863 research outputs found
The Claims Culture: A Taxonomy of Industry Attitudes
This paper presents an analysis of a familiar aspect of construction industry culture that we have dubbed 'the claims culture'. This is a culture of contract administration that lays a strong emphasis on the planning and management of claims. The principal elements of the analysis are two sets of distinctions. The first comprises economic and occupational orders, referring to two kinds of control that are exercised over the construction process; predicated respectively on economic ownership and occupational competence. The second refers to contrasting attitudes towards relationships and problem solving within these orders: respectively 'distributive' and 'integrative'. The concepts of economic and occupational order entail further sub-categories. The various attitudes associated with these categories and sub-categories are described. They are assessed as to their consequences for change initiatives in the industry
The role of wearable devices and objective gait analysis for the assessment and monitoring of patients with lumbar spinal stenosis: Systematic review
© 2019 The Author(s). Background: The purpose of this systematic review was to evaluate the accuracy and reliability of wearable devices for objective gait measurement of Lumbar Spinal Stenosis (LSS) patients, with a focus on relevant gait metrics. Methods: Systematic searches were conducted of five electronic databases to identify studies that assessed gait metrics by wearable or portable technology. Data was collected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines. Results: Four articles were identified for inclusion in this review. The objectives, methodology and quality of the studies varied. No single gait metric was investigated in all four studies, making comparison difficult. The most relevant metrics reported included gait cycle, gait velocity, step length and cadence, which were reported in two studies. Two studies explored gait symmetry. Differences between LSS patients and normal healthy subjects are demonstrable using wearable technology. Conclusions: The measurements of gait cycle, cadence, step length, gait velocity, and number of steps with wearable devices can be used in the gait measurement of LSS patients for initial assessment, and objective outcomes following interventions. However, data and analysis are limited, and further studies are necessary to comment on reliability
Metabolomic changes in Mycobacterium avium subsp. paratuberculosis (MAP) challenged HolsteinâFriesian cattle highlight the role of serum amino acids as indicators of immune system activation
INTRODUCTION: Paratuberculosis, commonly known as Johneâs disease, is a chronic granulomatous infection of ruminants caused by Mycobacterium avium subspecies paratuberculosis (MAP). Clinical signs, including reduced milk yields, weight loss and diarrhoea, are typically absent until 2 to 6 years post exposure. OBJECTIVES: To identify metabolomic changes profiles of MAP challenged HolsteinâFriesian (HF) cattle and correlate identified metabolites to haematological and immunological parameters. METHODS: At approximately 6 weeks of age, calves (nâ=â9) were challenged with 3.8âĂâ10(9) cells of MAP (clinical isolate CIT003) on 2 consecutive days. Additional unchallenged calves (nâ=â9) formed the control group. The study used biobanked serum from cattle sampled periodically from 3- to 33-months post challenge. The assessment of sera using flow infusion electrospray high resolution mass spectrometry (FIE-HRMS) for high throughput, sensitive, non-targeted metabolite fingerprinting highlighted differences in metabolite levels between the two groups. RESULTS: In total, 25 metabolites which were differentially accumulated in MAP challenged cattle were identified, including 20 which displayed correlation to haematology parameters, particularly monocyte levels. CONCLUSION: The targeted metabolites suggest shifts in amino acid metabolism that could reflect immune system activation linked to MAP and as well as differences in phosphocholine levels which could reflect activation of the Th1 (tending towards pro-inflammatory) immune response. If verified by future work, selected metabolites could be used as biomarkers to diagnose and manage MAP infected cattle. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11306-022-01876-w
Reflections on a 'virtual' practice development unit: changing practice through identity development
Aims. This paper draws together the personal thoughts and critical reflections of key people involved in the establishment of a âvirtualâ practice development unit of clinical nurse specialists in the south of England. Background. This practice development unit is âvirtualâ in that it is not constrained by physical or specialty boundaries. It became the first group of Trust-wide clinical nurse specialists to be accredited in the UK as a practice development unit in 2004. Design and methods. The local university was asked to facilitate the accreditation process via 11 two-hour audio-recorded learning sessions. Critical reflections from practice development unit members, leaders and university staff were written 12 months after successful accreditation, and the framework of their content analysed. Findings and discussion. Practice development was seen as a way for the clinical nurse specialists to realize their potential for improving patient care by transforming care practice in a collaborative, interprofessional and evolutionary manner. The practice development unit provided a means for these nurses to analyse their role and function within the Trust. Robertsâ identity development model for nursing serves as a useful theoretical underpinning for the reflections contained in this paper. Conclusions. These narratives provide another example of nurses making the effort to shape and contribute to patient care through organizational redesign. This group of nurses began to realize that the structure of the practice development unit process provided them with the means to analyse their role and function within the organization and, as they reflected on this structure, their behaviour began to change. Relevance to clinical practice. Evidence from these reflections supports the view that practice development unit participants have secured a positive and professional identity and are, therefore, better able to improve the patient experience
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The duration-energy-size enigma for acoustic emission
Abstract: Acoustic emission (AE) measurements of avalanches in different systems, such as domain movements in ferroics or the collapse of voids in porous materials, cannot be compared with model predictions without a detailed analysis of the AE process. In particular, most AE experiments scale the avalanche energy E, maximum amplitude Amax and duration D as E ~ Amaxx and Amax ~ DÏ with x = 2 and a poorly defined power law distribution for the duration. In contrast, simple mean field theory (MFT) predicts that x = 3 and Ï = 2. The disagreement is due to details of the AE measurements: the initial acoustic strain signal of an avalanche is modified by the propagation of the acoustic wave, which is then measured by the detector. We demonstrate, by simple model simulations, that typical avalanches follow the observed AE results with x = 2 and âhalf-moonâ shapes for the cross-correlation. Furthermore, the size S of an avalanche does not always scale as the square of the maximum AE avalanche amplitude Amax as predicted by MFT but scales linearly S ~ Amax. We propose that the AE rise time reflects the atomistic avalanche time profile better than the duration of the AE signal
Recommended from our members
The duration-energy-size enigma for acoustic emission
Abstract: Acoustic emission (AE) measurements of avalanches in different systems, such as domain movements in ferroics or the collapse of voids in porous materials, cannot be compared with model predictions without a detailed analysis of the AE process. In particular, most AE experiments scale the avalanche energy E, maximum amplitude Amax and duration D as E ~ Amaxx and Amax ~ DÏ with x = 2 and a poorly defined power law distribution for the duration. In contrast, simple mean field theory (MFT) predicts that x = 3 and Ï = 2. The disagreement is due to details of the AE measurements: the initial acoustic strain signal of an avalanche is modified by the propagation of the acoustic wave, which is then measured by the detector. We demonstrate, by simple model simulations, that typical avalanches follow the observed AE results with x = 2 and âhalf-moonâ shapes for the cross-correlation. Furthermore, the size S of an avalanche does not always scale as the square of the maximum AE avalanche amplitude Amax as predicted by MFT but scales linearly S ~ Amax. We propose that the AE rise time reflects the atomistic avalanche time profile better than the duration of the AE signal
An evaluation of the Working in Partnership Programme Self Care in Primary Care Initiative. Final Report
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