Coverage Options for a Low cost, High Resolution Optical Constellation

This paper presents the range of coverage options available to TopSat like small satellites, both singly and in a small constellation. TopSat is a low-cost, high resolution and image quality, optical small satellite, due for launch in October 2004. In particular, the paper considers the use of tuned, repeat ground track orbits to improve coverage for selected ground targets, at the expense of global coverage. TopSat is designed to demonstrate the capabilities of small satellites for high value remote sensing missions. It is a 108kg, sun-synchronous satellite, designed to provide 2.5m resolution imagery direct to users in the vicinity of the imaged area. Its objectives are to demonstrate the capability to cost performance available from small satellites, the utility of direct reception of remotely sensed imagery, and the affordability of constellations and individually owned assets. A description of the satellite, and update on the development and flight build of the satellite is given, as of June 2003. Two coverage improving augmentations to the TopSat satellite are discussed, namely the addition of a propulsion system and more capable attitude actuators. With limited orbit control, achievement and maintenance of tuned orbits, and phasing of a constellation within orbits, become practicable. TopSat is an agile small satellite, allowing boresight reorientation required for slews during imaging. The capability for performing multiple images in a single target pass is considered, with the existing and improved torque actuator implementations. Similar options for performing stereo imaging with 2 formation flying TopSats are outlined. Reconfiguration of repeat ground track orbits for a single satellite is analysed in terms of fuel cost and drift orbit options. A one day repeat orbit case is presented which would allow daily coverage of a fixed target, with orbit reconfiguration required to allow global access. A typical mission for such a satellite is summarised, along with practical requirements for the propulsion system. Coverage options for constellations of between 2 and 4 satellites are then also scrutinised, with fuel estimates for the most promising options explored. Again, the benefits that could be achieved by using repeat ground track orbits are weighed against the fuel requirements, to maintain and reconfigure such a constellation. The TopSat mission is a collaboration between four UK partners. QinetiQ are leading the mission and providing data handling and ground segment elements. Rutherford Appleton Laboratory (RAL) are developing the camera, Surrey Satellite Technology Limited (SSTL) are providing the bus, and InfoTerra are responsible for developing potential data markets. The programme is jointly funded by the UK Ministry of Defence (MoD) and by the British National Space Centre (BNSC)

Complementary therapies for labour and birth: A randomized controlled trial of antenatal integrative medicine for pain management in labour

Objective: To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use. Design: Open-label, assessor blind, randomized controlled trial. Setting: 2 public hospitals in Sydney, Australia. Population: 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics. Methods and intervention: The Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support. Randomisation occurred at 24–36 weeks’ gestation, and participants attended a 2-day antenatal education programme plus standard care, or standard care alone. Main outcome measures: Rate of analgesic epidural use. Secondary: onset of labour, augmentation, mode of birth, newborn outcomes. Results:There was a significant difference in epidural use between the 2 groups: study group (23.9%) standard care (68.7%; risk ratio (RR) 0.37 (95% CI 0.25 to 0.55), p≤0.001). The study group participants reported a reduced rate of augmentation (RR=0.54 (95% CI 0.38 to 0.77), p Conclusions: The Complementary Therapies for Labour and Birth study protocol significantly reduced epidural use and caesarean section. This study provides evidence for integrative medicine as an effective adjunct to antenatal education, and contributes to the body of best practice evidence

Relaxation techniques for pain management in labour

Background: Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute to the popularity of complementary methods of pain management. This review examined currently available evidence on the use of relaxation therapies for pain management in labour. This is an update of a review first published in 2011. Objectives: To examine the effects of mind-body relaxation techniques for pain management in labour on maternal and neonatal well-being during and after labour. Search methods: We searched Cochrane Pregnancy and Childbirth’s Trials Register (9 May 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 5 2017), MEDLINE (1966 to 24 May 2017), CINAHL (1980 to 24 May 2017), the Australian New Zealand Clinical Trials Registry (18 May 2017), ClinicalTrials.gov (18 May 2017), the ISRCTN Register (18 May 2017), the WHO International Clinical Trials Registry Platform (ICTRP) (18 May 2017), and reference lists of retrieved studies. Selection criteria: Randomised controlled trials (including quasi randomised and cluster trials) comparing relaxation methods with standard care, no treatment, other non-pharmacological forms of pain management in labour or placebo. Data collection and analysis: Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We attempted to contact study authors for additional information. We assessed evidence quality with GRADE methodology. Main results: This review update includes 19 studies (2519 women), 15 of which (1731 women) contribute data. Interventions examined included relaxation, yoga, music and mindfulness. Approximately half of the studies had a low risk of bias for random sequence generation and attrition bias. The majority of studies had a high risk of bias for performance and detection bias, and unclear risk of bias for, allocation concealment, reporting bias and other bias. We assessed the evidence from these studies as ranging from low to very low quality, and therefore the effects below should be interpreted with caution

Massage, reflexology and other manual methods for pain management in labour

Background Many women would like to avoid pharmacological or invasive methods of pain management in labour, and thismay contribute towards the popularity of complementary methods of pain management. This review examined the evidence currently available on manual methods, including massage and reflexology, for pain management in labour. This review is an update of the review first published in 2012. Objectives To assess the effect, safety and acceptability of massage, reflexology and other manual methods to manage pain in labour. Search methods For this update, we searched Cochrane Pregnancy and Childbirth’s Trials Register (30 June 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 6), MEDLINE (1966 to 30 June 2017, CINAHL (1980 to 30 June 2017), the Australian New Zealand Clinical Trials Registry (4 August 2017), Chinese Clinical Trial Registry (4 August 2017), ClinicalTrials.gov, (4 August 2017), the National Center for Complementary and Integrative Health (4 August 2017), theWHO International Clinical Trials Registry Platform (ICTRP) (4 August 2017) and reference lists of retrieved trials. Selection criteria We included randomised controlled trials comparing manual methods with standard care, other non pharmacological forms of pain management in labour, no treatment or placebo. We searched for trials of the following modalities: massage, warm packs, thermal manual methods, reflexology, chiropractic, osteopathy, musculo-skeletal manipulation, deep tissue massage, neuro-muscular therapy, shiatsu, tuina, trigger point therapy, myotherapy and zero balancing. We excluded trials for pain management relating to hypnosis, aromatherapy, acupuncture and acupressure; these are included in other Cochrane reviews. Data collection and analysis Two review authors independently assessed trial quality, extracted data and checked data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. Main results We included a total of 14 trials; 10 of these (1055 women) contributed data to meta-analysis. Four trials, involving 274 women, metour inclusion criteria but did not contribute data to the review. Over half the trials had a low risk of bias for random sequence generationand attrition bias. The majority of trials had a high risk of performance bias and detection bias, and an unclear risk of reporting bias.We found no trials examining the effectiveness of reflexology. Massage We found low-quality evidence that massage provided a greater reduction in pain intensity (measured using self-reported pain scales) than usual care during the first stage of labour (standardised mean difference (SMD) −0.81, 95% confidence interval (CI) −1.06 to −0.56, six trials, 362 women). Two trials reported on pain intensity during the second and third stages of labour, and there was evidence of a reduction in pain scores in favour of massage (SMD −0.98, 95% CI −2.23 to 0.26, 124 women; and SMD −1.03, 95% CI −2.17 to 0.11, 122 women). There was very low-quality evidence showing no clear benefit of massage over usual care for the length of labour (in minutes) (mean difference (MD) 20.64, 95% CI −58.24 to 99.52, six trials, 514 women), and pharmacological pain relief (average risk ratio (RR) 0.81, 95% CI 0.37 to 1.74, four trials, 105 women). There was very low-quality evidence showing no clear benefit of massage for assisted vaginal birth (average RR 0.71, 95% CI 0.44 to 1.13, four trials, 368 women) and caesarean section (RR 0.75, 95% CI 0.51 to 1.09, six trials, 514 women). One trial reported less anxiety during the first stage of labour for women receiving massage (MD -16.27, 95% CI −27.03 to −5.51, 60 women). One trial found an increased sense of control from massage (MD 14.05, 95% CI 3.77 to 24.33, 124 women, low-quality evidence). Two trials examining satisfaction with the childbirth experience reported data on different scales; both found more satisfaction with massage, although the evidence was low quality in one study and very low in the other. Warm packs We found very low-quality evidence for reduced pain (Visual Analogue Scale/VAS) in the first stage of labour (SMD −0.59, 95%CI −1.18 to −0.00, three trials, 191 women), and the second stage of labour (SMD −1.49, 95% CI −2.85 to −0.13, two trials,128 women). Very low-quality evidence showed reduced length of labour (minutes) in the warm-pack group (MD −66.15, 95% CI −91.83 to −40.47; two trials; 128 women). Thermal manual methods One trial evaluated thermal manual methods versus usual care and found very low-quality evidence of reduced pain intensity during The first phase of labour for women receiving thermal methods (MD −1.44, 95% CI −2.24 to −0.65, one trial, 96 women). There was a reduction in the length of labour (minutes) (MD −78.24, 95% CI −118.75 to −37.73, one trial, 96 women, very low-quality evidence). There was no clear difference for assisted vaginal birth (very low-quality evidence). Results were similar for cold packs versus usual care, and intermittent hot and cold packs versus usual care, for pain intensity, length of labour and assisted vaginal birth. Music One trial that compared manual methods with music found very low-quality evidence of reduced pain intensity during labour in the massage group (RR 0.40, 95% CI 0.18 to 0.89, 101 women). There was no evidence of benefit for reduced use of pharmacological pain relief (RR 0.41, 95% CI 0.16 to 1.08, very low-quality evidence). Of the seven outcomes we assessed using GRADE, only pain intensity was reported in all comparisons. Satisfaction with the childbirthexperience, sense of control, and caesarean section were rarely reported in any of the comparisons. Authors’ conclusions Massage, warm pack and thermal manual methods may have a role in reducing pain, reducing length of labour and improving women’s sense of control and emotional experience of labour, although the quality of evidence varies from low to very low and few trials reported on the keyGRADE outcomes. Few trials reported on safety as an outcome. There is a need for further research to address these outcomes and to examine the effectiveness and efficacy of these manual methods for pain management

Staff perceptions on the role and value of chaplains in first responder and military settings: A scoping review

Background&#x0D; Chaplains in first responder and military services support staff prior to, during and after critical incidents. Some studies have explored the role of chaplains in these settings predominantly in the military and from chaplains’ perspectives. However, few studies have explored the perspective of staff. This scoping review aims to map the literature on staff perceptions of the role and value of chaplains in first responder and military settings.&#x0D;  &#x0D; Method&#x0D; A scoping review using the Arksey &amp; O’Malley (2003) and Joanna Briggs Institute Scoping Review Methodology was conducted. English language peer-reviewed and grey literature in CINAHL, PubMed, PsychINFO, ProQuest and Google Scholar from 2004-2019 was reviewed for inclusion. Records were included if they provided staff perspectives on the role and value of chaplains in first responder and military settings. The initial search identified 491 records after removal of duplicates. All titles and abstracts were then screened for relevance to the research question and 84 were selected for full-text review. Seven records were included in final review; five dissertations and two peer-reviewed articles. Five of these were from the military and two from the police. Data were extracted and thematically analysed to identify staff perceptions of the role, skills and attributes, and value of chaplains in first responder and military settings.&#x0D;  &#x0D; Results &#x0D; Staff understood the role of chaplain to include the provision of spiritual and pastoral care and guidance and, in the case of police, providing scene support. Staff from all of the services identified requisite skills and attributes for chaplains such as being available, approachable and engaged; counselling; maintaining confidentiality and trust; being organisationally aware; and possessing distinct personality traits and knowledge of specialty content areas. The value chaplains brought to their services emerged from chaplains being trusted as a result of being proactively available for staff, families and bystanders for formal and informal conversation; organisational belonging and awareness resulting in enhanced staff satisfaction and retention; and promoting staff physical, mental, social and spiritual wellbeing.&#x0D;  &#x0D; Conclusions&#x0D; Although military and police staff identified spiritual, psychological and social benefits to chaplains maintaining an active and visible role in their services, the small number of papers identified make generalisation of these findings to other first responder services problematic. Further research is therefore required to understand the impact of the chaplain’s role as part of the care team in first responder services.</jats:p

Generic First Order Orientation Transition of Vortex Lattices in Type II Superconductors

First order transition of vortex lattices (VL) observed in various superconductors with four-fold symmetry is explained microscopically by quasi-classical Eilenberger theory combined with nonlocal London theory. This transition is intrinsic in the generic successive VL phase transition due to either gap or Fermi velocity anisotropies. This is also suggested by the electronic states around vortices. Ultimate origin of this phenomenon is attributed to some what hidden frustrations of a spontaneous symmetry broken hexagonal VL on the underlying four-fold crystalline symmetry.Comment: 4 pages, 5 figures, some typos are correcte

Enhanced flow-motion complexity of skin microvascular perfusion in Sherpas and lowlanders during ascent to high altitude

An increased and more effective microvascular perfusion is postulated to play a key role in the physiological adaptation of Sherpa highlanders to the hypobaric hypoxia encountered at high altitude. To investigate this, we used Lempel-Ziv complexity (LZC) analysis to explore the spatiotemporal dynamics of the variability of the skin microvascular blood flux (BF) signals measured at the forearm and finger, in 32 lowlanders (LL) and 46 Sherpa highlanders (SH) during the Xtreme Everest 2 expedition. Measurements were made at baseline (BL) (LL: London 35 m; SH: Kathmandu 1300 m) and at Everest base camp (LL and SH: EBC 5,300 m). We found that BF signal content increased with ascent to EBC in both SH and LL. At both altitudes, LZC of the BF signals was significantly higher in SH, and was related to local slow-wave flow-motion activity over multiple spatial and temporal scales. In SH, BF LZC was also positively associated with LZC of the simultaneously measured tissue oxygenation signals. These data provide robust mechanistic information of microvascular network functionality and flexibility during hypoxic exposure on ascent to high altitude. They demonstrate the importance of a sustained heterogeneity of network perfusion, associated with local vaso-control mechanisms, to effective tissue oxygenation during hypobaric hypoxia

Clinical simulation in Australia and New Zealand: Through the lens of an advisory group

Across Australia, innovations in simulation to enhance learning in nursing have been occurring for three decades and nursing is, and needs to be, a leading player in simulation knowledge diffusion. However, expertise is unevenly distributed across health services and education providers. Rather than build on the expertise and achievements of others, there is a tendency for resource duplication and for trial and error problem solving, in part related to a failure to communicate achievements for the benefits of the professional collective. For nursing to become a leader in the use of simulation and drive ongoing development, as well as conducting high quality research and evaluation, academics need to collaborate, aggregate best practice in simulation learning, and disseminate that knowledge to educators working in health services and higher education sectors across the whole of Australia and New Zealand. To achieve this strategic intent, capacity development principles and committed action are necessary. In mid 2010 the opportunity to bring together nurse educators with simulation learning expertise within Australia and New Zealand became a reality. The Council of Deans of Nursing and Midwifery (CDNM) Australia and New Zealand decided to establish an expert reference group to reflect on the state of Australian nursing simulation, to pool expertise and to plan ways to share best practice knowledge on simulation more widely. This paper reflects on the achievements of the first 18 months since the group's establishment and considers future directions for the enhancement of simulation learning practice, research and development in Australian nursing

Evaluation and comparison of native and recombinant LipL21 protein-based ELISAs for diagnosis of bovine leptospirosis

A 21-kDa leptospiral lipoprotein (LipL21) was evaluated for its diagnostic potential to detect bovine leptospirosis by ELISA. Both native LipL21 (nLipL21) and recombinant LipL21 (rLipL21) proteins were tested and compared regarding diagnostic efficiency, and no statistically significant difference was observed. The sensitivity of rLipL21 ELISA for 62 microscopic agglutination test (MAT) positive sera was 100% and the specificity with 378 MAT negative sera was 97.09%. Thus, rLipL21 protein-based ELISA could be used as an alternative to MAT for the diagnosis of bovine leptospirosis