The purchaser-provider split in NHS care in the United Kingdom and the role of the community dental service in planning

The former purchaser-provider split underwent an important change during the last years in UK. Especially since the new government came into office in 1997 the approach to equity and equality in dental health care has been characterised by two decisions. Firstly, the level of commissioning services was shifted from the centre to so-called natural communities of about 100,000 people. Secondly, the groups responsible for planning and providing care are constituted from local medical practitioners, community nurses and social services representatives, in line with the Regional Health Authority and the national framework "Our Healthier Nation". The new community dental service is expected to be in a better position to improve the situation in areas of social exclusion.     

Localization of Luminescent Inhomogeneities in Turbid Media with Spatially Resolved Measurements of cw Diffuse Luminescence Emittance

We present a steady-state method for localizing a source ofluminescence (i.e., fluorescence or phosphorescence) buried in asemi-infinite turbid medium with unknown optical properties. Adiffusion theory expression describing the emittance of an isotropicpoint source is fit to spatially resolved surface measurements of thediffuse emittance from the luminescent source. The techniquereports the location of the center of a 6.0-mm-diameter, fluorophore-containing spherical bulb embedded in a liquid phantom withan accuracy of 1.0 mm or better for source depths as great as 40.0mm. Monte Carlo data are analyzed to investigate the range and thepossible sources of error in the reconstructed source depth.     

HLA-DRB1 genes and disease severity in rheumatoid arthritis. The MIRA Trial Group. Minocycline in Rheumatoid Arthritis

OBJECTIVE: To examine the effect of alleles encoding the "shared"/"rheumatoid" epitope on rheumatoid arthritis (RA) disease severity in patients who participated in the minocycline in RA (MIRA) trial. METHODS: Of 205 patients with a week-48 visit, blood was available for typing of HLA-DRB1 and HLA-DQB1 in 174 (85%) and successfully completed in 169 (82%). Baseline erosions were used to assess disease severity and new erosions at the last visit served as a proxy for progression. RESULTS: At baseline, there was no association between the presence of erosive disease or rheumatoid factor status and the dose of rheumatoid epitope (homozygous, heterozygous, none) or the specific alleles identified. At the final visit, a gradient was observed for the 3 allelic subgroups (and their gene doses) in the occurrence of new erosions among the Caucasian placebo-treated, but not the minocycline-treated, patients. A treatment group/HLA-DR4 epitope interaction was demonstrated in multivariate analyses. Approximately two-thirds of African-American patients did not have the rheumatoid epitope. CONCLUSION: HLA-DRB1 oligotyping may be useful in predicting the progression of disease in some Caucasian patients. Our study corroborates the infrequency of the epitope among African-American patients with RA.     

Community resources for clients with mobility problems

Clients are leaving the hospital "quicker and sicker," and they frequently have acute care needs that must be met by resources outside the hospital setting. Community resources are diverse, vary widely from place to place, and have no central administration. Thus, using them can be challenging for both the nurse, client, and family. Reimbursement mechanisms underlie a person's ability to use resources and receive health care. By presenting two actual case scenarios where clients have mobility problems commonly seen by orthopaedic nurses, the authors discuss the community resources available, avenues of access to them, and their reimbursement mechanisms.     

SedLog: A shareware program for drawing graphic logs and log data manipulation

SedLog is a free multi-platform software package for creating graphic sediment logs providing an intuitive graphical user interface. The graphic sediment logs generated by SedLog can be exported as PDF, Scalable Vector Graphics (SVG), or JPEG for use by other drawing applications or for publications. Log data can be imported and exported in Comma Separated Values (CSV) format. The logs can also be printed to any paper size the user wants. Zoom In, Zoom Out, Fit page, Fit Height and Fit Width facilities are also provided to enable the user to customise the workspace size.     

Ensemble data assimilation in the presence of cloud

In numerical weather prediction (NWP) data assimilation (DA) methods are used to combine available observations with numerical model estimates. This is done by minimising measures of error on both observations and model estimates with more weight given to data that can be more trusted. For any DA method an estimate of the initial forecast error covariance matrix is required. For convective scale data assimilation, however, the properties of the error covariances are not well understood.An effective way to investigate covariance properties in the presence of convection is to use an ensemble-based method for which an estimate of the error covariance is readily available at each time step. In this work, we investigate the performance of the ensemble square root filter (EnSRF) in the presence of cloud growth applied to an idealised 1D convective column model of the atmosphere. We show that the EnSRF performs well in capturing cloud growth, but the ensemble does not cope well with discontinuities introduced into the system by parameterised rain. The state estimates lose accuracy, and more importantly the ensemble is unable to capture the spread (variance) of the estimates correctly. We also find, counter-intuitively, that by reducing the spatial frequency of observations and/or the accuracy of the observations, the ensemble is able to capture the states and their variability successfully across all regimes.     

基于MPLS的IPTV QoS研究

MPLS(Multi-Protocol Label Switch)和服务质量(QoS)是与下一代网络相关的重要技术.作者首先介绍了QoS的两种模型:综合服务(IntServ)和区分服务(DiffServ)模型,然后描述了基于MPLS网络的DiffServ模型的实现.文中介绍了网络电视(IPTV)系统的组成和存在的问题,并提出了一个基于MPLS的QoS区分服务模型改进方案.