Quality assessment instruments in nursing: towards validation

The aim of this study was to explore the validity of the nursing quality assessment instruments, Monitor, Senior Monitor and Qualpacs. This follows recommendations in the literature for the need for more comprehensive validation of instruments than has been the case hitherto. A multiple triangulation research design was used which included observation of and interviews with nurses and patients as well as administration of the instruments with the same patients and a questionnaire completed by the nurses in charge on ward organisation and their approach to nursing care. Results reported here focus on our experiences of using the instruments, their inter-rater reliability and comparisons of instrument scores within medical, surgical and elderly care wards. Difficulties were encountered in using the instruments but most of these can be overcome given sufficient time for preliminary discussions. Inter-rater reliability of all three instruments taken as a whole reached acceptable levels, although some of the section score correlation coefficients were low, especially for Qualpacs. Convergent validity was achieved for the Senior Monitor-Qualpacs comparisons in four elderly care wards. The results were less clear for the Monitor-Qualpacs comparisons in seven medical and surgical wards. Explanations for the equivocal results are suggested and subsequent hypotheses were tested which supported these explanations.     

Thumb reconstruction with a free neurovascular wrap-around flap from the big toe: long-term follow-up of thirty cases

From March 1982 to December 1992, 30 cases of thumb reconstruction with a free neurovascular wrap-around flap from the big toe were performed at Korea University Hospital. Twenty-nine of a total of 30 cases were successful and obtained excellent functional and cosmetic results. Postoperative complications included 1 case of graft failure, 6 partial skin necroses, 1 malunion, and 15 cases of resorption of iliac bone graft including 1 case of fatigue fracture of grafted bone. Even for the first metacarpal neck amputations, thumb reconstruction with a free neurovascular wrap-around flap was possible; however, limitation of motion of the reconstructed thumb and resorption of the grafted bone occurred. Thumb reconstruction with a wrap-around free flap from the big toe gives excellent cosmetic and functional results and causes minimal morbidity on the donor site.     

Fermentation of purines and their effect on the adenylate energy charge and viability of starved Peptococcus prévotii

Thirty six specimens of normal human skin were obtained from persons of both seces, diferent ages and localizations. Each lipid extract (Ex L) was analyzed by thin layer chromatography. After separation and development, the areas were determined by densitometry. The results are given in percentages for each development. Statistical studies were carried out for each variant (sex, age, and localization) and for each lipid fraction. According to results, the following data are of interest: 1) Underlined results on table V, are significative. 2) The variant: sex, does not change the results. 3) Squalene (Esc) is absent on plasma. 4) Cholesterol esters (EC) are age and localization dependant. 5) The total amount resulting from the addition of monoenoics (EM) and dienoics (ED) esters, is constant (approximatively the 75 % of EC). 6) EM are prevalent in skin, and the ED in plasma. 7) Phospholipids (FL) are not constant. 8) The results depend particularly on the localization of each specimen. Thin layer chromatography is a good qualitative method, but the densitometry is not an exact method, as a 5-10 % of error is usually accepted. Our results gave only an idea of the lipid components of normal human skin, but this data can be applied as a tentative pattern por subsequent studies in pathological cases.     

Nonlinear optical processes in optically trapped InP nanowires

We report on the observation of nonlinear optical excitation and related photoluminescence from single InP semiconductor nanowires held in suspension using a gradient force optical tweezers. Photoexcitation of free carriers is achieved through absorption of infrared (1.17 eV) photons from the trapping source via a combination of two- and three-photon processes. This was confirmed by power-dependent photoluminescence measurements. Marked differences in spectral features are noted between nonlinear optical excitation and direct excitation and are related to band-filling effects. Direct observation of second harmonic generation in trapped InP nanowires confirms the presence of nonlinear optical processes.     

Microstructure of (Hf-Ta-Zr-Nb)C high-entropy carbide at micro and nano/atomic level

A High Entropy (Hf-Ta-Zr-Nb)C Ultra-High Temperature Ceramic (UHTC) was fabricated by ball milling and Spark Plasma Sintering (SPS) with a density of 99%. The microstructure characteristics were investigated using X-ray diffraction (XRD), scanning electron microscopy (SEM) in combination with electron back scattered diffraction (EBSD) and transmission electron microscopy (TEM). Atomic structure and local chemical disorder was determined by means of scanning transmission electron microscopy (STEM) in conjunction with energy dispersive X-ray spectroscopy (EDS). According to the results, high purity, dense and homogeneous high entropy carbide with Fm-3?m crystal structure was successfully produced. The grain size ranged from approximately 5?μm to 25?μm with average grain size of 12?μm. Chemical analyses proved that all grains had the same chemical composition at the micro as well as on the nano/atomic level without any detectable segregation. The approximately 1.5?nm thin amorphous grain boundary phase contained impurities that came from the starting powders and the ball milling process.