A nonlinear transformation of the dispersive long wave equations in (2+1) dimensions and its applications

A nonlinear transformation of the dispersive long wave equations in (2+1) dimensions is derived by using the homogeneous balance method. With the aid of the transformation given here, exact solutions of the equations are obtained

Readmissions after general surgery: a prospective multicenter audit

Background: Readmission rates after surgical procedures are viewed as a marker of quality of care and as a driver to improve outcomes in the United Kingdom, they are not remunerated. However, readmissions are not wholly avoidable. The aim of this study was to develop a regional overview of readmissions to determine the proportion that might be avoidable and to examine predictors of readmissions at a unit level. Methods: We undertook a prospective multicenter audit of readmissions following National Health Service funded general surgical procedures in five National Health Service hospitals and three independent sector providers over a 2-wk period. Basic demographic and procedure data were captured. Readmissions to hospitals were identified through acute admissions lists. Reason for readmission was identified, and the readmission data assessed by a senior surgical doctor as to whether it was avoidable. Results: We identified 752 operations in the study period with all followed up to 30 d. The overall rate of readmissions was 4.7%, with 40% of these judged as being potentially avoidable. Pain and wound problems accounted for the vast majority of avoidable readmissions. The number of unavoidable readmissions was correlated with the workload of each center (r ¼ 0.63, P ¼ 0.06) and as with the higher (British United Provident Association) complexity of surgery (r ¼ 0.90, P ¼ 0.01). Patient and demographic factors were not associated with readmissions. Conclusions: This prospective audit describes readmission rates after general surgery. Volume and complexity of work are associated with readmission rates. A large proportion of readmissions could be reduced by attention to analgesia and outpatient arrangements for wound management

'Education, education, education' : legal, moral and clinical

This article brings together Professor Donald Nicolson's intellectual interest in professional legal ethics and his long-standing involvement with law clinics both as an advisor at the University of Cape Town and Director of the University of Bristol Law Clinic and the University of Strathclyde Law Clinic. In this article he looks at how legal education may help start this process of character development, arguing that the best means is through student involvement in voluntary law clinics. And here he builds upon his recent article which argues for voluntary, community service oriented law clinics over those which emphasise the education of students

Do Nurses Use Discourse Markers Differently when Using Their Second Language as Opposed to Their First while Interviewing Patients?

This study examined whether discourse-marker use changes in nurse-patient interactions as a function of nurses using their first (L1) or second (L2) language. Discourse markers were analyzed as turn-maintenance markers that indicate acknowledgement and discourse-shift markers that signal shifts of a topic or speaker in the conversation. These two categories differ in terms of degree of discourse management and interactional control. Sixteen nurses conducted a pain-assessment interview with a patient native speaker of English and with a patient native speaker of French, where the nurses used their own L1 in one case and their own weaker L2 in the other. The first hypothesis, that nurses would generally use discourse markers more frequently in the L1 than in the L2, was not supported. The second hypothesis, that nurses would use discourse-shift markers less frequently in their L2 compared to the L1, relative to their (baseline) use of turn-maintenance markers, was supported. The findings, especially the support for the second hypothesis, could have implications for the development of L2 training for health practitioners.</p