Nurses' views of using computerized decision support software in NHS Direct

Background. Nurses working in NHS Direct, the 24-hour telephone advice line in England, use computerized decision support software to recommend to callers the most appropriate service to contact, or to advise on self-care. Aims. To explore nurses' views of their roles and the computerized decision support software in NHS Direct. Methods. Qualitative analysis of semi-structured interviews with 24 NHS Direct nurses in 12 sites. Findings. Nurses described both the software and themselves as essential to the clinical decision-making process. The software acted as safety net, provider of consistency, and provider of script, and was relied upon more when nurses did not have clinical knowledge relevant to the call. The nurse handled problems not covered by the software, probed patients for the appropriate information to enter into the software, and interpreted software recommendations in the light of contextual information which the software was unable to use. Nurses described a dual process of decision-making, with the nurse as active decision maker looking for consensus with the software recommendation and ready to override recommendations made by the software if necessary. However, nurses' accounts of the software as a guide, prompt or support did not fully acknowledge the power of the software, which they are required to use, and the recommendation of which they are required to follow under some management policies. Over time, the influence of nurse and software merges as nurses internalize the software script as their own knowledge, and navigate the software to produce recommendations that they feel are most appropriate. Conclusions. The nurse and the software have distinct roles in NHS Direct, although the effect of each on the clinical decision-making process may be difficult to determine in practice

Economic Performance of U.S. Multinational Agribusinesses: Foreign Direct Investment and Firm Strategy

This paper empirically assesses the sequential relationships among firm strategic factors, FDI activity, and economic performance for a sample of U.S.-based Multinational agribusinesses. The most important findings of this research is a positive direct effect of FDI on performance, the complementary effect between FDI and firm strategic factors (positive and significant interaction terms) on performance, and the positive effect of FDI on performance given some thresholds of firm strategic factors. Specifically, it provides insights about the direct effect of FDI on performance, as well as about the joint effect of firm size and FDI, marketing intensity and FDI, and capital intensity and FDI on performance. These findings provide evidence that FDI activity is an important factor for U.S. agribusiness financial strength.Economic performance, Foreign direct investment, Firm strategic factors, Agribusiness, Agribusiness, International Relations/Trade, Marketing, F230, L250,

Ordering in the dilute weakly-anisotropic antiferromagnet Mn(0.35)Zn(0.65)F2

The highly diluted antiferromagnet Mn(0.35)Zn(0.65)F2 has been investigated by neutron scattering in zero field. The Bragg peaks observed below the Neel temperature TN (approximately 10.9 K) indicate stable antiferromagnetic long-range ordering at low temperature. The critical behavior is governed by random-exchange Ising model critical exponents (nu approximately 0.69 and gamma approximately 1.31), as reported for Mn(x)Zn(1-x)F2 with higher x and for the isostructural compound Fe(x)Zn(1-x)F2. However, in addition to the Bragg peaks, unusual scattering behavior appears for |q|>0 below a glassy temperature Tg approximately 7.0 K. The glassy region T<Tg corresponds to that of noticeable frequency dependence in earlier zero-field ac susceptibility measurements on this sample. These results indicate that long-range order coexists with short-range nonequilibrium clusters in this highly diluted magnet.Comment: 7 pages, 5 figure

Going micro: Analysing SAM multipliers for the dairy chain on Reunion Island

This poster presents a study on the multiplier effects in the dairy chain on Reunion Island. This Indian Ocean island is one of the French overseas departments. However, it struggles with similar problems as the developing areas in its neighbourhood, high levels of unemployment especially being a major concern. The agricultural sector justifies the state support it receives by stressing its role in the creation of employment and economic activity. Our focus is on the dairy sector of the Island, which is relatively recent and highly organized. Local milk production has increased over the years and our aim is to calculate the economywide impact of this trend. We use a social accounting matrix with disaggregated accounts for the dairy sector to calculate the impact of changes in this sector.Dairy, SAM, La Reunion, Livestock Production/Industries,

Spectral mode-beat phenomena in a cylindrical microcavity

Detailed spectral analysis of photon scanning tunneling microscope images has been carried out. The analysis of spectral mode-beat phenomena leads to an accurate determination of mode profiles and gives evidence of counterpropagating mode

Vacuum polarization by a global monopole with finite core

We investigate the effects of a $(D+1)$-dimensional global monopole core on the behavior of a quantum massive scalar field with general curvature coupling parameter. In the general case of the spherically symmetric static core, formulae are derived for the Wightman function, for the vacuum expectation values of the field square and the energy-momentum tensor in the exterior region. These expectation values are presented as the sum of point-like global monopole part and the core induced one. The asymptotic behavior of the core induced vacuum densities is investigated at large distances from the core, near the core and for small values of the solid angle corresponding to strong gravitational fields. In particular, in the latter case we show that the behavior of the vacuum densities is drastically different for minimally and non-minimally coupled fields. As an application of general results the flower-pot model for the monopole's core is considered and the expectation values inside the core are evaluated.Comment: 22 pages, 4 figures, misprint is corrected, discussion is added, figures are change

Detailed analysis of the intracavity phenomena inside a cylindrical microresonator

Based o­n a rigorous analysis of the intensity distribution inside a cylindrical microresonator (MR), a detailed description of the wavelength and spatial dependence of the intracavity intensity is given. The theory is in accordance with photon scanning tunneling microscopy (PSTM) of an integrated optics MR. Good agreement between the theory and the PSTM measurements is found