Pressure-relieving equipment: promoting its correct use amongst nurses via differing modes of educational delivery

Aims and objectives. To examine the impact of written and verbal education on bed-making practices, in an attempt to reduce the prevalence of pressure ulcers. Background. The Department of Health has set targets for a 5% reduction per annum in the incidence of pressure ulcers. Electric profiling beds with a visco-elastic polymer mattress are a new innovation in pressure ulcer prevention; however, mattress efficacy is reduced by tightly tucking sheets around the mattress. Design. A prospective randomized pre/post-test experimental design. Methods. Ward managers at a teaching hospital were approached to participate in the study. Two researchers independently examined the tightness of the sheets around the mattresses. Wards were randomized to one of two groups. Groups A and B received written education. In addition, group B received verbal education on alternate days for one week. Beds were re-examined one month later. One researcher was blinded to the educational delivery received by the wards. Results. Twelve wards agreed to participate in the study and 245 beds were examined. Before education, 113 beds (46%) had sheets tucked correctly around the mattresses. Following education, this increased to 215 beds (87.8%) (chi(2) = 68.03, P < 0.001). There was no significant difference in the number of correctly made beds between the two different education groups: 100 (87.72%) beds correctly made in group A vs. 115 (87.79%) beds in group B (chi(2) = 0, P 0.987). Conclusions. Clear, concise written instruction improved practice but verbal education was not additionally beneficial. Relevance to clinical practice. Nurses are receptive to clear, concise written evidence regarding pressure ulcer prevention and incorporate this into clinical practice.

Enhancing dominant modes in nonstationary time series by means of the symbolic resonance analysis

We present the symbolic resonance analysis (SRA) as a viable method for addressing the problem of enhancing a weakly dominant mode in a mixture of impulse responses obtained from a nonlinear dynamical system. We demonstrate this using results from a numerical simulation with Duffing oscillators in different domains of their parameter space, and by analyzing event-related brain potentials (ERPs) from a language processing experiment in German as a representative application. In this paradigm, the averaged ERPs exhibit an N400 followed by a sentence final negativity. Contemporary sentence processing models predict a late positivity (P600) as well. We show that the SRA is able to unveil the P600 evoked by the critical stimuli as a weakly dominant mode from the covering sentence final negativity. (c) 2007 American Institute of Physics. (c) 2007 American Institute of Physics.

Acoustic trapped modes in a three-dimensional waveguide of slowly varying cross section

In this paper we develop an asymptotic scheme to approximate the trapped mode solutions to the time harmonic wave equation in a three-dimensional waveguide with a smooth but otherwise arbitrarily shaped cross section and a single, slowly varying `bulge', symmetric in the longitudinal direction. Extending the work in Biggs (2012), we first employ a WKBJ-type ansatz to identify the possible quasi-mode solutions which propagate only in the thicker region, and hence find a finite cut-on region of oscillatory behaviour and asymptotic decay elsewhere. The WKBJ expansions are used to identify a turning point between the cut-on and cut-on regions. We note that the expansions are nonuniform in an interior layer centred on this point, and we use the method of matched asymptotic expansions to connect the cut-on and cut-on regions within this layer. The behaviour of the expansions within the interior layer then motivates the construction of a uniformly valid asymptotic expansion. Finally, we use this expansion and the symmetry of the waveguide around the longitudinal centre, x = 0, to extract trapped mode wavenumbers, which are compared with those found using a numerical scheme and seen to be extremely accurate, even to relatively large values of the small parameter.

Classification of instability modes in a model of aluminium reduction cells with a uniform magnetic field

A unified view on the interfacial instability in a model of aluminium reduction cells in the presence of a uniform, vertical, background magnetic field is presented. The classification of instability modes is based on the asymptotic theory for high values of parameter β, which characterises the ratio of the Lorentz force based on the disturbance current, and gravity. It is shown that the spectrum of the travelling waves consists of two parts independent of the horizontal cross-section of the cell: highly unstable wall modes and stable or weakly unstable centre, or Sele’s modes. The wall modes with the disturbance of the interface being localised at the sidewalls of the cell dominate the dynamics of instability. Sele’s modes are characterised by a distributed disturbance over the whole horizontal extent of the cell. As β increases these modes are stabilized by the field.

Computational modes and grid imprinting on five quasi-uniform spherical C-grids

Currently, most operational forecasting models use latitude-longitude grids, whose convergence of meridians towards the poles limits parallel scaling. Quasi-uniform grids might avoid this limitation. Thuburn et al, JCP, 2009 and Ringler et al, JCP, 2010 have developed a method for arbitrarily-structured, orthogonal C-grids (TRiSK), which has many of the desirable properties of the C-grid on latitude-longitude grids but which works on a variety of quasi-uniform grids. Here, five quasi-uniform, orthogonal grids of the sphere are investigated using TRiSK to solve the shallow-water equations. We demonstrate some of the advantages and disadvantages of the hexagonal and triangular icosahedra, a Voronoi-ised cubed sphere, a Voronoi-ised skipped latitude-longitude grid and a grid of kites in comparison to a full latitude-longitude grid. We will show that the hexagonal-icosahedron gives the most accurate results (for least computational cost). All of the grids suffer from spurious computational modes; this is especially true of the kite grid, despite it having exactly twice as many velocity degrees of freedom as height degrees of freedom. However, the computational modes are easiest to control on the hexagonal icosahedron since they consist of vorticity oscillations on the dual grid which can be controlled using a diffusive advection scheme for potential vorticity.

Controlling the computational modes of the arbitrarily structured C-grid

The arbitrarily structured C-grid, TRiSK (Thuburn, Ringler, Skamarock and Klemp, 2009, 2010) is being used in the ``Model for Prediction Across Scales'' (MPAS) and is being considered by the UK Met Office for their next dynamical core. However the hexagonal C-grid supports a branch of spurious Rossby modes which lead to erroneous grid-scale oscillations of potential vorticity (PV). It is shown how these modes can be harmlessly controlled by using upwind-biased interpolation schemes for PV. A number of existing advection schemes for PV are tested, including that used in MPAS, and none are found to give adequate results for all grids and all cases. Therefore a new scheme is proposed; continuous, linear-upwind stabilised transport (CLUST), a blend between centred and linear-upwind with the blend dependent on the flow direction with respect to the cell edge. A diagnostic of grid-scale oscillations is proposed which gives further discrimination between schemes than using potential enstrophy alone and indeed some schemes are found to destroy potential enstrophy while grid-scale oscillations grow. CLUST performs well on hexagonal-icosahedral grids and unrotated skipped latitude-longitude grids of the sphere for various shallow water test cases. Despite the computational modes, the hexagonal icosahedral grid performs well since these modes are easy and harmless to filter. As a result TRiSK appears to perform better than a spectral shallow water model.

Crystal structures of Λ-[Ru(phen)2dppz]2+ with oligonucleotides containing TA/TA and AT/AT steps show two intercalation modes

The ruthenium complex [Ru(phen)2(dppz)] (where phen is a phenanthroline and dppz a dipyridyl–phenazine ligand) is known as a ‘light switch’ complex because its luminescence in solution is significantly enhanced in the presence of DNA. This property is poised to serve in diagnostic and therapeutic applications, but its binding mode with DNA needs to be elucidated further. Here, we describe the crystal structures of the L enantiomer bound to two oligonucleotide duplexes. The dppz ligand intercalates symmetrically and perpendicularly from the minor groove of the d(CCGGTACCGG)2 duplex at the central TA/TA step, but not at the central AT/AT step of d(CCGGATCCGG)2. In both structures, however, a second ruthenium complex links the duplexes through the combination of a shallower angled intercalation into the C1C2/G9G10 step at the end of the duplex, and semi-intercalation into the G3G4 step of an adjacent duplex. The TA/TA specificity of the perpendicular intercalation arises from the packing of phenanthroline ligands against the adenosine residue.

Impact of global warming on the interannual and interdecadal climate modes in a coupled GCM

In this study, we investigated the impact of global warming on the variabilities of large-scale interannual and interdecadal climate modes and teleconnection patterns with two long-term integrations of the coupled general circulation model of ECHAM4/OPYC3 at the Max-Planck-Institute for Meteorology, Hamburg. One is the control (CTRL) run with fixed present-day concentrations of greenhouse gases. The other experiment is a simulation of transient greenhouse warming, named GHG run. In the GHG run the averaged geopotential height at 500 hPa is increased significantly, and a negative phase of the Pacific/North American (PNA) teleconnection-like distribution pattern is intensified. The standard deviation over the tropics (high latitudes) is enhanced (reduced) on the interdecadal time scales and reduced (enhanced) on the interannual time scales in the GHG run. Except for an interdecadal mode related to the Southern Oscillation (SO) in the GHG run, the spatial variation patterns are similar for different (interannual + interdecadal, interannual, and interdecadal) time scales in the GHG and CTRL runs. Spatial distributions of the teleconnection patterns on the interannual and interdecadal time scales in the GHG run are also similar to those in the CTRL run. But some teleconnection patterns show linear trends and changes of variances and frequencies in the GHG run. Apart from the positive linear trend of the SO, the interdecadal modulation to the El Niño/SO cycle is enhanced during the GHG 2040 ∼ 2099. This is the result of an enhancement of the Walker circulation during that period. La Niña events intensify and El Niño events relatively weaken during the GHG 2070 ∼ 2090. It is interesting to note that with increasing greenhouse gas concentrations the relation between the SO and the PNA pattern is reversed significantly from a negative to a positive correlation on the interdecadal time scales and weakened on the interannual time scales. This suggests that the increase of the greenhouse gas concentrations will trigger the nonstationary correlation between the SO and the PNA pattern both on the interdecadal and interannual time scales.

Tropical Atlantic variability modes (1979–2002). Part I: Time-evolving SST modes related to West African rainfall

This work presents a description of the 1979–2002 tropical Atlantic (TA) SST variability modes coupled to the anomalous West African (WA) rainfall during the monsoon season. The time-evolving SST patterns, with an impact on WA rainfall variability, are analyzed using a new methodology based on maximum covariance analysis. The enhanced Climate Prediction Center (CPC) Merged Analysis of Precipitation (CMAP) dataset, which includes measures over the ocean, gives a complete picture of the interannual WA rainfall patterns for the Sahel dry period. The leading TA SST pattern, related to the Atlantic El Niño, is coupled to anomalous precipitation over the coast of the Gulf of Guinea, which corresponds to the second WA rainfall principal component. The thermodynamics and dynamics involved in the generation, development, and damping of this mode are studied and compared with previous works. The SST mode starts at the Angola/Benguela region and is caused by alongshore wind anomalies. It then propagates westward via Rossby waves and damps because of latent heat flux anomalies and Kelvin wave eastward propagation from an off-equatorial forcing. The second SST mode includes the Mediterranean and the Atlantic Ocean, showing how the Mediterranean SST anomalies are those that are directly associated with the Sahelian rainfall. The global signature of the TA SST patterns is analyzed, adding new insights about the Pacific– Atlantic link in relation to WA rainfall during this period. Also, this global picture suggests that the Mediterranean SST anomalies are a fingerprint of large-scale forcing. This work updates the results given by other authors, whose studies are based on different datasets dating back to the 1950s, including both the wet and the dry Sahel periods.

Magnetic resonant modes in a wireless-powered circuit

A pair of circular loops of the same radius set at a distance form a closed induction circuit. Coupled to a capacitor, these loops form a resonant circuit wherein energy is transported from one to the other. When a current is introduced into one of the loops, it is received by its companion. This is due to the propagation of magnetic waves through the medium, in this instance, atmospheric air of a characteristic impedance.

Response of the North Atlantic wave climate to atmospheric modes of variability

This study investigates the relationship between the wind wave climate and the main climate modes of atmospheric variability in the North Atlantic Ocean. The modes considered are the North Atlantic Oscillation (NAO), the East Atlantic (EA) pattern, the East Atlantic Western Russian (EA/WR) pattern and the Scandinavian (SCAN) pattern. The wave dataset consists of buoys records, remote sensing altimetry observations and a numerical hindcast providing significant wave height (SWH), mean wave period (MWP) and mean wave direction (MWD) for the period 1989–2009. After evaluating the reliability of the hindcast, we focus on the impact of each mode on seasonal wave parameters and on the relative importance of wind-sea and swell components. Results demonstrate that the NAO and EA patterns are the most relevant, whereas EA/WR and SCAN patterns have a weaker impact on the North Atlantic wave climate variability. During their positive phases, both NAO and EA patterns are related to winter SWH at a rate that reaches 1 m per unit index along the Scottish coast (NAO) and Iberian coast (EA) patterns. In terms of winter MWD, the two modes induce a counterclockwise shift of up to 65° per negative NAO (positive EA) unit over west European coasts. They also increase the winter MWP in the North Sea and in the Bay of Biscay (up to 1 s per unit NAO) and along the western coasts of Europe and North Africa (1 s per unit EA). The impact of winter EA pattern on all wave parameters is mostly caused through the swell wave component.

'You show me yours, I'll show you mine': the negotiation of shifts from textual to visual modes in computer-mediated interaction among gay men

This article explores the way users of an online gay chat room negotiate the exchange of photographs and the conduct of video conferencing sessions and how this negotiation changes the way participants manage their interactions and claim and impute social identities. Different modes of communication provide users with different resources for the control of information, affecting not just what users are able to reveal, but also what they are able to conceal. Thus, the shift from a purely textual mode for interacting to one involving visual images fundamentally changes the kinds of identities and relationships available to users. At the same time, the strategies users employ to negotiate these shifts of mode can alter the resources available in different modes. The kinds of social actions made possible through different modes, it is argued, are not just a matter of the modes themselves but also of how modes are introduced into the ongoing flow of interaction.

Calcium Flux in Neuroblastoma Cells Is a Coupling Mechanism between Non-Genomic and Genomic Modes of Estrogens

Estrogens have been demonstrated to rapidly modulate calcium levels in a variety of cell types. However, the significance of estrogen-mediated calcium flux in neuronal cells is largely unknown. The relative importance of intra- and extracellular sources of calcium in estrogenic effects on neurons is also not well understood. Previously, we have demonstrated that membrane-limited estrogens, such as E-BSA given before an administration of a 2-hour pulse of 17beta-estradiol (E(2)), can potentiate the transcription mediated by E(2) from a consensus estrogen response element (ERE)-driven reporter gene. Inhibitors to signal transduction cascades given along with E-BSA or E(2) demonstrated that calcium flux is important for E-BSA-mediated potentiation of transcription in a transiently transfected neuroblastoma cell line. In this report, we have used inhibitors to different voltage-gated calcium channels (VGCCs) and to intracellular store receptors along with E-BSA in the first pulse or with E(2) in the second pulse to investigate the relative importance of these channels to estrogen-mediated transcription. Neither L- nor P-type VGCCs seem to play a role in estrogen action in these cells; while N-type VGCCs are important in both the non-genomic and genomic modes of estrogen action. Specific inhibitors also showed that the ryanodine receptor and the inositol trisphosphate receptor are important to E-BSA-mediated transcriptional potentiation. This report provides evidence that while intracellular stores of calcium are required to couple non-genomic actions of estrogen initiated at the membrane to transcription in the nucleus, extracellular sources of calcium are also important in both non-genomic and genomic actions of estrogens. Copyright (c) 2005 S. Karger AG, Basel.