The benefits of interprofessional education 10 years on.

Interprofessional education (IPE) was first conceived in 1973 by a World Health Organization (WHO) expert group in Geneva. WHO member states were then charged with implementing medical education IPE pilot projects and from then to today there has a been a rapid proliferation in the number of publications on the subject. IPE has generated research into its use, conferences specific to IPE, organisations dedicated to it and policy championing it. The authors question whether there has been any major shift in the silos in which different professions might be working. The authors published an article on the benefits of IPE ( Illingworth and Chelvanayagam, 2007 ). Ten years have now passed and many changes have been implemented and experienced in health and social care and therefore a review of the literature is required. Also, it is 7 years since the publication of WHO's report outlining the role of IPE in the preparation of health professionals ( WHO, 2010 ) and, increasingly, UK Government policy champions collaborative and integrated working. The conclusions from the 2007 article acknowledged the development of IPE; however, it highlighted the need for empirical evidence to demonstrate the effectiveness of IPE in service user and carer outcomes. This article will explore whether IPE has achieved the benefits discussed in the previous article and what developments have occurred since it was published

Development of a lightweight cryogenic insulating system Final report, 30 Jun. 1964 - 31 May 1966

Lightweight external panel insulation systems for thermal protection of cryogenic launch vehicle propellant tank

Variability in coastal zone color scanner (CZCS) Chlorophyll imagery of ocean margin waters off the US East Coast.

Abstract The purpose of our study was to use the 7.5-year coastal zone color scanner (CZCS) image time series (Oct. 1978 to July, 1986 to study general patterns in near-surface phytoplankton chlorophyll concentrations in ocean margin waters off the US East Coast. We defined 21 relatively large study areas (>100 km 2 ) within the MAB and SAB to set boundaries for averaging and subsequent analyses. Our objective was to partition the observed CZCS-derived chlorophyll concentration (CSAT, mg m À3 ) variability of these 21 study areas within three general categories based on time scale: daily (i.e. day-week), seasonal and interannual. An additional objective was to determine relations between the temporal patterns in the 21 study areas. All available CZCS imagery (more than 3500 scenes of Level 1 imagery, i.e. top-ofthe-atmosphere radiance in satellite swath coordinates) covering some or all of our area of interest (northwest Atlantic off the US East Coast) were obtained at full resolution, processed to Level 2 (waterleaving radiance, chlorophyll concentration and other derived products in satellite swath coordinates) and mapped to two different study regions located off the southeast and northeast coasts of the US. Satellitederived estimates of near-surface chlorophyll concentrations (CSAT) were extracted on a pixel-by-pixel basis from each of the 21 study areas (chosen based on oceanographic criteria) from each of the daily composite CSAT images. For each image and when satellite coverage permitted, CSAT values were averaged to yield a time series of daily mean values for each of the 21 study areas. We used three basic approaches to quantify temporal and spatial patterns in the 21 time series: (1) multiple linear correlation, (2) structure functions (semi-variance calculations) and (3) empirical orthogonal functions (EOF). Our results show: (1) a simple annual CSAT cycle common to all ocean margin waters along the entire US East Coast, consisting of a broad peak in CSAT concentration during winter and minimum concentrations during the summer

Pennsylvania Folklife Vol. 19, No. 1

• The Moravian Settlements of Pennsylvania in 1757: The Nicholas Garrison Views • The San Rocco Festival at Aliquippa, Pennsylvania: A Transplanted Tradition • Amish Genealogy: A Progress Report • Pulpit Humor in Central Pennsylvania • The Pre-Metric Foot and its Use in Pennsylvania German Architecture • Mennonite Contacts Across the Atlantic: The Van der Smissen Letter of 1838 • Bread, Baking, and the Bakeoven: Folk-Cultural Questionnaire No. 13https://digitalcommons.ursinus.edu/pafolklifemag/1037/thumbnail.jp

Modeling the resonant planetary system GJ876

The two planets about the star GJ 876 appear to have undergone extensive migration from their point of origin in the protoplanetary disk -- both because of their close proximity to the star (30 and 60 day orbital periods) and because of their occupying three stable orbital resonances at the 2:1 mean-motion commensurability. The resonances were most likely established by converging differential migration of the planets leading to capture into the resonances. A problem with this scenario is that continued migration of the system while it is trapped in the resonances leads to orbital eccentricities that rapidly exceed the observational upper limits of e_1 = 0.31 and e_2 = 0.05. As seen in forced 3-body simulations, lower eccentricities would persist during migration only for an applied eccentricity damping. Here we explore the evolution of the GJ 876 system using two-dimensional hydrodynamical simulations that include viscous heating and radiative effects. We find that a hydrodynamic evolution within the resonance, where only the outer planet interacts with the disk, always rapidly leads to large values of eccentricities that exceed those observed. Only if mass is removed from the disk on a time scale of the order of the migration time scale (before there has been extensive migration after capture), as might occur for photoevaporation in the late phases of planet formation, can we end up with eccentricities that are consistent with the observations.Comment: Paper accepted by A&A, 17 Pages, 17 Figure

Pennsylvania Folklife Vol. 18, No. 4

• Discord in the Garden • The Folk Festival Seminars: Crafts and Customs of the Year • What to Read on the Amish • Soup\u27s On! • Festival Highlights • Folk Festival Program • Folk Festival Geisinger • Four Interviews with Powwowers • The First Historian of the Pennsylvania Germans • The Public Sale Sixty Years Ago • The Long Shingle • Quilts and Quilting: Folk-Cultural Questionnaire No. 12https://digitalcommons.ursinus.edu/pafolklifemag/1036/thumbnail.jp

Surveillance for Waterborne-Disease Outbreaks Associated with Drinking Water--United States, 2001-2002

PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have maintained a collaborative surveillance system for collecting and periodically reporting data related to occurrences and causes of waterborne-disease outbreaks (WBDOs). This surveillance system is the primary source of data concerning the scope and effects of waterborne disease outbreaks on persons in the United States. REPORTING PERIOD COVERED: This summary includes data on WBDOs associated with drinking water that occurred during January 2001-December 2002 and on three previously unreported outbreaks that occurred during 2000. DESCRIPTION OF SYSTEM: Public health departments in the states, territories, localities, and the Freely Associated States are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC on a standard form. The surveillance system includes data for outbreaks associated with both drinking water and recreational water; only outbreaks associated with drinking water are reported in this summary. RESULTS: During 2001-2002, a total of 31 WBDOs associated with drinking water were reported by 19 states. These 31 outbreaks caused illness among an estimated 1,020 persons and were linked to seven deaths. The microbe or chemical that caused the outbreak was identified for 24 (77.4%) of the 31 outbreaks. Of the 24 identified outbreaks, 19 (79.2%) were associated with pathogens, and five (20.8%) were associated with acute chemical poisonings. Five outbreaks were caused by norovirus, five by parasites, and three by non-Legionella bacteria. All seven outbreaks involving acute gastrointestinal illness of unknown etiology were suspected of having an infectious cause. For the first time, this MMWR Surveillance Summary includes drinking water-associated outbreaks of Legionnaires disease (LD); six outbreaks of LD occurred during 2001-2002. Of the 25 non-Legionella associated outbreaks, 23 (92.0%) were reported in systems that used groundwater sources; nine (39.1%) of these 23 groundwater outbreaks were associated with private noncommunity wells that were not regulated by EPA. INTERPRETATION: The number of drinking water-associated outbreaks decreased from 39 during 1999-2000 to 31 during 2001-2002. Two (8.0%) outbreaks associated with surface water occurred during 2001-2002; neither was associated with consumption of untreated water. The number of outbreaks associated with groundwater sources decreased from 28 during 1999-2000 to 23 during 2001-2002; however, the proportion of such outbreaks increased from 73.7% to 92.0%. The number of outbreaks associated with untreated groundwater decreased from 17 (44.7%) during 1999-2000 to 10 (40.0%) during 2001-2002. Outbreaks associated with private, unregulated wells remained relatively stable, although more outbreaks involving private, treated wells were reported during 2001-2002. Because the only groundwater systems that are required to disinfect their water supplies are public systems under the influence of surface water, these findings support EPA\u27s development of a groundwater rule that specifies when corrective action (including disinfection) is required. PUBLIC HEALTH ACTION: CDC and EPA use surveillance data 1) to identify the types of water systems, their deficiencies, and the etiologic agents associated with outbreaks and 2) to evaluate the adequacy of technologies for providing safe drinking water. Surveillance data are used also to establish research priorities, which can lead to improved water-quality regulations. CDC and EPA recently completed epidemiologic studies that assess the level of waterborne illness attributable to municipal drinking water in nonoutbreak conditions. The decrease in outbreaks in surface water systems is attributable primarily to implementation of provisions of EPA rules enacted since the late 1980s. Rules under development by EPA are expected to protect the public further from microbial contaminants while addressing risk tradeoffs of disinfection byproducts in drinking water

Urine THC Metabolite Levels Correlate with Striatal D2/D3 Receptor Availability

poster abstractRationale: Although the incidence of cannabis abuse/dependence in Americans is rising, the neurobiology of cannabis addiction is not well understood. Recent imaging studies have demonstrated deficits in striatal D2/D3 receptor availability in several substance-dependent populations. However, this has not been studied in chronic cannabis users. Objective: The purpose of this study was to compare striatal D2/D3 receptor availability between currently using chronic cannabis users and healthy controls. Methods: Eighteen right-handed males, age 18-35 were studied. Ten subjects were chronic cannabis users; eight were demographically matched controls. Subject eligibility was determined during a screening interview, which included SCID-I and SCID-II assessments, self-report of past substance use, and drug toxicology screening. Subjects underwent a [11C]raclopride (RAC) PET scan; striatal RAC binding potential (BPND) was calculated on a voxel-wise basis with the multilinear reference tissue method. Prior to scanning, urine samples were obtained from cannabis users for quantification of urine Δ-9-tetrahydrocannabinol (THC) and THC metabolites (11-nor-Δ-9-THC-9-carboxylic acid; THC-COOH). Statistical analyses were conducted at voxel-wise level within the striatum. Two-sample t-tests were used to test for differences in BPND between groups. For cannabis subjects, multiple regression analyses were used to test for correlations between striatal BPND and urine THC/THC metabolite levels. Results: There were no differences in BPND between cannabis smokers and healthy controls. Smokers – regardless of substance – had 10% lower D2/D3 availability than non-smokers. Voxel-wise analyses revealed that striatal RAC BPND values were associated with urine levels of cannabis metabolites. Conclusions: Cannabis and cannabis metabolites in urine, markers of recent cannabis consumption, are negatively correlated with striatal RAC BPND. This provides the first evidence that degree of cannabis use is related to changes in the central DA system. Low BPND in both cannabis and cigarette users may indicate a deficiency in D2/D3 receptors as a function of chronic exposure to either or both substances. Alternatively, endogenous dopamine levels may be higher in smokers as a result of MAO inhibition from beta-carbolines in the inhaled smoke. Additional studies are needed to understand the complex relationships between chronic cannabis use and the dopamine system

Surveillance for Waterborne-Disease Outbreaks Associated With Recreational Water--United States, 2001-2002

PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency, and the Council of State and Territorial Epidemiologists have maintained a collaborative surveillance system for collecting and periodically reporting data related to occurrences and causes of waterborne-disease outbreaks (WBDOs) related to drinking water; tabulation of recreational water-associated outbreaks was added to the surveillance system in 1978. This surveillance system is the primary source of data concerning the scope and effects of waterborne disease outbreaks on persons in the United States. REPORTING PERIOD COVERED: This summary includes data on WBDOs associated with recreational water that occurred during January 2001-December 2002 and on a previously unreported outbreak that occurred during 1998. DESCRIPTION OF SYSTEM: Public health departments in the states, territories, localities, and the Freely Associated States are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC on a standard form. The surveillance system includes data for outbreaks associated with both drinking water and recreational water; only outbreaks associated with recreational water are reported in this summary. RESULTS: During 2001-2002, a total of 65 WBDOs associated with recreational water were reported by 23 states. These 65 outbreaks caused illness among an estimated 2,536 persons; 61 persons were hospitalized, eight of whom died. This is the largest number of recreational water-associated outbreaks to occur since reporting began in 1978; the number of recreational water-associated outbreaks has increased significantly during this period (p INTERPRETATION: The 30 outbreaks involving gastroenteritis comprised the largest proportion of recreational water-associated outbreaks during this reporting period. These outbreaks were associated most frequently with Cryptosporidium (50.0%) in treated water venues and with toxigenic Escherichia coli (25.0%) and norovirus (25.0%) in freshwater venues. The increase in the number of outbreaks since 1993 could reflect improved surveillance and reporting at the local and state level, a true increase in the number of WBDOs, or a combination of these factors. PUBLIC HEALTH ACTION: CDC uses surveillance data to identify the etiologic agents, types of aquatics venues, water-treatment systems, and deficiencies associated with outbreaks and to evaluate the adequacy of efforts (e.g., regulations and public awareness activities) for providing safe recreational water. Surveillance data are also used to establish public health prevention priorities, which might lead to improved water-quality regulations at the local, state, and federal levels