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  • Articles  (1,304)
  • 2005-2009  (1,304)
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  • 1
    Electronic Resource
    Electronic Resource
    Bradford : Emerald
    Clinical governance 10 (2005), S. 15-23 
    ISSN: 1477-7274
    Source: Emerald Fulltext Archive Database 1994-2005
    Topics: Medicine , Economics
    Notes: Purpose - To formulate an effective teaching prog ramme in the principles of clinical effectiveness for junior doctors, with simultaneous participation in a clinical audit project during their six-month period of employment. Design/methodology/approach - Accident and Emergency (A&E) Senior House Officers (SHOs) were educated in the principles of clinical effectiveness through a structured five-session approach whilst they concurrently performed their clinical audit project. Throughout the process the A&E SHOs were supported by the Clinical Effectiveness Unit and the A&E Consultant overseeing departmental audit. Findings - The structured teaching programme resulted in a good understanding of the clinical effectiveness process amongst the A&E SHOs, as demonstrated by their ability to perform a clinical audit project which ultimately improved practice. Research limitations/implications - This study has involved the construction and assessment of a teaching framework for junior doctors. The conclusions have been drawn on the basis of objective measures such as the completion of a clinical audit project which successfully improved practice. Thus, the publications of the findings may be considered in the category of a research paper. However, the authors accept that the assessment of a teaching programme's success and its portability to other departments or institutions can be highly subjective. Practical implications - With appropriate guidance and support, junior doctors are able to perform meaningful clinical effectiveness exercises at an early stage in their careers and within the constraints of short periods of employment. The structured teaching approach could be considered as a template which other institutions may wish to adopt to educate their own juniors. Originality/value - Despite the increasing importance of clinical audit in modern practice, the authors are not aware of any published teaching programmes which provide junior doctors with the necessary understanding of and skills required to take part in the clinical effectiveness process.
    Type of Medium: Electronic Resource
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  • 2
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  • 4
    Publication Date: 2009-02-01
    Print ISSN: 0898-6568
    Electronic ISSN: 1873-3913
    Topics: Biology , Medicine
    Published by Elsevier
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  • 5
    Publication Date: 2020-02-12
    Keywords: 550 - Earth sciences
    Type: info:eu-repo/semantics/article
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  • 6
    Publication Date: 2019-11-04
    Description: Fluids exert a strong physical and chemical control on local processes of rock fracture and friction. For example they may accelerate fracture by stress corrosion reactions or the development of overpressure (a form of positive feedback), or retard fracture by time-dependent stress relaxation or dilatant hardening (negative feed-back), thereby introducing a variable degree of local force conservation into the process. In particular the valve action of dynamic faulting may be important in tuning the Earth to a metastable state of incipient failure on all scales over several cycles, similar to current models of Self-Organised Criticality (SOC) as a paradigm for eartiquakes However laboratory results suggest that ordered fluctuations about this state may occur in a single cycle due to non conservative processes involving fluids which have the potential to be recognised, at least in the short term, in the scaling properties of earthquake statistics. Here we describe a 2-D cellular automaton which uses local rules of positive and negative feedback to model the effect of fluids on failure in a heterogeneous medium in a single earthquake cycle. The model successfully predicts the observed fractal distribution of fractures, with a negative correlation between the predicted seismic b-value and the local crack extension force G. Such a negative correlation is found in laboratory tests involving (a) fluid-assisted crack growth in tension (b) water-saturated compressional deformation, and (c) in field results on an intermediate scale from hydraulic mining-induced seismicity all cases where G can be determined independently, and where the physical and chemical action of pore fluids is to varying degrees a controlled variable. For a finite local hardening mechanism (negative feedback), the model exhibits a systematic increase followed by a decrease in the seismic b-value as macroscopic failure is approached, similar to that found in water-saturated laboratory tests under controlled «undrained» conditions, and where dilatancy hardening is independently known to be a local mechanism of negative feedback. A similar pattern is suggested from selected field observations from natural seismicity, albeit with a lesser degree of statistical significance.
    Description: JCR Journal
    Description: open
    Keywords: self-organised criticality ; fractals ; fluid-rock interactions ; seismicity ; 04. Solid Earth::04.06. Seismology::04.06.02. Earthquake interactions and probability
    Repository Name: Istituto Nazionale di Geofisica e Vulcanologia (INGV)
    Type: article
    Format: 6396760 bytes
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  • 7
    Publication Date: 2019-07-16
    Description: In a recent article, Lyle et al. (2005) used acoustic data to argue that 230Th-normalization overestimates sediment focusing in the equatorial Pacific by as much as an order of magnitude. They argue that lateral transport of 230Th in the water column results in much wider geographical variability in the vertical flux of scavenged 230Th than recognized by geochemists who have studied the behavior of this isotope in the water column. We disagree with this view and point to what we perceive as flaws in the arguments presented by these authors.
    Repository Name: EPIC Alfred Wegener Institut
    Type: Article , isiRev
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  • 8
    Publication Date: 2019-07-16
    Description: Trace elements serve important roles as regulators of ocean processes including marine ecosystem dynamics and carbon cycling. The role of iron, for instance, is well known as a limiting micronutrient in the surface ocean. Several other trace elements also play crucial roles in ecosystem function and their supply therefore controls the structure, and possibly the productivity, of marine ecosystems. Understanding the biogeochemical cycling of these micronutrients requires knowledge of their diverse sources and sinks, as well as their transport and chemical form in the ocean. Much of what is known about past ocean conditions, and therefore about the processes driving global climate change, is derived from trace-element and isotope patterns recorded in marine deposits. Reading the geochemical information archived in marine sediments informs us about past changes in fundamental ocean conditions such as temperature, salinity, pH, carbon chemistry, ocean circulation and biological productivity. These records provide our principal source of information about the ocean's role in past climate change. Understanding this role offers unique insights into the future consequences of global change. The cycle of many trace elements and isotopes has been significantly impacted by human activity. Some of these are harmful to the natural and human environment due to their toxicity and/or radioactivity. Understanding the processes that control the transport and fate of these contaminants is an important aspect of protecting the ocean environment. Such understanding requires accurate knowledge of the natural biogeochemical cycling of these elements so that changes due to human activity can be put in context. Despite the recognised importance of understanding the geochemical cycles of trace elements and isotopes, limited knowledge of their sources and sinks in the ocean and the rates and mechanisms governing their internal cycling, constrains their application to illuminating the problems outlined above. Marine geochemists are poised to make significant progress in trace-element biogeochemistry. Advances in clean sampling protocols and analytical techniques provide unprecedented capability for high-density sampling and measurement of a wide range of trace elements and isotopes which can be combined with new modelling strategies that have evolved from the World Ocean Circulation Experiment (WOCE) and Joint Global Ocean Flux Study (JGOFS) programmes. A major new international research programme, GEOTRACES, has now been developed as a result of community input to study the global marine biogeochemical cycles of trace elements and their isotopes. Here, we describe this programme and its rationale.
    Repository Name: EPIC Alfred Wegener Institut
    Type: Article , notRev
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  • 9
    Publication Date: 2022-05-25
    Description: Author Posting. © 2005 Author(s). This work is licensed under a Creative Commons License. The definitive version was published Biogeosciences 2 (2005): 141-157, doi:10.5194/bg-2-141-2005.
    Description: Submarine groundwater discharge was quantified by a variety of methods for a 4-day period during the early summer of 2004, in Salt Pond, adjacent to Nauset Marsh, on Cape Cod, USA. Discharge estimates based on radon and salinity took advantage of the presence of the narrow channel connecting Salt Pond to Nauset Marsh, which allowed constructing whole-pond mass balances as water flowed in and out due to tidal fluctuations. The data suggest that less than one quarter of the discharge in the vicinity of Salt Pond happened within the pond itself, while three quarters or more of the discharge occurred immediately seaward of the pond, either in the channel or in adjacent regions of Nauset Marsh. Much of this discharge, which maintains high radon activities and low salinity, is carried into the pond during each incoming tide. A box model was used as an aid to understand both the rates and the locations of discharge in the vicinity of Salt Pond. The model achieves a reasonable fit to both the salinity and radon data assuming submarine groundwater discharge is fresh and that most of it occurs either in the channel or in adjacent regions of Nauset Marsh. Salinity and radon data, together with seepage meter results, do not rule out discharge of saline groundwater, but suggest either that the saline discharge is at most comparable in volume to the fresh discharge or that it is depleted in radon. The estimated rate of fresh groundwater discharge in the vicinity of Salt Pond is 3000-7000 m3 d-1. This groundwater flux estimated from the radon and salinity data is comparable to a value of 3200-4500 m3 d-1 predicted by a recent hydrologic model (Masterson, 2004; Colman and Masterson, 2004), although the model predicts this rate of discharge to the pond whereas our data suggest most of the groundwater bypasses the pond prior to discharge. Additional work is needed to determine if the measured rate of discharge is representative of the long-term average, and to better constrain the rate of groundwater discharge seaward of Salt Pond.
    Description: Financial support was provided by the US Geological Survey and by National Science Foundation grant #OCE-0346933 to MAC.
    Keywords: Submarine groundwater discharge ; Radon
    Repository Name: Woods Hole Open Access Server
    Type: Article
    Format: 5648339 bytes
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  • 10
    Publication Date: 2022-05-25
    Description: Author Posting. © Elsevier B.V., 2007. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Marine Chemistry 110 (2008): 120-127, doi:10.1016/j.marchem.2008.02.011.
    Description: Submarine groundwater discharge (SGD), in form of springs and diffuse seepage, has long been recognized as a source of chemical constituents to the coastal ocean. Because groundwater is two to four orders of magnitude richer in radon than surface water, it has been used as both a qualitative and a quantitative tracer of groundwater discharge. Besides this large activity gradient, the other perceived advantage of radon stems from its classification as noble gas; that is, its chemical behavior is expected not to be influenced by salinity, redox, and diagenetic conditions present in aquatic environments. During our three-year monthly sampling of the subterranean estuary (STE) in Waquoit Bay, MA, we found highly variable radon activities (50-1600 dpm L-1) across the fresh-saline interface of the aquifer. We monitored pore water chemistry and radon activity at 8 fixed depths spanning from 2 to 5.6 m across the STE, and found seasonal fluctuations in activity at depths where elevated radon was observed. We postulate that most of pore water 222Rn is produced from particle-surface bound 226Ra, and that the accumulation of this radium is likely regulated by the presence of manganese (hydr)oxides. Layers of manganese (hydr)oxides form at the salinity transition zone (STZ), where water with high salinity, high manganese, and low redox potential mixes with fresh water. Responding to the seasonality of aquifer recharge, the location of the STZ and the layers with radium enriched manganese (hydr)oxide follows the seasonal land- or bay-ward movement of the freshwater lens. This results in seasonal changes in the depth where elevated radon activities are observed. The conclusion of our study is that the freshwater part of the STE has a radon signature that is completely different from the STZ or recirculated sea water. Therefore, the radon activity in SGD will depend on the ratio of fresh and recirculated seawater in the discharging groundwater.
    Description: This work is a result of research sponsored by NSF (OCE- 0425061 to M.A.C.) and the WHOI Postdoctoral Scholar program (to H.D.).
    Keywords: Subterranean estuary ; Geochemical tracers ; Radon ; Radium ; Manganese ; Groundwater ; Submarine groundwater discharge ; Geochemical transformations
    Repository Name: Woods Hole Open Access Server
    Type: Preprint
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