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Theorists and researchers have linked resilience with a host of positive psychological and physical health outcomes. This paper examines perceptions of resilience and physical health symptoms in a sample of individuals exposed to multiple community disasters following involvement in integrated mental health services.
A multiwave naturalistic design was used to follow 762 adult clinic patients (72% female; 28% minority status), ages 18-92 years (mean age=40 years), who were evaluated for resilience and physical health symptoms prior to receiving services and at 1, 3, and 6 months’ follow-up.
Data indicated increases in perceptions of resilience and decreased physical health symptoms reported over time. Results also indicated that resilience predicted physical health symptoms, such that resilience and physical health symptoms were negatively associated (ie, improved resilience was associated with decreases in physical health symptoms). These effects were primarily observed for those individuals with previous exposure to natural disasters.
Findings provide correlational evidence for behavioral health treatment provided as part of a stepped-care, collaborative model in reducing physical health symptoms and increasing resilience post-disaster. Controlled trials are warranted. (Disaster Med Public Health Preparedness. 2019;13:223–229)
The unique composition and configuration of doctors and hospitals in the US is leading to a crisis in primary care provision. There are significantly more specialists than generalists, and many community hospitals and outpatient facilities are concentrated in affluent areas with high rates of comprehensive insurance coverage. These particular features present difficult challenges to policymakers seeking to increase access to care. Carl F. Ameringer shows why the road to universal healthcare is not built on universal finance alone. Policymakers in other countries successfully align finance with delivery to achieve better access, lower costs, and improved population health. This book explains how the US healthcare system developed, and why efforts to expand insurance coverage in the absence of significant changes to delivery will fuel higher costs without achieving the desired results.
Yawing wind turbines has emerged as an appealing method for wake deflection. However, the associated flow properties, including the magnitude of the transverse velocity associated with yawed turbines, are not fully understood. In this paper, we view a yawed turbine as a lifting surface with an elliptic distribution of transverse lift. Prandtl’s lifting line theory provides predictions for the transverse velocity and magnitude of the shed counter-rotating vortex pair known to form downstream of the yawed turbine. The streamwise velocity deficit behind the turbine can then be obtained using classical momentum theory. This new model for the near-disk inviscid region of the flow is compared to numerical simulations and found to yield more accurate predictions of the initial transverse velocity and wake skewness angle than existing models. We use these predictions as initial conditions in a wake model of the downstream evolution of the turbulent wake flow and compare predicted wake deflection with measurements from wind tunnel experiments.
A numerical model for an interacting ice shelf and ocean is presented in which the ice- shelf base exhibits a channelized morphology similar to that observed beneath Petermann Gletscher’s (Greenland) floating ice shelf. Channels are initiated by irregularities in the ice along the grounding line and then enlarged by ocean melting. To a first approximation, spatially variable basal melting seaward of the grounding line acts as a steel-rule die or a stencil, imparting a channelized form to the ice base as it passes by. Ocean circulation in the region of high melt is inertial in the along-channel direction and geostrophically balanced in the transverse direction. Melt rates depend on the wavelength of imposed variations in ice thickness where it enters the shelf, with shorter wavelengths reducing overall melting. Petermann Gletscher’s narrow basal channels may therefore act to preserve the ice shelf against excessive melting. Overall melting in the model increases for a warming of the subsurface water. The same sensitivity holds for very slight cooling, but for cooling of a few tenths of a degree a reorganization of the spatial pattern of melting leads, surprisingly, to catastrophic thinning of the ice shelf 12 km from the grounding line. Subglacial discharge of fresh water along the grounding line increases overall melting. The eventual steady state depends on when discharge is initiated in the transient history of the ice, showing that multiple steady states of the coupled system exist in general.
The Danjon Astrolabe at the Naval Observatory has been traditionally used to determine Universal Time and improve the systematic accuracy of star positions. During the past year, it has been used to determine latitude and longitude at remotely scattered sites for geodetic purposes. Operating this instrument away from the Observatory necessitated a mobile support and timing system rugged enough to operate dependably in ever changing, and sometimes harsh, environmental conditions.
This paper describes the performance of the astrolabe timing and data acquisition system, gives engineering design considerations, and describes the equipment and instrumentation.