Accounting for actions and omissions:a discourse analysis of student nurse accounts of responding to instances of poor care

Aims: To explore how nursing students account for decisions to report or not report poor care witnessed on placement and to examine the implications of findings for educators. Background: Concern has been raised about the extent to which cases of poor care go unreported. Failure to report cases may have serious consequences for patient safety. Design: Semi structured interviews were conducted with 13 under graduate students at a UK university during 2013. They were asked to consider their response to episodes of poor practice witnessed on placement. Methods: Data were transcribed verbatim and categorized according to whether or not students reported concerns. Cases were analysed in accordance with Potter and Wetherall’s version of discourse analysis to identify the discursive strategies used to account for decisions to report or not report poor practice. Results: Participants took care to present themselves in a positive light regardless of whether or not they had reported an episode of concern. Those who had reported tended to attribute their actions to internal factors such as moral strength and a commitment to a professional code. Those who had not or would not report concerns provided accounts which referred to external influences that prevented them from doing so or made reporting pointless. Conclusion: This study provides information about how students account for their actions and omissions in relation to the reporting of poor care. Findings suggest ways educators might increase reporting of concerns

On the Range and Application of Arched Plate Theory

This paper deals with the effects of symmetrical loading on thin shells of uniform thickness; cyclical loads are not included. The equations of equilibrium and stress-strain relations are established for a portion of thin curved plate subject to tangential and radial loading. From these are derived the particular sets of equations for circular flat plates, cylindrical, conical and spherical walls. The distortion and stress equations for the different sets are presented In expressions of similar type. In conical and spherical walls, experimental corroboration has been obtained for the more complicated expressions, which are believed to appear for the first time. The applications include important practical engineering problems on the separate and combined forms. A comparison of the probable effects between welded and riveted joints in the cylindrical wall with a hemispherical dished end serves as an introduction to a final discussion of the elliptical and double segmental end

Some observations on the therapeutic value of antibacterial serum in the treatment of the severe type of diphtheria

1. Severe Diphtheria occurs, and exacts its toll of human life in Manchester. 2. The idea of a new Therapeutic Agent was conceived in the nature of a Gravis Diphtheria Anti-bacterial Serum. 3. The outline of preparation and standardisation of Gravis Diphtheria Anti-bacterial Serum is described. 4. The attempt at experimental evaluation of the Therapeutic Serum was carried out in animals. 5. The results of the treatment of 35 severe cases of Gravis Diphtheria, with Gravis Anti-bacterial Serum, are compared with the results in 40 cases of similar type and severity, which were treated without Anti-bacterial Serum. 6. The results of the treatment of 6 cases of severe Diphtheria, due to the Intermediate type of Diphtheria organism, with j Gravis Anti-bacterial Serum, are compared with 5 similar cases which were treated without Anti-bacterial Serum. 7. The results of treatment of 3 complicated cases of Gravis Diphtheria with Anti-bacterial Serum, are compared with 3 similar cases which were treated without Anti-bacterial Serum. 8. The results of treatment of 3 severe cases of Diphtheria, due to Atypical Gravis organisms, which were treated with Anti-bacterial Seram, are described. 9. The course of the disease was not modified in any way by the administration of Anti-bacterial Serum

The Adaptive Priority Queue with Elimination and Combining

Priority queues are fundamental abstract data structures, often used to manage limited resources in parallel programming. Several proposed parallel priority queue implementations are based on skiplists, harnessing the potential for parallelism of the add() operations. In addition, methods such as Flat Combining have been proposed to reduce contention by batching together multiple operations to be executed by a single thread. While this technique can decrease lock-switching overhead and the number of pointer changes required by the removeMin() operations in the priority queue, it can also create a sequential bottleneck and limit parallelism, especially for non-conflicting add() operations. In this paper, we describe a novel priority queue design, harnessing the scalability of parallel insertions in conjunction with the efficiency of batched removals. Moreover, we present a new elimination algorithm suitable for a priority queue, which further increases concurrency on balanced workloads with similar numbers of add() and removeMin() operations. We implement and evaluate our design using a variety of techniques including locking, atomic operations, hardware transactional memory, as well as employing adaptive heuristics given the workload.Comment: Accepted at DISC'14 - this is the full version with appendices, including more algorithm