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Direct Communication (direct + communication)
Selected AbstractsEmployee participation and union voice in the National Health ServiceHUMAN RESOURCE MANAGEMENT JOURNAL, Issue 2 2004Stephen Bach This article examines the role of trade unions in the health service at workplace level under the Labour government's modernisation agenda, and focuses on the shifting balance between forms of direct and indirect participation drawing on case studies of three acute hospital trusts. There has been a strong growth in forms of direct communication within the case study trusts and some increase in direct participation among professional groups. Despite this ,dualism' in employment relations, however, the target culture of the NHS has precluded the development of effective voice mechanisms. The policy implications for trade unions and the implications for the implementation of NHS pay modernisation are considered. [source] Diagnostic criteria for locating acquired arteriovenous fistulas with color doppler sonographyJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2002Jian-Chu Li MD Abstract Purpose. The purpose of this prospective study was to evaluate and determine criteria for locating acquired arteriovenous fistulas using color Doppler sonography. Methods. We performed color Doppler sonography on 12 consecutive patients with acquired arteriovenous fistulas. We evaluated the morphologic and hemodynamic changes in the involved vessels to help locate the fistulas (10 in the extremities, 1 in the neck, and 1 in the abdomen). Results. In all cases, turbulent high-velocity flow spectrum and flow signals were present at the fistula sites, and arterialized waveforms from the draining veins were detected. In the 10 cases of acquired arteriovenous fistulas in the extremities, the resistance indices in the arteries proximal to the fistulas were all less than 1.00 (mean, 0.65), whereas the resistance indices in the arteries distal to the fistulas were all 1.00 or greater (mean, 1.17). In 70% of the cases, the diameter of the artery proximal to the fistula was at least 1.2 mm larger than that distal to the fistula. The fistula site was inferred by the point of maximal venous dilatation in 70% of the cases and by the focal perivascular color artifact in 82% of the cases. The fistula site was identified on gray-scale sonography and color flow imaging in 33% and 75% of the cases, respectively. Conclusions. Fistula sites can be located effectively and quickly by a combination of major and minor diagnostic criteria. The major diagnostic criteria are (1) junction of low- and high-resistance flow in the supplying artery, (2) a high-velocity arterialized waveform in the draining vein, and (3) a turbulent, high-velocity flow spectrum at the junction of the artery and the vein. The minor diagnostic criteria are (1) direct communication between the involved artery and vein, (2) significant change in the diameter of the supplying artery, (3) a focal point of venous dilatation, and (4) a focal perivascular color artifact. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:336,342, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.10084 [source] British-born Chinese teenagers: The influence of Chinese ethnicity on their attitudes towards sexual behaviorNURSING & HEALTH SCIENCES, Issue 1 2007Juping Yu msc Abstract, This paper explores the influence of ethnicity on attitudes towards sexual behavior of British-born Chinese teenagers. Using an ethnographic approach and snowball sampling, data were collected through in-depth interviews with 20 British-born Chinese teenagers and 20 Chinese-born parents. The parents highlighted the influence of Chinese culture and religion on their sexual values and wanted to convey these values to their children. Although direct communication about sex-related topics was rare within these families because of a number of barriers, the parents used other strategies to pass on their values. The paper concludes that sexual values within families and the influence of culture need to be considered in order to provide culturally competent health services. Chinese parents need extra support and help to discuss sex-related topics and pass on their values, which encourage teenage sexual abstinence. Considering the fundamental influence of the parents, this support will be crucial. [source] Lymphatic/Blood Endothelial Cell Connections at the Capillary Level in Adult Rat MesenteryTHE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 10 2010Jennifer L. Robichaux Abstract Analyses of microvascular networks with traditional tracer filling techniques suggest that the blood and lymphatic systems are distinct without direct communications, yet involvement of common growth factors during angiogenesis and lymphangiogenesis suggest that interactions at the capillary level are possible. To investigate the structural basis for lymphatic/blood endothelial cell connections during normal physiological growth, the objective of this study was to characterize the spatial relations between lymphatic and blood capillaries in adult rat mesenteric tissue. Using immunohistochemical methods, adult male Wistar rat mesenteric tissues were labeled with antibodies against PECAM (an endothelial marker) and LYVE-1, Prox-1, or Podoplanin (lymphatic endothelial markers) or NG2 (a pericyte marker). Positive PECAM labeling identified apparent lymphatic/blood endothelial cell connections at the capillary level characterized by direct contact or direct alignment with one another. In PECAM labeled networks, a subset of the lymphatic and blood capillary blind ends were connected with each other. Intravital imaging of FITC-Albumin injected through the femoral vein did not identify lymphatic vessels. At contact sites, lymphatic endothelial markers did not extend along blood capillary segments. However, PECAM positive lymphatic sprouts, structurally similar to blood capillary sprouts, lacked observable lymphatic marker labeling. These observations suggest that nonlumenal lymphatic/blood endothelial cell interactions exist in unstimulated adult microvascular networks and highlight the potential for lymphatic/blood endothelial cell plasticity. Anat Rec 293:1629,1638, 2010. © 2010 Wiley-Liss, Inc. [source] | ||||||||||