Objective To describe the rationale and experiences of families with a pediatrician who also use retail clinics (RCs) for pediatric care. Design Cross-sectional study Setting 19 pediatric practices in a Midwestern practice-based research network Exposure Self-administered paper survey Participants Parents attending the pediatrician’s office Outcome Measures Parents’ experience with RC care for their children Results 1484 parents (92% response) completed the survey. Parents (23%) who used RC for pediatric care were more likely to report RC care for themselves (OR 7.79, 95% CI, 5.13 to 11.84), have > 1 child (OR 2.16, 95%CI 1.55 to 3.02), and be older (OR 1.05, 95%CI 1.03 to 1.08). Seventy-four percent first considered going to the pediatrician but reported they chose the RC because the RC had more convenient hours (37%), no office appointment was available (25%), they did not want to bother the pediatrician after hours (15%), or because the problem was not serious enough (13%). Forty-six percent of RC visits occurred between 8am and 4pm on weekdays or 8am and noon on the weekend. Most commonly, visits were reportedly for acute upper respiratory illnesses (34% sore throat, 26% ear infection, 19% colds or flu) and for physicals (13%). While 7% recalled the RC indicating they would inform the pediatrician of the visit, only 42% informed the pediatrician themselves. Conclusions Parents with established relationships with a pediatrician most commonly took their children to RCs for care because access was convenient. Almost half the visits occurred when the pediatricians’ offices were likely open.

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Objective To describe pediatric primary care providers’ attitudes toward retail clinics and their experiences of retail clinics use by their patients. Study design A 51-item, self-administered survey from four pediatric practice-based research networks from the Midwestern United States, which gauged providers’ attitudes toward and perceptions of their patients’ interactions with retail clinics, and changes to office practice to better compete. Results A total of 226 providers participated (50% response). Providers believed that retail clinics were a business threat (80%) and disrupted continuity of chronic disease management (54%). Few (20%) agreed that retail clinics provided care within recommended clinical guidelines. Most (91%) reported that they provided additional care after a retail clinic visit (median 1–2 times per week) and 37% felt this resulted from suboptimal care at retail clinics “most or all of the time.” Few (15%) reported being notified by the retail clinic within 24 hours of a patient visit. Those reporting prompt communication were less likely to report suboptimal retail clinic care (OR 0.20, 95%CI 0.10 to 0.42) or disruption in continuity of care (OR 0.32, 95%CI 0.15 to 0.71). Thirty-six percent reported changes to office practice to compete with retail clinics (most commonly adjusting or extending office hours) and change was more likely if retail clinics were perceived as a threat (OR 3.70, 95%CI 1.56 to 8.76); 30% planned to make changes in the near future. Conclusions Based on the perceived business threat, pediatric providers are making changes to their practice to compete with retail clinics. Improved communication between the clinic and providers may improve collaboration.

This research is focused on the effects of large changes in Reynolds number that typically occurs during the flight of high altitude UAV's. This paper documents the influence of Reynolds number, turbulence level, and exit Mach number on the vane surface Stanton number. Reynolds number is based on true chord and exit conditions and ranges from 90,000 through 1,000,000. Low and high inlet turbulence levels were developed for the study and determined to be 0.8% and 9.0%. Tests were run at exit Mach numbers of 0.7, 0.8 and 0.9. These surface heat transfer measurements were acquired in the University of North Dakota's transonic cascade test facility. This facility uses a closed loop to allow the regulation of system pressure to control the test condition Reynolds number. The Mach number is adjusted using a "roots" blower driven by a variable frequency drive. Heat transfer measurements were acquired using a constant heat flux foil fabricated using a 0.023 mm Inconel foil backed with 0.05 mm of Kapton and adhered to the heat transfer vane using a high temperature acrylic adhesive. The linear cascade is configured in a four vane three full passage arrangement. The low turbulence condition is developed using the existing flow conditioning section coupled to a 4.7 to 1 area ratio nozzle. The high turbulence condition uses a mock aero combustor to generate a turbulence level of around 9.0%. These data show the influence of Mach number, Reynolds number and turbulence level on transition and heat transfer augmentation and are expected to be useful in grounding heat transfer predictive methods applicable to small or high altitude gas turbine engines. NomenclatureC vane true chord length, m Cp specific heat ratio, (J/kg/K) h surface heat transfer coefficient, (W/m 2 /K) Lu energy scale, Lu = 1.5 u' 3 / Ma Mach number Re C Reynolds number based on true chord and exit conditions S surface distance from stagnation point, m St Stanton number, h/V EX Cp Tu turbulence intensity, Tu = |u'|/U IN u' rms fluctuation velocity, m/s U IN ideal cascade inlet velocity, m/s V EX ideal cascade exit velocity, m/s Y Normal distance from the wall, m Y + normal distance in wall units, Y + = Y (/)/ Greek Letter Symbols  turbulent dissipation rate, m 2 /s 3  kinematic viscosity, m 2 /s  density, kg/m 3  surface shear stress, N/m 2 Subscripts EX refers to conditions at the nozzle exit plane IN refers to conditions at the nozzle inlet plane INTRODUCTIONUnmanned aerial vehicles (UAVs) have a growing mission in supporting military engagements abroad as well as ensuring domestic security in the US. UAV's have been engaged to help assess the damage of natural disasters, patrol borders and assess crop health. The yearly market for unmanned aerial vehicles (UAV's) is expected to grow to at a rate of 12% through 2018 to a value of $18.6 billion according to Market Research Media. A growing number of large to medium UAV's are being designed to use turbofan engines due to the ability to achieve high thrust to weight ratios and high thermal and propu...

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