Novel inferences of ionisation & recombination for particle/power balance during detached discharges using deuterium Balmer line spectroscopy

The physics of divertor detachment is determined by divertor power, particle and momentum balance. This work provides a novel analysis technique of the Balmer line series to obtain a full particle/power balance measurement of the divertor. This supplies new information to understand what controls the divertor target ion flux during detachment. Atomic deuterium excitation emission is separated from recombination quantitatively using Balmer series line ratios. This enables analysing those two components individually, providing ionisation/recombination source/sinks and hydrogenic power loss measurements. Probabilistic Monte Carlo techniques were employed to obtain full error propagation - eventually resulting in probability density functions for each output variable. Both local and overall particle and power balance in the divertor are then obtained. These techniques and their assumptions have been verified by comparing the analysed synthetic diagnostic 'measurements' obtained from SOLPS simulation results for the same discharge. Power/particle balance measurements have been obtained during attached and detached conditions on the TCV tokamak.Comment: The analysis results of this paper were formerly in arXiv:1810.0496

Tearing down walls: opening the border between hospital and ambulatory care for quality improvement in Germany

The hospital benchmarking system in Germany was originally introduced to detect unintended consequences of reimbursement based on diagnosis-related groups. The new nationwide SQG programme aims to provide information on quality and outcomes of health care provided in hospital, ambulatory specialist and primary care settings, including the healthcare delivery across different sectors. In 2010 the topics for indicator development were cataract surgery, cervical conization, colectoral cancer and percutaneous coronary interventions or coronary angiography. A systematic stepwise modified RAND/UCLA procedure is applied to develop quality indicators in each of these domains. A general framework for data collection is implemented. Benchmarking results are fed back to providers on a regular basis

Does patient satisfaction of general practice change over a decade?

Background The Patient Participation Program (PPP) was a patient satisfaction survey endorsed by the Royal Australian College of General Practitioners and designed to assist general practitioners in continuous quality improvement (CQI). The survey was been undertaken by 3500 practices and over a million patients between 1994 and 2003. This study aimed to use pooled patient questionnaire data to investigate changes in satisfaction with primary care over time. Methods The results of 10 years of the PPP surveys were analyzed with respect to 10 variables including the year of completion, patient age, gender, practice size, attendance at other doctors, and whether the practice had previously undertaken the survey. Comparisons were made using Logistic Generalized Estimating Equations (LGEE). Results There was a very high level of satisfaction with general practice in Australia (99% of respondents). An independent indicator of satisfaction was created by pooling the results of 12 questions. This new indicator had a greater variance than the single overall satisfaction question. Participants were shown to have higher levels of satisfaction if they were male, older, did not attend other practitioners or the practice was small in size. A minimal improvement in satisfaction was detected in this pooled indicator for the second or third survey undertaken by a practice. There was however no statistically significant change in pooled satisfaction with the year of survey. Conclusion The very high level of satisfaction made it difficult to demonstrate change. It is likely that this and the presentation of results made it difficult for GPs to use the survey to improve their practices. A more useful survey would be more sensitive to detect negative patient opinions and provide integrated feedback to GPs. At present, there are concerns about the usefulness of the PPP in continuous quality improvement in general practice.James Allan, Peter Schattner, Nigel Stocks and Emmae Ramsa

Does patient satisfaction of general practice change over a decade?

Background The Patient Participation Program (PPP) was a patient satisfaction survey endorsed by the Royal Australian College of General Practitioners and designed to assist general practitioners in continuous quality improvement (CQI). The survey was been undertaken by 3500 practices and over a million patients between 1994 and 2003. This study aimed to use pooled patient questionnaire data to investigate changes in satisfaction with primary care over time. Methods The results of 10 years of the PPP surveys were analyzed with respect to 10 variables including the year of completion, patient age, gender, practice size, attendance at other doctors, and whether the practice had previously undertaken the survey. Comparisons were made using Logistic Generalized Estimating Equations (LGEE). Results There was a very high level of satisfaction with general practice in Australia (99% of respondents). An independent indicator of satisfaction was created by pooling the results of 12 questions. This new indicator had a greater variance than the single overall satisfaction question. Participants were shown to have higher levels of satisfaction if they were male, older, did not attend other practitioners or the practice was small in size. A minimal improvement in satisfaction was detected in this pooled indicator for the second or third survey undertaken by a practice. There was however no statistically significant change in pooled satisfaction with the year of survey. Conclusion The very high level of satisfaction made it difficult to demonstrate change. It is likely that this and the presentation of results made it difficult for GPs to use the survey to improve their practices. A more useful survey would be more sensitive to detect negative patient opinions and provide integrated feedback to GPs. At present, there are concerns about the usefulness of the PPP in continuous quality improvement in general practice.James Allan, Peter Schattner, Nigel Stocks and Emmae Ramsa

Effect of Composition, Temperature, and Pressure on the Viscosities and Densities of Three Diesel Fuels

In this work, a Rolling-Ball Viscometer/Densimeter is used to measure high-pressure, hightemperature (HPHT) density and viscosity data from 298.2 to 532.6 K and pressures up to 300.0 MPa for three different diesel fuels. The densities and viscosities have combined expanded uncertainties of 0.6% and 2.5%, respectively, with a coverage factor, k = 2. Two of the diesels, Highly Paraffinic (HPF) and Highly Aromatic (HAR), contain a larger paraffinic and aromatic content relative to the others, and are standard engine test fuels. The third is a Ultra-Low Sulfur Diesel (ULSD) that resembles an unfinished commercial diesel. Detailed compositional information is also reported for each diesel that provides a basis for interpreting the impact of composition on density and viscosity at high pressures. Both density and viscosity data are correlated to Tait-type equations with uncertainties of 0.6% and 4.0%, respectively. The Tait equations provide a facile means to compare observed differences in the density-pressure and viscosity-pressure profiles of the three different diesels. Density data are modeled with the Perturbed-Chain Statistical Associating Fluid Theory (PC-SAFT) equation of state (EoS) with pure component parameters calculated representing diesel as a single, pseudo-component only requiring average molecular weight (Mave) and hydrogen to carbon ratio (RH/C) as inputs. Viscosity data are modeled reasonably well using entropy scaling coupled with the PC-SAFT EoS and information on the diesel Mave and RH/C. The HPHT viscosity data are also modeled reasonably well with Free Volume Theory (FVT) with model parameters correlated to Mave and RH/C

European Practice Assessment of Cardiovascular risk management (EPA Cardio): protocol of an international observational study in primary care

Contains fulltext : 80788.pdf (publisher's version ) (Open Access

The multi-spectral imaging diagnostic

The Multi-Spectral Imaging system is a new diagnostic that captures simultaneous spectrally filtered images from a common line of sight while maintaining a large etendue and high throughput. Imaging several atomic line intensities simultaneously may enable numerous measurement techniques. By making a novel modification of a polychromator layout, the MSI sequentially filters and focuses images onto commercial CMOS cameras while exhibiting minimal vignetting and aberrations. A four-wavelength system was initially installed and tested on Alcator C-Mod and subsequently moved to TCV. The images are absolutely calibrated and spatially registered enabling 2D mappings of atomic line ratios and absolute line intensities. The spectral transmission of the optical system was calibrated using an integrating sphere of known radiance. The images are inverted by cross-referencing points on TCV with a computer-aided design (CAD) model. Published by AIP Publishing