Nonintegrable Interaction of Ion-Acoustic and Electromagnetic Waves in a Plasma

In this paper we re-examine the one-dimensional interaction of electromagnetic and ion acoustic waves in a plasma. Our model is similar to one solved by Rao et al. (Phys. Fluids, vol. 26, 2488 (1983)) under a number of analytical approximations. Here we perform a numerical investigation to examine the stability of the model. We find that for slightly over dense plasmas, the propagation of stable solitary modes can occur in an adiabatic regime where the ion acoustic electric field potential is enslaved to the electromagnetic field of a laser. But if the laser intensity or plasma density increases or the laser frequency decreases, the adiabatic regime loses stability via a transition to chaos. New asymptotic states are attained when the adiabatic regime no longer exists. In these new states, the plasma becomes rarefied, and the laser field tends to behave like a vacuum field.Comment: 19 pages, REVTeX, 6 ps figures, accepted for publication in Phys. Rev.

Training medical specialists to communicate better with patients with medically unexplained physical symptoms (MUPS). A randomized, controlled trial

Background Patients with medically unexplained physical symptoms (MUPS) are prevalent 25-50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don't feel understood. We developed an evidence-based communication training, aimed to improve specialists' interviewing, information-giving and planning skills in MUPS consultations, and tested its effectiveness. Methods The intervention group in this multi-center randomized controlled trial received a 14-hour training program to which experiential learning and feedback were essential. Using techniques from Cognitive Behavioral Therapy, they were stimulated to seek interrelating factors (symptoms, cognitions, emotions, behavior, and social environment) that reinforced a patient's symptoms. They were taught to

Training specialists to write appropriate reply letters to general practitioners about patients with medically unexplained physical symptoms; A cluster-randomized trial.

Objective: To evaluate effects of a communication training for specialists on the quality of their reply letters to general practitioners (GPs) about patients with medically unexplained physical symptoms (MUPS). Methods: Before randomization, specialists included ≤3 MUPS patients in a multi-center cluster-randomized trial. In 14 h of MUPS-specific communication training, 2.5 h focused on reply letters. Letters were discussed with regard to reporting and answering GPs' referral questions and patients' questions, and to reporting findings, explaining MUPS with perpetuating factors and giving advice. After the training, all doctors again included ≤3 MUPS patients. Reply letters to GPs were assessed for quality and blindly rated on a digital scale. Results: We recruited 478 MUPS patients and 123 specialists; 80% of the doctors wrote ≥1 reply letters, 285 letters were assessed. Trained doctors reported (61% versus 37%, OR=2.55, F(1281)=6.60, pgroup*time=.01) and answered (63% versus 33%, OR=3.31, F(1281)=5.36, pgroup*time=.02) patients' questions more frequently than untrained doctors. Conclusion: Training improves reply letters with regard to patients' questions, but not with regard to the following: GPs' referral questions, somatic findings, additional testing, explaining, and advice. Practice implications: Training specialists to write appropriate reply letters needs more focus on explanation and advice

DESC9115: Digital Audio Systems - Final Project

The Flanger Toolbox creates a flanged signal based on user inputs. Also submitted is a help page with a more detailed description, a MATLAB function and an audio example of the Flanger Toolbox's output. Assessment 2 is submitted as well, in which the Flanger Toolbox is pitched to a venture capitalist.Architecture & Allied Art

Encounters between medical specialists and patients with medically unexplained physical symptoms; influences of communication on patient outcomes and use of health care: a literature overview

Item does not contain fulltextMedically unexplained physical symptoms (MUPS) burden patients and health services due to large quantities of consultations and medical interventions. The aim of this study is to determine which elements of communication in non-psychiatric specialist MUPS care influence health outcomes. Systematic search in PubMed, PsycINFO and Embase. Data extraction comprising study design, patient characteristics, number of patients, communication strategies, outcome measures and results. Elements of doctor-patient communication were framed according to symptoms, health anxiety, satisfaction, daily functioning and use of health care. Eight included studies. Two studies described the effect of communication on patient outcome in physical symptoms, three studies on health anxiety and patient satisfaction and one study on daily functioning. Two studies contained research on use of health care. Qualitative synthesis of findings was conducted. Communication matters in non-psychiatric MUPS specialist care. Perceiving patients' expectations correctly enables specialists to influence patients' cognitions, to reduce patients' anxiety and improve patients' satisfaction. Patients report less symptoms and health anxiety when symptoms are properly explained. Positive interaction and feedback reduces use of health care and improves coping. Development of communication skills focused on MUPS patients should be part of postgraduate education for medical specialists