Evaluation of demand in a rural English hospital emergency department

The purpose of this article is to analyse the patient demand placed on a rural district general hospital (DGH) emergency department within the context of the Purpose, Process, People (PPP) framework used in the private sector. This analysis was undertaken to inform wider evaluation of the implementation of the enterprise culture—the NHS policy to adopt private sector best practice to produce resource use, quality and efficiency improvements. The article concludes with a view that the PPP framework provides methods of calculating the level of discharge necessary to meet the four-hour wait target. Data describing the characteristics and patterns of attending patients can be used to develop an emergency department’s processes and people to achieve its time-based target

Lean job design and musculoskeletal disorder risk: A two plant comparison

This study examined the relationship between lean job design and work-related musculoskeletal disorder (WMSD) risk factors. Repetition, force, and posture were assessed for a sample of 56 production jobs across departments at a lean automobile-manufacturing plant and compared to 56 similar jobs at a traditional automobile-manufacturing plant. The results showed greater productivity in the lean plant: less waiting ( p = .006) and walking ( p < .001); and greater repetition exposure ( p = .001). The mean rating for repetition was 5.5 in the lean plant, compared to 5.0 in the traditional plant based on the Latko (1997) hand activity level scale. However, the lean plant had significantly lower peak hand force ratings ( p = .01). When examining force and repetition combined, the lean plant had a lower percentage of jobs above the American Conference for Governmental Industrial Hygienists (ACGIH)-recommended Threshold Limit Value (TLV ® ). The findings suggest that lean manufacturing does not necessarily increase workers' risk for WMSD injuries. © 2009 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63064/1/20159_ftp.pd

Computer Model for Dynamic Skyline Behaviour

The development and experimental verification of a numerical model for the dynamic behavior of a cable logging system skyline is discussed. The model is intended to simulate the skyline behavior after a turn of logs breaks out of a "hang-up" on the ground. Output from the model may be used as a forcing function for a dynamic load on the tailspar or other component of the cable logging system. The numerical model uses finite difference and Runge-Kutta techniques. Output from the model consists of time-histories of the fluctuations in skyline tensions. From this output the frequencies of the skyline vibrations may be determined. The model was verified by experimental data collected while operating a small cable logging system in Oregon State University's McDonald Research Forest

Dynamic Characteristics of a Small Skyline Logging System with a Guyed Tailspar

A series of dynamic loading tests were conducted on a small skyline logging system (15.8 mm [5/8 inch] skyline) operating in a second-growth Douglas fir stand. The tests included free vibration tests and logging tests with turns weighing from 1.5 to 9 kN [340 to 2050 lbs]. Natural frequency and damping were evaluated from free vibration tests, and the free vibration portion of logging tests. Dynamic load magnitude was evaluated for logging tests with natural and artificial breakouts of turns with a range in turn weights, and for a series of logging tests with the same turn. The natural frequencies of the guylines were in good agreement with simple cable theory. However, the presence of the carriage on the skyline resulted in measured natural frequencies significantly lower than simple cable theory would predict. Damping of the tailspar system and the skyline averaged about 10% of critical damping, but was highly variable from test to test. Dynamic load magnitude, whether expressed as the load peak produced by turn break-out, or the maximum cyclic load, was highly variable, with coefficients of variation ranging from 31 to 79%. Even a series of logging tests with the same two-log turn produced maximum cyclic loads with a coefficient of variation of nearly 40%

A Study of The Local Toxicity of Agents Used for Variceal Injection Sclerotherapy

Injection sclerotherapy is widely used in the treatment of oesophageal varices. However, few studies have compared the local toxicity of sclerosant agents which may be important if serious local complications are to be avoided

White matter changes and confrontation naming in retired aging national football league athletes

Using diffusion tensor imaging (DTI), we assessed the relationship of white matter integrity and performance on the Boston Naming Test (BNT) in a group of retired professional football players and a control group. We examined correlations between fractional anisotropy (FA) and mean diffusivity (MD) with BNT T-scores in an unbiased voxelwise analysis processed with tract-based spatial statistics (TBSS). We also analyzed the DTI data by grouping voxels together as white matter tracts and testing each tract's association with BNT T-scores. Significant voxelwise correlations between FA and BNT performance were only seen in the retired football players (p < 0.02). Two tracts had mean FA values that significantly correlated with BNT performance: forceps minor and forceps major. White matter integrity is important for distributed cognitive processes, and disruption correlates with diminished performance in athletes exposed to concussive and subconcussive brain injuries, but not in controls without such exposure

Atomic-scale tailoring of spin susceptibility via non-magnetic spin-orbit impurities

Following the discovery of topological insulators, there has been a renewed interest in superconducting systems that have strong spin-orbit (SO) coupling. Here we address the fundamental question of how the spin properties of a otherwise spin-singlet superconducting ground state evolve with increasing SO impurity density. We have mapped out the Zeeman critical field phase diagram of superconducting Al films that were deposited over random Pb cluster arrays of varying density. These phase diagrams give a direct measure of the Fermi liquid spin renormalization, as well as the spin orbit scattering rate. We find that the spin renormalization is a linear function of the average Pb cluster -to- cluster separation and that this dependency can be used to tune the spin susceptibility of the Al over a surprisingly wide range from 0.8χ0 to 4.0χ0, where χ0 is the non-interacting Pauli susceptibility

Observation of a mesoscopic magnetic modulation in chiral Mn1/3NbS2

We have investigated the structural, magnetic, thermodynamic, and charge transport properties of Mn1/3NbS2 single crystals through x-ray and neutron diffraction, magnetization, specific heat, magnetoresistance, and Hall effect measurements. Mn1/3NbS2 displays a magnetic transition at TC ~ 45 K with highly anisotropic behavior expected for a hexagonal structured material. Below TC, neutron diffraction reveals increased scattering near the structural Bragg peaks having a wider Q-dependence along the c-axis than the nuclear Bragg peaks. This indicates helimagnetism with a long pitch length of ~250 nm (or a wavevector q~0.0025 {\AA}-1) along the c-axis. This q is substantially smaller than that found for the helimagnetic state in isostructural Cr1/3NbS2 (0.015 {\AA}-1). Specific heat capacity measurements confirm a second-order magnetic phase transition with a substantial magnetic contribution that persists to low temperature. The large low-temperature specific heat capacity is consistent with a large density of low-lying magnetic excitations that are likely associated with topologically interesting magnetic modes. Changes to the magnetoresistance, the magnetization, and the magnetic neutron diffraction, which become more apparent below 20 K, imply a modification in the character of the magnetic ordering corresponding to the magnetic contribution to the specific heat capacity. These observations signify a more complex magnetic structure both at zero and finite fields for Mn1/3NbS2 than for the well-investigated Cr1/3NbS2.Comment: 22 pages, 7 figure

Mexican Perspectives on Mexico-U.S. Immigration:Implications for Adult Education in the U.S. & Mexico

Mexican immigration has spawned a public discourse about the private motivations and experiences of immigrants and their families that is shaped by U.S. political and economic interests. This study sought to recover Mexican immigrants’ stories about their experiences and to imagine how adult educators can address this transnational phenomenon

A multi-wavelength study of a double intermediate-mass protostar - from large-scale structure to collimated jets

(abridged) We study a previously discovered protostellar source that is deeply embedded and drives an energetic molecular outflow. The source, UYSO1, is located close to IRAS 07029-1215 at a distance of ~1 kpc. The multi-wavelength observations resulted in the detection of a double intermediate-mass protostar at the location of UYSO1. In addition to the associated molecular outflow, with a projected size of 0.25 pc, two intersecting near-infrared jets with projected sizes of 0.4 pc and 0.2 pc were found. However, no infrared counterparts to the driving sources could be detected in sensitive near- to far-infrared observations. In interferometric millimeter observations, UYSO1 was resolved into two continuum sources with high column densities and gas masses of 3.5 Mo and 1.2 Mo, with a linear separation of 4200 AU. We report the discovery of a H2O maser toward one of the two sources. The total luminosity is roughly estimated to be ~50 Lo, shared by the two components, one of which is driving the molecular outflow that has a dynamical timescale of less than a few thousand years. The jets of the two individual components are not aligned. Submillimeter observations show that the region lacks typical hot-core chemistry. We thus find two protostellar objects, whose associated circumstellar and parent core masses are high enough to suggest that they may evolve into intermediate-mass stars. This is corroborated by their association with a very massive and energetic CO outflow, suggesting high protostellar accretion rates. The short dynamical timescale of the outflow, the pristine chemical composition of the cloud core and absence of hot core tracers, the absence of detectable radio continuum emission, and the very low protostellar luminosity argue for an extremely early evolutionary stage.Comment: 10 pages, 10 figures, accepted for publication in A&A; minor changes: typos corrected, revised argument in Section