Portfolio-Based Performance Appraisal for Doctors: A Case of Paperwork Compliance

This paper discusses the findings of research exploring the conduct of portfolio-based performance appraisal within medicine. Portfolios are now used throughout medical school and junior doctor training, in later specialist training, as well as to support the implementation of annual NHS appraisal of doctors as part of their employment contract. They will also play a role in the new medical governance quality assurance process known as revalidation, when it is implemented in 2010. The paper discusses how the growth of portfolio-based performance appraisal within medicine is bound up with the growth of managerial systems of surveillance and control within western health care systems. Theoretically, it draws upon a Governmentality perspective to analyse doctor\'s accounts of the appraisal process. This views appraisal as an information panopticon that to better enable social control seeks to construct appraisees as calculable and administrable subjects. However, the paper highlights how the doctors interviewed used the tacit dimensions of their expertise to engage in creative game-playing toward appraisal, adopting a stance of paperwork compliance toward it. Paperwork compliance leaves a paper trail that makes it appear doctors have complied with the technical requirements of performance appraisal when in fact they have not. The paper concludes that current reforms to medical governance introduced to ensure the general public is protected from medical error and malpractice, provide sociologists with an invaluable opportunity to undertake a dedicated research program into the performance management of medical work.Annual Appraisal, Audit Society,, Governmentality, Medical Autonomy, Medical Regulation, Paperwork Compliance, Performance Appraisal, Revalidation

Alien Registration- Chamberlain, John (Houlton, Aroostook County)

https://digitalmaine.com/alien_docs/36093/thumbnail.jp

The Exchange Rate Exposure of U.S. and Japanese Banking Institutions

In this paper, we examine the foreign exchange exposure of a sample of U. S. and Japanese banking firms. Using daily data, we construct estimates of the exchange rate sensitivity of the equity returns of the U.S. bank holding companies and compare them to those of the Japanese banks. We find that the stock returns of a significant fraction of the U. S. companies move with the exchange rate, while few of the Japanese returns that we observe do so. We next examine more closely the sensitivity of the U.S. firms by linking the U.S. estimates cross-sectionally to accounting-based measures of currency risk. We suggest that the sensitivity estimates can provide a benchmark for assessing the adequacy of existing accounting measures of currency risk. Benchmarked in this way, the reported measures that we examine appear to provide a significant, though only partial, picture of the exchange rate exposure of U. S. banking institutions. The cross-sectional evidence is also consistent with the use of foreign exchange contracts for the purpose of hedging.Foreign Exchange Risk, Banking, Market Risk

Heat transfer between a turbulent round jet and a segmented flat plate perpendicular to it

Heat transfer between a room temperature, turbulent round jet and a segmented flat plate perpendicular to it has been investigated. The heat transfer surface consisted of invar rings insulated from each other with silicone rubber. The source of heat was steam at atmospheric pressure condensing on the back of the heat transfer surface. Since data were taken over a wide range of vertical distances between the nozzle and the flat surface both the potential cone and the fully developed regions of the jet were observed interacting with the heated plate. It was determined that two modes of heat transfer occur; one in the potential cone region and the other in the fully developed region of the jet striking the plate. Results were successfully correlated at the stagnation point for all vertical distances between the jet and the plate. The decrease in heat transfer coefficient with increasing radial distance from the stagnation point has been successfully correlated in both the potential cone and the fully developed regions of the jet as well

A workbook for world geography in the seventh grade.

Thesis (M.A.)--Boston Universit

A Mineralized Alga and Acritarch Dominated Microbiota from the Tully Formation (Givetian) of Pennsylvania, USA

Sphaeromorphic algal cysts, most probably of the prasinophyte Tasmanites, and acanthomorphic acritarch vesicles, most probably Solisphaeridium, occur in a single 20 cm thick bed of micritic limestone in the lower part of the Middle Devonian (Givetian) Tully Formation near Lock Haven, Pennsylvania. Specimens are composed of authigenic calcite and pyrite crystals about 5–10 µm in length. Some specimens are completely calcitic; some contain both pyrite and calcite; and many are composed totally of pyrite. The microfossils are about 80 to 150 µm in diameter. Many show signs of originally containing a flexible wall composed of at least two layers. Some appear to have been enclosed in a mucilaginous sheath or membrane when alive. The acanthomorphic forms have spines that are up to 20 µm in length, expand toward the base, and are circular in cross-section. The microflora occurs with microscopic molluscs, dacryoconarids, the enigmatic Jinonicella, and the oldest zooecia of ctenostome bryozoans known from North America. The microalgal horizon lacks macrofossils although small burrows are present. Microalgae and acritarchs have been preserved via a complex preservational process involving rapid, bacterially-mediated post-mortem mineralization of dead cells. The microfossil horizon, and possibly much of the Tully Formation at Lock Haven with similar lithology, formed in a relatively deep, off-shore basin with reduced oxygen availability in the substrate

Late Paper: Payload Design Guidelines To Enhance Cargo Mixing On Space Shuttle Flights

Payloads on Space Shuttle flights can be designed to enhance their potential to be integrated with other Shuttle payloads. Pertinent design guidelines have been identified in the areas of loads and dynamics, thermal and acoustic considerations, contamination, avionics and electromagnetic compatibility, ground processing and orbital operations. Consideration of these payload design guidelines throughout the design cycle can result in flight hardware with a high mixing potential. The resulting cargo manifesting flexibility provides earlier and more frequent flight opportunities for payloads, reduced costs, minimum post-design cycle modifications to accommodate cargo mixing and, ultimately, optimum utilization of the Space Shuttle