Length of stay comparisons for private and public hospitals.

This analysis uses average length of stay as a proxy for efficiency, to compare the Australian private and public hospital sectors. We conclude that private hospitals are more efficient than public hospitals in providing the range of care provided by private hospitals. However, public hospitals are more efficient in handling the casemix of the public hospital sector. The picture is more complicated when particular types of care (such as obstetric and psychiatric) are excluded.

Containing precious metals: hallmarking, minting and the materiality of gold and silver in medieval and modern England.

This book chapter extends the argument constructed by Oakley in his conference paper ‘Containing gold: Institutional attempts to define and constrict the values of precious metal objects’ presented at ‘Itineraries of the Material’, a conference held at Goethe Universitaet, Frankfurt am Main in 2011. Oakley’s chapter investigates the social forces that define the identities, social pathways and physical movement of objects made of precious metal. It presents a case study in which constitutive substance rather than the conceptual object is the key driver behind the social trajectories of numerous artefacts and their reception by contemporary audiences. This supports the main contention of the book as a whole: the need to reconsider, and when necessary challenge, the dominance of the social biography of objects in the study of material culture. Oakley’s research used historical and ethnographic approaches, including three years’ of ethnographic field research in the jewellery industry. This included training as a precious metal assayer at the Birmingham Assay Office and observing the industry and public response to government proposals to abolish the hallmarking legislation. This fieldwork was augmented by archive, library and object collection research on the histories of assaying and goldsmithing. Oakley presents an analysis of the historical development and contemporary social relevance of hallmarking, a technological process that has never previously been subject to ethnographic study, yet is fundamental to one of the UK’s creative industries.

Introduction to the Transforming Dementia Care in Hospitals Series

A short series of articles in Nursing Older People, starting in September, presents case study examples of the positive work achieved by trusts that participated in the RCN’s development programme to improve dementia care in acute hospitals. This introductory article reports on the independent evaluation of the programme. The programme included a launch event, development days, site visits, ongoing support by the RCN lead and carer representatives and a conference to showcase service improvements. The evaluation drew on data from a survey, the site visits, trust action plans and a range of self-assessment tools for dementia care. The findings highlight substantial progress towards programme objectives and learning outcomes and suggest that the programme provided the focus, impetus and structure for trusts to make sustainable changes. It also equipped participants with the strategies and confidence to change practice. Recommendations are made for taking the programme forward.

A Bilingual Thesaurus of Everyday Life in Medieval England: Some Issues at the Interface of Semantics and Lexicography

This paper reports on issues at the interface between semantics and lexicography that arose out of the data collection and classification of vocabulary in Anglo-Norman and Middle English in order to create a bilingual thesaurus of everyday life in medieval England. The Bilingual Thesaurus project is based at Birmingham City University and the University of Westminster. Issues to be resolved included the definition of an occupational domain; the creation of a methodology of data collection; the delimitation of domain-specific vocabulary; making distinctions between sense and usage; and the categorisation of the lexical items. Some of these issues are general to thesaurus-making, some are specific to the making of historical thesauruses, while some are unique to the production of a thesaurus of two languages whose use overlapped for several centuries in the late medieval period in England.

Technical Vocabulary and Medieval Text Types: A Semantic Field Approach

This paper seeks to discover in what sense we can classify vocabulary items as technical terms in the later medieval period. In order to arrive at a principled categorization of technicality, distribution is taken as a diagnostic factor: vocabulary shared across the widest range of text types may be assumed to be both prototypical for the semantic field, but also the most general and therefore least technical terms since lexical items derive at least part of their meaning from context, a wider range of contexts implying a wider range of senses. A further way of addressing the question of technicality is tested through the classification of the lexis into semantic hierarchies: in the terms of componential analysis, having more components of meaning puts a term lower in the semantic hierarchy and flags it as having a greater specificity of sense, and thus as more technical. The various text types are interrogated through comparison of the number of levels in their hierarchies and number of lexical items at each level within the hierarchies. Focusing on the vocabulary of a single semantic field, DRESS AND TEXTILES, this paper investigates how four medieval text types (wills, sumptuary laws, petitions, and romances) employ technical terminology in the establishment of the conventions of their genres.

Post-surgical wound infections involving Enterobacteriaceae with reduced susceptibility to ß-lactams in two Portuguese hospitals

The post-surgical period is often critical for infection acquisition. The combination of patient injury and environmental exposure through breached skin add risk to pre-existing conditions such as drug or depressed immunity. Several factors such as the period of hospital staying after surgery, base disease, age, immune system condition, hygiene policies, careless prophylactic drug administration and physical conditions of the healthcare centre may contribute to the acquisition of a nosocomial infection. A purulent wound can become complicated whenever antimicrobial therapy becomes compromised. In this pilot study, we analysed Enterobacteriaceae strains, the most significant gram-negative rods that may occur in post-surgical skin and soft tissue infections (SSTI) presenting reduced β-lactam susceptibility and those presenting extended-spectrum β-lactamases (ESBL). There is little information in our country regarding the relationship between β-lactam susceptibility, ESBL and development of resistant strains of microorganisms in SSTI. Our main results indicate Escherichia coli and Klebsiella spp. are among the most frequent enterobacteria (46% and 30% respectively) with ESBL production in 72% of Enterobacteriaceae isolates from SSTI. Moreover, coinfection occurred extensively, mainly with Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (18% and 13%, respectively). These results suggest future research to explore if and how these associations are involved in the development of antibiotic resistance.

A importância da linha costeira na estruturação do Reino medieval português. Algumas reflexões

pp. 9-24

Materials handling in hospitals: An analysis of how the storage and materials handling system can be improved, using the example of Hospital Santa Maria

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics