9,558 research outputs found

    Integrated care and the working record

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    By default, many discussions and specifications of electronic health records or integrated care records often conceptualize the record as a passive information repository. This article presents data from a case study of work in a medical unit in a major metropolitan hospital. It shows how the clinicians tailored, re-presented and augmented clinical information to support their own roles in the delivery of care for individual patients. This is referred to as the working record: a set of complexly interrelated clinician-centred documents that are locally evolved, maintained and used to support delivery of care in conjunction with the more patient-centred chart that will be stored in the medical records department on the patient’s discharge. Implications are drawn for how an integrated care record could support the local tailorability and flexibility that underpin this working record and hence underpin practice

    New Ultraviolet Extinction Curves for Interstellar Dust in M31

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    New low-resolution UV spectra of a sample of reddened OB stars in M31 were obtained with HST/STIS to study the wavelength dependence of interstellar extinction and the nature of the underlying dust grain populations. Extinction curves were constructed for four reddened sightlines in M31 paired with closely matching stellar atmosphere models. The new curves have a much higher S/N than previous studies. Direct measurements of N(H I) were made using the Lyα\alpha absorption lines enabling gas-to-dust ratios to be calculated. The sightlines have a range in galactocentric distance of 5 to 14 kpc and represent dust from regions of different metallicities and gas-to-dust ratios. The metallicities sampled range from Solar to 1.5 Solar. The measured curves show similarity to those seen in the Milky Way and the Large Magellanic Cloud. The Maximum Entropy Method was used to investigate the dust composition and size distribution for the sightlines observed in this program finding that the extinction curves can be produced with the available carbon and silicon abundances if the metallicity is super-Solar.Comment: ApJ, in press, 9 pages, 5 figure

    Relaxing to a three dimensional brane junction

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    We suggest a mechanism which leads to 3+1 space-time dimensions. The Universe assumed to have nine spatial dimensions is regarded as a special nonlinear oscillatory system -- a kind of Einstein solid. There are p-brane solutions which manifest as phase oscillations separating different phase states. The presence of interactions allows for bifurcations of higher dimensional spaces to lower dimensional ones in the form of brane junctions. We argue this is a natural way to select lower dimensions.Comment: RevTex, 5 pages; version to appear in Europhys. Let

    Protocol for the United Kingdom Rotator Cuff Study (UKUFF) : a randomised controlled trial of open and arthroscopic rotator cuff repair

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    This project was funded by the NIHR Health Technology Assessment programme (project number 05/47/02). J. L. Rees has received a grant from Oxford University which is related to this paper. J. Dawson reports that Oxford University has received a grant from HTA which is related to this paper, as well as a study grant.Peer reviewedPublisher PD

    Automation of environmental ELISAs

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    ELISAs for pesticides and herbicides in environmental and agricultural samples are becoming very important in screening applications [1-3]. Traditional chromatographic methods are expensive and results need long turnaround times, making them incompatible with rapid on-site decision making. ELISA methods have been shown to meet or exceed the performance of gas chromatography—they offer rapid low-cost analysis, thereby increasing the frequency of sampling and enhancing data quality. Automated ELISA workstations allow the full benefit of these kits to be realized. Sample preparation, reagent pipetting, incubation, and photometric evaluation can be performed without user intervention. Reliability is increased through the elimination of operator error, better accuracy and precision, and often higher speed. Much larger batch sizes are possible and these systems can provide sample tracking with report generation for documentation requirements. In this paper the manual procedures and ELISA methods are compared and some critical aspects of automating these ELISA kits are discussed

    A model for microinstability destabilization and enhanced transport in the presence of shielded 3-D magnetic perturbations

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    A mechanism is presented that suggests shielded 3-D magnetic perturbations can destabilize microinstabilities and enhance the associated anomalous transport. Using local 3-D equilibrium theory, shaped tokamak equilibria with small 3-D deformations are constructed. In the vicinity of rational magnetic surfaces, the infinite-n ideal MHD ballooning stability boundary is strongly perturbed by the 3-D modulations of the local magnetic shear associated with the presence of nearresonant Pfirsch-Schluter currents. These currents are driven by 3-D components of the magnetic field spectrum even when there is no resonant radial component. The infinite-n ideal ballooning stability boundary is often used as a proxy for the onset of virulent kinetic ballooning modes (KBM) and associated stiff transport. These results suggest that the achievable pressure gradient may be lowered in the vicinity of low order rational surfaces when 3-D magnetic perturbations are applied. This mechanism may provide an explanation for the observed reduction in the peak pressure gradient at the top of the edge pedestal during experiments where edge localized modes have been completely suppressed by applied 3-D magnetic fields

    Global Mutual Fund Industry Comparisons: Canada, The United Kingdom And The United States

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    The concept of mutual funds is older than many believe, originating in Holland over 230 years ago.  Through the years, mutual funds have evolved by allowing investors to invest their capital in various venues.  The structure of mutual funds in Canada, the United Kingdom, and the United States possess similar configurations.  The majority of funds in all three nations are invested in the equity market.  Although the structure may be the same, the size in terms of assets varies by these three countries.  This is not the only difference though; the expense ratio is greatly differentiated, dramatically affecting the amount of return that the investor will anticipate over time.  Assuming identical returns, the authors illustrate that over a hypothetical ten-year time period, your funds would grow the most in the United States, followed by the United Kingdom and finally Canada.  This analysis assumes comparable contemporary expense ratios of 1.4% for the United States, 1.63% for the United Kingdom, and 2.1% for Canada.  In addition, we make the assumption that these comparison countries are having investors procure funds in no-load mutual funds

    Global bifurcation of homoclinic trajectories of discrete dynamical systems

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    We prove the existence of an unbounded connected branch of nontrivial homoclinic trajectories of a family of discrete nonautonomous asymptotically hyperbolic systems parametrized by a circle under assumptions involving the topological properties of the asymptotic stable bundles.Comment: 28 pages. arXiv admin note: text overlap with arXiv:1111.140
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