Patients' and health professionals' views on primary care for people with serious mental illness : focus group study

Objective To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting Six primary care trusts in the West Midlands. Participants Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and prefer-red to consult their own GP, who listened and was willing to learn, rather than be referred to a different,GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness

Aerodynamic behavior of the bridge of a capacitive RF MEMS switch

This paper was presented at the 4th Micro and Nano Flows Conference (MNF2014), which was held at University College, London, UK. The conference was organised by Brunel University and supported by the Italian Union of Thermofluiddynamics, IPEM, the Process Intensification Network, the Institution of Mechanical Engineers, the Heat Transfer Society, HEXAG - the Heat Exchange Action Group, and the Energy Institute, ASME Press, LCN London Centre for Nanotechnology, UCL University College London, UCL Engineering, the International NanoScience Community, www.nanopaprika.eu.The present paper proposes a coupled 3D multi-physics model and presents the results of its transient simulation, for a RF MEMS capacitive switch of bridge-type. The fluid structure interaction (FSI) simulation sustains time-varying viscous damping and modified time response of the bridge deflection compared to the actuation modulation above closing of the switch. Complex 3D geometries of the bridge were rarely taken into account in viscous damping assessment much less in the simulation of the full flow around the bridge of the switch. The final goal of the paper is to obtain the dependency of an equivalent damping coefficient with respect to time, to be used in subsequent reduced order models for the switch, that include the aerodynamic behaviour of the switch

Friedrich Wilhelm Froebel: Unity and Creativity

Friedrich Wilhelm Froebel (1782-1852), the son of a clergyman, was born in Oberweissbach, Thuringia, Germany. He was educated at Jena following an apprenticeship in forestry. Later he worked with an architect before teaching. He visited Pestalozzi\u27s school at Yverdon in 1805 and again in 1808. He opened his first school in 1816. In 1826 The Education of Man was published; it is considered to be his most important work. Froebel first used the name “kindergarten” for his school in 1840. The author of this article, Lawrence J. Sorohan, is a former member of the faculty of the University of Dayton. Currently he is teaching at the University of North Carolina at Greensboro

FEM Applications of Catenary Type Structures

The paper deals with Finite Element Modeling of catenary type structures starting from practical problems related to a single cable segment in the case of an electric transmission line. Finite element models allow the analysis of the resulting deformed position and stress state for a given configuration obtained by using the geometric and physical data of a cable. Beam type linear/nonlinear finite element models which can take into account also the temperature variation and extra loading on the cable were developed. Another application of this type of models is for the case of form finding of aerial refueling cable subjected to dynamic pressure. The results were obtained by the commercial finite element software ANSYS

Low velocity failure and integrity assessment of foam core sandwich panels

Impact resistance and energy absorbing capability are of great interest in the design of composite sandwich structures. This paper experimentally studies damage, failure and energy absorption properties of foam core sandwich panels with aluminum and glass fiber reinforced plastic (GFRP) facesheets subjected to low velocity impact. Tests are performed using a drop weight impact tower at different impact velocities. The energy absorbing capabilities of aluminum and composite facesheet sandwich panels with PUR and PS foam core are evaluated by means of absorbed energy-time histories and by specific parameters as normalized absorbed energy, specific energy absorption, and crush force efficiency. Stiffer panels behave better at lower impact velocities, while more ductile ones do better if impact energy is increased

Failure analysis of dissimilar single-lap joints

Single-lap joints made of aluminium and carbon fibre adherends of different thickness are tested to understand better the behaviour of such dissimilar joints. The overlap length and the thickness of the adhesive are kept constant. Local deformation fields are monitored by using the digital image correlation method. Peeling and shearing strains are investigated, emphasizing that peeling is important in the region where failure is initiated, towards an extremity of the overlap region. The use of only carbon fibre adherends is not recommended for a smaller thickness as an additional interface failure is produced and compromises the integrity of the lap joint. However, a dissimilar joint (aluminium-carbon) with smaller thickness adherends succeeds to maintain the stiffness of the assembly, but its strength is diminished. The obtained results are suggesting that a complete monitoring of the failure processes in the overlap region can be fully understood only if local deformation measurements are possible

Influence of cell wall curvature radius and adhesive layer on the effective elastic out-of-plane properties of hexagonal honeycombs

Numerical modeling of honeycomb structures in aerospace engineering is too tedious and time consuming. The homogenization of these structures permits to obtain an equivalent orthotropic homogeneous solid and its elastic effective properties and thus realizing very efficient simulations. In a sandwich structure the most important effective constants of the core are the out-of-plane shear moduli G23 and G13. These particular effective constants can be obtained analytically, numerically or, if available, can be taken from the producer's data sheets. In the last case they are generally obtained experimentally, but only for some particular thicknesses of the cores and sandwich faces. The analytical models usually neglect the curvature radius of the cell walls and the adhesive layer influence by using some additional hypotheses. In this paper a general parameterization of commercial honeycombs is first discussed. Then, neglecting the skin effect and considering the rigid skin effect, the out-of-plane properties of the core are obtained using a finite element analysis of a representative volume element. The numerical results are analyzed by comparing them to the ones given by the existing analytical models and/or experimental data and their advantages and pitfalls are discussed and explained. The results provide new insights into understanding the mechanics of honeycombs

Inferior Vena Cava and Renal Vein Thrombosis Associated with Thymic Carcinoma

Thymic tumors are rare mediastinal tumors that can present with a wide variety of symptoms. They can cause distant manifestations and are frequently associated with paraneoplastic syndromes. In our case, we describe the evolution of a 68-year-old male whose first manifestation was thrombosis of the inferior vena cava and renal veins. Thrombosis of large abdominal veins is rare, especially without being associated with any other comorbidity or risk factors

Modelling guided waves in anisotropic plates using the Legendre polynomial method

A numerical method to compute phase dispersion curve in unidirectional laminate is described. The basic feature of the proposed method is the expansion of fields quantities in single layer on different polynomial bases. The Legendre polynomial method avoid to solve the transcendental dispersion equation of guided wave. Guided waves that have very close propagation constants are calculated with great accuracy. Numerical solution of dispersion relation are calculated for guided waves propagation in orthotropic unidirectional fiber composites. The validation of the polynomial approach is depicted by a comparison between the associated solution and those obtained using Transfer matrix method