Which diagrams and when? Health workers' choice and usage of different diagram types for service improvement

Diagrammatic representations, such as process mapping and care pathways, have been often used for service evaluation and improvement in healthcare. While a broad range of diagrammatic representations exist, their application in healthcare has been very limited. There is a lack of understanding about how and which diagrams could be usable and useful to health workers. In this study, ten mental health workers were asked to discuss positive and negative issues around their service delivery using one or two diagrams of their choice out of seven different diagrams representing their service: care pathway diagram; organisation diagram; communication diagram; service blueprint; patient state transition diagram; free form diagram; geographic map. Their interactions with diagrams were video-taped for analysis. The patient state transition diagram was the most popular choice in spite of relatively low previous familiarity. The overall findings provided insight into a better use of diagrams in healthcare. © 2012 Springer-Verlag.

Effects of ethanol on vehicle energy efficiency and implications on ethanol life-cycle greenhouse gas analysis.

Bioethanol is the world's largest-produced alternative to petroleum-derived transportation fuels due to its compatibility within existing spark-ignition engines and its relatively mature production technology. Despite its success, questions remain over the greenhouse gas (GHG) implications of fuel ethanol use with many studies showing significant impacts of differences in land use, feedstock, and refinery operation. While most efforts to quantify life-cycle GHG impacts have focused on the production stage, a few recent studies have acknowledged the effect of ethanol on engine performance and incorporated these effects into the fuel life cycle. These studies have broadly asserted that vehicle efficiency increases with ethanol use to justify reducing the GHG impact of ethanol. These results seem to conflict with the general notion that ethanol decreases the fuel efficiency (or increases the fuel consumption) of vehicles due to the lower volumetric energy content of ethanol when compared to gasoline. Here we argue that due to the increased emphasis on alternative fuels with drastically differing energy densities, vehicle efficiency should be evaluated based on energy rather than volume. When done so, we show that efficiency of existing vehicles can be affected by ethanol content, but these impacts can serve to have both positive and negative effects and are highly uncertain (ranging from -15% to +24%). As a result, uncertainties in the net GHG effect of ethanol, particularly when used in a low-level blend with gasoline, are considerably larger than previously estimated (standard deviations increase by >10% and >200% when used in high and low blends, respectively). Technical options exist to improve vehicle efficiency through smarter use of ethanol though changes to the vehicle fleets and fuel infrastructure would be required. Future biofuel policies should promote synergies between the vehicle and fuel industries in order to maximize the society-wise benefits or minimize the risks of adverse impacts of ethanol.

Large and negative lateral displacement in an active dielectric slab configuration

We investigate the large negative lateral displacements of TE polarized light beams reflected from or transmitted through an active slab surrounded by transparent medium. The large negative displacements can be achieved when the incidence angle of the beam is less than but close to the critical angle for total reflection. It is also shown that both the reflectivity and transmissivity of the beam that correspond to the large negative displacements can be enhanced by active medium. These phenomena may lead to convenient measurements and interesting applications in optical devices. (c) 2006 Elsevier B.V. All rights reserved.

SELF-CONSISTENT TREATMENT OF 3-DIMENSIONAL - 2-DIMENSIONAL AND 2-DIMENSIONAL - 2-DIMENSIONAL RESONANT-TUNNELING IN DOUBLE-BARRIER STRUCTURES

By using a transfer-matrix method on the basis of two-dimensional (2D) Bloch sums in accordance with a tight-binding scheme, a self-consistent calculation on the resonant tunneling in asymmetric double-barrier structures is presented, in which contributions to resonant tunneling from both three-dimensional (3D) electrons in the contacts and 2D electrons in the spacer or accumulation layers are considered simultaneously. The charge buildup effect on the current versus voltage (I-V) curves is evaluated systematically, showing quantitatively how it results in the I-V bistability and enhanced differences between I-V curves for positive and negative bias in an asymmetric double-barrier structure. Special attention is focused on the interaction between 3D-2D and 2D-2D resonant-tunneling processes, including the suppression of 2D-2D resonant tunneling by the charge buildup in the well accompanying the 3D-2D resonant tunneling. The effects of the emitter doping condition (doping concentration, spacer thickness) on the presence of two types of quasi-2D levels in the emitter accumulation layers, and on the formation of a potential bulge in the emitter region, are discussed in detail in relation to the tunneling process.

Electrical bistability and negative differential resistance in diodes based on silver nanoparticle-poly(N-vinylcarbazole) composites

An electrically bistable device has been fabricated using nanocomposite films consisting of silver nanoparticles and a semiconducting polymer by a simple spin-coating method. The current-voltage characteristics of the as-fabricated devices exhibit an obvious electrical bistability and negative differential resistance effect. The current ratio between the high-conducting state and low-conducting state can reach more than 103 at room temperature. The electrical bistability of the device is attributed to the electric-filed-induced charge transfer between the silver nanoparticles and the polymer, and the negative differential resistance behavior is related to the charge trapping in the silver nanoparticles. The results open up a simple approach to fabricate high quality electrically bistable devices by doping metal nanoparticles into polymer.

Raninfall and Slope Characteristics Affecting Soil Erosion on Hillsopes

A soil erosion model including interrill erosion and rill erosion was developed for hillslope. The rainfall and slope characteristics affecting soil erosion on hillslopes was analyzed by simulation. The results show that the slope length and gradient, rainfall intensity and process have varying influence on runoff and soil erosion. The unit discharge of runoff and erosion rate increases with increases in the rainfall intensity and the slope length. The same precipitation but with different rainfall processes may cause different runoff and erosion results. The effect of the slope gradient on runoff and soil erosion can be both positive and negative. There exists a critical slope gradient for runoff and soil erosion.

High negative ion production yield in 30 keV F2+ + adenine (C5H5N5) collisions

In collisions between slow F2+ ions (30 keV) and molecular targets, adenine, scattered particle production yields have been measured directly by simultaneous detection of neutrals, positive and negative ions. The relative cross-section for a negative ion formation channel was measured to be 1%. Despite a slight decrease compared to a larger target, the fullerene C-60, the measured negative ion formation cross section is still at least one order of magnitude larger than the yield in ion-atom interactions.

Medium-spin states in Ge-70 and the role of the g(9/2) orbital

Medium-spin states of Ge-70 have been studied via the Ni-60(C-12,2p gamma)Ge-70 reaction at 45 MeV. The ground-state band and the second 0(+) band have been extended to the 12(+) and 8(+) states, respectively. Two negative-parity bands, one of which has a coupled structure and the other has a decoupled structure, have been observed additionally. Although the latter decoupled structure was known up to the (21(-)) state from a previous experiment, the part of the level scheme up to the 15(-) state has been largely modified by the present experiment. Backbendings observed in the positive- and negative-parity yrast bands have been compared with those of the neighboring even Ge isotopes. The experimental level structure has been compared with the shell-model calculations in the model space (2p(3/2), 1f(5/2), 2(p1/2), 1g(9/2)) employing two kinds of effective interactions, one of which is an extended P + QQ interaction with monopole interactions and the other is developed from a renormalized G matrix. Microscopic structures of the observed bands have been discussed with the help of the shell-model calculations.

Impact of carbon dioxide pressurization on liquid phase organic reactions: A case study on Heck and Diels-Alder reactions

Heck coupling reactions of methyl acrylate with various aryl bromides have been investigated using a Pd/TPP catalyst in toluene under pressurized CO2 conditions up to 13 MPa. Although CO2 is not a reactant, the pressurization of the reaction liquid phase with CO2 has positive and negative impacts on the rate of Heck coupling depending on the structures of the substrates examined. In the case of either 2-bromoacetophenone or 2-bromocinnamate, the conversion has a maximum at a CO2 pressure of about 3 MPa; for the former, it is much larger by a factor of 3 compared with that under ambient pressure. For 2-bromobenzene, in contrast, the conversion is minimized at a similar CO2 pressure, being half compared with that at ambient pressure

Impact of Carbon Dioxide Pressurization on Liquid Phase Organic Reactions: A Case Study on Heck and Diels–Alder Reactions

Heck coupling reactions of methyl acrylate with various aryl bromides have been investigated using a Pd/TPP catalyst in toluene under pressurized CO2 conditions up to 13 MPa. Although CO2 is not a reactant, the pressurization of the reaction liquid phase with CO2 has positive and negative impacts on the rate of Heck coupling depending on the structures of the substrates examined. In the case of either 2-bromoacetophenone or 2-bromocinnamate, the conversion has a maximum at a CO2 pressure of about 3 MPa;

Analysis of Saponins from Leaves of Aralia elata by Liquid Chromatography and Multi-stage Tandem Mass Spectrometry

Four saponins were isolated from the leaves of Aralia elata, and established using NMR and other spectroscopic methods, as well as data reported in the literature. Three Aralia saponins from the leaves of Aralia elata sharing the same structures as those isolated from the root bark suggested that the leaves would be a good substitute for the root bark of Aralia elata. These four Aralia saponins were then extensively investigated using complementarily positive and negative electrospray ionization multistage tandem mass spectrometry (ESI-MSn). Two isomers of saponins with different sugar linkages were then successfully differentiated by positive ESI-MSn and verified with different retention times and the collision-induced dissociation (CID) spectra by LC-MS. A simple and effective LC-MS method was thus developed for the rapid identification and screening of these saponins in plant extracts from leaves of Aralia elata.

Charge carrier mobility and electroluminescence in a green-emitting alternating block copolymer with a methoxy Bi-substituted chromophore

We determine the mobility of positive and negative charge carriers in a soluble green-emitting alternating block copolymer with, a methoxy bi-subsbituted conjugated segment. The negative charge carrier mobility of 6 x 10(-11) cm(2)/V.s is directly determined using space-charge-limited current analytical expressions. Positive charge carrier transport is also space-charge-limited, with a mobility of I x 10(-8) cm(2)/V.s. The electron trap distribution is exponential, with a characteristic energy of similar to 0.12 eV. A hole trap with energy similar to 0.4 eV was observed. This copolymer is used as emissive material in organic light-emitting diodes that present brightness of similar to 900 cd/m(2) at 12.5 V.

Electrospray ionization mass spectrometry of cyclodextrin complexes with amino acids in incubated solutions and in eluates of gel permeation chromatography

1:1 complexes of beta-cyclodextrin (CD) with three amino acids (Gly, Phe and Trp) have been detected as ions in the gas phase using infusion positive and negative ion electrospray ionization mass spectrometry (ESI-MS). In contrast with the positive ion ESI mass spectra of simple aqueous solutions, the aggregates and adducts usually formed in the ESI process did not appear in the positive ion ESI spectra of solutions buffered with ammonium acetate (NH4Ac), even at higher analyte concentrations, These studies suggest that addition of buffer and/or use of a low analyte concentration should be used to overcome formation of aggregates and metal ion adducts in such mass spectrometry studies. Also, the deprotonated complexes are dissociated by collision induced dissociation (CID) to form an abundant product ion, the deprotonated CD, requiring transfer of a proton to the amino acid carboxyl group, To understand formation of complexes in the gas phase, gel permeation chromatography (GPC) was used to separate free amino acids (AAs) from complexes in an incubated solution. The ESI mass spectra of the GPC fractions show the presence of 1:1 complexes of both CD-aromatic amino acids and CD-aliphatic amino acids. Compared with CD-aliphatic amino acid complexes, CD-aromatic amino acid complexes appear to be destabilized in the gas phase, possibly because the hydrophobic interaction which binds the aromatic group of amino acids in the CD cavity in solution may become repulsive when solvent evaporates from the droplets during the electrospray process, whereas those complex ions formed as proton bound dimers are stabilized by electrostatic forces, the major binding force for such complexes in the gas phase. In addition, the GPC technique coupled with off-line ESI-MS can rapidly separate CD complexes by size, and provides some information on the character of the complexes in solution. (C) 1998 John Wiley & Sons, Ltd.