Professionalism, personal taste and social inclusion : does it matter what clients wear?

An earlier opinion piece considered the professional issues surrounding the occupational therapists dress code within the work place (Davys et al 2006). This second paper considers the role of the occupational therapist when a clients choice of clothing may conflict with social expectations and negatively impact upon social inclusion. Three hypothetical cases that reflect clinical realities are presented, which serve as prompts for reflection upon informed choice, professional responsibilities and the therapeutic relationship. This paper concludes that there needs to be debate about the conflict between each of these areas and the concept of social inclusion

Non-local 2D Generalized Yang-Mills theories on arbitrary surfaces with boundary

The non-local generalized two dimensional Yang Mills theories on an arbitrary orientable and non-orientable surfaces with boundaries is studied. We obtain the effective action of these theories for the case which the gauge group is near the identity, $U\simeq I$. Furthermore, by obtaining the effective action at the large-N limit, it is shown that the phase structure of these theories is the same as that obtain for these theories on orientable and non-orientable surface without boundaries. It is seen that the $\phi^2$ model of these theories on an arbitrary orientable and non-orientable surfaces with boundaries have third order phase transition only on $g=0$ and $r=1$ surfaces, with modified area $\tilde{A}+{\cal A}/2$ for orientable and $\bar{A}+\mathcal{A}$ for non-orientable surfaces respectivly.Comment: 10 pages, no figures, late

Groundwater recharge influenced by ephemeral river flow and land use in the semiarid Limpopo Province of South Africa

Determining the sustainability of groundwater use in drylands with high climate variability is complex. Central to this determination is an understanding of groundwater recharge and associated processes and controls. Groundwater recharge in drylands can occur by diffuse and focused recharge (focused recharge being associated with intense episodic rainfall events and ephemeral river flow, predicted to increase and intensify with climate change). This study evaluated the relative significance and dominant controls on these two recharge processes. Ten groundwater hydrographs with multidecadal observations were collated from the Limpopo Province, South Africa, based on their proximity to river channels and rain gauges, representing diversity in local climate, landscape, vegetation, and hydrogeological conditions. The hydrographs showed that groundwater-level rises are sensitive to rainfall intensity during the rainy season, with generally larger increases after years with large episodic rainfall events, which disproportionately contribute to groundwater replenishment. Recharge processes and annual recharge volumes were quantified using the water-table fluctuation method and the numerical model HYDRUS-1D. This allowed for the inference of additional recharge contributions from focused recharge in proximity to ephemeral rivers, up to a factor of five relative to diffuse recharge. The analysis revealed synchronicity and linear correlation between annual river discharge and recharge close to the river, substantiating the importance of focused recharge close to the river network. The study showed that recharge in drylands is subject to large spatial and temporal variation and that consideration of focused and episodic recharge is critically important for managing groundwater resources at various scales in these regions

Does landscape-scale conservation management enhance the provision of ecosystem services?

Biodiversity conservation approaches are increasingly being implemented at the landscape-scale to support the maintenance of metapopulations and metacommunities. However, the impact of such interventions on the provision of ecosystem services is less well defined. Here we examine the potential impacts of landscape-scale conservation initiatives on ecosystem services, through analysis of five case study areas in England and Wales. The provision of multiple ecosystem services was projected according to current management plans and compared with a baseline scenario. Multicriteria analysis indicated that in most cases landscape-scale approaches lead to an overall increase in service provision. Consistent increases were projected in carbon storage, recreation and aesthetic value, as well as biodiversity value. However, most study areas provided evidence of trade-offs, particularly between provisioning services and other types of service. Results differed markedly between study areas, highlighting the importance of local context. These results suggest that landscape-scale conservation approaches are likely to be effective in increasing ecosystem service provision, but also indicate that associated costs can be significant, particularly in lowland areas

Chemically peculiar stars in the Large Magellanic Cloud

The detection of magnetic chemically peculiar (CP2) stars in open clusters of extragalactic systems can give observational answers to many unsolved questions. The mean percentage of CP2 stars in the Milky Way is of the order of 5% for the spectral range from early B- to F-type, luminosity class V objects. The origin of the CP2 phenomenon seems to be closely connected to the overall metallicity and global magnetic field environment. The theoretical models are still only tested by observations in the Milky Way. It is therefore essential to provide high quality observations in rather different global environments. The young clusters NGC 2136/7 were observed in the Delta a photometric system. This intermediate band photometric system samples the depth of the 520nm flux depression by comparing the flux at the center with the adjacent regions with bandwidths of 11nm to 23nm. The Delta a photometric system is most suitable for detecting CP2 stars with high efficiency, but is also capable of detecting a small percentage of non-magnetic CP objects. We present high precision photometric Delta a observations of 417 objects in NGC 2136/7 and its surrounding field, of which five turned out to be bona fide magnetic CP stars. In addition, we discovered two Be/Ae stars. From our investigations of NGC 1711, NGC 1866, NGC 2136/7, their surroundings, and one independent field of the LMC population, we derive an occurrence of classical chemically peculiar stars of 2.2(6)% in the LMC, which is only half the value found in the Milky Way. The mass and age distribution of the photometrically detected CP stars is not different from that of similar objects in galactic open clusters.Comment: 5 pages, 4 figures, accepted by A&

Dual-source computed tomography coronary artery imaging in children

Computed tomography (CT) has a well-established diagnostic role in the assessment of coronary arteries in adults. However, its application in a pediatric setting is still limited and often impaired by several technical issues, such as high heart rates, poor patient cooperation, and radiation dose exposure. Nonetheless, CT is becoming crucial in the noninvasive approach of children affected by coronary abnormalities and congenital heart disease. In some circumstances, CT might be preferred to other noninvasive techniques such as echocardiography and MRI for its lack of acoustic window influence, shorter acquisition time, and high spatial resolution. The introduction of dual-source CT has expanded the role of CT in the evaluation of pediatric cardiovascular anatomy and pathology. Furthermore, technical advances in the optimization of low-dose protocols represent an attractive innovation. Dual-source CT can play a key role in several clinical settings in children, namely in the evaluation of children with suspected congenital coronary artery anomalies, both isolated and in association with congenital heart disease. Moreover, it can be used to assess acquired coronary artery abnormalities, as in children with Kawasaki disease and after surgical manipulation, especially in case of transposition of the great arteries treated with arterial switch operation and in case of coronary re-implantation

Increasing access to erectile dysfunction treatment via pharmacies to improve healthcare provider visits and quality of life: Results from a prospective real-world observational study in the United Kingdom

OBJECTIVES: The Medicines and Healthcare Products Regulatory Agency in the United Kingdom (UK) formally reclassified sildenafil citrate 50 mg tablets as a pharmacy medicine (sildenafil-P) in 2017 for adult men with erectile dysfunction (ED). A 1-year prospective real-world observational study was conducted to track men's health behaviour, particularly their healthcare resource utilisation (HCRU) and quality of life (QoL) before and after the availability of sildenafil-P. METHODS: Adult men with ED aged ≥18 years provided data at baseline (prior to launch of sildenafil-P) and every 3 months after the launch. Demographics, health characteristics, treatments at baseline and HCRU, including number of pharmacist and physician/nurse practitioner visits over time are reported. QoL-related outcomes were assessed via the Self-Esteem and Relationship Questionnaire (SEAR), 2-Item Patient Health Questionnaire and ratings of sexual satisfaction. Generalised linear models were used to assess the association of sildenafil-P use with total physician/nurse practitioner and pharmacist visits and QoL-related outcomes at 12 months. RESULTS: Overall, 1162 men completed the survey at all 5 time points. The mean ± SD age was 59.02 ± 12.06 years; 55.42% reported having a moderate-to-severe ED. Hypertension (37.52%) and hypercholesterolaemia (31.50%) were the most common risk factors for ED. At baseline, 62.99% were not using any ED treatment. After adjusting for baseline visits/other covariates, mean physician/nurse practitioner (3.68 vs 2.87; P = .003) and pharmacist visits for any reason (2.10 vs 1.34; P < .001) at 12 months were significantly higher among sildenafil-P users than those who never used sildenafil-P. Sildenafil-P users also had significantly higher SEAR total and domain (sexual relationship and self-esteem) scores at 12 months. CONCLUSION: Following the reclassification to a pharmacy medicine in the UK, sildenafil-P was associated with a higher number of physician/nurse practitioner and pharmacist visits for any reason. Sildenafil-P use was also associated with better QoL, although group differences were small in magnitude

A method to implement the reservoir-wave hypothesis using phase-contrast magnetic resonance imaging

The reservoir-wave hypothesis states that the blood pressure waveform can be usefully divided into a “reservoir pressure” related to the global compliance and resistance of the arterial system, and an “excess pressure” that depends on local conditions. The formulation of the reservoir-wave hypothesis applied to the area waveform is shown, and the analysis is applied to area and velocity data from high-resolution phase-contrast cardiovascular magnetic resonance (CMR) imaging. A validation study shows the success of the principle, with the method producing largely robust and physically reasonable parameters, and the linear relationship between flow and wave pressure seen in the traditional pressure formulation is retained. The method was successfully tested on a cohort of 20 subjects (age range: 20–74 years; 17 males). This paper: • Demonstrates the feasibility of deriving reservoir data non-invasively from CMR. • Includes a validation cohort (CMR data). • Suggests clinical applications of the method