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The Department of Health in the UK wants the National Health Service to make £20 Billion worth of efficiency savings by 2015 to reinvest.
In the UK the General Hospitals use paper records which are then scanned to create electronic records while Psychiatric Hospitals require that information to be typed on to their electronic records and these electronic records are not available to each other.
Therefore liaison psychiatry assessments require a written entry to be made in the Medical notes and a second entry typed on to the psychiatric electronic patient record which requires a full psychiatric history.
This duplication in typing information was consuming a considerable amount of this Teams time and resources which could have instead been spent with patients.
To identify how much time is spent by Staff typing information on to the psychiatric electronic patient records.
We electronically checked for the preceding three months the amount of time spent typing information on to the electronic records after every liaison psychiatry assessment.
We were then able to obtain the average for every week.
On average about 36 to 40 hours were spent every week typing information on to the electronic records.
Liaison Psychiatry should dispense with the requirement for information to be duplicated on to the electronic patient records and should instead scan the written entry made in the Medical notes.
This should lead to a saving of about £50,000, enough to employ an additional member of Staff every week.
The deviation from thermodynamic equilibrium of the ion velocity distribution functions (VDFs), as measured by the Magnetospheric Multiscale (MMS) mission in the Earth’s turbulent magnetosheath, is quantitatively investigated. Making use of the unprecedented high-resolution MMS ion data, and together with Vlasov–Maxwell simulations, this analysis aims at investigating the relationship between deviation from Maxwellian equilibrium and typical plasma parameters. Correlations of the non-Maxwellian features with plasma quantities such as electric fields, ion temperature, current density and ion vorticity are found to be similar in magnetosheath data and numerical experiments, with a poor correlation between distortions of ion VDFs and current density, evidence that questions the occurrence of VDF departure from Maxwellian at the current density peaks. Moreover, strong correlation has been observed with the magnitude of the electric field in the turbulent magnetosheath, while a certain degree of correlation has been found in the numerical simulations and during a magnetopause crossing by MMS. This work could help shed light on the influence of electrostatic waves on the distortion of the ion VDFs in space turbulent plasmas.
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It introduces the current best practice in histopathology and cytopathology as it pertains to head and neck and thyroid cancers.
• Accurate diagnosis of the type of malignancy is a key component of effective management. (R)
• Surgeons and oncologists should understand the scope and limitations of cellular pathology in order to inform multidisciplinary discussions. (R)
• A clinically suspected diagnosis of malignancy should be confirmed by biopsy or cytology before operation. (R)
• Cytopathological diagnoses should be discussed with surgeons and radiologists to maximise the information gained from each modality of investigation. (R)
• Pathological investigations are the basis for accurate cancer staging and stratification of clinical outcomes. (R)
Bulk ZnO grown by the hydrothermal technique was investigated using electron paramagnetic resonance (EPR), photoluminescence (PL), and infrared absorption (FTIR) techniques. Isolated subsitutional lithium is the dominant acceptor and could be detected using EPR or PL. A large concentration of neutral Li+-OH− centers were observed using FTIR data. EPR spectra assigned to Mn, Co, Ni, Fe, and Group III (Al, Ga) donors were also observed. Photoinduced changes in the charge states of the different deep and shallow centers were produced using 325 nm light, and the stability of these changes were monitored with EPR during pulsed thermal anneals. The charge-state changes for some defects were persistent and remained up to 300 K. These impurities, when present in device structures, may act as stable charge trapping sites.
Bulk crystals of CdGeAs2 have been characterized using photoluminescence (PL), optical absorption, Hall effect, and electron paramagnetic resonance (EPR) techniques. An absorption band near 5.5 microns at room temperature is observed in all of the p-type samples we have studied. A correlation between the magnitude of this optical absorption and the excess hole concentration at room temperature is established. Also, an EPR signal is found to correlate with the strength of this absorption band. PL data are consistent with an increased concentration of shallow acceptors being present in high-absorption samples. From the EPR data, we suggest that a model for the paramagnetic defect associated with the absorption at 5.5 microns may be an acceptor on an anion site.
Bulk ZnGeP2 (ZGP) crystals grown for high-power tunable mid-infrared laser systems contain large concentrations of three native defects. Using EPR, these three defects have been identified as the Zn vacancy (an acceptor), the phosphorus vacancy (a donor), and the germanium-on-zinc antisite (also a donor). We have studied the wavelength dependence of the photoinduced changes in the EPR signal intensity of the three defect centers using 633 nm and 1064 nm light. We observe a significant increase in the EPR signal under 633 nm light. The 633-nm light also produces an increase in the defect-related 1-R.m absorption band, and we have used a spectrophotometer to measure the spectral shape of the photoinduced change in absorption in this near-IR region. The 633-nm wavelength produces paramagnetic forms of both donor centers, while 1064 nm light only produces the EPR-active center. Time decays of the photoinduced EPR signals have been measured for each of the donors.
Zinc germanium diphosphide (ZnGeP2) is a nonlinear optical material used in mid-infrared optical parametric oscillators. The near-infrared photoluminescence (PL) from single crystals of bulk ZnGeP2 has been studied as a function of excitation power, wavelength, temperature, and polarization. At 5 K, a broad PL band extending from 0.7 µm to beyond 1 µm is typically observed. Two distinct emissions with different polarization, power, and temperature behaviors have been resolved. These bands have peaks in intensity near 1.6 eV and 1.4 eV. The relative intensities of these two bands were found to correlate with the presence of phosphorus vacancies, as determined by electron paramagnetic resonance (EPR). A resonance in the intensity of the 1.6-eV band occurs when pumping into a level ∼90 meV below the minimum conduction band. This level is tentatively assigned to the shallow state.
This paper is an interim report of our inferences about the hydrostatic structure of the Sun, following the first report of the GONG team in Science (Gough et al., 1996). That work confirms that the spherically averaged structure of the Sun is more or less in agreement with current standard solar models. However, there remain some significant deviations which we regard as important clues to the existence of dynamical phenomena which are not taken into account in standard solar modelling.
The adult cochlear implant programme in Manchester was established in 1988 and the evaluation of the cochlear implant service involved the first 58 implants users (mean age = 51.65 years, range 19–75 years). Questionnaires were sent to implant users and their partners to evaluate the service with regard to provision of information, clinical care during in-patient assessments, waiting times, operation for cochlear implant and postoperative rehabilitation. The results show that the majority of patients (78 per cent) felt that the implant gave them as much or more benefit than expected. Areas identified for improvements include provision of more written information about cochlear implants; reduction in waiting times for first appointments; more information about the surgical risks and more instruction about home auditory training exercises for family and friends.
As a consequence of the audit results the clinical practice and service provision for cochlear implantation in Manchester has been modified.
Electron paramagnetic resonance (EPR) has been used to monitor native defects, both acceptors and donors, in ZnGeP2 crystals grown by the horizontal gradient freeze technique. These active centers include singly ionized zinc vacancies (Vzn-), neutral phosphorus vacancies (VP0), and neutral phosphorus antisite defects (PGe0). The concentration of Vzn− acceptors correlates with the near-infrared optical absorption present in all ZnGeP2 crystals. A photoluminescence band near 1.4 eV is shown to be polarized and is attributed to donor-acceptor-pair (DAP) recombination. Preliminary time-decay measurements support this assignment. Observation of the EPR spectrum of Mn2+ is also reported.
We derive exact finite-sample expressions for the biases and risks of several common pretest estimators of the scale parameter in the linear regression model. These estimators are associated with least squares, maximum likelihood and minimum mean squared error component estimators. Of these three criteria, the last is found to be superior (in terms of risk under quadratic loss) when pretesting in typical situations.
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