1,114 research outputs found
An evaluation of relationships between fatigue and depression in patients with chronic obstructive pulmonary disease
Cryogenic Thermal Emittance Measurements on Small-Diameter Stainless Steel Tubing
The Mid Infrared Instrument aboard the James Webb Space Telescoep includes a mechanical cryocooler which cools its detectors to their 6 K operating temperature. The refrigerant flows through several meters of approximately 2 mm diameter 304L stainless steel tubing, with some sections gold plated, and some not, which are exposed to their environment. An issue of water freezing onto the tube surfaces is mitigated by a running a warm gas through the lines to sublimate the water. To model the effect of this process on nearby instruments, an accurate measure of the tube emittance is needed. Previously we reported the abosprtance of the gold plated stainless steel tubing as a function of source temperature (i.e. its environment). In this work the thermal emittance of the uncoated tubing is measured as a function of its temperature between 100 and 300 K. This value leads to an accurate prediction of the minimum length of time required to thermally recycle the system. We report the technique and present the results
Tourism stakeholder exclusion and conflict in a small island
Research in the Isle of Man, British Isles, reveals limited and dysfunctional collaboration between stakeholders, and in particular between public and private sector actors. Power and influence over tourism decision making is generally felt to be restricted to a small and opaque network. Moreover, different levels of interest in and support for tourism further divide stakeholders. Various negative consequences are shown to arise from this absence of collaboration, including a lack of shared vision or future strategy for local tourism, and high levels of mutual mistrust between stakeholders. Resulting conflict, wasted resources, lost enthusiasm and lack of strategic direction appear to undermine the current and future management of island tourism. Emphasised by research is the importance of stakeholder collaboration to sustainable tourism management and underlying factors which may enhance or undermine. Focus on dysfunctional collaboration and the small island setting makes a unique contribution to the existing literature
Cryogenic System for the Origins Space Telescope: Cooling a Large Space Telescope to 4K with Today's Technology
The Origins Space Telescope (OST) concept is one of four NASA Science Mission Directorate, Astrophysics Division, observatory concepts being studied for launch in the mid 2030's. OST's wavelength coverage will be from the midinfrared to the sub-millimeter, 6-600 microns. To enable observations at the zodiacal background limit the telescope must be cooled to about 4 K. Combined with the telescope size (currently the primary is 9 m in diameter) this appears to be a daunting task. However, simple calculations and thermal modeling have shown the cooling power required is met with several currently developed cryocoolers. Further, the telescope thermal architecture is greatly simplified, allowing simpler models, more thermal margin, and higher confidence in the final performance values than previous cold observatories. We will describe design principles to simplify modeling and verification. We will argue that the OST architecture and design principles lower its integration and test time and reduce its ultimate cost
Correlates of Complete Childhood Vaccination in East African Countries.
Despite the benefits of childhood vaccinations, vaccination rates in low-income countries (LICs) vary widely. Increasing coverage of vaccines to 90% in the poorest countries over the next 10 years has been estimated to prevent 426 million cases of illness and avert nearly 6.4 million childhood deaths worldwide. Consequently, we sought to provide a comprehensive examination of contemporary vaccination patterns in East Africa and to identify common and country-specific barriers to complete childhood vaccination. Using data from the Demographic and Health Surveys (DHS) for Burundi, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda, we looked at the prevalence of complete vaccination for polio, measles, Bacillus Calmette-Guérin (BCG) and DTwPHibHep (DTP) as recommended by the WHO among children ages 12 to 23 months. We conducted multivariable logistic regression within each country to estimate associations between complete vaccination status and health care access and sociodemographic variables using backwards stepwise regression. Vaccination varied significantly by country. In all countries, the majority of children received at least one dose of a WHO recommended vaccine; however, in Ethiopia, Tanzania, and Uganda less than 50% of children received a complete schedule of recommended vaccines. Being delivered in a public or private institution compared with being delivered at home was associated with increased odds of complete vaccination status. Sociodemographic covariates were not consistently associated with complete vaccination status across countries. Although no consistent set of predictors accounted for complete vaccination status, we observed differences based on region and the location of delivery. These differences point to the need to examine the historical, political, and economic context of each country in order to maximize vaccination coverage. Vaccination against these childhood diseases is a critical step towards reaching the Millennium Development Goal of reducing under-five mortality by two-thirds by 2015 and thus should be a global priority
Integrating Soft Skills With Technology in Online Postsecondary Career and Technical Education
International and U.S. economic need for postsecondary training and degree attainment has fueled the demand for online courses and programs to meet the requirements of busy adults. Rapidly changing businesses and technologies necessitate that workers continually update skills and industry credentials. Employers want to hire workers who possess both technical skills and soft skills—people skills, attitudes, and values—and who can adapt to a culturally diverse, collaborative team workplace.
Higher education institutions must support faculty efforts to provide effective, quality programs and courses that prepare students for this work environment. Career and Technical Education (CTE) faculty are generally hired for their industry and workforce expertise and may need assistance transitioning to eLearning strategies. Thus, a condensed manual was created as a resource to assist new online postsecondary CTE instructors with identifying and selecting the most appropriate technology and tools for incorporating soft skills development into online courses.Signature Page / Title Page / Abstract / Table of Contents / Acknowledgements / Dedication / Introduction / Review of Literature / Method / Discussion / Conclusion / References / Appendix - Project - Technology Compatibility Guide for Soft Skills Integratio
Calculating total health service utilisation and costs from routinely collected electronic health records using the example of patients with irritable bowel syndrome before and after their first gastroenterology appointment
INTRODUCTION: Health economic models are increasingly important in funding decisions but most are based on data, which may therefore not represent the general population. We sought to establish the potential of real-world data available within the Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES) to determine comprehensive healthcare utilisation and costs as input variables for economic modelling.
METHODS: A cohort of patients with irritable bowel syndrome (IBS) who first saw a gastroenterologist in 2008 or 2009, and with 3 years of data before and after their appointment, was created in the CPRD. Primary care, outpatient, inpatient, prescription and colonoscopy data were extracted from the linked CPRD and HES. The appropriate cost to the NHS was attached to each event. Total and stratified annual healthcare utilisation rates and costs were calculated before and after the gastroenterology appointment with distribution parameters. Absolute differences were calculated with 95 % confidence intervals.
RESULTS: Total annual healthcare costs over 3 years increase by £935 (95 % CI £928–941) following a gastroenterology appointment for IBS. We derived utilisation and cost data with parameter distributions stratified by demographics and time. Women, older patients, smokers and patients with greater comorbidity utilised more healthcare resources, which generated higher costs.
CONCLUSIONS: These linked datasets provide comprehensive primary and secondary care data for large numbers of patients, which allows stratification of outcomes. It is possible to derive input parameters appropriate for economic models and their distributions directly from the population of interest
Identification, Motivation and Facilitation of Domestic Tourism in a Small Island
This paper presents a case concerning domestic tourism in the Isle of Man, British Isles; a small maritime nation with Norse heritage. Qualitative interviews find the existence of considerable domestic tourism activity conducted by island residents, including daytrips and overnight stays, and explore the motivational and facilitating factors which underpin this. Such behaviour is identified by residents as touristic and distinct from other leisure pursuits. Yet recognition of domestic tourism in small geographic spaces is currently almost entirely absent. This article attempts to highlight the issue and draw attention to attendant benefits of domestic tourism which include economic and social inputs. These may be relevant to a small island community, and in the case of the Isle of Man help to support an otherwise ailing tourism industry
Narcissism normalisation: tourism influences and sustainability implications
The concept of narcissism normalisation suggests that individuals and societies are becoming more narcissistic due to various cultural influences. Tourism is reviewed here as one such possible influence. Exploitative, entitled and exhibitionistic tendencies associated with narcissism are wellestablished
in tourism. Yet tourism is also an intimate, communal and satisfying activity which may counteract narcissism. Increases in narcissism
have significant implications from a sustainable tourism perspective. Narcissism is associated with exploitative and entitled behaviours that over time cause significant harm to those people and landscapes that
come into contact with. Narcissism appears to be incompatible with principles of sustainability and the challenges this poses for the industry are reviewed, while the opportunities are also explored. There are signs that narcissism, particularly those aspects relating to exhibitionism, can be
co-opted to benefit sustainable development
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