High resolution study of low-lying correlation satellites below 25 eV in xenon probed by pulsed-field-ionization-zero-kinetic-energy photoelectron spectroscopy

No description supplie

The mechanical response of glassy carbon recovered from high pressure

Glassy carbon (GC) is usually considered the prototypical super-elastic material, which can almost fully recover its shape after compression of several gigapascals (GPa). In this work, nanoindentation is used to study the mechanical response of GC, which was subjected to a range of high pressures using a diamond anvil cell (DAC). We show that GC starts to lose its elasticity after compression to 6 GPa and becomes clearly mechanically anisotropic after being compressed beyond ∼30 GPa. Molecular dynamics (MD) simulations are used to calculate Young’s modulus before and after compression. Through our experimental results and MD simulations, we show that the elasticity of GC is at a minimum around 30 GPa but recovers after compression to higher pressures along the DAC compression axis.The authors would like to acknowledge the Australian Research Council (ARC) for funding under the ARC Discovery Project Scheme (Nos. DP190101438, DP170102087, and DP140102331) and M. V. Swain for useful discussions

Responding to Young People's Health Risks in Primary Care: A Cluster Randomised Trial of Training Clinicians in Screening and Motivational Interviewing.

OBJECTIVE: To evaluate the effectiveness of a complex intervention implementing best practice guidelines recommending clinicians screen and counsel young people across multiple psychosocial risk factors, on clinicians' detection of health risks and patients' risk taking behaviour, compared to a didactic seminar on young people's health. DESIGN: Pragmatic cluster randomised trial where volunteer general practices were stratified by postcode advantage or disadvantage score and billing type (private, free national health, community health centre), then randomised into either intervention or comparison arms using a computer generated random sequence. Three months post-intervention, patients were recruited from all practices post-consultation for a Computer Assisted Telephone Interview and followed up three and 12 months later. Researchers recruiting, consenting and interviewing patients and patients themselves were masked to allocation status; clinicians were not. SETTING: General practices in metropolitan and rural Victoria, Australia. PARTICIPANTS: General practices with at least one interested clinician (general practitioner or nurse) and their 14-24 year old patients. INTERVENTION: This complex intervention was designed using evidence based practice in learning and change in clinician behaviour and general practice systems, and included best practice approaches to motivating change in adolescent risk taking behaviours. The intervention involved training clinicians (nine hours) in health risk screening, use of a screening tool and motivational interviewing; training all practice staff (receptionists and clinicians) in engaging youth; provision of feedback to clinicians of patients' risk data; and two practice visits to support new screening and referral resources. Comparison clinicians received one didactic educational seminar (three hours) on engaging youth and health risk screening. OUTCOME MEASURES: Primary outcomes were patient report of (1) clinician detection of at least one of six health risk behaviours (tobacco, alcohol and illicit drug use, risks for sexually transmitted infection, STI, unplanned pregnancy, and road risks); and (2) change in one or more of the six health risk behaviours, at three months or at 12 months. Secondary outcomes were likelihood of future visits, trust in the clinician after exit interview, clinician detection of emotional distress and fear and abuse in relationships, and emotional distress at three and 12 months. Patient acceptability of the screening tool was also described for the intervention arm. Analyses were adjusted for practice location and billing type, patients' sex, age, and recruitment method, and past health risks, where appropriate. An intention to treat analysis approach was used, which included multilevel multiple imputation for missing outcome data. RESULTS: 42 practices were randomly allocated to intervention or comparison arms. Two intervention practices withdrew post allocation, prior to training, leaving 19 intervention (53 clinicians, 377 patients) and 21 comparison (79 clinicians, 524 patients) practices. 69% of patients in both intervention (260) and comparison (360) arms completed the 12 month follow-up. Intervention clinicians discussed more health risks per patient (59.7%) than comparison clinicians (52.7%) and thus were more likely to detect a higher proportion of young people with at least one of the six health risk behaviours (38.4% vs 26.7%, risk difference [RD] 11.6%, Confidence Interval [CI] 2.93% to 20.3%; adjusted odds ratio [OR] 1.7, CI 1.1 to 2.5). Patients reported less illicit drug use (RD -6.0, CI -11 to -1.2; OR 0.52, CI 0.28 to 0.96), and less risk for STI (RD -5.4, CI -11 to 0.2; OR 0.66, CI 0.46 to 0.96) at three months in the intervention relative to the comparison arm, and for unplanned pregnancy at 12 months (RD -4.4; CI -8.7 to -0.1; OR 0.40, CI 0.20 to 0.80). No differences were detected between arms on other health risks. There were no differences on secondary outcomes, apart from a greater detection of abuse (OR 13.8, CI 1.71 to 111). There were no reports of harmful events and intervention arm youth had high acceptance of the screening tool. CONCLUSIONS: A complex intervention, compared to a simple educational seminar for practices, improved detection of health risk behaviours in young people. Impact on health outcomes was inconclusive. Technology enabling more efficient, systematic health-risk screening may allow providers to target counselling toward higher risk individuals. Further trials require more power to confirm health benefits. TRIAL REGISTRATION: ISRCTN.com ISRCTN16059206

Evaluation of obstetric early discharge - overview, CHERE Discussion Paper No 9

This paper gives an overview of evaluations of obstetric early discharge schemes at three hospitals in Western Sydney Area Health Service. Satisfaction of early discharge and hospital clients with their postnatal care, the reasons given by eligible women who chose not to participate in the schemes, and cost-effectiveness analyses are presented. It was found that women choosing early discharge were more likely to be satisfied with their postnatal care than were women choosing institutional care. This result is dependent on sufficient support for the women in the home, absence of medical complications, and autonomy over the selection of the type of postnatal care received. Participation in the schemes could be increased through better communication of information and increased provision of help in the home. Both Blacktown and Westmead Early Discharge Schemes currently cost the health care system more than the value of the hospital resources which they release. The value of hospital resources released by the Auburn scheme exceeds its costs, but the difference is slight. All results are sensitive to assumptions made in the analyses. Improvements in cost-effectiveness are possible, but would not necessarily lead to reductions in hospital expenditure, as that would depend on the uses made of released resources. From the perspective of the wider community, all three schemes cost more than the value of resources which are released. At issue, therefore, is whether the increase in client choice which the early discharge schemes bring about is judged worth the additional cost.Obstetric early discharge, evaluation

Internet-based medical education: a realist review of what works, for whom and in what circumstances

http://creativecommons.org/licenses/by/2.0

Forced migrants involved in setting the agenda and designing research to reduce impacts of complex emergencies: combining Swarm with patient and public involvement

Background: Many events with wide-ranging negative health impacts are notable for complexity: lack of predictability, non-linear feedback mechanisms and unexpected consequences. A multi-disciplinary research team was tasked with reducing the public health impacts from complex events, but without a pre-specified topic area or research design. This report describes using patient and public involvement within an adaptable but structured development process to set research objectives and aspects of implementation. Methods: An agile adaptive development approach, sometimes described as swarm, was used to identify possible research areas. Swarm is meant to quickly identify strengths and weaknesses of any candidate project, to accelerate early failure before resources are invested. When aspects of the European migration crisis were identified as a potential priority topic area, two representatives of forced migrant communities were recruited to explore possible research ideas. These representatives helped set the specific research objectives and advised on aspects of implementation, still within the swarm framework for project development. Results: Over ten months, many research ideas were considered by the collaborative working group in a series of six group meetings, supplemented by email contact in between. Up to four possible research ideas were scrutinised at any one meeting, with a focus on identifying practical or desirable aspects of each proposed project. Interest settled on a study to solicit original data about successful strategies that forced migrants use to adapt to life in the UK, with an emphasis on successfully promoting resilience and minimizing emotional distress. “Success in resettlement” was identified to be a more novel theme than “barriers to adaption” research. A success approach encourages participation when individuals may find discussion of mental illness stigmatising. The patient representatives helped with design of patient-facing and interview training materials, interviewer training (mock interviews), and aspects of the recruitment. Conclusion: Using patient and public involvement (PPI) within an early failure development approach that itself arises from theory on complex adaptive systems, we successfully implemented a dynamic development process to determine research topic and study design. The PPI representatives were closely involved in setting research objectives and aspects of implementation

Cost and disease burden of Dengue in Cambodia

<p>Abstract</p> <p>Background</p> <p>Dengue is endemic in Cambodia (pop. estimates 14.4 million), a country with poor health and economic indicators. Disease burden estimates help decision makers in setting priorities. Using recent estimates of dengue incidence in Cambodia, we estimated the cost of dengue and its burden using disability adjusted life years (DALYs).</p> <p>Methods</p> <p>Recent population-based cohort data were used to calculate direct and productive costs, and DALYs. Health seeking behaviors were taken into account in cost estimates. Specific age group incidence estimates were used in DALYs calculation.</p> <p>Results</p> <p>The mean cost per dengue case varied from US$36 -$75 over 2006-2008 respectively, resulting in an overall annual cost from US$3,327,284 in 2008 to US$14,429,513 during a large epidemic in 2007. Patients sustain the highest share of costs by paying an average of 78% of total costs and 63% of direct medical costs. DALY rates per 100,000 individuals ranged from 24.3 to 100.6 in 2007-2008 with 80% on average due to premature mortality.</p> <p>Conclusion</p> <p>Our analysis confirmed the high societal and individual family burden of dengue. Total costs represented between 0.03 and 0.17% of Gross Domestic Product. Health seeking behavior has a major impact on costs. The more accurate estimate used in this study will better allow decision makers to account for dengue costs particularly among the poor when balancing the benefits of introducing a potentially effective dengue vaccine.</p

STUDENTS’ DROPOUT RATES AND CAUSES

This study determined the students’ dropout rates, and identified the profile of the dropout students in terms of degree, year level, gender, religion, nationality and civil status. The data were taken from the change of program forms accomplished&nbsp; by the 153 college students who dropped out from a university. The results revealed that 19 students dropped out from the College of Nursing, 12 from the BSBA Business Management, 11 from AB English and BS Accountancy and ten from the BS&nbsp; in Medical Laboratory. The majority of the dropouts are first year college students, followed by the second year college students and the new freshmen. Out of 153 dropouts, 80 were male, and 73 were female.&nbsp; SDA religion has the largest number of 101 dropouts, the Roman Catholics with 28 dropouts and 12 dropouts with no religion. Seventy-nine (79) Filipinos dropped out of school, followed by the Koreans with 40 dropouts, and Papua New Guineans with 13 dropouts.&nbsp; One hundred forty-nine (149) single students and four married students. The 1st Sem 2013-2014 (June-October) ranks no. 1 with the biggest number of 25(.63%) dropouts. Followed by the 1st Sem 2015-2016 (August- December) with 17 (.43%) dropouts, the 3rd in rank is 1st Sem 2010-2011 (June-October)&nbsp; with 13 (.36%) dropouts. The top five reasons for dropping out were identified: transferred to another school ranks no. 1 with the highest number of dropouts, go back home ranks no. 2, family problem ranks no. 3, health problems ranks no. 4 and personal problem ranks no. 5

Prevalence of Hepatitis B, C, HIV and syphilis markers among refugees in Bari, Italy

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to assess the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) serological markers and the prevalence of VDRL positive subjects in a population of refugees of various nationalities, living in the Asylum Seeker Centre in Bari Palese, Southern Italy.</p> <p>Methods</p> <p>The study was carried out in the period May-July 2008 and recruited only voluntarily enrolled healthy refugees. HBsAg, anti-HBc, anti-HCV and anti-HIV virus antibodies were detected. VDRL syphilis screening was also carried out on the serum samples.</p> <p>Results</p> <p>A total of 529 refugees, 442 males and 87 females, aged between 7 and 52 years, were studied. Of these, 510 were from Africa and 19 from Asia.</p> <p>Forty-four individuals (8.3%) were HBsAg positive and 241 (45.6%) were anti-HBc positive. A total of 24 (4.5%) individuals were anti-HCV positive. Eight asylum seekers (1.5%) were HIV positive. VDRL tests were performed on 269 subjects and 4 (1.5%) were positive. 12.3% of the study population had serological markers of chronic and transmissible infections with potential blood-borne or sexual transmission.</p> <p>Conclusions</p> <p>In Italy, a suitable protocol is necessary for the early diagnosis of infectious diseases on entering Asylum Centres, so allowing the adoption of prevention measures to safeguard the health of the individuals, the residents and workers in the Centres and the general population.</p

The role of social capital in participatory arts for wellbeing: findings from a qualitative systematic review

BACKGROUND:Social capital is often cited as shaping impacts of participatory arts, although the concept has not been systematically mapped in arts, health and wellbeing contexts. In wider health inequalities research, complex, differential, and sometimes negative impacts of social capital have been recognised. METHODS:This paper maps of social capital concepts in qualitative research as part of the UK What Works for Wellbeing evidence review programme on culture, sport and wellbeing. RESULTS:Studies often cite positive impacts of bonding and, to a lesser extent, bridging social capital. However, reported challenges suggest the need for a critical approach. Forms of linking social capital, such as reframing and political engagement to address social divisions, are less often cited but may be important in participatory arts and wellbeing. CONCLUSIONS:Future research should further specify dimensions of social capital as well as their nuanced effects in arts, and wellbeing contexts