Disempowerment and resistance in the print industry? Reactions to surveillance-capable technology

This article offers a critique of recent characterisations of the effects of electronic technologies in the workplace. It presents detailed case study evidence that calls into question a number of common theoretical assumptions about the character of surveillance at work and the responses of employees to it

Waiting list behaviour and the consequences for NHS targets

The United Kingdom’s National Health Service (NHS) is investing considerable resources in reducing patient waiting times for elective treatment. This paper describes the development of a waiting list model and its use in a simulation to assess management options. Simulation usually assumes that waiting is adequately described by simple queuing disciplines, typically first-in-first-out. However, waiting in the United Kingdom’s National Health Service is a more complex phenomenon. The waiting list behaviour is explored through an analysis of the changes in waiting time distributions for elective orthopaedics in one Scottish Health Board, NHS Fife. The evolving distributions suggest that there have been substantial changes in priorities in response to the various NHS targets. However, in the short or medium term, the form of the distribution appears reasonably stable, providing a basis for estimating future waiting times in different scenarios. A model of the waiting behaviour and prioritisation in the appointment allocations was embedded in a simulation of the complete elective orthopaedic patient journey from referral, through outpatients and diagnostics to surgery. The model has been used to explore the consequences of various management options in the context of the NHS target that no patient should wait more than 18 weeks between referral and treatment

Characterizing upward lightning with and without a terrestrial gamma-ray flash

We compare two observations of gamma-rays before, during, and after lightning flashes initiated by upward leaders from a tower during low-altitude winter thunderstorms on the western coast of Honshu, Japan. While the two leaders appear similar, one produced a terrestrial gamma-ray flash (TGF) so bright that it paralyzed the gamma-ray detectors while it was occurring, and could be observed only via the weaker flux of neutrons created in its wake, while the other produced no detectable TGF gamma-rays at all. The ratio between the indirectly derived gamma-ray fluence for the TGF and the 95% confidence gamma-ray upper limit for the gamma-ray quiet flash is a factor of $1\times10^7$. With the only two observations of this type providing such dramatically different results -- a TGF probably as bright as those seen from space and a powerful upper limit -- we recognize that weak, sub-luminous TGFs in this situation are probably not common, and we quantify this conclusion. While the gamma-ray quiet flash appeared to have a faster leader and more powerful initial continuous current pulse than the flash that produced a TGF, the TGF-producing flash occurred during a weak gamma-ray "glow", while the gamma-ray quiet flash did not, implying a higher electric field aloft when the TGF was produced. We suggest that the field in the high-field region approached by a leader may be more important for whether a TGF is produced than the characteristics of the leader itself.Comment: 21 pages, 6 figures, accepted for publication by the Journal of Geophysical Research - Atmosphere

Sternalis muscle: a mystery still

Despite intensive anatomical research during the last century, anatomical structures or variations of these structures may still cause confusion or even iatrogenic injury. A matter of debate is the sternalis muscle. We present a review of the literature of the sternalis muscle with special emphasis on its clinical anatomy

Non-rigidity of spherical inversive distance circle packings

We give a counterexample of Bowers-Stephenson's conjecture in the spherical case: spherical inversive distance circle packings are not determined by their inversive distances.Comment: 6 pages, one pictur

Providential Tides: the Double Low Water of Narragansett Bay

We investigate a mechanism for producing double-lows and double-highs in the semi-diurnal tide by selective amplification of higher harmonics in a resonant gulf. A double low water is observed at Providence, RI, near the head of Narragansett Bay on days when there is a flattening of the low water tidal curve at Newport, at the mouth of the bay. The flattening is caused by an unusually large quarter-diurnal component to the tide at Newport. The quarter diurnal component has the right phase (a maximum close to the time of the minimum in the semi-diurnal tide) to produce a prolonged flattening of the tidal curve around low water. The natural period of Narragansett Bay (for quarter-wavelength resonance) is close to 4 h and the quarter diurnal tide is amplified, relative to the semi-diurnal tide, within the bay. The selective amplification of the higher harmonic further prolongs the flattening effect at Providence and, occasionally, is sufficient to create a double low water at the head of the bay from quarter and semi-diurnal tides alone. More often, though, a sixth-diurnal harmonic produced within the bay, added to the flattened low water at Providence, creates the double low water. This mechanism of selective amplification of tidal harmonics could be relevant to double tides elsewhere

Diagnosis and Decision-Making in Telemedicine

This article provides an analysis of the skills that health professionals and patients employ in reaching diagnosis and decision-making in telemedicine consultations. As governmental priorities continue to emphasize patient involvement in the management of their disease, there is an increasing need to accurately capture the provider–patient interactions in clinical encounters. Drawing on conversation analysis of 10 video-mediated consultations in 3 National Health Service settings in England, this study examines the interaction between patients, General Practitioner (GPs), nurses, and consultants during diagnosis and decision-making, with the aim to identify the range of skills that participants use in the process and capture the interprofessional communication and patient involvement in the diagnosis and decision-making phases of telemedicine consultations. The analysis shows that teleconsultations enhance collaborative working among professionals and enable GPs and nurses to develop their skills and actively participate in diagnosis and decision-making by contributing primary care–specific knowledge to the consultation. However, interprofessional interaction may result in limited patient involvement in decisionmaking. The findings of this study can be used to inform training programs in telemedicine that focus on the development of effective skills for professionals and the provision of information to patients