48,333 research outputs found

    Device for handling printed circuit cards Patent

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    Handling tool for printed circuit card

    Smoking cessation activities by general practitioners and practice nurses

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    OBJECTIVES—To assess general practitioners' and practice nurses' self reported behaviour, attitudes, and knowledge in relation to smoking cessation.
DESIGN AND SETTING—Two postal surveys of random national samples of 303 GPs (survey 1) and 459 practice nurses (survey 2) covering England and Wales; effective response rates were 75% and 96%, respectively.
RESULTS—Survey 1 found that 96% of GPs accepted that intervening against smoking was part of their role and almost all (99%) said that they recorded smoking status when patients registered; 57% reported that they routinely updated their records on smoking status, 50% said they advised smokers to stop during most or all consultations, and 76% said they advised smokers to cut down if they cannot stop. A large majority (83%) said they either recommended or prescribed nicotine replacement therapy (NRT). Although most GPs (86%) thought that NRTs were effective, only a minority thought they were worth the cost (47%) or should be on National Health Service (NHS) prescription (32%). There was little evidence that previous training in smoking cessation was associated with more activity, more positive attitudes, or greater knowledge. Survey 2 found that almost all practice nurses (99%) agreed that intervening against smoking was part of their role and 95% said they advised patients to stop at least occasionally; 71% said they advised smokers to stop at most or all consultations. A majority (74%) said that they recommended NRT to their patients. As with the GPs most practice nurses thought that nicotine replacement was effective (79%), but fewer (42%) thought the cost was justified, and only about half (53%) thought it should be available on NHS prescription. Nurses who said they had been trained in smoking cessation engaged in more activity relating to smoking cessation, had more positive attitudes, and were more knowledgeable.
CONCLUSION—GPs and practice nurses accepted that intervening with smoking was an important part of their role and a large majority reported that they intervened at least with some smokers. This represents a promising baseline from which to proceed in terms of implementation of the new smoking cessation guidelines, but it is hoped that improvements can be made in terms of the frequency of updating records and intervening, and acceptance of the cost-effectiveness of NRT as a life preserving intervention.


Keywords: cessation interventions; general practitioners; practice nurse

    MMI Devices with Weak Guiding Designed in Three Dimensions Using a Genetic Algorithm

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    We discuss the design of weakly guided multimode interference (MMI) devices using a genetic algorithm. For devices exhibiting a nonnegligible vertical waveguide offset, such as those produced using ion exchange in glass, three-dimensional modeling is required to properly evaluate the device performance. A combination of semivectorial finite difference modeling in two transverse dimensions and mode propagation analysis (MPA) in the propagation direction is used to evaluate the merit of each trial design. An example is provided of a 1 x 4 power splitter designed for ion exchange, which shows considerable improvement over that obtained by self-imaging theory

    Determination of Ion Exchange Parameters by a Genetic Algorithm

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    Modeling the process of ion exchange in glass requires accurate knowledge of the self-diffusion coefficients of the incoming and outgoing ions. Furthermore, correlating the concentration profile of the incoming ions to a change in refractive index requires knowledge of the correlation coefficient. We present a method by which these three parameters can be quickly determined experimentally, using a genetic algorithm. Comparison with published data is presented

    Method and apparatus for making a heat insulating and ablative structure Patent

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    Method and apparatus for fabrication of heat insulating and ablative reentry structur

    When Teachers Choose Pension Plans: The Florida Story

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    Although long ignored by education-policy analysts, the structure of teacher retirement benefits has come under increasing scrutiny in recent years. The vast majority of teachers, like other state and local public employees, are covered by traditional defined-benefit (DB) pension plans. Now rare in the private sector of the United States economy, these plans provide a retired teacher with a guaranteed lifetime benefit, the annual value of which is typically based on his number of years of service and average salary during the final years of his career. A teacher is often required to contribute from her salary to funds set aside to pay for this plan, but the size of her benefit is not tied to the amount of any contributions.Critics of existing teacher pension systems raise two broad sets of concerns. First, they note that the time lag between when the government funds and pays out retirement benefits encourages politicians to contribute too little to their pension systems, effectively borrowing from future taxpayers to fund current spending on government services.The shortfalls facing state and local pension systems covering teachers and other public workers due to persistent underfunding are staggering. Novy-Marx and Rauh13 estimate that achieving full funding of promised pension liabilities nationally over thirty years would require a tax increase of $1,385 per household each year. A more likely outcome is substantial cuts to public services such as education.Second, critics note that the reliance on traditional DB pension plans makes total teacher compensation severely back-loaded, potentially hindering efforts to improve teacher quality. Most of these plans have vesting periods of five or more years and are structured so that employees do not amass substantial benefits until late in their careers -- at which point benefits increase rapidly. These features may make teaching less attractive to individuals who are uncertain of whether they will remain in the profession long enough to benefit or would prefer to receive a higher salary to support present consumption. Recent evidence confirms that DB pension plans lead some veteran teachers to continue teaching solely for the sake of increasing pension wealth, while encouraging others to retire prematurely so as not to sacrifice years of benefit payments.The back-loading of benefits also imposes heavy costs on career-switchers and geographically mobile teachers, who typically stand to receive benefits worth far less than the pension contributions made on their behalf. The most prominent alternative to a traditional DB pension plan is the defined contribution (DC) model. Under DC plans, an employee builds up an individual retirement account through her or her employer's regular contributions throughout her career and exercises some control over how the account is invested. Because the value of that account is tied directly to these contributions (and the performance of investments), DC plans, by definition, cannot be underfunded. Rapidvesting, portability, and the smooth accrual of benefits over time eliminate the problematic end-of-career incentives created by existing DB plans and could make teaching more attractive to young workers, possible career-switchers, or those likely to be geographically mobile.Finally, because benefits take the form of a personal account that can be converted into a lifetime annuity, the employee gains control over the timing and structure of her retirement benefit. An important potential drawback of the DC model is that employees, rather than taxpayers, bear the consequences if disappointing investment returns or poor withdrawal decisions yield inadequate retirement savings. Unions representing teachers and other public employees have vigorously opposed proposals to convert public pension plans to the DC model, largely on these grounds. Proponents of DB pensions cite survey data suggesting that public employees strongly prefer the DB model and contend that "when given the choice between a primary DB or DC plan, public employees overwhelmingly choose the DB pension plan."Yet there is reason to believe that many current and potential teachers could find well-designed DC plans as or more attractive than traditional DB plans. As noted above, DB plans typically provide minimal benefits to those who do not remain in the profession (and in the same state retirement system) for many years. They may therefore be unappealing to a younger generation of workers prone to exploring multiple career paths before settling on one. Other teachers may simply prefer to exercise greater control over their retirement savings, either due to confidence in their investment abilities or to doubts as to whether public pension funds will be able to deliver on their promises. Consistent with this logic, a survey of Washington State teachers found that a plurality of teachers would prefer to invest additional retirement savings in a DC plan rather than in a DB plan. The extent to which preferences expressed on surveys correspond to the actual behavior of teachers when given the option remains unclear.In this paper, we examine teacher preferences as revealed by their decisions when empowered to choose between alternative pension-plan structures. Since 2002, public school teachers (and most other state and local employees) in Florida have been permitted to choose between a traditional DB retirement plan and a new DC plan. During the time period of our study, school districts were required to contribute 9 percent of the salary of teachers taking the DC option to personalinvestment accounts in their names. Neither DB nor DC choosers were required to contribute from their own salaries to the retirement system, meaning that teachers' plan choice did not alter their take-home pay. The benefits of teachers choosing the DC plan vested after just one year, as compared with six under the DB plan

    Mining Missing Hyperlinks from Human Navigation Traces: A Case Study of Wikipedia

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    Hyperlinks are an essential feature of the World Wide Web. They are especially important for online encyclopedias such as Wikipedia: an article can often only be understood in the context of related articles, and hyperlinks make it easy to explore this context. But important links are often missing, and several methods have been proposed to alleviate this problem by learning a linking model based on the structure of the existing links. Here we propose a novel approach to identifying missing links in Wikipedia. We build on the fact that the ultimate purpose of Wikipedia links is to aid navigation. Rather than merely suggesting new links that are in tune with the structure of existing links, our method finds missing links that would immediately enhance Wikipedia's navigability. We leverage data sets of navigation paths collected through a Wikipedia-based human-computation game in which users must find a short path from a start to a target article by only clicking links encountered along the way. We harness human navigational traces to identify a set of candidates for missing links and then rank these candidates. Experiments show that our procedure identifies missing links of high quality

    GP prescribing of nicotine replacement and bupropion to aid smoking cessation in England and Wales

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    Aims Prescribing nicotine replacement therapy (NRT) or bupropion for smoking cessation is of considerable importance to public health but little is known about prescribing practices. This paper examines general practitioners' (GPs') prescribing patterns in Britain where these drugs are reimbursed. The results have implications for other health-care systems considering introducing reimbursement.Design, participants and setting Postal survey conducted in 2002 of a random sample of 1088 GPs in England and Wales, of whom 642 (59%) responded.Measures Number of requests GPs reported having received from patients for NRT and bupropion over the past month, the number of prescriptions they reported issuing and ratings of attitudes to these medications.Findings GPs reported receiving an average of 4.3 requests for NRT and 1.9 for bupropion in the previous month. They reported issuing 3.5 prescriptions for NRT and 1.2 for bupropion. Almost all GPs accepted that NRT (95%) and bupropion (97%) should be reimbursable on National Health Service (NHS) prescription. However, a significant minority of those who received requests for prescriptions did not issue any (81% for NRT and 26% for bupropion). This was related to whether they thought these products should be available on NHS prescription for both NRT and bupropion (OR = 0.66, P < 0.05), which in turn was related to beliefs about whether smokers should have to pay for treatment themselves, the cost-effectiveness of NRT/bupropion and the low priority they would give NRT/bupropion in the drug budget. For bupropion, concern about side-effects independently predicted not prescribing [odds ratio (OR) = 1.46, P < 0.03].Conclusion In the British health-care system, which has a well-established system for technology assessment and professionally endorsed guidelines, a significant minority of GPs decline all patient requests for stop-smoking medicines

    Dispersion Tailoring of the Quarter-Wave Bragg Reflection Waveguide

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    We present analytical formulae for the polarization dependent first- and second-order dispersion of a quarter-wave Bragg reflection waveguide (QtW-BRW). Using these formulae, we develop several qualitative properties of the QtW-BRW. In particular, we show that the birefringence of these waveguides changes sign at the QtW wavelength. Regimes of total dispersion corresponding to predominantly materialdominated and waveguide-dominated dispersion are identified. Using this concept, it is shown that the QtW-BRW can be designed so as to provide anomalous group velocity dispersion of large magnitude, or very small GVD of either sign, simply by an appropriate chose of layer thicknesses. Implications on nonlinear optical devices in compound semiconductors are discussed
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