Profile of allergy-related articles in the primary academic publication for UK General Practitioners

Background: Concern is often expressed about primary health care professionals’ lack of knowledge about allergies, particularly diagnostic testing and the management of atopic disorders. Limited training opportunities in allergy have been documented in both undergraduate and postgraduate education. The British Journal of General Practice is the leading UK-based Family Practice journal, it has a strong clinical focus. The BJGP was established in 1953. It is a high quality journal and is the world’s 2nd most highly cited journal of general practice and primary care. Methods: Keyword search of bjgp.org. Terms used were ‘allergy’, ‘allergies’, ‘allergic’, ‘rhinitis’, ‘urticaria’, ‘eczema’, ‘angioedema’. All titles and articles from 1953 to 2013 were searched. Full copies of relevant publications were downloaded and variables extracted, including title, year of publication, type of article, clinical focus. As a comparator a similar search was conducted for articles about asthma using the search term ‘asthma’. Results: 41 allergy-related articles were identified in the 60 years since the journal was launched. In the same time period there were 147 articles about asthma. In 31 of the 60 years reviewed there were no articles at all about any allergy-related topic. The focus of the articles published were eczema (6), food allergy (6), rhinoconjunctivitis (5), anaphylaxis (4), urticaria (1). There were no articles on angioedema. Some articles addressed multiple atopic disorders, eg ‘Allergic diseases in the elderly’ (1968), ‘Allergic disorders amongst horticultural, agricultural and forestry workers’ [letter] (1965). Conclusions: Allergy has a low profile in the British Journal of General Practice. This low profile persists despite the increasing prevalence of atopic disorders and major national reports highlighting the need for better care of the allergic patient in primary care. Our exploratory study highlights a missed opportunity to educate and inform General Practitioners about allergy through this widely circulated journal. Further work is needed to understand better why so few articles on allergy are published in the BJGP. If the paucity of publications reflects the number of articles submitted then BSACI members interested in informing and improving allergy management in General Practice should include the BJGP on their list of target journals. Where next: To share these observations with the Editor of the BJGP to understand whether they reflect editorial policy or lack of submissions from clinicians and researchers with expertise in allergy. To work with the BJGP to identify collaborative initiatives to address the serious mismatch between the prevalence of allergy in the clinical consultation and the number of allergy- related articles in the literature for GPs

The onset of instability in unsteady boundary-layer separation

The process of unsteady two-dimensional boundary-layer separation at high Reynolds number is considered. Solutions of the unsteady non-interactive boundary-layer equations are known to develop a generic separation singularity in regions where the pressure gradient is prescribed and adverse. As the boundary layer starts to separate from the surface, however, the external pressure distribution is altered through viscous-inviscid interaction just prior to the formation of the separation singularity; hitherto this has been referred to as the first interactive stage. A numerical solution of this stage is obtained here in Lagrangian coordinates. The solution is shown to exhibit a high-frequency inviscid instability resulting in an immediate finite-time breakdown of this stage. The presence of the instability is confirmed through a linear stability analysis. The implications for the theoretical description of unsteady boundary-layer separation are discussed, and it is suggested that the onset of interaction may occur much sooner than previously thought

Unsteady separation past moving surfaces

Unsteady boundary-layer development over moving walls in the limit of infinite Reynolds number is investigated using both the Eulerian and Lagrangian formulations. To illustrate general trends, two model problems are considered, namely the translating and rotating circular cylinder and a vortex convected in a uniform flow above an infinite flat plate. To enhance computational speed and accuracy for the Lagrangian formulation, a remeshing algorithm is developed. The calculated results show that unsteady separation is delayed with increasing wall speed and is eventually suppressed when the speed of the separation singularity approaches that of the local mainstream velocity. This suppression is also described analytically. Only 'upstream-slipping' separation is found to occur in the model problems. The changes in the topological features of the flow just prior to the separation that occur with increasing wall speed are discussed

Revenue Losses from Exemptions of Goods from the Georgia Sales and Use Tax

This report provides estimates of the revenue loss from sales tax exemptions. FRC Report 13

The structure of a three-dimensional turbulent boundary layer

The three-dimensional turbulent boundary layer is shown to have a self-consistent two-layer asymptotic structure in the limit of large Reynolds number. In a streamline coordinate system, the streamwise velocity distribution is similar to that in two-dimensional flows, having a defect-function form in the outer layer which is adjusted to zero at the wall through an inner wall layer. An asymptotic expansion accurate to two orders is required for the cross-stream velocity which is shown to exhibit a logarithmic form in the overlap region. The inner wall-layer flow is collateral to leading order but the influence of the pressure gradient, at large but finite Reynolds numbers, is not negligible and can cause substantial skewing of the velocity profile near the wall. Conditions under which the boundary layer achieves self-similarity and the governing set of ordinary differential equations for the outer layer are derived. The calculated solution of these equations is matched asymptotically to an inner wall-layer solution and the composite profiles so formed describe the flow throughout the entire boundary layer. The effects of Reynolds number and cross-stream pressure gradient on the cross-stream velocity profile are discussed and it is shown that the location of the maximum cross-stream velocity is within the overlap region

The psychological contract in apprenticeships and traineeships : differing perceptions

As with any contract of employment, the mutual expectations of the employer and the apprentice/trainee are very important. Apprenticeships and traineeships have greater expectations than other employment contracts of employment because of the training component of the contract. This paper reports on some of the findings of a major NCVER-funded national project examining mutual expectations in apprenticeships and traineeships through the concept of the psychological contract. The paper focuses on the differences between employers and apprentices/trainees, in the expectations each party has of the other and in the extent to which the expectations are perceived to have been met.<br /

The Interdependence of School Outcomes and School and Neighborhood Crime

In this paper, we estimate the effects of neighborhood crime and in-school crime on educational outcomes for elementary and secondary schools in the city of Atlanta over the period 1999 to 2002. We specify a model that accounts for the joint determination of both types of crime along with school outcomes. Despite the large empirical literature on both education production functions and crime incidence, there has been little empirical work on crime's effect on school outcomes. One exception is Grogger (1997) who used individual data from the High School and Beyond study to estimate the effect of school violence on measures of individual student performance. After controlling for individual and school characteristics, he found that moderate and severe levels of school violence had substantial negative consequences for school outcomes. Our study both updates and expands on his work, using current data and better measures of neighborhood violence. Working Paper 07-1

Short-scale break-up in unsteady interactive layers: Local development of normal pressure gradients and vortex wind-up

Following the finite-time collapse of an unsteady interacting boundary layer (step 1), shortened length and time scales are examined here in the near-wall dynamics of transitional-turbulent boundary layers or during dynamic stall. The next two steps are described, in which (step 2) normal pressure gradients come into operation along with a continuing nonlinear critical-layer jump and then (step 3) vortex formation is induced typically. Normal pressure gradients enter in at least two ways, depending on the internal or external flow configuration. This yields for certain internal flows an extended KdV equation with an extra nonlinear integral contribution multiplied by a coefficient which is proportional to the normal rate of change of curvature of the velocity profile locally and whose sign turns out to be crucial. Positive values of the coefficient lead to a further finite-time singularity, while negative values produce a rapid secondary instability phenomenon. Zero values in contrast allow an interplay between solitary waves and wave packets to emerge at large scaled times, this interplay eventually returning the flow to its original, longer, interactive, boundary-layer scales but now coupled with multiple shorter-scale Euler regions. In external or quasi-external flows more generally an extended Benjamin–Ono equation holds instead, leading to a reversal in the roles of positive and negative values of the coefficient. The next step, 3, typically involves the strong wind-up of a local vortex, leading on to explosion or implosion of the vortex. Further discussion is also presented, including the three-dimensional setting, the computational implications, and experimental links