Search

Double shell targets are a promising potential avenue to obtain robust neutron yield at current laser facilities. Similar to single shell designs, double shells require the symmetric implosion of an ablator in order to uniformly compress and heat a fuel volume, with the goal of achieving thermonuclear burn. Significant differences between double and single shells include the usage of an aluminum ablator as well as a reverse ramp laser pulse. In addition, double shells require a different convergence than single shells for fuel ignition. Numerical implosion studies at various energies with comparisons to experimental outcomes are required to gain confidence that simulations can capture the ablator shape from subscale to full scale. The current work builds on previous implosion experiments conducted at 1-MJ laser energy to confirm achieved ablator symmetry at 1.25 and 1.5 MJ. Average ablator P2 and P4 shapes measured in these experiments are within 5% of the simulated shape, which merits the platforms for further experimental studies. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: The US Graduate Medical Education (GME) system is failing to produce primary care physicians in sufficient quantity or in locations where they are most needed. Decentralization of GME training has been suggested by several federal advisory boards as a means of reversing primary care maldistribution, but supporting evidence is in need of updating. We assessed the geographic relationship between family medicine GME training sites and graduate practice location. METHODS: Using the 2012 American Medical Association Masterfile and American Academy of Family Physicians membership file, we obtained the percentage of family physicians in direct patient care located within 5, 25, 75, and 100 miles and within the state of their family medicine residency program (FMRP). We also analyzed the effect of time on family physician distance from training site. RESULTS: More than half of family physicians practice within 100 miles of their FMRP (55%) and within the same state (57%). State retention varies from 15% to 75%; the District of Columbia only retains 15% of family physician graduates, while Texas and California retain 75%. A higher percentage of recent graduates stay within 100 miles of their FMRP (63%), but this relationship degrades over time to about 51%. CONCLUSIONS: The majority of practicing family physicians remained proximal to their GME training site and within state. This suggests that decentralized training may be a part of the solution to uneven distribution among primary care physicians. State and federal policy-makers should prioritize funding training in or near areas with poor access to primary care services. [ABSTRACT FROM AUTHOR]

William Byrd, the great English composer of the sixteenth and early seventeenth century, has not been easy on his biographers. Not, I suppose, that he could in any way be [...]

This is a splendid book. Damian Thompson was formerly Religious Correspondent on the Daily Telegraph and has since found a new niche with the Catholic Herald, while working also in [...]

This is what the Editor's foreword says about the book: 'The Companion is essentially a collaborative work, a series of mini-biographies and essays combining the imaginative insights and scholarship of [...]

States currently electing not to expand Medicaid possibly forego the opportunity to expand their primary care workforces by a total of 1,525 physicians. Increased demand from expansion states and a limited primary care physician pool may provide a pull across state lines to the disadvantage of nonexpansion states. [ABSTRACT FROM AUTHOR]

The article discusses a study on Northern Ireland-based Daisy Hill Hospital's out-of-hours admissions of 216 head injury patients where tests including Glasgow Coma Scale (GCS) for patient consciousness level were not conducted fully. It suggests a reevaluation of the 2007 British National Institute for Health and Care Excellence (NICE) clinical guidelines 56 (CG-56) and its applicability in a busy District General Hospital (DGH).

The article presents data which show that family physicians (FPs) lower hospital readmission rates and costs. According to the Medicare Hospital Compare Database, 30-day readmission rates for pneumonia, heart attack and heart failure decrease as the number of FPs increases. Meanwhile, it also shows that increased number of physicians in all other major specialties is connected with increased risk of readmission. A figure that shows actual and estimated 30-day hospital readmission rates in 2005 per county density of FPs is presented.

The article examines the health professional shortage area (HPSA) status of primary care physicians in the U.S. from 2008-2013. Topics discussed include efforts to encourage physicians to practice in shortage areas, percentage of physicians who lost a primary care HPSA designation based on data from the American Medical Association (AMA) Masterfile, and impact of volatility in HPSA designation on physicians' incentive to practice in shortage areas.

The authors discuss the influence of family medicine residency program location on postgraduate practice location, referencing the 2009 American Medical Association Physician Masterfile. They cite the implications of regional retention statistics for family medicine residency programs for state planners working to address primary care shortages. They believe that more research is needed to determine the influences of practice site other than training location.

A small but nontrivial proportion of US family physicians devote most of their time providing emergency or urgent care. With considerable attention focused on expanding access to primary care, it is important to account for providers principally working outside of traditional primary care., (© Copyright 2014 by the American Board of Family Medicine.)