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Using paradox theory to understand responses to tensions between service and training in general surgery

CONTEXT: The tension between service and training in pressured health care environments can have a detrimental impact on training quality and job satisfaction. Yet the management literature proposes that competing demands are inherent in organisational settings: it is not the demands as such that lead to negative outcomes but how people and organisations react to opposing tensions. We explored how

Introducing programming and digital competence in Swedish K-9 education

The role of computer science and IT in Swedish schools has varied throughout the years. In fall 2014, the Swedish government gave the National Agency for Education (Skolverket) the task of preparing a proposal for K–9 education on how to better address the competences required in a digitalized society. In June 2016, Skolverket handed over a proposal introducing digital competence and programming a

Assessing health-related quality of life (HRQoL) in survivors of out-of-hospital cardiac arrest : A systematic review of patient-reported outcome measures

Aim High quality evidence of out-of-hospital cardiac arrest (OHCA) survivors’ health-related quality of life (HRQoL) can measure the long-term impact of CA. The aim of this study was to critically appraise the evidence of psychometric quality and acceptability of measures used in the assessment of HRQoL in cardiac arrest survivors. Methods Systematic literature searches (2004–2017) and named autho

Multi-objective performance assessment of wastewater treatment plants combining plant-wide process models and life cycle assessment

Multi-objective performance assessment of operational strategies at wastewater treatment plants (WWTPs) is a challenging task. The holistic perspective applied to evaluation of modern WWTPs, including not only effluent quality but also resource efficiency and recovery, global environmental impact and operational cost calls for assessment methods including both on- and off-site effects. In this stu

Numerical study of heat transfer enhancement due to the use of fractal-shaped design for impingement cooling

This paper describes a numerical analysis of a heat transfer enhancement technique that introduces fractal-shaped design for impingement cooling. Based on the gas turbine combustion chamber cooling, a fractal-shaped nozzle is designed for the constant flow area in a single impingement cooling model. The incompressible Reynolds-averaged Navier-Stokes equations are applied to the system using CFD so

Asymmetric semantic interaction in Jedek-Jahai bilinguals : Spatial language in a small-scale, non-standardized, egalitarian, long-term multilingual setting in Malaysia

Aims and objectives/purpose/research questions:We investigate semantic interaction in bilinguals’ topological relations descriptions in a small-scale, non-standardized, egalitarian, long-term multilingual setting in Malaysia.Design/methodology/approach:Two groups of bilingual speakers of Jedek and Jahai (8 Jedek-identifying, 6 Jahai-identifying bilinguals) and two groups of monolingual Jedek and J

Circular Economy in the building sector : Three cases and a collaboration tool

The Circular Economy (CE) gained significant traction in business and academia. While in the building sector issues around energy efficiency are being widely explored, CE is still a relatively new topic. This article reports on three CE pilots in the Dutch building sector and develops a collaboration tool for developing and operating circular buildings and their supply chain collaborations. First,

Separation of pathogenic bacteria by chain length

Using Deterministic Lateral Displacement devices optimized for sensitivity to particle length, we separate subpopulations of bacteria depending on known properties that affect their capability to cause disease (virulence). For the human bacterial pathogen Streptococcus pneumoniae, bacterial chain length and the presence of a capsule are known virulence factors contributing to its ability to cause

VEGF synthesis is induced by prostacyclin and TGF-β in distal lung fibroblasts from COPD patients and control subjects : Implications for pulmonary vascular remodelling

Background and objective: Involvement of pulmonary vascular remodelling is a characteristic sign in COPD. Vascular mediators such as vascular endothelial growth factor (VEGF) and prostacyclin may regulate fibroblast activity. The objective was to study the synthesis of VEGF and interactions with prostacyclin and transforming growth factor (TGF)-β1 in lung fibroblasts from patients with COPD and he

Allogeneic Stem Cell Transplantation for Myelodysplastic Syndrome Patients with a 5q Deletion

The deletion (5q) karyotype (del [5q]) in patients with myelodysplastic syndrome (MDS) is the most common karyotypic abnormality in de novo MDS. An increased number of blasts and additional karyotypic abnormalities (del [5q]+) are associated with a poor outcome. We analyzed the outcome of allogeneic hematopoietic cell transplants (HCT) in patients suffering from MDS with only del (5q) or del (5q)+

Fire frequency drives decadal changes in soil carbon and nitrogen and ecosystem productivity

Fire frequency is changing globally and is projected to affect the global carbon cycle and climate. However, uncertainty about how ecosystems respond to decadal changes in fire frequency makes it difficult to predict the effects of altered fire regimes on the carbon cycle; for instance, we do not fully understand the long-term effects of fire on soil carbon and nutrient storage, or whether fire-dr

Self-Seeded Axio-Radial InAs-InAs1-xPx Nanowire Heterostructures beyond "common" VLS Growth

Semiconductors are essential for modern electronic and optoelectronic devices. To further advance the functionality of such devices, the ability to fabricate increasingly complex semiconductor nanostructures is of utmost importance. Nanowires offer excellent opportunities for new device concepts; heterostructures have been grown in either the radial or axial direction of the core nanowire but neve

Costs of Care of Agitation Associated With Dementia in 8 European Countries : Results From the RightTimePlaceCare Study

Objective To estimate the additional societal costs for people living with dementia (PwD) with agitation in home care (HC) and institutional long-term care (ILTC) settings in 8 European countries. Design Cross-sectional data from the RightTimePlaceCare cohort. Setting HC and ILTC settings from 8 European countries (Estonia, Finland, France, Germany, Netherlands, Spain, Sweden, and England). Partic

Counting ovarian antral follicles by ultrasound : a practical guide

This Consensus Opinion summarizes the main aspects of several techniques for performing ovarian antral follicle count (AFC), proposes a standardized report and provides recommendations for future research. AFC should be performed using a transvaginal ultrasound (US) probe with frequency ≥ 7 MHz. For training, we suggest a minimum of 20–40 supervised examinations. The operator should be able to adj