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Constant Change (constant + change)
Selected AbstractsThe practice characterization model: the importance of organizational life cycles and targeted interventions in general medical practiceINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 2 2001E. M. Atkins Abstract In response to a climate of constant change and increasing demand for services, general practice in the UK has undergone significant modification over the last 10 years. It has become a multi-disciplinary organisation encouraged by funding bodies to plan for service delivery using a more structured team based approach. In Tayside in 1996, practices were charged with producing formal Practice Development Plans (PDPs) which would focus on priority areas aligned with the Health Boards own strategic plan,those were teamwork, information management and technology, and clinical service delivery. The University of Dundee's Department of General Practice successfully applied for funding to develop ways of facilitating practices so that they could a) identify their own development priorities, and b) plan and implement action and learning to see these priorities through. Using action research methodology, the project attempted to create a climate for change, provide support and training to see the changes implemented, and ensure commitment to the changes from all members of the practice team. The Facilitator adopted a flexible style varying her role between expert, guide and support. Analysis of progress made by different practices, coupled with the Facilitator's in depth knowledge of them, suggested the importance of certain key aspects of practice organisation and culture. A practice characterisation model identified practices which were stable, currently coping, proactive and ready to face the challenge of change as best placed to engage in a full scale development programme. Other profiles suggested a range of alternative interventions as more likely to be acceptable and productive. [source] The evolutionary significance of parasitism: do parasite-driven genetic dynamics occur ex silico?JOURNAL OF EVOLUTIONARY BIOLOGY, Issue 1 2002T. J. Little It has long been recognized that reciprocal antagonism might lock host and parasite populations into a process of constant change, adapting and reacting in open-ended coevolution. A significant body of theory supports this intuition: dynamic genetic polymorphisms are a common outcome of computer simulations of host,parasite coevolution. These in silico experiments have also shown that dynamical interactions could be responsible for high levels of genetic diversity in host populations, and even be the principle determinant of rates of genetic recombination and sexuality. The evolutionary significance of parasitism depends on the strength and prevalence of parasite-mediated selection in nature. Here I appraise whether parasitism is a pervasive agent of evolutionary change by detailing empirical evidence for selection. Although there is considerable evidence of genetic variation for resistance, and hence the potential for selection, direct observation of parasite-driven genetic change is lacking. [source] The scope of nursing in Australia: a snapshot of the challenges and skills neededJOURNAL OF NURSING MANAGEMENT, Issue 2 2003Jacqueline Jones RN Contemporary nursing is an increasingly complex concept encompassing and encapsulating wide variation under the broad rubric of the nursing work place. This paper reports on a study that was designed to contribute to understandings of nursing practice by describing what nurses in Australia are doing everyday in various practice and work settings, the type of skills they need, the challenges they face and the interactions nurses have with other health workers. Drawing on the research which informed the National Review of Nurse Education in Australia in 2001, the paper raises issues critical to the management of contemporary nursing practice. Flexible approaches both to the day-to-day management of nurses and nursing, and educational preparation in partnership with key stakeholders, are a necessity if management of nursing is to keep pace with constant change in health care systems as well as facilitating the attraction and retention of nurses in those systems. [source] The micro-topography of the wetlands of the Okavango Delta, BotswanaEARTH SURFACE PROCESSES AND LANDFORMS, Issue 1 2005T. Gumbricht Abstract The surface of the 40 000 km2 Okavango alluvial fan is remarkably smooth, and almost everywhere lies within two to three metres of a perfectly smooth theoretical surface. Deviations from this perfect surface give rise to islands in the Okavango wetlands. This micro-topography was mapped by assigning empirical elevations to remotely sensed vegetation community classes, based on the observation that vegetation is very sensitive to small, local differences in elevation. Even though empirical, the method produces fairly accurate results. The technique allows estimation of depths of inundation and therefore will be applicable even when high resolution radar altimetry becomes available. The micro-topography has arisen as a result of clastic sedimentation in distributary channels, which produces local relief of less than two metres, and more importantly as a result of chemical precipitation in island soils, which produces similar local relief. The micro-topography is, therefore, an expression of the non-random sedimentation taking place on the fan. Volume calculations of islands extracted from the micro-topography, combined with estimates of current sediment in,ux, suggest that the land surface of the wetland may only be a few tens of thousands of years old. Constant switching of water distribution, driven by local aggradation, has distributed sediment widely. Mass balance calculations suggest that over a period of c. 150 000 years all of the fan would at one time or other have been inundated, and thus subject to sedimentation. Coalescing of islands over time results in net aggradation of the fan surface. The amount of vertical aggradation on islands and in channels is restricted by the water depth. Restricted vertical relief, in turn, maximizes the distribution of water, limiting its average depth. Aggradation in the permanent swamps occurs predominantly by clastic sedimentation. Rates of aggradation here are very similar to those in the seasonal swamps, maintaining the overall gradient, possibly because of the operation of a feedback loop between the two. The limited amount of local aggradation arising from both clastic and chemical sedimentation, combined with constant changes in water distribution, has resulted in a near-perfect conical surface over the fan. In addition to providing information on sedimentary processes, the micro-topography has several useful hydrological applications. Copyright © 2004 John Wiley & Sons, Ltd. [source] Density Functional Study of the Complexation Reaction of Sn(CH3)3X (X = F, Cl, Br and I) with Halide AnionsEUROPEAN JOURNAL OF INORGANIC CHEMISTRY, Issue 20 2003Frank De Proft Abstract The Lewis acid-base reaction between Sn(CH3)3X and Y, (with X, Y = F, Cl, Br and I) has been studied using quantum chemical calculations. Complexation energies were calculated at the Density Functional Theory (DFT) level and rationalized on the basis of a local application of the hard and soft acids and bases principle. It was observed that smaller differences in the local softness of the interacting sites in the Lewis acid and base correspond to stronger interactions. Moreover, the calculated sequences in complexation energies can be reproduced using equations containing chemical concepts introduced within the framework of conceptual density functional theory and rooted in the hard and soft acids and bases principle and referring only to the reactants. A method of treating the electronegativity and softness of the halide anions is presented based on a Taylor expansion of the electronegativity of the neutral halogens and the softness-polarizability proportionality. Experimental evidence for the calculated sequences was gathered from measured 117Sn chemical shifts and 1J (13C- 119/117Sn) coupling constant changes upon complexation. (© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2003) [source] Substantive unconscious and adjective unconscious: the contribution of Wilfred BionTHE JOURNAL OF ANALYTICAL PSYCHOLOGY, Issue 1 2000Ana Maria Andrade de Azevedo The author first provides her readers with a brief summary of some of Freud's ideas, as found throughout his work, on the notion of ,unconscious'. The notion of unconscious as noun is contrasted to the idea of unconscious as adjective, this latter being proposed as a quality, or a state, ever temporary, dynamic, and subject to the constant changes going on in the individual's internal psychic world, as well as to external conditions. After presenting some considerations, the author then contrasts the Kleinian model of the mind to the Freudian, and Wilfred Bion's contribution is discussed at some length. Within Bion's conception of psychic functioning, the model of ,dream' is highlighted and, in this regard, clarifications are sought regarding Bion's view of the unconscious. To conclude, a brief and superficial approximation to the work of Carl Jung is touched upon, although the author admits to knowing little of Jung's positions. [source] | ||||||||||