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Major Discrepancies (major + discrepancy)
Selected AbstractsA review of hand-washing techniques in primary care and community settingsJOURNAL OF CLINICAL NURSING, Issue 6 2009Sheree MS Smith Aim., This review seeks to identify the most effective hand-washing and hand-cleansing practice that could be used in primary care. Background., Healthcare associated infection is a major problem in the UK causing 5000 deaths every year. Current guidelines indicate expert opinion is the level of evidence for hand washing as an activity to reduce infection. Design., Systematic review. Method., Publications on hand-washing, hand-cleansing studies, policy and practice-based documents were sought by searching several databases. Terms used included hand washing, hand cleansing, hand hygiene, hand decontamination, infection control and primary care. Results., Few articles described the hand-washing technique in detail and some publications simply referred to either the European and British Standards or the Centre for Disease Control statement on hand washing. Major discrepancies in hand position and water flow direction were found. Several methodological problems were also identified and few studies were undertaken in primary care. Conclusion., This review has found a lack of evidence for hand-washing techniques being undertaken in practice today. Findings from hand-washing technique studies were inconclusive and methodological issues exist resulting in sparse reliable evidence. There is an urgent need to undertake methodologically sound studies of hand-washing techniques for use in the ever expanding scope of primary care practice. Relevance to clinical practice., Evidence for hand-washing and hand-cleansing techniques will inform healthcare professional practice, and contribute to the overall management of infection control in primary care. [source] Extra-departmental anatomic pathology expert consultation inTaiwan: A research grant supported 4-year experienceJOURNAL OF SURGICAL ONCOLOGY, Issue 5 2010Chih-Yi Hsu MD Abstract Background This report analyzed a research project supported nationwide expert consultation of anatomic pathology in Taiwan. Methods The data were collected from the requisitions and consultation reports of 2,686 cases in this project from 2003 to 2006. The number of cases, tissue origin, additional special stains, turnaround time (TAT), concordance, discordance, referring pathologists, and consultants were analyzed. Results Skin, hematopoietic system, and bone and soft tissue were the most common (48.3%) specimens sent for consultation. The tentative diagnosis and consultation diagnosis were discordant in 1,074 (64.3%) cases. Major discrepancy was seen in 205 (12.3%) cases, of which 66.8% were changed from malignant to benign, 21.0% were changed from benign to malignant, whereas 12.2% were changed from one category of malignancy to another. Additional special stains were performed on 38.7% of cases and hematology specimen was the most frequent. The mean TAT was 3.4 days. Pathologists working in institutes having fewer pathologists sent more cases for consultation. The opinion of the estimated annual consultation rate from the pathologists in Taiwan was 0.7%. Conclusions This program was beneficial simply by helping the referring pathologists in the workup and diagnosis. This result made the entire program a reasonable quality improvement program. J. Surg. Oncol. 2010; 101:430,435. © 2010 Wiley-Liss, Inc. [source] Analytical and 3-D numerical modelling of Mt. Etna (Italy) volcano inflationGEOPHYSICAL JOURNAL INTERNATIONAL, Issue 2 2005A. Bonaccorso SUMMARY Since 1993, geodetic data obtained by different techniques (GPS, EDM, SAR, levelling) have detected a consistent inflation of the Mt. Etna volcano. The inflation, culminating with the 1998,2001 strong explosive activity from summit craters and recent 2001 and 2002 flank eruptions, is interpreted in terms of magma ascent and refilling of the volcanic plumbing system and reservoirs. We have modelled the 1993,1997 EDM and GPS data by 3-D pressurized sources to infer the position and dimension of the magma reservoir. We have performed analytical inversions of the observed deformation using both spheroidal and ellipsoidal sources embedded in a homogeneous elastic half-space and by applying different inversion methods. Solutions for these types of sources show evidence of a vertically elongated magma reservoir located 6 km beneath the summit craters. The maximum elevation of topography is comparable to such depth and strong heterogeneities are inferred from seismic tomography; in order to assess their importance, further 3-D numerical models, employing source parameters extracted from analytical models, have been developed using the finite-element technique. The deformation predicted by all the models considered shows a general agreement with the 1993,1997 data, suggesting the primary role of a pressure source, while the complexities of the medium play a minor role under elastic conditions. However, major discrepancies between data and models are located in the SE sector, suggesting that sliding along potential detachment surfaces may contribute to amplify deformation during the inflation. For the first time realistic features of Mt. Etna are studied by a 3-D numerical model characterized by the topography and lateral variations of elastic structure, providing a framework for a deeper insight into the relationships between internal sources and tectonic structures. [source] Kafka, Critical Theory, Dialectical Theology: Adorno's Case against Hans-Joachim SchoepsGERMAN LIFE AND LETTERS, Issue 2 2010Margarete Kohlenbach ABSTRACT Theodor Adorno derived from his reading of Kafka some of the central assumptions that inform the critical theory of the Frankfurt School. He opposed theological Kafka interpretations in general, and in particular rejected Hans-Joachim Schoeps's reading of Kafka in the context of Karl Barth's dialectical theology. Adorno and Schoeps thus came to exemplify the dichotomy with which we still characterise the early reception of Kafka's work as either secular (sociological or political) or theological and religious. The disintegration of religion as a comprehensive social system in twentieth-century Germany means that writers can agree with traditional theology and religion in some regards while opposing them in others. This article argues that any unqualified adoption of the dichotomy between the secular and the religious is detrimental to our understanding of both Kafka's work and its early reception. First, the article outlines some of the major discrepancies in Kafka's heterogeneous engagements with religion. Second, it places Adorno's rejection of Schoeps's interpretation in the political context of National Socialism and the Holocaust. Finally, it compares Adorno's notion of ,inverse theology' with Schoeps's inversion of salvation history. Throughout, the article aims to ascertain the differences as well as the underlying commonalities between Adorno's and Schoeps's Kafka reception. Wesentliche Richtlinien der Kritischen Theorie der Frankfurter Schule verdanken sich der Kafka-Rezeption Adornos, die theologische Deutungen Kafkas im allgemeinen abweist und insbesondere Hans-Joachim Schoeps' Verständnis von Kafkas Werk im Kontext der Dialektischen Theologie Karl Barths verwirft. Adorno und Schoeps repräsentieren die Pole einer Dichotomie, mit der noch heute die Beiträge der frühen Kafka-Rezeption entweder als soziologisch und politisch oder als theologisch und religiös klassifiziert werden. Die Desintegration religiösen Lebens in der deutschen Gesellschaft des 20. Jahrhunderts bringt es mit sich, dass Schriftsteller in jeweils bestimmten Hinsichten traditionelle Theologie und Religion verwerfen,und,übernehmen können. Der vorliegende Beitrag argumentiert, dass jede nicht-spezifizierte Vorstellung einer Dichotomie von religiösem und weltlichem Leben und Denken aufgegeben werden muss, wenn wir Kafkas Werk und seine frühe Rezeption verstehen wollen. Der Beitrag skizziert zunächst zentrale Diskrepanzen in Kafkas heterogenen Bezugnahmen auf Religiöses. Im Anschluss stellt er Adornos Schoeps-Kritik in den politischen Kontext von Nationalsozialismus und Holocaust. Wie der Beitrag als ganzer soll der abschließende Vergleich der Begiffe ,inverse Theologie' (Adorno) und ,Unheilsgeschichte' (Schoeps) ein angemessenes Verständnis der Unterschiede und Gemeinsamkeiten in der Kafka-Deutung der beiden Autoren ermöglichen. [source] O knowledge, where art thou?JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 6 2009Evidence, suspected appendicitis Abstract Background, Much effort goes into developing and publishing guidelines which physicians fail to implement. We feel that major discrepancies still exist between theory and reality and that the translational approach to this aspect of medical care has not yet established itself. We therefore decided to investigate in an exemplary audit how liberally inappropriate imaging is used in our emergency department (ED) to rule out acute appendicitis. Material and methods, Our electronic medical record ED database ,Qualicare' (http://www.qualidoc.ch) was searched using the ,appendicitis' sub data base. The frequency and accuracy of abdominal imaging was determined in patients with clinically suspected appendicitis on admission over a 5-year period at a university hospital emergency unit. Results, In total, 272 (41.2%) of the 577 patients were male and 305 (46.3%) were female. The attending physicians ordered abdominal X-rays in 133 patients, abdominal ultrasounds in 319, and abdominal computerized tomography (CT) scans in 93 patients. 125 patients underwent more than one imaging procedure. In all, 85/125 patients received a combination of X-rays, ultrasound and CT scanning! Discussion, Physicians are often insecure about indications for surgery and therefore order useless imaging procedures. The reliability of such procedures in excluding acute appendicitis is limited, which was confirmed by our results. Although evidence-based medicine guidelines exist, they are neglected for many reasons. Future academic efforts should therefore focus more on knowledge translation and the implementation of existing knowledge by heightening awareness, rather than on simply creating new guidelines. [source] A REEXAMINATION OF THE SYSTEMATICS OF THE ACROCHAETIALES (RHODOPHYTA) USING LARGE-SUBUNIT RDNA SEQUENCE DATAJOURNAL OF PHYCOLOGY, Issue 2000J.T. Harper The taxonomic history of the red algal order Acrochaetiales is chaotic. There is no consensus in the literature as to how many genera should be recognized or in the assignment of the over 400 species to these genera. Morphological and anatomical studies have provided a suite of possible characters to delineate genera within this order, but there have been major discrepancies in the assessment and use of these features. The phylogenetic placement of the Acrochaetiales has also been the focus of debate. Once thought to be the most ancestral florideophyte lineage, recent molecular systematic studies have illustrated that this order is a derived lineage closely related to the Nemaliales and Palmariales. Phylogenies using sequences of the small-subunit (SSU) rDNA have strongly supported two very divergent lineages within a possibly polyphyletic Acrochaetiales. The relationships between these two groups and among other closely related rhodophyte orders were not resolved. We have generated large-subunit (LSU) rDNA sequence data for representatives of the Acrochaetiales and related taxa. Distance and parsimony phylogenies based on LSU and combined SSU and LSU data will be presented. The increased phylogenetic signal afforded by this approach will shed light on previous conundrums in the systematics of this group. [source] Effect of global atmospheric carbon dioxide on glacial,interglacial vegetation changeGLOBAL ECOLOGY, Issue 5 2000K. D. Bennett Abstract Global vegetation changes at the time-scale of the Earth's orbital variations (104,105 years) have been interpreted as a direct effect of consequential climatic changes, especially temperature. At mid- and high latitudes, the evidence from fossil data and general circulation models (GCMs) supporting this hypothesis is strong, but at low latitudes there is a major discrepancy. GCMs predict temperature changes that are less than those inferred from palaeoclimatic data, including the plant fossil record. However, changes in atmospheric CO2 concentrations can account for a high proportion of the low-latitude vegetation change hitherto attributed to temperature change, and may thus explain the discrepancy. The implications of this finding are considerable for understanding patterns of macroevolution and ecosystem development throughout the geological record. [source] | |||||||||||||