852 resultados para National characteristics, British
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Background: There is some evidence from a Cochrane review that rehabilitation following spinal surgery may be beneficial. Methods: We conducted a survey of current post-operative practice amongst spinal surgeons in the United Kingdom in 2002 to determine whether such interventions are being included routinely in the post-operative management of spinal patients. The survey included all surgeons who were members of either the British Association of Spinal Surgeons ( BASS) or the Society for Back Pain Research. Data on the characteristics of each surgeon and his or her current pattern of practice and post-operative care were collected via a reply-paid postal questionnaire. Results: Usable responses were provided by 57% of the 89 surgeons included in the survey. Most surgeons (79%) had a routine post-operative management regime, but only 35% had a written set of instructions that they gave to their patients concerning this. Over half (55%) of surgeons do not send their patients for any physiotherapy after discharge, with an average of less than two sessions of treatment organised by those that refer for physiotherapy at all. Restrictions on lifting, sitting and driving showed considerable inconsistency both between surgeons and also within the recommendations given by individual surgeons. Conclusion: Demonstrable inconsistencies within and between spinal surgeons in their approaches to post-operative management can be interpreted as evidence of continuing and significant uncertainty across the sub-speciality as to what does constitute best care in these areas of practice. Conducting further large, rigorous, randomised controlled trials would be the best method for obtaining definitive answers to these questions.
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Over the last one hundred years, compartmentalization and water management activities have reduced water flow to the ridge and slough landscape of the Everglades. As a result, the once corrugated landscape has become topographically and vegetationally uniform. The focus of this study was to quantify variation in surface flow in the ridge and slough landscape and to relate flow conditions to particulate transport and deposition. Over the 2002–2003 and 2003–2004 wet seasons, surface velocities and particulate accumulation were measured in upper Shark River Slough in Everglades National Park. Landscape characteristics such as elevation, plant density and biomass also were examined to determine their impact on flow characteristics and material transport. The results of this study demonstrate that the release of water during the wet season not only increases water levels, but also increased flow speeds and particulate transport and availability. Further, flow speeds were positively and significantly correlated with water level thereby enhancing particulate transport in sloughs relative to ridges especially during peak flow periods. Our results also indicate that the distribution of biomass in the water column, including floating plants and periphyton, affects velocity magnitude and shape of vertical profiles, especially in the sloughs where Utricularia spp. and periphyton mats are more abundant. Plot clearing experiments suggest that the presence of surface periphyton and Utricularia exert greater control over flow characteristics than the identity (i.e., sawgrass or spike rush) or density of emergent macrophytes, two parameters frequently incorporated into models describing flow through vegetated canopies. Based on these results, we suggest that future modeling efforts must take the presence of floating biomass, such as Utricularia, and presence of periphyton into consideration when describing particulate transport.
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Athletic training is an allied health profession recognized by the American Medical Association requiring certification by examination. There are two routes towards certification as an athletic trainer: attending a university with an accredited athletic training program or with an internship program By 2004, the only route towards certification will be by attending a Commission on Accreditation of Allied Health Education Programs (CAAHEP) or National Athletic Trainers' Association (NATA) accredited athletic training program. CAAHEP looks at passing rates on the NATA Board of Certification (NATABOC) examination when granting accreditation. This study examined characteristics of programs associated with first time passing rates. ^ Directors from 39 CAAHEP or NATA accredited athletic training programs completed a descriptive 17-question survey regarding academic characteristics, faculty characteristics, and program characteristics. Analysis used Spearman's rho correlation coefficient, with significance of p = <.05. Four program directors were interviewed to gather additional insight. ^ There were three program characteristics that showed a significant positive association with first attempt passing rates: the number of full-time and part-time approved clinical instructors (ACIs), and the number of students in the program. Further investigation found a statistically significant association between a low ratio of ACIs to athletic training students and first time passing rates. ACIs are certified athletic trainers (ATCs) who have received special training in order to supervise athletic training students. CAAHEP mandates a 1:8 ratio of ATCs to athletic training student. This study showed that a smaller ratio of ATC to student in combination with ACI training was significantly associated with higher first time passing rates. The number of courses above the required 13 delineated by the Education Council showed a significant negative association with first attempt passing rates. ^ Universities seeking or maintaining accreditation should incorporate characteristics associated with a higher passing rate on the NATABOC examination. Characteristics include utilizing a large number of full-time and part-time ACIs, admitting a large number of students into the program while maintaining a low ACI to athletic training student ratio, and offering curricula that focuses on the 13 courses that have been deemed relevant to the athletic training curriculum by the Education Council. ^
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A pivotal component of hydrological restoration of the Florida Everglades is the improvement of water conveyance to Everglades National Park by the degradation of the current network of canals, roadways and levees. The Tamiami Trail (L29) road/canal complex represents a major barrier to natural water flows into the park and a variety of modification options for flow improvement are currently being explored, including the installation of spreader swales immediately downstream of culverts conveying water under Tamiami Trail from the L29 canal into Everglades National Park. In this study, we evaluated water column chemistry and wet-season diatom community structure to provide baseline information for use in future monitoring activities related to the proposed Tamiami Trail modifications. Water chemistry showed pronounced fluctuations in response to precipitation and anthropogenically mediated hydrological events. Differences in water quality variables among sites were dampened during periods of inundation, and became more pronounced during periods of low canal stage, suggesting the importance of small-scale mechanisms related to isolation of habitat patches. Diatom assemblages were unexpectedly speciose (127 taxa in 40 samples) compared to typical Everglades assemblages, and spatially heterogeneous in sites associated with concentric areas of dense vegetation immediately downstream of culverts. We also observed significant compositional dissimilarities among transects, indicating that culvert pool and north transect assemblages were substantially influenced by propagule input from the canal and areas to the north, while south transect sites were compositionally similar to typical sawgrass prairie diatom communities. Central transect sites were compositionally intermediate to their north and south counterparts. We propose that the position and spatial extent of this “transitional assemblage” is a sensitive indicator of subtle environmental change related to Tamiami Trail modifications.
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Earlier versions were presented at the ECPR Joint Sessions Workshop on ‘How and Why of Party Manifestos in New and Established Democracies’, University of St. Gallen, April 2011, and at PSA and EPOP Conferences in 2011. We are grateful to all participants for their feedback, and particularly Bob Harmel and Lars Svasand for their comments and leading this project. We are also grateful to Dai Moon for discussions around Welsh manifestos and highlighting some otherwise unavailable literature. The usual disclaimers naturally apply. Alistair Clark gratefully acknowledges the financial support of a British Academy Overseas Conference Grant, Award Number OC100383 for travel to the 2011 ECPR Joint Sessions. The final definitive version of this paper has been published in Party Politics by SAGE Publications Ltd and is available on the journal website at: http://ppq.sagepub.com/ All Rights Reserved © Alistair Clark and Lynn Bennie.
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The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.
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A distinct metonymic pattern was discovered in the course of conducting a corpus-based study of figurative uses of WORD. The pattern involved examples such as Not one word of it made any sense and I agree with every word. It was labelled ‘hyperbolic synecdoche’, defined as a case in which a lexeme which typically refers to part of an entity (a) is used to stand for the whole entity and (b) is described with reference to the end point on a scale. Specifically, the speaker/writer selects the perspective of a lower-level unit (such as word for ‘utterance’), which is quantified as NOTHING or ALL, thus forming a subset of ‘extreme case formulations’. Hyperbolic synecdoche was found to exhibit a restricted range of lexicogrammatical patterns involving word, with the negated NOTHING patterns being considerably more common than the ALL patterns. The phenomenon was shown to be common in metonymic uses in general, constituting one-fifth of all cases of metonymy in word. The examples of hyperbolic synecdoche were found not to be covered by the oftquoted ‘abbreviation’ rationale for metonymy; instead, they represent a more roundabout way of expression. It is shown that other cases of hyperbolic synecdoche exist outside of word and the domain of communication (such as ‘time’ and ‘money’).