Pressure-relieving equipment: promoting its correct use amongst nurses via differing modes of educational delivery

Aims and objectives. To examine the impact of written and verbal education on bed-making practices, in an attempt to reduce the prevalence of pressure ulcers. Background. The Department of Health has set targets for a 5% reduction per annum in the incidence of pressure ulcers. Electric profiling beds with a visco-elastic polymer mattress are a new innovation in pressure ulcer prevention; however, mattress efficacy is reduced by tightly tucking sheets around the mattress. Design. A prospective randomized pre/post-test experimental design. Methods. Ward managers at a teaching hospital were approached to participate in the study. Two researchers independently examined the tightness of the sheets around the mattresses. Wards were randomized to one of two groups. Groups A and B received written education. In addition, group B received verbal education on alternate days for one week. Beds were re-examined one month later. One researcher was blinded to the educational delivery received by the wards. Results. Twelve wards agreed to participate in the study and 245 beds were examined. Before education, 113 beds (46%) had sheets tucked correctly around the mattresses. Following education, this increased to 215 beds (87.8%) (chi(2) = 68.03, P < 0.001). There was no significant difference in the number of correctly made beds between the two different education groups: 100 (87.72%) beds correctly made in group A vs. 115 (87.79%) beds in group B (chi(2) = 0, P 0.987). Conclusions. Clear, concise written instruction improved practice but verbal education was not additionally beneficial. Relevance to clinical practice. Nurses are receptive to clear, concise written evidence regarding pressure ulcer prevention and incorporate this into clinical practice.

Femtosecond evolution of spatially inhomogeneous carrier excitations: part 2: stochastic approach and GRID implementation

We present a stochastic approach for solving the quantum-kinetic equation introduced in Part I. A Monte Carlo method based on backward time evolution of the numerical trajectories is developed. The computational complexity and the stochastic error are investigated numerically. Variance reduction techniques are applied, which demonstrate a clear advantage with respect to the approaches based on symmetry transformation. Parallel implementation is realized on a GRID infrastructure.

Coping with multiple enemies - the evolution of resistance and host-parasitoid community structure

Recent work has shown that the evolution of Drosophila melanogaster resistance to attack by the parasitoid Asobara tabida is constrained by a trade-off with larval competitive ability. However, there are two very important questions that need to be answered. First, is this a general cost, or is it parasitoid specific? Second, does a selected increase in immune response against one parasitoid species result in a correlated change in resistance to other parasitoid species? The answers to both questions will influence the coevolutionary dynamics of these species, and also may have a previously unconsidered, yet important, influence on community structure.

The evolution of indigenous contractors in Ghana

This paper provides some preliminary insights into the emergence and development of indigenous general contractors in Ghana. General contracting is the means by which an individual or organisation takes responsibility for supplying all of the materials, labour, equipment and services necessary for the construction of a project. Whereas the development of general contracting in places like the UK is well documented, the evolution of contractors in Ghana is not clearly articulated in the literature. Therefore, the main question in this paper is: How did indigenous contractors evolve in Ghana? To examine and analyze the research question, a literature review on similar developments elsewhere was first carried out. This was followed by discussions and unstructured interviews with experienced construction practitioners in Ghana most of whom were Quantity Surveyors. Most interviewees narrated their knowledge of contractor development in Ghana dating back to around 1945. From the explanations given, it was possible to develop a general understanding of the research question and to make a qualitative interpretation of the respondents’ comments and to draw some conclusions. General contractors emerged rapidly in the Gold Coast (now Ghana) shortly after World War II. Most were Italian master craftsmen in Ghana who were capitalized by the British colonial government to develop infrastructure in the Gold Coast following devastating effects of the war. Some of the indigenous people learned from the Italians and also established construction firms. Thus, general contracting in Ghana has a relatively short history in comparison to countries like Britain where the profession developed rapidly in the early part of the 19th century in response to the industrial revolution. Although they may possess sufficient technical expertise, many indigenous contractors in Ghana today lack the capacity to carry out major projects because of low capitalization and poor organisational structures. The current construction market in Ghana is dominated by foreign contractors. To become major players in the market, indigenous Ghanaian contractors should build strong organisational structures and pursue mergers and joint venturing to boost their financial, technical and managerial capacity.

Evaluating forecasts of the evolution of the cloudy boundary layer using diurnal composites of radar and lidar observations

Observations of boundary-layer cloud have been made using radar and lidar at Chilbolton, Hampshire, UK. These have been compared with output from 7 different global and regional models. Fifty-five cloudy days have been composited to reveal the mean diurnal variation of cloud top and base heights, cloud thickness and liquid water path of the clouds. To enable like-for-like comparison between model and observations, the observations have been averaged on to the grid of each model. The composites show a distinct diurnal cycle in observed cloud; the cloud height exhibits a sinusoidal variation throughout the day with a maximum at around 1600 and a minimum at around 0700 UTC. This diurnal cycle is captured by six of the seven models analysed, although the models generally under-predict both cloud top and cloud base heights throughout the day. The two worst performing models in terms of cloud boundaries also have biases of around a factor of two in liquid water path; these were the only two models that did not include an explicit formulation for cloud-top entrainment.

The evolution of maximum body size of terrestrial mammals

The extinction of dinosaurs at the Cretaceous/Paleogene (K/Pg) boundary was the seminal event that opened the door for the subsequent diversification of terrestrial mammals. Our compilation of maximum body size at the ordinal level by sub-epoch shows a near-exponential increase after the K/Pg. On each continent, the maximum size of mammals leveled off after 40 million years ago and thereafter remained approximately constant. There was remarkable congruence in the rate, trajectory, and upper limit across continents, orders, and trophic guilds, despite differences in geological and climatic history, turnover of lineages, and ecological variation. Our analysis suggests that although the primary driver for the evolution of giant mammals was diversification to fill ecological niches, environmental temperature and land area may have ultimately constrained the maximum size achieved.

Political market characteristics and the provision of educational infrastructure in North India

In this paper, we are concerned with the provision of schools in rural North India, particularly with whether such provision is determined by the demographic and economic characteristics of the region or whether local democracy also plays a role. We find that the probability that a governing party loses an election has a positive effect on the provision of schooling infrastructure, while the margin of victory of the governing party has a negative effect. Political reservation for members of the Scheduled Castes (SCs) has a positive effect on schooling infrastructure in villages with a large SC population, but a negative effect overall.

Evolution of coronal mass ejection morphology with increasing heliocentric distance. II. In Situ observations

Interplanetary coronal mass ejections (ICMEs) are often observed to travel much faster than the ambient solar wind. If the relative speed between the two exceeds the fast magnetosonic velocity, then a shock wave will form. The Mach number and the shock standoff distance ahead of the ICME leading edge is measured to infer the vertical size of an ICME in a direction that is perpendicular to the solar wind flow. We analyze the shock standoff distance for 45 events varying between 0.5 AU and 5.5 AU in order to infer their physical dimensions. We find that the average ratio of the inferred vertical size to measured radial width, referred to as the aspect ratio, of an ICME is 2.8 ± 0.5. We also compare these results to the geometrical predictions from Paper I that forecast an aspect ratio between 3 and 6. The geometrical solution varies with heliocentric distance and appears to provide a theoretical maximum for the aspect ratio of ICMEs. The minimum aspect ratio appears to remain constant at 1 (i.e., a circular cross section) for all distances. These results suggest that possible distortions to the leading edge of ICMEs are frequent. But, these results may also indicate that the constants calculated in the empirical relationship correlating the different shock front need to be modified; or perhaps both distortions and a change in the empirical formulae are required.

A three-regime model of speculative behaviour: modelling the evolution of the S&P 500 composite index

We examine whether a three-regime model that allows for dormant, explosive and collapsing speculative behaviour can explain the dynamics of the S&P 500. We extend existing models of speculative behaviour by including a third regime that allows a bubble to grow at a steady rate, and propose abnormal volume as an indicator of the probable time of bubble collapse. We also examine the financial usefulness of the three-regime model by studying a trading rule formed using inferences from it, whose use leads to higher Sharpe ratios and end of period wealth than from employing existing models or a buy-and-hold strategy.