the pitch point for the case where the oil jet velocity is equal to or less than pitch line velocity. The analysis includes the case for the oil jet offset from the pitch point in the direction of the pinion and where the oil jet is inclined to intersect the common pitch point. Equations were developed for the minimum oil jet velocity required to impinge on the pinion or gear and the optimum oil jet velocity to obtain the maximum impingement depth