298 research outputs found
Accessing nanotube bands via crossed electric and magnetic fields
We investigate the properties of conduction electrons in single-walled
armchair carbon nanotubes in the presence of mutually orthogonal electric and
magnetic fields transverse to the tube's axis. We find that the fields give
rise to an asymmetric dispersion in the right- and left-moving electrons along
the tube as well as a band-dependent interaction. We predict that such a
nanotube system would exhibit spin-band-charge separation and a band-dependant
tunneling density of states. We show that in the quantum dot limit, the fields
serve to completely tune the quantum states of electrons added to the nanotube.
For each of the predicted effects, we provide examples and estimates that are
relevant to experiment.Comment: 4 pages, 2 figure
Mental Health Programs in Remote Divisions of General Practice: PARC Knowledge Harvesting Program Issues Report
Part of the Primary Mental Health Care Australian Resource Centre (PARC) knowledge management strategy for the Primary Mental Health Care Network.This discussion paper describes the mental health activities of Divisions of General Practice (DGPs) operating in remote areas of Australia , and documents the knowledge of the people who work in these programs.Primary Mental Health Care Australian Resource Centre (PARC)
Primary Mental Health Care Network
Transitioning a home telehealth project into a sustainable, large-scale service: a qualitative study
© 2016 Wade et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
This study was a component of the Flinders Telehealth in the Home project, which tested adding home telehealth to existing rehabilitation, palliative care and geriatric outreach services. Due to the known difficulty of transitioning telehealth projects services, a qualitative study was conducted to produce a preferred implementation approach for sustainable and large-scale operations, and a process model that offers practical advice for achieving this goal.
Methods
Initially, semi-structured interviews were conducted with senior clinicians, health service managers and policy makers, and a thematic analysis of the interview transcripts was undertaken to identify the range of options for ongoing operations, plus the factors affecting sustainability. Subsequently, the interviewees and other decision makers attended a deliberative forum in which participants were asked to select a preferred model for future implementation. Finally, all data from the study was synthesised by the researchers to produce a process model.
Results
19 interviews with senior clinicians, managers, and service development staff were conducted, finding strong support for home telehealth but a wide diversity of views on governance, models of clinical care, technical infrastructure operations, and data management. The deliberative forum worked through these options and recommended a collaborative consortium approach for large-scale implementation. The process model proposes that the key factor for large-scale implementation is leadership support, which is enabled by 1) showing solutions to the problems of service demand, budgetary pressure and the relationship between hospital and primary care, 2) demonstrating how home telehealth aligns with health service policies, and 3) achieving clinician acceptance through providing evidence of benefit and developing new models of clinical care. Two key actions to enable change were marketing telehealth to patients, clinicians and policy-makers, and building a community of practice.
Conclusions
The implementation of home telehealth services is still in an early stage. Change agents and a community of practice can contribute by marketing telehealth, demonstrating policy alignment and providing potential solutions for difficult health services problems. This should assist health leaders to move from trials to large-scale services
Isolation and characterisation of graves’ disease-specific extracellular vesicles from tissue maintained on a bespoke microfluidic device
AbstractThis report demonstrates the ability of a microfluidic device to maintain human Graves' disease tissue enabling the isolation and characterisation of Graves' disease specific exosomes. Graves' disease (n = 7) and non-Graves’ disease (Hashimoto's thyroiditis, n = 3; follicular adenoma, n = 1) human tissue was incubated in a microfluidic device for 6 days ± dexamethasone or methimazole and effluent was analysed for the size and concentration of extracellular vesicles (EV) using nanoparticle tracking analysis. Exosomes were isolated by centrifugation and characterised using Western blotting and qRT-PCR for miRNA-146a and miRNA-155, previously reported to be immunomodulatory. EV were detected in all effluent samples. No difference in concentration was observed in the EV released from Graves' compared to non-Graves’ disease tissue and although the size of EV from Graves' disease tissue was smaller compared to those from non-Graves’ disease tissue, the difference was not consistently significant. No effect of treatment was observed on the size or concentration of EV released. The exosome markers CD63 and CD81 were detectable in 2/5 Graves' disease tissue exosomes and CD63 was also evident in exosomes from a single non-Graves’ sample. miRNA-146a and miRNA-155 were detectable in all samples with no difference between tissue cohorts. Treatment did not influence miRNA expression in exosomes isolated from Graves' disease tissue. Although miRNA-146a and miRNA-155 were both elevated following treatment of non-Graves’ disease tissue with dexamethasone and methimazole, the increase was not significant. This study provides a proof of concept that incubation of tissue on a microfluidic device allows the detection, isolation and characterisation of extracellular vesicles from human tissue biopsies
Improving management of student clinical placements: insights from activity theory
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
An approach to improve management of student clinical placements, the Building Teams for Quality Learning project, was trialed in three different health services. In a previous paper the authors explored in some detail the factors associated with considerable success of this approach at one of these services. In this paper, the authors extend this work with further analysis to determine if the more limited outcomes observed with participants at the other two services could be explained by application of activity theory and in particular the expansive learning cycle.
Methods
Staff at three health services participated in the Building Teams for Quality Learning project: a dental clinic, a community aged care facility and a rural hospital. At each site a team of seven multi-disciplinary staff completed the project over 9 to 12 months (total 21 participants). Evaluation data were collected through interviews, focus groups and direct observation of staff and students. Following initial thematic analysis, further analysis was conducted to compare the processes and outcomes at each participating health service drawing on activity theory and the expansive learning cycle.
Results
Fifty-one interview transcripts, 33 h of workplace observation and 31 sets of workshop field notes (from 36 h of workshops) were generated. All participants were individually supportive of, and committed to, high quality student learning experiences. As was observed with staff at the dental clinic, a number of potentially effective strategies were discussed at the aged care facility and the rural hospital workshops. However, participants in these two health services could not develop a successful implementation plan. The expansive learning cycle element of modeling and testing new solutions was not achieved and participants were unable, collectively to reassess and reinterpret the object of their activities.
Conclusion
The application of activity theory and the expansive learning cycle assisted a deeper understanding of the differences in outcomes observed across the three groups of participants. This included identifying specific points in the expansive learning cycle at which the three groups diverged. These findings support some practical recommendations for health services that host student clinical placements
Do GPs use electronic mental health resources? A qualitative study
BACKGROUNDThe Better Outcomes in Mental Health Care (BOMHC) initiative encourages general practitioners to use electronic mental health resources (EMHRs) during consultation with patients requiring psychological assistance. However, there is little data on GPs’ acceptance and use of EMHRs.METHODSemistructured interviews were conducted with 27 GPs to determine their attitude toward EMHRs, and their use during consultation with patients.RESULTSFew GPs reported frequently using EMHRs in consultation. Identified barriers to use included lack of familiarity with information technology, and insufficient knowledge of available resources. Identified advantages of electronic resources included high patient acceptance, time efficiency, and improved quality of information.DISCUSSIONGeneral practitioners recognise several advantages of utilising electronic resources for managing patients with mental illness. However, GPs are not sufficiently familiar with electronic resources to use them effectively. This could be overcome by education.<br /
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Marine reserve impacts : why have marine reserves been established in Oregon?
Overview:
Marine reserves are a type of marine protected area with full protections. This means that taking of marine species within an Oregon Marine Reserve is never allowed. Many studies from around the world show that marine reserves can provide long-term conservation benefits to marine organisms, populations, and biodiversity. In this lesson, students learn about the goals that have been set for Oregon’s Marine Reserves, and how scientific data is being collected to help determine whether the goals are being met.Learning Goals:
Students will learn the following:
• Oregon’s five marine reserves were established to protect marine ecosystems.
• Researchers collect data over many years to determine the impacts of marine reserves and whether the goals for the reserves are being met.
• Understanding the impacts of marine reserves can inform and improve fishery management decisions
The effect of locomotion on early visual contrast processing in humans
Most of our knowledge about vision comes from experiments in which stimuli are presented to immobile human subjects or animals. In the case of human subjects, movement during psychophysical, electrophysiological or neuroimaging experiments is considered to be a source of noise to be eliminated. Animals used in visual neuroscience experiments are typically restrained and, in many cases, anaesthetized. In reality however, vision is often used to guide the motion of awake, ambulating organisms. Recent work in mice has shown that locomotion elevates visual neuronal response amplitudes (Erisken et al., 2014; Fu et al., 2014; Lee et al., 2014; Mineault et al., 2016; Niell and Stryker, 2010) and reduces long-range gain control (Ayaz et al., 2013). Here we use both psychophysics and steady-state electrophysiology to ask whether similar effects of locomotion on early visual processing can be measured in humans. Our psychophysical results show that brisk walking has little effect on subjects’ ability to detect briefly-presented contrast changes and that co-oriented flankers are, if anything, more effective masks when subjects are walking. Our electrophysiological data were consistent with the psychophysics, indicating no increase in stimulus-driven neuronal responses whilst walking and no reduction in surround suppression. In summary we find evidence that early contrast processing is altered by locomotion in humans but in a manner that differs from that reported in mice. The effects of locomotion on very low-level visual processing may differ on a species-by-species basis and may reflect important differences in the levels of arousal associated with locomotion
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