Logics of marginalisation in health and social care reform:integration, choice, and provider-blind provision

The period 2010–2013 was a time of far-reaching structural reforms of the National Health Service in England. Of particular interest in this paper is the way in which radical critiques of the reform process were marginalised by pragmatic concerns about how to maintain the market-competition thrust of the reforms while avoiding potential fragmentation. We draw on the Essex school of political discourse theory and develop a ‘nodal’ analytical framework to argue that widespread and repeated appeals to a narrative of choice-based integrated care served to take the fragmentation ‘sting’ out of radical critiques of the pro-competition reform process. This served to marginalise alternative visions of health and social care, and to pre-empt the contestation of a key norm in the provision of health care that is closely associated with the notions of ‘any willing provider’ and ‘any qualified provider’: provider-blind provision.

Cell exclusion in couette flow:evaluation through flow visualisation and mechanical forces

Cell exclusion is the phenomenon whereby the hematocrit and viscosity of blood decrease in areas of high stress. While this is well known in naturally occurring Poiseuille flow in the human body, it has never previously been shown in Couette flow, which occurs in implantable devices including blood pumps. The high-shear stresses that occur in the gap between the boundaries in Couette flow are known to cause hemolysis in erythrocytes. We propose to mitigate this damage by initiating cell exclusion through the use of a spiral-groove bearing (SGB) that will provide escape routes by which the cells may separate themselves from the plasma and the high stresses in the gap. The force between two bearings (one being the SGB) in Couette flow was measured. Stained erythrocytes, along with silver spheres of similar diameter to erythrocytes, were visualized across a transparent SGB at various gap heights. A reduction in the force across the bearing for human blood, compared with fluids of comparable viscosity, was found. This indicates a reduction in the viscosity of the fluid across the bearing due to a lowered hematocrit because of cell exclusion. The corresponding images clearly show both cells and spheres being excluded from the gap by entering the grooves. This is the first time the phenomenon of cell exclusion has been shown in Couette flow. It not only furthers our understanding of how blood responds to different flows but could also lead to improvements in the future design of medical devices.

English-for-teaching:rethinking teacher proficiency in the classroom

The expansion of English teaching in state education systems places increasing demands on English language teachers and how they are trained. A major thrust of these efforts has focused on improving teachers' English language proficiency. This expectation is manifested in policy and pedagogical directives that teachers 'teach English in English'. We argue for a reconceptualization of teacher language proficiency, not as general English proficiency but as a specialized subset of language skills required to prepare and teach lessons. This concept of English-for-Teaching as a bounded form of English for Specific Purposes (ESP) for the classroom builds on what teachers know about teaching, while introducing and confirming specific classroom language. This article describes how the construct was developed and then describes sample classroom tasks and the language needed to enact them in three major areas: managing the classroom, understanding and communicating lesson content, and assessing students and giving feedback.

Radially rotating miniature heat pipes for turbine blade cooling applications

Aerospace turboengines present a demanding challenge to many heat transfer scientists and engineers. Designers in this field are seeking the best design to transform the chemical energy of the fuel into the useful work of propulsive thrust at maximum efficiency. To this aim, aerospace turboengines must operate at very high temperatures and pressures with very little heat losses. These requirements are often in conflict with the ability to protect the turboengine blades from this hostile thermal environment. Heat pipe technology provides a potential cooling means for the structure exposed to high heat fluxes. Therefore, the objective of this dissertation is to develop a new radially rotating miniature heat pipe, which would combine the traditional air-cooling technology with the heat pipe for more effective turboengine blade cooling. ^ In this dissertation, radially rotating miniature heat pipes are analyzed and studied by employing appropriate flow and heat transfer modeling as well as experimental tests. The analytical solutions for the flows of condensate film and vapor, film thickness, and vapor temperature distribution along the heat pipe length are derived. The diffuse effects of non-condensable gases on the temperature distribution along the heat pipe length are also studied, and the analytical solutions for the temperature distributions with the diffuse effects of non-condensable gases are obtained. Extensive experimental tests on radially rotating miniature heat pipes with different influential parameters are undertaken, and various effects of these parameters on the operation of the heat pipe performance are researched. These analytical solutions are in good agreement with the experimental data. ^ The theoretical and experimental studies have proven that the radially rotating miniature heat pipe has a very large heat transfer capability and a very high effective thermal conductance that is 60–100 times higher than the thermal conductivity of copper. At the same time, the heat pipe has a simple structure and low manufacturing cost, and can withstand strong vibrations and work in a high-temperature environment. Therefore, the combination of the traditional air-cooling technology with the radially rotating miniature heat pipe is a feasible and effective cooling means for high-temperature turbine blades. ^

History and evolutionary trajectory of the Iranian nuclear program

What actors and processes at what levels of analysis and through what mechanisms have pushed Iran's nuclear program (INP) towards being designated as a proliferation threat (securitization)? What actors and processes at what levels of analysis and through what mechanisms have pushed Iran's nuclear program away from being designated as an existential threat (de-securitization)? What has been the overall balance of power and interaction dynamics of these opposing forces over the last half-century and what is their most likely future trajectory? ^ Iran's nuclear story can be told as the unfolding of constant interaction between state and non-state forces of "nuclear securitization" and "nuclear de-securitization." Tracking the crisscrossing interaction between these different securitizing and de-securitizing actors in a historical context constitutes the central task of this project. ^ A careful tracing of "security events" on different analytical levels reveals the broad contours of the evolutionary trajectory of INP and its possible future path(s). Out of this theoretically conscious historical narrative, one can make informed observations about the overall thrust of INP along the securitization - de-securitization continuum. ^ The main contributions of this work are three fold: First, it brings a fresh theoretical perspective on Iran's proliferation behavior by utilizing the "securitization" theory tracing the initial indications of the threat designation of INP all the way back to the mid 1970s. Second, it gives a solid and thematically grounded historical texture to INP by providing an intimate engagement with the persons, processes, and events of Tehran's nuclear pursuit over half a century. Third, it demonstrates how INP has interacted with and even at times transformed the NPT as the keystone of the non-proliferation regime, and how it has affected and injected urgency to the international discourse on nuclear proliferation specifically in the Middle East.^

Oman's foreign policy: Foundations and practice

The object of this dissertation is to record and analyze the foreign policy of the Sultanate of Oman from the early twentieth century until 2004. It challenges the central assumption of the contemporary scholarship on the subject that Muscat's modern foreign policy begins in 1970. It is often presumed that the pre-1970 era does not merit a thorough investigation to understand Muscat's modus operandi today. This study argues that for a comprehensive understanding of Muscat's foreign policy since 1970, the frontier of the historical analysis of Oman's regional and international involvement should be pushed back to the 1930's, when the young Sultan Said assumed power over the country divided by the "Treaty" or the "Agreement" of Sib. Indeed, the thrust of this research lies at once in repudiating the conventional wisdom regarding both the persona of Sultan Said and the customary political/historical narrative of Said's reign. The critical analysis of this period is utilized to rebut the pervasive and largely inaccurate historical narrative of the events prior to 1970, to recount an original interpretation of the period, and to use the narrative as a preamble for subsequent foreign policy directions and initiatives. Furthermore, this dissertation covers the gaps in the literature resulting from the absence of any materials that either record or analyze Muscat's foreign policy from 1996 until 2004. In addition, his study provides new information and a fresh analysis of the international relations of the region, including great power rivalry, especially the competition between the United States and Great Britain, and the attitudes of major regional actors, such as Iran, Saudi Arabia, and Iraq. ^ The use of a thorough historical inquiry is vital to support the central claim of this dissertation; therefore, a large section of this dissertation is based almost exclusively on archival materials collected from the British Public Records Office, the University of Oxford and the Library of Congress. This project represents the most comprehensive use of archival materials on the subject matter to date. ^

Oman's foreign policy : foundations and practice

The object of this dissertation is to record and analyze the foreign policy of the Sultanate of Oman from the early twentieth century until 2004. It challenges the central assumption of the contemporary scholarship on the subject that Muscat's modern foreign policy begins in 1970. It is often presumed that the pre-1970 era does not merit a thorough investigation to understand Muscat's modus operandi today. This study argues that for a comprehensive understanding of Muscat's foreign policy since 1970, the frontier of the historical analysis of Oman's regional and international involvement should be pushed back to the 1930's, when the young Sultan Said assumed power over the country divided by the "Treaty" or the "Agreement" of Sib. Indeed, the thrust of this research lies at once in repudiating the conventional wisdom regarding both the persona of Sultan Said and the customary political/historical narrative of Said's reign. The critical analysis of this period is utilized to rebut the pervasive and largely inaccurate historical narrative of the events prior to 1970, to recount an original interpretation of the period, and to use the narrative as a preamble for subsequent foreign policy directions and initiatives. Furthermore, this dissertation covers the gaps in the literature resulting from the absence of any materials that either record or analyze Muscat's foreign policy from 1996 until 2004. In addition, his study provides new information and a fresh analysis of the international relations of the region, including great power rivalry, especially the competition between the United States and Great Britain, and the attitudes of major regional actors, such as Iran, Saudi Arabia, and Iraq. The use of a thorough historical inquiry is vital to support the central claim of this dissertation; therefore, a large section of this dissertation is based almost exclusively on archival materials collected from the British Public Records Office, the University of Oxford and the Library of Congress. This project represents the most comprehensive use of archival materials on the subject matter to date.

Love comes in at the eye

LOVE COMES IN AT THE EYE relates the story of Marshall Craig, a Midwesterner transplanted to South Florida who turns 35 in the course of the book. Marshall is an assistant curator for a Miami art museum, a man who has been obsessed with--as he calls it--a greed for seeing from a young age. His fascination with the surface of appearance of things is exacerbated by his precocious studies in art and its histories. Marshall views himself as marked by his red hair and freckled skin, as someone whose chances of attracting a partner into a meaningful relationship have been diminished by his looks. He is colored by his image of himself as unattractive and most importantly, convinced that his romantic life would be more successful, more vibrant, if he'd been graced with the face and figure of, say, a Velazquez. When Marshall meets a Cuban-born man from Atlanta, he is transfixed by the conviction that this is the man the universe has selected for him. The thrust of the story goes beyond boy-meets/loses/gets-boy to an exploration of said boy coming to terms with his definition of self. In a pivotal span of six months, the book explores Marshall's obsessions with seeing and how they define his vision of reality, the emphasis placed on beauty in gay culture, the tentative beginnings of a relationship as it takes root and grows, and finally, the inexplicable, magical forces that direct our romantic destinies.

Effective energy conservation and management in the building sector : the answer to the energy predicament

Modern civilization has developed principally through man's harnessing of forces. For centuries man had to rely on wind, water and animal force as principal sources of power. The advent of the industrial revolution, electrification and the development of new technologies led to the application of wood, coal, gas, petroleum, and uranium to fuel new industries, produce goods and means of transportation, and generate the electrical energy which has become such an integral part of our lives. The geometric growth in energy consumption, coupled with the world's unrestricted growth in population, has caused a disproportionate use of these limited natural resources. The resulting energy predicament could have serious consequences within the next half century unless we commit ourselves to the philosophy of effective energy conservation and management. National legislation, along with the initiative of private industry and growing interest in the private sector has played a major role in stimulating the adoption of energy-conserving laws, technologies, measures, and practices. It is a matter of serious concern in the United States, where ninety-five percent of the commercial and industrial facilities which will be standing in the year 2000 - many in need of retrofit - are currently in place. To conserve energy, it is crucial to first understand how a facility consumes energy, how its users' needs are met, and how all internal and external elements interrelate. To this purpose, the major thrust of this report will be to emphasize the need to develop an energy conservation plan that incorporates energy auditing and surveying techniques. Numerous energy-saving measures and practices will be presented ranging from simple no-cost opportunities to capital intensive investments.

The United States and the politics of trade: the banana war with Europe and the Caribbean

This thesis examines the involvement of the United States in the decade-long trade dispute before the World Trade Organization (WTO) over the European Union's preferential banana regime. Washington's justification for bringing this case to the WTO comes from Section 301 of the U.S. trade act, which allows for disputes to be undertaken if U.S. "interests" are violated; however, this is the first case ever undertaken by the United States that does not directly threaten any American banana industry, nor affect any American jobs. Why, then, would the United States involve itself in this European-Caribbean-Latin American dispute? It is the contention of this thesis that the United States thrust itself headlong into this debate for two reasons: domestically, the United States Trade Representative came under pressure, via the White House and Congress, from Chiquita CEO Carl Lindner, who in the past decade donated more than $7.1 million to American politicians to take the case to the WTO. Internationally, the United States used the case as an opportunity to assert its power over Europe, with the Eastern Caribbean islands being caught in the economic crossfire. According to existing literature, in undertaking this case, the United States did as any nation would: it operated within both domestic and international levels, satisfying at each level key interests, with the overall goal of maintaining the nation's best interests.

Modelagem numérica de uma estrutura de contenção de estacas espaçadas atirantadas em areia

Retaining walls design involves factors such as plastification, loading and unloading, pre-stressing, excessive displacements and earth and water thrust. Furthermore, the interaction between the retained soil and the structure is rather complex and hard to predict. Despite the advances in numerical simulation techniques and monitoring of forces and displacements with field instrumentation, design projects are still based on classical methods, whose simplifying assumptions may overestimate structural elements of the retaining wall. This dissertation involves a three-dimensional numerical study on the behavior of a retaining wall using the finite element method (FEM). The retaining wall structure is a contiguous bored pile wall with tie-back anchors. The numerical results were compared to data obtained from field instrumentation. The influence of the position of one or two layers of anchors and the effects of the construction of a slab bounded at the top of the retaining wall was evaluated. Furthermore, this study aimed at investigating the phenomenon of arching in the soil behind the wall. Arching was evaluated by analyzing the effects of pile spacing on horizontal stresses and displacements. Parametric analysis with one layers of anchors showed that the smallest horizontal displacements of the structure were achieved for between 0.3 and 0.5 times the excavation depth. Parametric analyses with two anchor layers showed that the smallest horizontal displacements were achieve for anchors positioned in depths of 0.4H and 0.7H. The construction of a slab at the top of the retaining wall decreased the horizontal displacements by 0.14% times the excavation depth as compared to analyses without the slab. With regard to the arching , analyzes showed an optimal range of spacing between the faces of the piles between 0.4 and 0.6 times the diameter of the pile

Acompanhamento do crescimento e desenvolvimento da criança: a participação das mães da área rural

The accompaniment of growth and development is the central thrust of child care in primary health care in order to contribute to the reduction of infant morbidity and mortality and promote healthy development. Despite its importance, the family health unit located in rural Parazinhocounty experiences the problem of frequent absences of children to follow-up consultations. Thus, this study aims to analyze the participation of mothers in the accompaniment of growth and development of children in the Family Health Strategy. This is an exploratory, descriptive study with a qualitative approach with the method action research, developed with mothers who are part of the monitoring of the growth and development of children in the rural area of the municipality of Parazinho/RN from May to October 2014. Data collection was performed using the focus group techniques, participant observation and individual interviews. Data were analyzed using thematic analysis of categorization. The study was approved by the Research Ethics Committee, under the opinion embodied 617,559 and CAAE 28598014.7.0000.5537. In step situation analysis, were conducted two focus groups, attended by a total of 14 mothers of different rural locations. From the speeches, one realizes that they have a satisfactory understanding of the monitoring of the growth and development of the childwas a learning moment. The nurse was mentioned as key professional that actionof accompaniment. The main reason that mothers to abandon consultations is access to health services, due to the distance from their homes to the basic unit, the shortage of public transport for the movement of users and delay between the service and the back home. As a strategy to try to tackle these problems, at the suggestion of their mothers was created Monitoring of Growth and Development Itinerant, where the FHS team moved to rural locations, performing activities related to children's health. Mothers who participated in the action approved the initiative as improving access and care of health needs, despite indicate dissatisfaction as the poor infrastructure and little privacy in consultations. Therefore, it is concluded that, despite the difficulties encountered often for lack of management support and involvement of some professionals, the monitoring of growth and development itinerant proved to be an important tool in solving the problem of access to services oriented to the health of child, in addition to functioning as a space for the realization of health education, becoming, since then, an activity inherent in family health team schedule.

Estudo da evolução das tensões residuais através da difratometria de raios x em aço rolamento submetido a esforços cíclicos

The micro-deformations caused by cyclic loading origins the variation of the distances between atoms of the crystal lattice producing the irreversible component. In order to study and understand the microstructural behavior of the material this paper investigated the influence suffered by residual stresses in thrust rolling bearing races fabricated in AISI 52100 steel, after tests by cyclic rolling contact in a tribometer at 1m/s under two contact pressures (500 MPa and 1400 MPa) in dry and boundary lubrication conditions. Procedures of tests thermo-acustically isolated were developed for monitoring the contact temperature and sound pressure level signals to establish a comparison between the residual stress measurements, micro-hardness Vickers and micrographic registers searching an indication of wear evolution. The sin²ψ method by X-ray diffraction technique was used to quantify the residual stresses. Three raceway zones were selected for the evaluation of wear and surface morphology after predetermined cycling, comparing with their new condition ("as received"). Micro-hardness and residual stress measurements showed significant changes after the tests and it was possible to observe the relationship between the increase of sound pressure level and the residual stress for dry and lubricated conditions.

Estudo da evolução das tensões residuais através da difratometria de raios x em aço rolamento submetido a esforços cíclicos

The micro-deformations caused by cyclic loading origins the variation of the distances between atoms of the crystal lattice producing the irreversible component. In order to study and understand the microstructural behavior of the material this paper investigated the influence suffered by residual stresses in thrust rolling bearing races fabricated in AISI 52100 steel, after tests by cyclic rolling contact in a tribometer at 1m/s under two contact pressures (500 MPa and 1400 MPa) in dry and boundary lubrication conditions. Procedures of tests thermo-acustically isolated were developed for monitoring the contact temperature and sound pressure level signals to establish a comparison between the residual stress measurements, micro-hardness Vickers and micrographic registers searching an indication of wear evolution. The sin²ψ method by X-ray diffraction technique was used to quantify the residual stresses. Three raceway zones were selected for the evaluation of wear and surface morphology after predetermined cycling, comparing with their new condition ("as received"). Micro-hardness and residual stress measurements showed significant changes after the tests and it was possible to observe the relationship between the increase of sound pressure level and the residual stress for dry and lubricated conditions.

Análise de falhas em rolamentos por análise de vibração aplicado a aerogeradores

With the heavy use of bearings in various segments of the industry, there are a large number of necessary interruptions in industrial processes to perform maintenance on these devices, with the case study wind turbines. The growth of the wind energy sector, encouraged to conduct research that helps to solve this problem. To contribute to predictive maintenance has been carried out a signal analysis using techniques which allow detection and location of the problem in order to prevent accidents caused and losses due to unexpected equipment failures, whereas low system rotation complicates the detection of the failure. To work around this problem, there was the indication of standard signals for defects in the bearings, making diagnosis of possible failures. With this diagnosis can be performed predictive maintenance, identifying the failure of the system that were tested, such as the introduction of grains of sand in the bearing, wear on the outer race of the bearing and bearing rust. By processing signals it is possible to construct graphs developing a mapping of defects by different peaks in the frequency band.