Deflection of jets discharged into a reservoir with a free surface

Deflections of jets discharged into a reservoir with a free surface are investigated numerically. The jets are known to deflect towards either side of the free surface or the bottom, whose direction is not determined uniquely in some experimental conditions, i.e. there are multiple stable states realizable in the same condition. The origin of the multiple stable states is explored by utilizing homotopy transformations in which the top boundary of the reservoir is transformed from a rigid to a free boundary and also the location of the outlet throat is continuously moved from mid-height to the top. We depicted bifurcation diagrams of the flow compiling the data of numerical simulations, from which we identified the origin as an imperfect pitchfork bifurcation, and obtained an insight into the mechanism for the direction to be determined. The parameter region where such multiple stable states are possible is also delimited. © 2011 The Japan Society of Fluid Mechanics and IOP Publishing Ltd.

Medicines reconciliation in comparison with NICE guidelines across secondary care mental health organisations

Background Medicines reconciliation-identifying and maintaining an accurate list of a patient's current medications-should be undertaken at all transitions of care and available to all patients. Objective A self-completion web survey was conducted for chief pharmacists (or equivalent) to evaluate medicines reconciliation levels in secondary care mental health organisations. Setting The survey was sent to secondary care mental health organisations in England, Scotland, Northern Ireland and Wales. Method The survey was launched via Bristol Online Surveys. Quantitative data was analysed using descriptive statistics and qualitative data was collected through respondents free-text answers to specific questions. Main outcomes measure Investigate how medicines reconciliation is delivered, incorporate a clear description of the role of pharmacy staff and identify areas of concern. Results Forty-two (52 % response rate) surveys were completed. Thirty-seven (88.1 %) organisations have a formal policy for medicines reconciliation with defined steps. Results show that the pharmacy team (pharmacists and pharmacy technicians) are the main professionals involved in medicines reconciliation with a high rate of doctors also involved. Training procedures frequently include an induction by pharmacy for doctors whilst the pharmacy team are generally trained by another member of pharmacy. Mental health organisations estimate that nearly 80 % of medicines reconciliation is carried out within 24 h of admission. A full medicines reconciliation is not carried out on patient transfer between mental health wards; instead quicker and less exhaustive variations are implemented. 71.4 % of organisations estimate that pharmacy staff conduct daily medicine reconciliations for acute admission wards (Monday to Friday). However, only 38 % of organisations self-report to pharmacy reconciling patients' medication for other teams that admit from primary care. Conclusion Most mental health organisations appear to be complying with NICE guidance on medicines reconciliation for their acute admission wards. However, medicines reconciliation is conducted less frequently on other units that admit from primary care and rarely completed on transfer when it significantly differs to that on admission. Formal training and competency assessments on medicines reconciliation should be considered as current training varies and adherence to best practice is questionable.

Finding qualitative research: an evaluation of search strategies

Background Qualitative research makes an important contribution to our understanding of health and healthcare. However, qualitative evidence can be difficult to search for and identify, and the effectiveness of different types of search strategies is unknown. Methods Three search strategies for qualitative research in the example area of support for breast-feeding were evaluated using six electronic bibliographic databases. The strategies were based on using thesaurus terms, free-text terms and broad-based terms. These strategies were combined with recognised search terms for support for breast-feeding previously used in a Cochrane review. For each strategy, we evaluated the recall (potentially relevant records found) and precision (actually relevant records found). Results A total yield of 7420 potentially relevant records was retrieved by the three strategies combined. Of these, 262 were judged relevant. Using one strategy alone would miss relevant records. The broad-based strategy had the highest recall and the thesaurus strategy the highest precision. Precision was generally poor: 96% of records initially identified as potentially relevant were deemed irrelevant. Searching for qualitative research involves trade-offs between recall and precision. Conclusions These findings confirm that strategies that attempt to maximise the number of potentially relevant records found are likely to result in a large number of false positives. The findings also suggest that a range of search terms is required to optimise searching for qualitative evidence. This underlines the problems of current methods for indexing qualitative research in bibliographic databases and indicates where improvements need to be made.

Text messaging forensics : Txt 4n6: idiolect free authorship analysis?

Current debate within forensic authorship analysis has tended to polarise those who argue that analysis methods should reflect a strong cognitive theory of idiolect and others who see less of a need to look behind the stylistic variation of the texts they are examining. This chapter examines theories of idiolect and asks how useful or necessary they are to the practice of forensic authorship analysis. Taking a specific text messaging case the chapter demonstrates that methodologically rigorous, theoretically informed authorship analysis need not appeal to cognitive theories of idiolect in order to be valid. By considering text messaging forensics, lessons will be drawn which can contribute to wider debates on the role of theories of idiolect in forensic casework.