Unity in diversity: electronic patient record use in multidisciplinary practice

In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this perspective is illustrated through the analysis of a year-long, longitudinal case study of a multidisciplinary team of surgeons, oncologists, pathologists, radiologists, and nurse specialists adopting a new EPR. Each group adapted their use of the EPR to their diverse specialist practices, but they nonetheless orientated their use of the EPR to each others' practices sufficiently to support unity in multidisciplinary teamwork. Multidisciplinary practice elements were also reconfigured in an episode of explicit negotiations, resulting in significant changes in EPR use within team meetings. Our study contributes to the growing literature that questions the feasibility and necessity of achieving high levels of standardized, uniform health information technology use in healthcare.

DIRECT DETECTION OF PICOSECOND PULSES EMITTED BY AN INJECTION LASER WITH ACTIVE MODE LOCKING.

An Agat-SF linear-scan streak image-converter camera was used to record output pulses of 2. 7 psec duration generated by an injection laser with an external dispersive resonator operated in the active mode-locking regime. The duration of the pulses was determined by the reciprocal of the spectral width and the product of the duration and the spectral width was 0. 30.

Response of clamped sandwich beams subjected to high-velocity impact by sand slugs

The dynamic response of end-clamped sandwich and monolithic beams of equal areal mass subjected to loading via high-velocity slugs of dry and water-saturated sand is measured using a novel laboratory-based method. The sandwich beams comprise aluminium face sheets and an aluminium honeycomb core: the effect of sandwich core strength and beam thickness on the dynamic beam deflection is investigated by varying the orientation and height of the anisotropic aluminium honeycomb core material. High-speed imaging is used to measure the transient transverse deflection of the beams and to record the dynamic modes of deformation. The measurements show that sandwich beams with thick, strong cores are optimal and that these beams significantly outperform monolithic beams of equal mass. The water-saturated sand slugs cause significantly higher deflections compared to the dry sand slugs having the same mean slug velocity and we demonstrate that this enhanced deflection is due to the larger mass of the water-saturated slugs. Finally, we show that the impact of sand slugs is equivalent to the impact of a crushable foam projectile. The experiments using foam projectiles are significantly simpler to perform and thus represent a more convenient laboratory technique. © 2014 Elsevier Ltd. All rights reserved.