Use of Prescription Drugs and Investigations by Doctors in Primary Care Settings in Oman and the UK

Objectives: This audit aimed to investigate the use of prescription drugs and investigations by trainee doctors in primary care settings in Oman and the UK. Methods: This audit took place between February and April 2015. The medical records of consecutive patients seen by five family medicine trainee doctors at a primary care setting in Oman were retrospectively reviewed. These data were compared to those gathered from two trainees at a general practice clinic in the UK as well as an experienced general practitioner (GP) who had practiced in both countries. Results: The average number of items prescribed per patient was 1.19, 0.43 and 0.24 and the rate of investigations was 20%, 21% and 11% for Omani trainees, UK trainees and the GP, respectively. Conclusion: This audit suggests that family medicine trainees in Oman prescribe almost three times as many drugs as trainees in the UK. The findings also point towards an over-investigation of the relatively young Omani patient population

The Tongue\u27s Worth: The Use of Language to Preserve Culture in Havelok the Dane and The Mabinogion

Most Americans are unaware of how far back the cultural dichotomy goes, its source, or how significant it is in determining our behavior. Therefore, the use of language to preserve culture in Havelok the Dane and The Mabinogion is examined. The Mabinogion and Havelok the Dane are quite different in provenance, style, and purpose; yet, there are similarities. Each work has pathos, humor, excitement, and human emotion. Most importantly, each explores the questions of who we are, what we are, what we might become, and why we are, with seriousness, sympathy, and an occasional chortle at the ridiculousness of us all

Shannon entropies of atomic structure factors, off-diagonal order and electron correlation

Shannon entropies of one- and two-electron atomic structure factors in the position and momentum representations are used to examine the behavior of the off-diagonal elements of density matrices with respect to the uncertainty principle and to analyze the effects of electron correlation on off-diagonal order. We show that electron correlation induces off-diagonal order in position space which is characterized by larger entropic values. Electron correlation in momentum space is characterized by smaller entropic values as information is forced into regions closer to the diagonal. Related off-diagonal correlation functions are also discussed

Re-estimation of argon isotope ratios leading to a revised estimate of the Boltzmann constant

In 2013, NPL, SUERC and Cranfield University published an estimate for the Boltzmann constant [1] based on a measurement of the limiting low-pressure speed of sound in argon gas. Subsequently, an extensive investigation by Yang et al [2] revealed that there was likely to have been an error in the estimate of the molar mass of the argon used in the experiment. Responding to [2], de Podesta et al revised their estimate of the molar mass [3]. The shift in the estimated molar mass, and of the estimate of kB, was large: -2.7 parts in 106, nearly four times the original uncertainty estimate. The work described here was undertaken to understand the cause of this shift and our conclusion is that the original samples were probably contaminated with argon from atmospheric air.
 In this work we have repeated the measurement reported in [1] on the same gas sample that was examined in [2, 3]. However in this work we have used a different technique for sampling the gas that has allowed us to eliminate the possibility of contamination of the argon samples. We have repeated the sampling procedure three times, and examined samples on two mass spectrometers. This procedure confirms the isotopic ratio estimates of Yang et al [2] but with lower uncertainty, particularly in the relative abundance ratio R38:36.
 Our new estimate of the molar mass of the argon used in Isotherm 5 in [1] is 39.947 727(15) g mol-1 which differs by +0.50 parts in 106 from the estimate 39.947 707(28) g mol-1 made in [3]. This new estimate of the molar mass leads to a revised estimate of the Boltzmann constant of kB = 1.380 648 60 (97) × 10−23 J K−1 which differs from the 2014 CODATA value by +0.05 parts in 106.&#13

Morphology and Formation of an Holocene Coastal Dune Field, Bruce Peninsula, Ontario

This paper describes a dune field on the gently-sloping Lake Huron shoreline of the Bruce Peninsula, Ontario. The inland boundary is marked by a prominent dune ridge 60 m wide and up to 30 m high, which extends parallel to the shoreline for about 19 km, and was formed about 5000 years BP near the end of the Nipissing transgression. The islands and rock reefs which protect the modern shoreline were submerged under the higher lake levels, giving rise to a relatively straight, exposed beach from which sediment was supplied for building the dune ridge. Dunes formed between this ridge and the modern shoreline during the post-Nipissing regression decrease in height and continuity, reflecting decreased sediment supply associated with regression and reduced wave exposure as the offshore islands emerged. The sequence described here supports previous conclusions that transgressions are associated with periods of coastal dune formation and instability.On fait ici la description d'un champ de dunes situé sur le rivage faiblement incliné de la péninsule de Bruce, au lac Huron. La limite intérieure est caractérisée par une chaîne de dunes de 60 m de large et jusqu'à 30 m de haut qui s'étend parallèlement au rivage sur une longueur de 19 km; elle a été formée il y a 5000 ans BP, presque la fin de la transgression de Nipissing. Les îles et les écueils rocheux qui protègent le rivage actuel étaient alors immergés sous des niveaux lacustres supérieurs, permettant ainsi la formation d'une plage découverte relativement rectiligne qui a fourni le sable nécessaire à l'édification de la chaîne de dunes. La formation, au cours de la régression post-Nipissing, de dunes moins hautes et plus dispersées, entre la chaîne de dunes et le rivage actuel, témoigne d'une faible alimentation en sédiments associée à la régression et d'une moindre exposition aux vagues en raison de l'émersion des îles. La séquence décrite ici corroborent les conclusions antérieures selon lesquelles les transgressions correspondent à des périodes de formation et d'instabilité des dunes littorales.Dieser Aufsatz beschreibt ein Dùnenfeld, das am schwach abfallenden Ufer des Huron-Sees, Bruce-Halbinsel liegt. Die Grenze zum Landinnern ist hervorgehoben durch eine Kette von Dunen, die 60 m breit und bis zu 30 m hoch sind, und die sich parallel zum Ufer ùber eine Lange von 19 km ausdehnt; sie wurde vor 5000 Jahren v.u.Z. gebildet, fast am Ende der Transgression von Nipissing. Die Insein und die Felsklippen, die das heutige Ufer schùtzen, waren damais unter den hôheren Seen-Niveaus untergetaucht, so dass ein offener, relativ gerader Strand entstehen konnte, der den fur den Aufbau der Dunenkette notwendigen Sand lieferte. Wàhrend der Regression post-Nipissing haben sich zwischen der Dunenkette und dem heutigen Uferweniger hohe und mehr verstreute Dùnen gebildet, welche Zeugnis von einer schwachen Sediment-Zufuhr abgeben, in Verbindung mit der Regression und einem geringeren Einfluss der Wellen wegen des Auftauchens der Insein. Die hier beschriebene Sequenz bestàtigt frùhere Schlussfolgerungen. denen zufolge die Transgressionen mit Perioden der Bildung und Instabilitàt von Kùstendùnen in Verbindung gebracht werden

An adult social care compendium of approaches and tools for organisational change

The purpose of this compendium is to support managers working in adult social care to be more knowledgeable about and confident in the application of different approaches and tools relevant to managing change in their organisations. In the compendium an ‘approach to change’ is used to denote an ‘overarching framework that can guide a change process’ and ‘change management tools’ as ‘techniques or templates to understand or support a specific aspect of the change process’. Examples of the latter would be stakeholder mapping exercises, organisational diagnostic methodologies, engagement processes, and direct team based interventions. The compendium does not provide detailed guidance on how to apply each approach and tool, but presents an accessible overview of what each entails, the thinking that lies behind them, and (where available) a reflection on the empirical evidence of their application in practice. Having access to this information will help to demystify the often confusing and intimidating terminology that surrounds change approaches, and in doing so will enable managers to identify the approaches most relevant to a change they are leading and explore in more depth. Understanding the method being followed will also support individuals who access services and their families to engage on a more equal playing field within a change process. This includes people who access services and their families. While potentially relevant to social care managers working at all levels of an organisation, the compendium is specifically designed for those responsible for a single service (e.g. home care team, residential care home) or team (e.g. care management team), and those who directly manage service and team managers

Suppression-induced forgetting diminishes following a delay of either sleep or wake

We investigated the duration of suppression-induced forgetting (SIF), and the extent to which retrieval suppression differs between negative and neutral memories. We further examined if SIF was differently affected by sleep versus wake during the delay interval between retrieval suppression and re-test. Fifty participants first learned to associate neutral words with either neutral or negative images. Then, a subset of the words was shown again, and participants were asked to either recall (Think), or to suppress retrieval of (No-Think) the associated images. Finally, a memory test for all items was performed either immediately after the Think/No-Think (T/NT) phase (No Delay), or after a 3.5 h delay interval containing either sleep or wake. Results revealed a SIF effect only in the No Delay group, indicating that this forgetting effect dissipates already after a 3.5 h delay interval. Negative items were experienced as more intrusive than neutral ones during the T/NT phase

User-centred design for civil construction: optimising productivity by reducing safety and health risks associated with the operation and maintenance of on-road vehicles and mobile plant.

A range of productivity implications, injury and health risks are associated with the operation and maintenance of road construction equipment. Potential unwanted events giving rise to these risks include: slip, trips and falls from ground or at height; performance of hazardous manual tasks; exposure to heat, chemicals and whole body vibration; vehicle roll overs; and collisions. It may be possible to remove or reduce the risk of these events through improved design of the equipment and wider organisational systems. Design analysis techniques and a risk assessment tool (Design OMAT and EDEEP) were applied in the review of an asphalt job truck. Findings have led to preliminary design considerations for improvement and there are implications for organisational system change