981 resultados para Postsurgical Lifting Restrictions


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Department of Health staff wished to use systems modelling to discuss acute patient flows with groups of NHS staff. The aim was to assess the usefulness of system dynamics (SD) in a healthcare context and to elicit proposals concerning ways of improving patient experience. Since time restrictions excluded simulation modelling, a hybrid approach using stock/flow symbols from SD was created. Initial interviews and hospital site visits generated a series of stock/flow maps. A ‘Conceptual Framework’ was then created to introduce the mapping symbols and to generate a series of questions about different patient paths and what might speed or slow patient flows. These materials formed the centre of three workshops for NHS staff. The participants were able to propose ideas for improving patient flows and the elicited data was subsequently employed to create a finalized suite of maps of a general acute hospital. The maps and ideas were communicated back to the Department of Health and subsequently assisted the work of the Modernization Agency.

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An investigation is presented of a quasi-stationary convective system (QSCS) which occurred over the UK Southwest Peninsula on 21 July 2010. This system was remarkably similar in its location and structure to one which caused devastating flash flooding in the coastal village of Boscastle, Cornwall on 16 August 2004. However, in the 2010 case rainfall accumulations were around four times smaller and no flooding was recorded. The more extreme nature of the Boscastle case is shown to be related to three factors: (1) higher rain rates, associated with a warmer and moister tropospheric column and deeper convective clouds; (2) a more stationary system, due to slower evolution of the large-scale flow; and (3) distribution of the heaviest precipitation over fewer river catchments. Overall, however, the synoptic setting of the two events was broadly similar, suggesting that such conditions favour the development of QSCSs over the Southwest Peninsula. A numerical simulation of the July 2010 event was performed using a 1.5-km grid length configuration of the Met Office Unified Model. This reveals that convection was repeatedly initiated through lifting of low-level air parcels along a quasi-stationary coastal convergence line. Sensitivity tests are used to show that this convergence line was a sea breeze front which temporarily stalled along the coastline due to the retarding influence of an offshore-directed background wind component. Several deficiencies are noted in the 1.5-km model’s representation of the storm system, including delayed convective initiation; however, significant improvements are observed when the grid length is reduced to 500 m. These result in part from an improved representation of the convergence line, which enhances the associated low-level ascent allowing air parcels to more readily reach their level of free convection. The implications of this finding for forecasting convective precipitation are discussed.

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Many factors, both mesoscale and larger scale, often come together in order for a particular convective initiation to take place. The authors describe a modeling study of a case from the Convective Storms Initiation Project (CSIP) in which a single thunderstorm formed behind a front in the southern United Kingdom. The key features of the case were a tongue of low-level high θw air associated with a forward-sloping split front (overrunning lower θw air above), a convergence line, and a “lid” of high static stability air, which the shower was initially constrained below but later broke through. In this paper, the authors analyze the initiation of the storm, which can be traced back to a region of high ground (Dartmoor) at around 0700 UTC, in more detail using model sensitivity studies with the Met Office Unified Model (MetUM). It is established that the convergence line was initially caused by roughness effects but had a significant thermal component later. Dartmoor had a key role in the development of the thunderstorm. A period of asymmetric flow over the high ground, with stronger low-level descent in the lee, led to a hole in a layer of low-level clouds downstream. The surface solar heating through this hole, in combination with the tongue of low-level high θw air associated with the front, caused the shower to initiate with sufficient lifting to enable it later to break through the lid.

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This Editorial presents the focus, scope and policies of the inaugural issue of Nature Conservation, a new open access, peer-reviewed journal bridging natural sciences, social sciences and hands-on applications in conservation management. The journal covers all aspects of nature conservation and aims particularly at facilitating better interaction between scientists and practitioners. The journal will impose no restrictions on manuscript size or the use of colour. We will use an XML-based editorial workflow and several cutting-edge innovations in publishing and information dissemination. These include semantic mark-up of, and enhancements to published text, data, and extensive cross-linking within the journal and to external sources. We believe the journal will make an important contribution to better linking science and practice, offers rapid, peer-reviewed and flexible publication for authors and unrestricted access to content.

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We discuss the modeling of dielectric responses of electromagnetically excited networks which are composed of a mixture of capacitors and resistors. Such networks can be employed as lumped-parameter circuits to model the response of composite materials containing conductive and insulating grains. The dynamics of the excited network systems are studied using a state space model derived from a randomized incidence matrix. Time and frequency domain responses from synthetic data sets generated from state space models are analyzed for the purpose of estimating the fraction of capacitors in the network. Good results were obtained by using either the time-domain response to a pulse excitation or impedance data at selected frequencies. A chemometric framework based on a Successive Projections Algorithm (SPA) enables the construction of multiple linear regression (MLR) models which can efficiently determine the ratio of conductive to insulating components in composite material samples. The proposed method avoids restrictions commonly associated with Archie’s law, the application of percolation theory or Kohlrausch-Williams-Watts models and is applicable to experimental results generated by either time domain transient spectrometers or continuous-wave instruments. Furthermore, it is quite generic and applicable to tomography, acoustics as well as other spectroscopies such as nuclear magnetic resonance, electron paramagnetic resonance and, therefore, should be of general interest across the dielectrics community.

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Andrews (1984) has shown that any flow satisfying Arnol'd's (1965, 1966) sufficient conditions for stability must be zonally-symmetric if the boundary conditions on the flow are zonally-symmetric. This result appears to place very strong restrictions on the kinds of flows that can be proved to be stable by Arnol'd's theorems. In this paper, Andrews’ theorem is re-examined, paying special attention to the case of an unbounded domain. It is shown that, in that case, Andrews’ theorem generally fails to apply, and Arnol'd-stable flows do exist that are not zonally-symmetric. The example of a circular vortex with a monotonic vorticity profile is a case in point. A proof of the finite-amplitude version of the Rayleigh stability theorem for circular vortices is also established; despite its similarity to the Arnol'd theorems it seems not to have been put on record before.

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This study investigates the extent to which advanced native-English L2 learners of Spanish come to acquire restrictions on bare plural preverbal subjects in L2 Spanish (e.g. gatos “cats” vs. definite plurals such as los gatos “the cats”). It tests L2 knowledge of available semantic readings of bare plurals and definite plurals in Spanish, where [+specific] and [+generic] interpretations are syntactically represented differently from English. Assuming L1 transfer, and in view of a potential subset/superset relationship of the two grammars, the learning task in this domain is not a straightforward one. Target acquisition requires both grammatical expansion and retraction; Spanish definite plural subjects require the addition of an L1-unavailable [+generic] reading, while a loss of an L1-available [+generic] reading for preverbal subject bare plurals is required. The results and analysis show that advanced L2 learners of Spanish (English L1) can circumvent a superficial subset/superset learnability problem by means of feature resetting in line with the Nominal Mapping Parameter.

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How does the work of designers impact on the safety of operatives at the construction site? Safety research and policy emphasize the importance of designing for safe construction, yet the interface between design and construction is poorly understood: accidents have multiple causes making it hard to establish causal links between design choices and safety outcomes. An in-depth case study of a major station project examines how professionals on the construction site perceive and manage the safety challenges of a building design. Analyses reveal understandings that, on the project studied, design has an impact on safety because of: (1) the timing of design work, where the volume of late design changes increased the difficulty of planning safe procedures, e.g. for working at height, lifting heavy items, refurbishing and demolishing old buildings; and (2) inputs from design stakeholders with insufficient practical knowledge of construction and operation required unplanned work-arounds, e.g. to coordinate different sub-systems, provide maintenance access, and manage loads during construction. These findings suggest that safety suffers where projects are under-designed, and that alongside regulation, there is a need for robust management attention to the contractual structures, incentives, processes and tools that enable clients and designers to understand material practices of construction and operation.

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Slabakova (2006b) poses and directly addresses the question of whether or not there is a maturational effect (a critical/sensitive period) that affects the semantic component. She demonstrates that there is no empirical evidence suggesting that adults are unable to acquire phrasal semantic properties, even when the accessing of semantic universals is conditioned upon the acquisition of L2 morphosyntactic features (see Dekydtspotter and Sprouse 2001, Slabakova and Montrul 2003). In light of this, the authors test for interpretive properties associated with the aspectual projection higher (outer) AspP in advanced English learners of adult L2 Portuguese via their knowledge of [+/- accidental] related nuances in adverbially quantified preterit and imperfect sentences (Lenci and Bertinetto 2000; Menéndez-Benito 2002). In two experiments, the authors test for L2 knowledge of this [+/- accidental] distinction via semantic felicitousness judgments of adverbially quantified preterit and imperfect sentences depending on a supporting context as well as related restrictions on subject DP interpretations. Overall, the data show that advanced learners acquire this distinction. As the authors discuss, the present data support Full Access theories (White 1989, Schwartz and Sprouse 1996; Duffield and White 1999) and the No-Critical Period for semantics position (Slabakova 2006b), demonstrating that the syntax-semantics interface is not an inevitable locus for fossilization.

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We discuss public policy towards vertical relations, comparing different types of contracts between a manufacturer and a maximum of two retailers. Together with (potential) price competition between the retailers, we study the role of a (sunk) differentiation cost paid by them in order to relax competition in the retail market and broaden the market potential of the distributed product. This non-price competition element in the downstream market is responsible for our conclusion that, unlike in standard policy guidelines and previous theoretical analysis, restrictions in intra-brand competition may deserve a permissive treatment even in the absence of inter-brand competition, if retailer differentiation is costly.

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Social media utilities have made it easier than ever to know about the range of online or offline social activities one could be engaging. On the upside, these social resources provide a multitude of opportunities for interaction; on the downside, they often broadcast more options than can be pursued, given practical restrictions and limited time. This dual nature of social media has driven popular interest in the concept of Fear of Missing Out – popularly referred to as FoMO. Defined as a pervasive apprehension that others might be having rewarding experiences from which one is absent, FoMO is characterized by the desire to stay continually connected with what others are doing. The present research presents three studies conducted to advance an empirically based understanding of the fear of missing out phenomenon. The first study collected a diverse international sample of participants in order to create a robust individual differences measure of FoMO, the Fear of Missing Out scale (FoMOs); this study is the first to operationalize the construct. Study 2 recruited a nationally representative cohort to investigate how demographic, motivational and well-being factors relate to FoMO. Study 3 examined the behavioral and emotional correlates of fear of missing out in a sample of young adults. Implications of the FoMOs measure and for the future study of FoMO are discussed.

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We pursue the first large-scale investigation of a strongly growing mutual fund type: Islamic funds. Based on an unexplored, survivorship bias-adjusted data set, we analyse the financial performance and investment style of 265 Islamic equity funds from 20 countries. As Islamic funds often have diverse investment regions, we develop a (conditional) three-level Carhart model to simultaneously control for exposure to different national, regional and global equity markets and investment styles. Consistent with recent evidence for conventional funds, we find Islamic funds to display superior learning in more developed Islamic financial markets. While Islamic funds from these markets are competitive to international equity benchmarks, funds from especially Western nations with less Islamic assets tend to significantly underperform. Islamic funds’ investment style is somewhat tilted towards growth stocks. Funds from predominantly Muslim economies also show a clear small cap preference. These results are consistent over time and robust to time varying market exposures and capital market restrictions.

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Question: What plant properties might define plant functional types (PFTs) for the analysis of global vegetation responses to climate change, and what aspects of the physical environment might be expected to predict the distributions of PFTs? Methods: We review principles to explain the distribution of key plant traits as a function of bioclimatic variables. We focus on those whole-plant and leaf traits that are commonly used to define biomes and PFTs in global maps and models. Results: Raunkiær's plant life forms (underlying most later classifications) describe different adaptive strategies for surviving low temperature or drought, while satisfying requirements for reproduction and growth. Simple conceptual models and published observations are used to quantify the adaptive significance of leaf size for temperature regulation, leaf consistency for maintaining transpiration under drought, and phenology for the optimization of annual carbon balance. A new compilation of experimental data supports the functional definition of tropical, warm-temperate, temperate and boreal phanerophytes based on mechanisms for withstanding low temperature extremes. Chilling requirements are less well quantified, but are a necessary adjunct to cold tolerance. Functional traits generally confer both advantages and restrictions; the existence of trade-offs contributes to the diversity of plants along bioclimatic gradients. Conclusions: Quantitative analysis of plant trait distributions against bioclimatic variables is becoming possible; this opens up new opportunities for PFT classification. A PFT classification based on bioclimatic responses will need to be enhanced by information on traits related to competition, successional dynamics and disturbance.

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In the UK, architectural design is regulated through a system of design control for the public interest, which aims to secure and promote ‘quality’ in the built environment. Design control is primarily implemented by locally employed planning professionals with political oversight, and independent design review panels, staffed predominantly by design professionals. Design control has a lengthy and complex history, with the concept of ‘design’ offering a range of challenges for a regulatory system of governance. A simultaneously creative and emotive discipline, architectural design is a difficult issue to regulate objectively or consistently, often leading to policy that is regarded highly discretionary and flexible. This makes regulatory outcomes difficult to predict, as approaches undertaken by the ‘agents of control’ can vary according to the individual. The role of the design controller is therefore central, tasked with the responsibility of interpreting design policy and guidance, appraising design quality and passing professional judgment. However, little is really known about what influences the way design controllers approach their task, providing a ‘veil’ over design control, shrouding the basis of their decisions. This research engaged directly with the attitudes and perceptions of design controllers in the UK, lifting this ‘veil’. Using in-depth interviews and Q-Methodology, the thesis explores this hidden element of control, revealing a number of key differences in how controllers approach and implement policy and guidance, conceptualise design quality, and rationalise their evaluations and judgments. The research develops a conceptual framework for agency in design control – this consists of six variables (Regulation; Discretion; Skills; Design Quality; Aesthetics; and Evaluation) and it is suggested that this could act as a ‘heuristic’ instrument for UK controllers, prompting more reflexivity in relation to evaluating their own position, approaches, and attitudes, leading to better practice and increased transparency of control decisions.