5,209 research outputs found

    Morphological aspects of male and female hands

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    This is an electronic version of an article published in Annals of Human Biology, 1996, 23(6), 491-494. Annals of Human Biology is available online at informaworldTM http://www.informaworld.com/smpp/content~content=a739339013~db=all~order=pageThis journal article discusses a series of hand radiographs from Gwynedd, North Wales, which were assessed for frequencies in digital and metacarpal formulae between the genders

    Extended scope of nursing practice: a multicentre randomised controlled trial of appropriately trained nurses and pre-registration house officers in pre-operative assessment in elective general surgery

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    Aim/ Principal Research Question:1) To determine whether pre-operative assessment carried out by an appropriately trained nurse (ATN) is equivalent in quality to that carried out by a pre-registration house officer (PRHO).2) To assess whether pre-assessments carried out by ATNs and PRHOs are equivalent in terms of cost.3) To determine whether assessments carried out by ATNs are acceptable to patients.4) To investigate the quality of communication between senior medical staff and ATNs.Factors of Interest:The extended role of appropriately trained nurses and pre-registration house officers in pre-operative assessment in elective general surgery.Methods:The study design was principally a prospective randomised equivalence trial but was accompanied by additional qualitative assessment of patient and staff perceptions, and an economic evaluation.The intervention consisted of a pre-operative assessment carried out by either an ATN or a PRHO. Of the patients who completed the study with a full evaluation, 926 patients were randomised to the PRHO arm of the trial and 948 to the ATN arm. Three ATNs took part in the study, one from each centre, together with a total of 87 PRHOs.Immediately following the initial assessment of a patient by a PRHO or an ATN, one of a number of clinical research fellows, all specialist registrars in anaesthetics, repeated the assessment and recorded it on a study form, together with a list of investigations required. The clinical research fellow then evaluated the competency of the initial assessor by comparing the quality of their assessment with their own. Any deficiencies in ordering of investigations and referral to other specialities were met in order to maximise patient care.Sample groups:All patients attending at one site for assessment prior to general anaesthetic for elective general, vascular, urological or breast surgery were potentially included in the study. Of 1907 patients who were randomised, 1874 completed the study with a full evaluation.The study was carried out at four NHS hospitals, three of which were teaching hospitals, in three NHS Trusts in Southampton, Sheffield and Doncaster.Outcome measures:Three areas of ATN and PRHO performance were judged separately, history taking, examination and ordering of tests, and each was graded into one of four categories, the most important of which was under-assessment, which would possibly have affected peri-operative management. In the case of ordering of tests, it was possible to have both over- and under-assessed a patient on different tests.Findings:The pre-operative assessments carried out by the ATNs were essentially equivalent to those performed by the PRHOs in terms of under-assessment that might possibly have affected peri-operative management, although there was variation between the ATNs in terms of the quality of history taking. This may be related to the low number of patients seen at one study site.PRHOs ordered significantly more unnecessary tests than the ATNs. The substitution of ATNs for PRHOs was calculated to be cost neutral.The results of the qualitative assessment showed that the use of ATNs for pre-operative assessment was acceptable to patients; however, there was no evidence that communication between senior medical staff and those carrying out pre-operative assessments was improved by their introduction.Conclusions:This study demonstrated no reason to inhibit the development of fully nurse-led pre-operative assessment, provided that the nurses are appropriately trained and maintain sufficient workload to retain skills.Implications for Further Research:Further research is needed in the following areas:1) the extent and type of training needed for nurses undertaking the pre-operative assessment role2) the use, costs and benefits of routine pre-operative testing.<br/

    Some Notable Discoveries in Organosilicon Chemistry: Proceedings of the History and Retrospective Session of the 34th Organosilicon Symposium (2001)

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    The 34th Organosilicon Symposium at White Plains, NY, in 2001 featured a History and Retrospective Session, during which invited speakers from academic and industrial laboratories recounted the path to some significant 20th century discoveries in organosilicon chemistry. The Si=C Story: The Way it Happened, Adrian G. Brook (University of Toronto) The Discovery of Stable Disilenes and Silylenes, Robert West (University of Wisconsin) Yellow Fever: The Story Behind the Synthesis of Germasilenes, Kim M. Baines (University of Western Ontario) Direct Synthesis of Tris(dimethylamino)silane, William B. Herdle (OSi Specialties, formerly of Union Carbide Corporation) Discovery of Tin and Phosphorus Effects on the Direct Synthesis of Methylchlorosilanes, Larry H. Wood (Dow Corning Corporation) Discovery of Methylchlorosilylene (CH3SiCl) as a Key Intermediate in the Direct Synthesis of Dimethyldichlorosilane ((CH3)2SiCl2), Kenrick M. Lewis (OSi Specialties, formerly of Union Carbide Corporation) The First Platinum-Catalyzed Hydrosilylation With Supported Platinum Catalysts, George H. Wagner (Retired, formerly of Union Carbide Corporation) The Discovery of Silicone Surfactants for Polyurethane Foam, Bernard Kanner (Retired, formerly of Union Carbide Corporation) The Discovery of Silane Coupling Agents, Bernard Kanner (Retired, formerly of Union Carbide Corporation)https://ir.lib.uwo.ca/organosiliconproceedings/1006/thumbnail.jp

    Performance management practices within emerging market multinational enterprises: the case of Brazilian multinationals

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    This study advances our understanding of HRM within EM-MNEs by examining the extent to, and mechanism by, which Brazilian MNEs standardize or localise their performance management (PM) policies and practices, and the factors that influence their design and implementation. We explored these issues through qualitative case studies of three Brazilian MNEs. The analysis of interview data reveals a strong tendency for Brazilian MNEs to centralise and standardise their PM policies and practices. The key finding of this paper is that PM practices within Brazilian MNEs are not based on indigenous Brazilian practices, but rather, are heavily influenced by global best practices. The findings are at odds with previous research, which suggests that EM-MNEs apply different HR practices in developed country subsidiaries and developing country subsidiaries. Also, contrary to expectations, our results indicate that institutional distance does not have a significant influence on the adaptation of PM practices at subsidiary level

    What is the Total Deuterium Abundance in the Local Galactic Disk?

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    Analyses of spectra obtained with the Far Ultraviolet Spectroscopic Explorer (FUSE) satellite, together with spectra from the Copernicus and IMAPS instruments, reveal an unexplained very wide range in the observed deuterium/hydrogen (D/H) ratios for interstellar gas in the Galactic disk beyond the Local Bubble. We argue that spatial variations in the depletion of deuterium onto dust grains can explain these local variations in the observed gas-phase D/H ratios. We present a variable deuterium depletion model that naturally explains the constant measured values of D/H inside the Local Bubble, the wide range of gas-phase D/H ratios observed in the intermediate regime (log N(H I} = 19.2-20.7), and the low gas-phase D/H ratios observed at larger hydrogen column densities. We consider empirical tests of the deuterium depletion hypothesis: (i) correlations of gas-phase D/H ratios with depletions of the refractory metals iron and silicon, and (ii) correlation with the molecular hydrogen rotational temperature. Both of these tests are consistent with deuterium depletion from the gas phase in cold, not recently shocked, regions of the ISM, and high gas-phase D/H ratios in gas that has been shocked or otherwise heated recently. We argue that the most representative value for the total (gas plus dust) D/H ratio within 1 kpc of the Sun is >=23.1 +/- 2.4 (1 sigma) parts per million (ppm). This ratio constrains Galactic chemical evolution models to have a very small deuterium astration factor, the ratio of primordial to total (D/H) ratio in the local region of the Galactic disk, which we estimate to be f_d <= 1.19 +/-0.16 (1 sigma) or <= 1.12 +/- 0.14 (1 sigma) depending on the adopted light element nuclear reaction rates.Comment: 19 pages, 9 figure

    The CTRW in finance: Direct and inverse problems with some generalizations and extensions

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    We study financial distributions within the framework of the continuous time random walk (CTRW). We review earlier approaches and present new results related to overnight effects as well as the generalization of the formalism which embodies a non-Markovian formulation of the CTRW aimed to account for correlated increments of the return.Comment: 25 pages, 3 figures, Elsart, submitted for publicatio

    Reaction of Small-Grain Varieties and Hybrids to Greenbug Attack

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    The Oklahoma Agricultural Experiment Station periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311
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