Peer evaluation. A visual picture

To meet the criteria of role accountability, nursing competence and ongoing staff development, an improved peer-evaluation system was designed to continuously monitor these new roles. This peer-evaluation process converts evaluation input into data, giving staff a visual picture of how their performance compares within their peer group. This peer-evaluation process was designed as a tool to assist in staff growth and development, not as a punitive system.     

Overnight closed suction drainage after axillary lymphadenectomy for breast cancer

Axillary lymphadenectomy in breast conservation surgery is associated with substantial morbidity in either seroma formation or infection. Seroma formation in the axilla requiring aspiration occurs in up to 42 per cent of patients treated without drainage. Prolonged outpatient suction drainage reduces but does not eliminate the incidence of seroma formation, while increasing cost, discomfort, and possibly infection rates. We studied the efficacy of overnight closed suction drainage in patients undergoing breast conservation surgery. Fifty consecutive patients undergoing a standard axillary dissection for breast cancer were studied. The axilla was drained with a 7-French closed suction drain. All drains were removed within 23 hours of surgery and prior to discharge from the outpatient surgical center. Patients were examined by the operating surgeon 7 to 10 days after surgery. One patient (2%) experienced a seroma postoperatively. No infections were observed in all 50 patients, and the remaining 49 patients did not experience visible or symptomatic seromas. The number of lymph nodes removed ranged between 5 and 33 with a mean of 15.5 +/- 0.6. Nine out of 50 (18%) patients had metastatic breast cancer to the axillary lymph nodes. Patients undergoing breast conservation surgery benefit from overnight closed suction drainage of the axilla. This short-term method reduces the incidence and the inherent morbidity of axillary seroma formation.     

Coronary bypass in vascular patients: a relatively high-risk procedure

A premise of cardiac risk stratification is that the added risk of coronary artery bypass grafting (CABG) is offset by the improved safety of subsequent vascular reconstruction (VR). We questioned if elective CABG is patients with severe peripheral vascular disease (PVD) is a relatively high-risk procedure. A cohort study of 680 elective CABG patients from January 1993 to December 1994 was performed using three mutually exclusive outcomes of complication-free survival, morbidity, and mortality. Patient characteristic, operative, and outcome data were prospectively collected. Retrospective review determined that 58 patients had either a standard indication for or a history of VR. Overall CABG mortality was 2.5%, with statistically similar but relatively higher rates for PVD as compared to non-PVD patients. In contrast, major morbidity occurred at rates 3.6-fold higher in PVD patients (39.7%) than in disease-free patients (16.7%) after adjustment for the effects of patient and operative variables (odds ratio [OR] 3.67, 95% confidence interval [CI] 1.93-6.99). CABG morbidity in the PVD patient was most likely in those patients with aortoiliac (OR 9.51, CI 3.20-28.27) and aortic aneurysmal (OR 5.24, CI 1.28-21.41) disease types. CABG in PVD patients is associated with significant major morbidity. Such morbidity may preclude or alter the timing of subsequent VR.     

Gel permeation chromatography: Automatic data acquisition and reduction in real-time with a process computer

A real-time computer system is described which minimizes the total analysis time in gel permeation chromatography by automatically acquiring the data, performing the necessary calculations and displaying the molecular weight distribution and molecular weight averages as soon as the polymer peak has eluted. The calculation method described here is valid for linear homopolymers only, and does not include corrections for instrumental peak broadening. The experimental results show good reproducibility and precision. On-line changes of the constants and other parameters may be implemented by means of an auxiliary program which runs in parallel with the data analysis program. A system such as that described here is suitable for utilization as a measurement technique in process control applications. The programs are written in CORAL 66 for a Ferranti Argus 700 E computer.     

The contact of elastic regular wavy surfaces

A complete solution in closed form to the elastic contact of a one-dimensional sinusoidal surface with a flat surface was presented by Westergaard in 1939. This paper is concerned with the elastic contact of a two-dimensional sinusoidal surface with a flat. In this case the stress distribution within the elastic solids is three-dimensional. As the load is increased the contact areas change in shape from being circular to square and finally leave a circular region of no contact when the waves are almost squashed flat. The problem is solved in general using a numerical method due to Kalker, but asymptotic solutions in closed form have been found for light loads and also for heavy loads at which contact is almost complete. The variation of the mean separation with load, which determines the volume of the space trapped between the two surfaces, is also found.     

Properties of nanoporous organosilicate hybrid thin films with a bimodal pore size distribution

Low dielectric poly[methylsilsesquioxane‐ran‐trifluoropropylsilsesquioxane‐ran‐(2,4,6,8‐tetramethyl‐2,4,6,8‐tetraethylenecyclotetrasiloxane)silsesquioxane]s {P[M‐ran‐TFP‐ran‐(TCS)]SSQs} having various compositions were synthesized using trifluoropropyl trimethoxysilane, methyl trimethoxysilane and 2,4,6,8‐tetramethyl‐2,4,6,8‐tetra(trimethoxysilylethyl)cyclotetrasiloxane. The chemical composition of the polymers and the content of SiOH end‐groups were controlled by adjusting the reaction conditions, and they were characterized by ¹H‐NMR. The thermally decomposable trifluoropropyl groups on the P[M‐ran‐TFP‐ran‐(TCS)]SSQ backbone and heptakis(2,3,6‐tri‐O‐methyl)‐β‐cyclodextrin (CD) were employed as pore generators. The dielectric constants of the porous CD/P[M‐ran‐TFP‐ran‐(TCS)]SSQ films were in the range 2.0–2.7 (at 100 kHz) depending on the concentration of the porogens, and showed no change over 4 days under aqueous conditions. The pore size of the films showed a bimodal distribution, with diameters of ca 0.5–1.0 nm for those originating from the trifluoropropyl groups and 1.7 nm from the CD. The elastic modulus and hardness of the 30 vol% CD‐blended film with a dielectric constant of 2.26 were 2.40 and 0.38 GPa, respectively, as determined by a nanoindenter. Copyright © 2005 Society of Chemical Industry     

Admiral John A. B. Dahlgren (1809–1870): His life, times and technical work in U.S. naval ordnance

John Dahlgren served in the U.S. Navy for nearly 35 years, sometimes in a sea-keeping capacity but mostly developing large naval artillery. To-day, his name, when recognised by students of naval ordnance, is associated with teh Dahlgren or ‘soda bottle shaped’ gun of 9 to 11 inch calibre. He designed, developed and lived to see his guns installed aboard warships and used to considerable effect, especially in the American Civil War. However, a nearly indistinguishable external design of gun was developed for the Army by T. J. Rodman, an officer now even less known than Dahlgren and whose researches and contributions are virtually forgotten. This paper and that in Ref. [1] attempt to appreciate (along with other technical questions of the period) the different ways pursued by these men towards the final development of the ‘soda bottle shaped’ gun, though it is a matter still not entirely understood.

Both names are totally omitted from several ‘classic’ books on artillery and this is a grave misfortune. Besides trying to throw factual light on the Dahlgren-Rodman controversy and the priority issue (though not one pursued with acrimony by the men themselves at the time), the paper describes Admiral Dahlgren's general career, the books he wrote, the technical problems he attacked and the problematic ordnance discussions of his day, to which he gave his life.

The work of Dahlgren and Rodman, in particular, saw the elevation of American gun design from the level of mere copying (of early Columbiads in the first decades of the century) to that which compelled attention from, and study by, the super-powers of the day, Great Britain, France and Russia.     

Current and future water issues in the Oldman River Basin of Alberta, Canada.

Long-term trends in alpine and prairie snow pack accumulation and melt are affecting streamflow within the Oldman River Basin in southern Alberta, Canada. Unchecked rural and urban development also has contributed to changes in water quality, including enhanced microbial populations and increased waterborne pathogen occurrence. In this study we look at changing environment within the Oldman River Basin and its impact on water quality and quantity. The cumulative effects include a decline in net water supplies, and declining quality resulting in increased risk of disease. Our data indicates that decreases in the rate of flow of water can result in sedimentation of bacterial contaminants within the water column. Water for ecosystems, urban consumption, recreation and distribution through irrigation is often drawn from waterholding facilities such as dams and weirs, and concern must be expressed over the potential for contaminate build-up and disproportionate potential of these structures to pose a risk to human and animal health. With disruption of natural flow rates for water resulting from environmental change such as global warming and/or human intervention, increased attention needs to be paid to use of best management practices to protect source water supplies.