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1.
AM Vleugels 《Canadian Metallurgical Quarterly》1997,59(3):185-206; discussion 206-8
Clinical practice guidelines are systematically developed statements that are intended to support medical decision making in well-defined clinical situations. Essentially, their object is to reduce the variability in medical practice, to improve quality, and to make appropriated control of the financial resources possible. Internationally, ever more organisations, associations, and institutions are concerned with the development of guidelines in many different areas of care. Making implicit knowledge explicit is one of the associated advantages of guidelines: they have a potential utility in training, in process evaluation, and in the reevaluation of outcome studies. In liability issues, their existence has a double effect: they can be used to justify medical behaviour, and they constitute a generally accepted reference point. A derivative problem is the legal liability of the compilers of the guidelines. The principle of the guideline approach can be challenged academically: science cannot give a definition of optimal care with absolute certainty. What is called objectivity often rests on methodologically disputable analyses; also the opinion of opinion leaders is not always a guarantee for scientific soundness. Moreover, patients are not all identical: biological variability, situational factors, patient expectations, and other elements play a role in this differentiation. Clinicians are often hesitant with respect to clinical guidelines: they are afraid of cookbook medicine and curtailment of their professional autonomy. Patients fear reduction of individualization of care and the use of guidelines as a rationing instrument. The effects of the introduction of clinical practice guidelines on medical practice, on the results and on the cost of care vary but are generally considered to be favourable. The choice of appropriate strategies in development, dissemination, and implementation turns out to be of critical importance. The article ends with concrete suggestions for the various steps in the development of guidelines and their actual compilation. 相似文献
2.
Mariana Ušáková Jozef Lukáč Rastislav Dosoudil Vladimír Jančárik Anna Grusková Elemír Ušák Jozef Sláma Jan Šubrt 《Journal of Materials Science: Materials in Electronics》2007,18(12):1183-1189
The paper is devoted to the preparation of NiZn ferrite with small substitutions of copper by means of ceramic technology.
The influence of small Cu substitution on the microstructural and magnetic properties of NiZn ferrites have been analysed
by means of various experimental methods and interpreted from the point of view of preparation technology optimisation and
possible applications of such materials. A strong correlation between the substituent content and resulting properties has
been observed, thus allowing preparation of material with the properties tailored for any particular application. 相似文献
3.
This contribution summarizes our recent efforts to unravel the radical chemistry of autoxidations. Abstraction of the weakly bonded αH-atom of the primary hydroperoxide product by chain carrying peroxyl radicals is identified as the source of major end products such as alcohol and ketone/aldehyde. In the case of cyclohexane autoxidation, this reaction is even responsible for the majority of ring-opened by-products. In a second part, different approaches to autoxidation catalysis are discussed, ranging from transition metal ion catalysis to organocatalysis with immobilized N-hydroxyphthalimide. 相似文献
4.
Jozef P H Linssen Anneloes L G M Janssens Hanneke C E Reitsma Wender L P Bredie Jacques P Roozen 《Journal of the science of food and agriculture》1993,61(4):457-462
Taste recognition threshold concentrations (TRTC) of styrene were determined in samples of oil-in-water emulsions (30–300 g kg?1 oil) and yoghurts (1–30 g kg?1 fat), spiked with styrene. The observed TRTC increased linearly with increasing fat content and ranged from 0–3 to 2–1 mg kg?1 for the emulsions and from 36 to 171 g kg?1 for the yoghurts. Styrene equilibrium partition coefficients between emulsions and their respective vapour phases were determined. The concentrations of styrene in the continuous aqueous phase of the emulsions and yoghurts were calculated at the TRTC. The styrene concentrations in the continuous phase had constant values of about 15 g kg?1 indicating that perception of styrene for oil-in–water emulsions is determined by the aqueous phase of the emulsion. The concentrations of styrene in the vapor phases above the emulsions and yoghurts were also calculated and were found to be constant at the TRTC. This relationship probably resulted from the equilibrium of distribution of styrene between the respective phases. Commercial yoghurt packed in polystyrene beakers contained styrene levels in the range 2–11 g kg?1, much lower then the TRTC reported. 相似文献
5.
6.
Jozef Kula Magdalena Sikora Robert Dabrowski 《Journal of the American Oil Chemists' Society》1994,71(5):545-546
A one-step procedure is described for the synthesis of (E)-2-nonenal from commercial castor oil by ozonolysis in methanol, followed by reduction of the ozonide products with dimethyl
sulfide and exposure of the resulting intermediate product to dilute sulfuric acid. The developed process allows the production
of the aldehyde with a yield of 80% at a purity of 95%. The method has advantages over all those reported earlier, because
of inexpensive raw material and reducing agent, recycling of the solvent and its unusual simplicity. 相似文献
7.
A range of 18 diesel fuels and 21 kerosene fuels from mainly Australian petroleum and synthetic fuel sources, including coal, shale and peat, was investigated. Compositional details were defined as the weight per cent abundances of n-alkanes, branched plus cyclic saturates, single-ring aromatics, doublering aromatics and polynuclear aromatics, using both h.p.l.c. and 13C n.m.r. techniques. Relationships between fuel composition and a range of fuel properties were sought. Simple linear relationships between property values and compositional data were used. Explicit correlative expressions were derived using multiple linear regression analysis, with the coefficient of multiple determination, R2, indicating the quality of the fit between observed and calculated property values. In most cases good correlations were achieved. For diesels the properties investigated, with R2 values in parentheses, were: inverse specific gravity (0.99); 13C n.m.r. aromaticity (0.99); 1H n.m.r. aromaticity (0.88); cetane index (0.97); aniline point (0.96); diesel index (0.98); and FIA-measured aromatics content (0.77). For kerosenes the properties, with R2 values in parentheses, were: 13C n.m.r. aromaticity (0.98); 1H n.m.r. aromaticity (0.97); smoke point (0.88); and FIA-measured aromatics content (0.94). The results are shown to be of value in assessing the potential and limitations of hydrotreating as a process for upgrading synfuels. 相似文献
8.
9.
Copper–graphite composite materials in the range of 0–10 vol% of carbon phase were prepared from the mixture of copper and graphite powders by hot isostatic pressing. The microstructure, mechanical (tensile strength, elongation to fracture) and physical (electrical and thermal conductivity) properties of composite samples were investigated, and the cross-property connections were calculated. It was shown that electrical and thermal conductivity cross-property (Lorenz number) is almost constant and increases only slightly (no more than 10 % increase was observed). This implies that in the investigated composition range the Lorenz number of a copper–graphite composite system behaves according to Franz–Wiedemann law for pure metals at constant temperature. On the contrary, the conductivity to tensile strength cross-property connections showed significant linear increase (over 200 % in the investigated composition range) for both electrical conductivity and thermal conductivity of composite materials. The cross-property connections of conductivity to the elongation to fracture exhibit a nonlinear dependence on the volume fraction of graphite. 相似文献
10.