Peptic Ulcer: Rise and Fall
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Shana Vijayan Thesis.Pdf
Performance Anxiety: The nature of performance management in the NHS under New Labour Shana Vijayan Thesis submitted for the degree of Doctor of Philosophy Department of Science and Technology Studies University College London 0 Declaration I, Shana Vijayan, confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. 1 Abstract This thesis explores both the proliferation and prominence of ‘performance’ in the NHS, focusing on the New Labour years from 1997-2010. The research’s main objective was to understand how performance policy impacts the work-place experience: to understand the nature of work undertaken by performance managers, the tools used and the effect of these techniques. The secondary objective was to understand the goals of performance management. The introduction and rise of performance saw a change in expert authority. A new set of professionals had arrived in the NHS: regulators, auditors and performance managers. This thesis looks at the performance managers’ body of expertise, drawing upon several forms of qualitative research. The primary research tool used was institutional ethnography, which included focused interviews, a case study and experiences and notes gathered during a period based as a participant in NHS organisations. Documentary analysis carried out in the first phase of this thesis revealed that the principal rhetoric employed by politicians concerned the function of performance management in reducing risk and harm to patients. However, further research based on interviews and ethnography suggests that performance was experienced as a process of rationalisation and stigma, with risk rarely mentioned in the same way as in policy documents. -
Royal Statistical Scandal
Royal Statistical Scandal False and misleading claims by the Royal Statistical Society Including on human poverty and UN global goals Documentary evidence Matt Berkley Draft 27 June 2019 1 "The Code also requires us to be competent. ... We must also know our limits and not go beyond what we know.... John Pullinger RSS President" https://www.statslife.org.uk/news/3338-rss-publishes-revised-code-of- conduct "If the Royal Statistical Society cannot provide reasonable evidence on inflation faced by poor people, changing needs, assets or debts from 2008 to 2018, I propose that it retract the honour and that the President makes a statement while he holds office." Matt Berkley 27 Dec 2018 2 "a recent World Bank study showed that nearly half of low-and middle- income countries had insufficient data to monitor poverty rates (2002- 2011)." Royal Statistical Society news item 2015 1 "Max Roser from Oxford points out that newspapers could have legitimately run the headline ' Number of people in extreme poverty fell by 137,000 since yesterday' every single day for the past 25 years... Careless statistical reporting could cost lives." President of the Royal Statistical Society Lecture to the Independent Press Standards Organisation April 2018 2 1 https://www.statslife.org.uk/news/2495-global-partnership-for- sustainable-development-data-launches-at-un-summit 2 https://www.statslife.org.uk/features/3790-risk-statistics-and-the-media 3 "Mistaken or malicious misinformation can change your world... When the government is wrong about you it will hurt you too but you may never know how. -
Description Ileostomy/Enterostomy an Ileostomy Is an Opening In
Description Ileostomy/enterostomy An ileostomy is an opening in your belly wall that is made during surgery. Ileostomies are used to deliver waste out of the body when the colon or rectum is not working properly. The word "ileostomy" comes from the words "ileum" and "stoma." Your ileum is the lowest part of your small intestine. "Stoma" means "opening." Your ileum will pass through a stoma after your surgery An ileostomy is a surgical incision performed by bringing the end of the small intestine onto the surface of the skin. The procedure is usually performed in instances where the large intestine has become incapable of safely processing intestinal waste, as a result of the colon being partially or fully removed. Diseases most associated with ielostomy surgery include Crohn's disease, ulcerative colitis, and colorectal cancer. After surgery, ileostomy patients are often required to wear an "ostomy pouch" to collect intestinal waste, where the appearance of the pouch is worn. Before you have surgery to create an ileostomy, you may have surgery to remove all of your colon and rectum, or just part of your small intestine. Ileostomies are used to deliver waste out of the body when the colon or rectum are not working properly. Signs and symptoms y Bleeding inside your belly y Damage to nearby organs y (not having enough fluid in your body) Dehydration if there is a lot of watery drainage from your ileostomy y Difficulty absorbing needed nutrients from food y Infection, including in the lungs, urinary tract, or belly y Poor healing of the wound in your perineum (if your rectum was removed) y Scar tissue in your belly that causes a blockage in your intestines y Wound breaks open Causes Ileostomy surgery is done when problems with your large intestine cannot be treated without surgery. -
Etditaxmurnats. ~THE JOURNAL of the BRITISH MEDICAL ASSOCIATION
THE ritishJ eTdiTaXMurnaTS. ~THE JOURNAL OF THE BRITISH MEDICAL ASSOCIATION. EDITED BY NORMAN GERALD HORNER, M.A., M.D. VOLUME 1, 1932 JANUARY TO JUNE I PRINTED AND PUBLISHED AT THE OFFICE OF THE BRITISH MEDICAL ASSOCIATION, TAVISTOCK SQUARE, LONDON, W.C.1. [Thu Bama-- J"A.-JUNE, I932j 1MXUDAL JOURNAL KEY TO DATES AND PAGES THE following table, giving a key to the dates of issue and the page numbers of the BRITISH MEDICAL JOURNAL and SUPPLEMENT in the first volume for 1932, may prove convenient to readers in search of a reference. Serial Date of Journal Supplement No. Issue. Pages. Pages. 3704 Jan. 2nd 1- 44 1- 8 3705 9th 45- 84 9- 12 3706 16th 85- 128 13- 20 3707 23rd 129- 176 21- 28 3708 30th 177- 222 29- 36 3709 Feb. 6th 223- 268 37- 48 3710 ,, 13th 269- 316 49- 60 3711 ,, 20th 317- 362 61- 68 3712 ,, 27th 363- 410 .69- 76 3713 March 5th 411- 456 ......77- 84 3714 12th 457- 506 ......85- 92 3715 19th 507- 550 93 - 104 3716 26th 551- 598 .105- 112 3717 April 2nd 599i.- 642 .113- 120 3718 9th 643- 692 .121 - 132 3719 ,, 16th 693- 738 .133- 144 3720 23rd 739- 784 .145- 160 3721 30th 785- 826 .161 - 208 3722 May 7th 827- 872 .209- 232 *3723 ,, 14th 873- 918 3724 21st 919- 968 .233 - 252 3725 , 28th 969- 1016 .253 - 264 3726 June 4th 1017 - 1062 .265 - 280 3727 11th 1063 - 1110 .281 - 288 3728 , 18th 1111 - 1156 .289- 312 3729 Pt 25th 1157 - 1200 .313- 348 * This No. -
Die Woche Spezial
In cooperation with DIE WOCHE SPEZIAL >> Autographs>vs.>#NobelSelfie Special >> Big>Data>–>not>a>big>deal,> Edition just>another>tool >> Why>Don’t>Grasshoppers> Catch>Colds? SCIENCE SUMMIT The>64th>Lindau>Nobel>Laureate>Meeting> devoted>to>Physiology>and>Medicine More than 600 young scientists came to Lindau to meet 37 Nobel laureates CAREER WONGSANIT > Women>to>Women: SUPHAKIT > / > Science>and>Family FOTOLIA INFLAMMATION The>Stress>of>Ageing > FLASHPICS > / > MEETINGS > FOTOLIA LAUREATE > CANCER RESEARCH NOBEL > LINDAU > / > J.>Michael>Bishop>and GÄRTNER > FLEMMING > JUAN > / the>Discovery>of>the>first> > CHRISTIAN FOTOLIA Human>Oncogene EDITORIAL IMPRESSUM Chefredakteur: Prof. Dr. Carsten Könneker (v.i.S.d.P.) Dear readers, Redaktionsleiter: Dr. Daniel Lingenhöhl Redaktion: Antje Findeklee, Jan Dönges, Dr. Jan Osterkamp where>else>can>aspiring>young>scientists> Ständige Mitarbeiter: Lars Fischer Art Director Digital: Marc Grove meet>the>best>researchers>of>the>world> Layout: Oliver Gabriel Schlussredaktion: Christina Meyberg (Ltg.), casually,>and>discuss>their>research,>or>their> Sigrid Spies, Katharina Werle Bildredaktion: Alice Krüßmann (Ltg.), Anke Lingg, Gabriela Rabe work>–>or>pressing>global>problems?>Or> Verlag: Spektrum der Wissenschaft Verlagsgesellschaft mbH, Slevogtstraße 3–5, 69126 Heidelberg, Tel. 06221 9126-600, simply>discuss>soccer?>Probably>the>best> Fax 06221 9126-751; Amtsgericht Mannheim, HRB 338114, UStd-Id-Nr. DE147514638 occasion>is>the>annual>Lindau>Nobel>Laure- Geschäftsleitung: Markus Bossle, Thomas Bleck Marketing und Vertrieb: Annette Baumbusch (Ltg.) Leser- und Bestellservice: Helga Emmerich, Sabine Häusser, ate>Meeting>in>the>lovely>Bavarian>town>of> Ute Park, Tel. 06221 9126-743, E-Mail: [email protected] Lindau>on>Lake>Constance. Die Spektrum der Wissenschaft Verlagsgesellschaft mbH ist Kooperati- onspartner des Nationalen Instituts für Wissenschaftskommunikation Daniel>Lingenhöhl> GmbH (NaWik). -
History of the Chair of Clinical Surgery
History of the Chair of Clinical Surgery Eleven people have held the Chair of Clinical Surgery since its establishment in 1802. They are, in chronological order: • Professor James Russell • Professor James Syme • Lord Joseph Lister • Professor Thomas Annandale • Professor Francis Mitchell Caird • Sir Harold Stiles • Sir John Fraser • Sir James Learmonth • Sir John Bruce • Sir Patrick Forrest • Sir David Carter Introduction At the end of the 18th century surgeons had been advocating that the teaching of surgery in the University of Edinburgh was of sufficient importance to justify a chair in its own right. Resistance to this development was largely directed by Munro Secundus, who regarded this potentially as an infringement on his right to teach anatomy and surgery. James Russell petitioned the town council to establish a Chair of Clinical Surgery and, in 1802, he was appointed as the first Professor of Clinical Surgery. The chair was funded by a Crown endowment of £50 a year from George III in 1803. James Russell 1754-1836 James Russell followed his father of the same name into the surgical profession. His father had served as deacon of the Incorporation of Surgeons (Royal College of Surgeons of Edinburgh) in 1752.The younger James Russell was admitted into the Incorporation in 1774, the year before it became the Royal College of Surgeons of the City of Edinburgh. Prior to his appointment to the Regius Chair of Clinical Surgery, Russell was seen as a popular teacher attracting large classes in the extramural school. Though he was required by the regulations of the time to retire from practice at the Royal Infirmary at the age of 50, he continued to lecture and undertake tutorials in clinical surgery over the next 20 years. -
Perforated Peptic Ulcer in Khartoum State
ﺑﺴﻢ ﺍﷲ ﺍﻟﺮﲪﻦ ﺍﻟﺮﺣﻴﻢ UNIVERSITY OF KHARTOUM Faculty of Medicine Postgraduate Medical Studies Board Perforated peptic ulcer in Khartoum state By Dr. Al Fatih Mohamed Ahmed Alnajib M.B.B.S (University of Gezira) A thesis Submitted in partial fulfillment for the requirements of the Degree of Clinical MD in Surgery, October, 2002 Supervisor Prof. Mohamed El Makki Ahmed MS, FRCSI, Professor of Surgery ﺑﺴﻢ ﺍﷲ ﺍﻟﺮﲪﻦ ﺍﻟﺮﺣﻴﻢ ﻗﺎﻝ ﺍﷲ ﺗﻌﺎﻟﻰ : } ﻗﺎﻟﻮﺍ ﺳﺒﺤﺎﻧﻚ ﻻ ﻋﻠﻢ ﻟﻨﺎ ﺇﻻ ﻣﺎ ﻋﻠﻤﺘﻨﺎ ﺇﻧﻚ .{ ﺃﻧﺖ ﺍﻟﻌﻠﻴﻢ ﺍﻟﺤﻜﻴﻢ ﺻﺪﻕ ﺍﷲ ﺍﻟﻌﻈﻴﻢ CONTENTS Page Dedication I Acknowledgements II List of abbreviations III English abstract IV V Arabic abstract VI List of tables VIII List of figures CHAPTER ONE 1 Introduction and Literature review Objectives 25 CHAPTER TWO Patients & Methods 26 CHAPTER THREE Results 28 CHAPTER FOUR Discussion 58 Conclusion 65 Recommendations 67 References 68 APPENDIX Questionnaire 69 APACHE II Score 73 Dedications To my parents, teachers, Sisters & brothers ACKNOWLEDGEMENT I will always feel indebted to my supervisor Prof. Mohamed El Makki Ahmed, Professor of surgery, Faculty of Medicine, University of Khartoum, for his kind and meticulous supervision, encouragement, and guidance in this work with great patience from it’s beginning to the final touches. I would also like to express my sincere thanks and gratitude to my colleagues the registrars of surgery and the house officers who help a lot in data collection, their indefatigable efforts and cheerful co-operation are without parallel. Special thanks for all those helped or participated in this work to come to the light, not forgetting to thank Miss. Widad for help in typing and Mr. -
Studies of Established Forms of Therapy for Peptic
STUDIES OF ESTABLISHED FORMS OF THERAPY FOR PEPTIC ULCER ON THE DEVELOPMENT AND GROWTH OF COLORECTAL CANCER THE INFLUENCE OF PREVIOUS PEPTIC ULCER SURGERY AND OMEPRAZOLE by James Robert Duncan M.B., Ch.B ; F.R.C.S. Thesis submitted for the Degree of Doctor of Medicine from The University Department of Surgery Western Infirmary Glasgow August 1998 James R. Duncan 1998 ProQuest Number: 11007788 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a com plete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest ProQuest 11007788 Published by ProQuest LLC(2018). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States C ode Microform Edition © ProQuest LLC. ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346 rmrmrsTO //5t2 ( coj 2 I dedicate the time and effort contained in these pages to my wife, Anne and to all my family, past, present and future. 3 Contents List of Contents 3 List of Figures 13 List of Tables 15 List of Appendices 16 Acknowledgements 17 Declaration 19 Preface 20 4 Chapter 1 - Introduction 22 1. Colorectal Cancer - an overview 22 2. Peptic Ulcer Disease - an overview 27 3. Pathophysiology of Peptic Ulcer 29 3.1. Mucosal Protection 29 3.2. Helicobacter pylori 30 3.3. -
Cold War Scrapbook Compiled by Frances Mckenney, Assistant Managing Editor
Cold War Scrapbook Compiled by Frances McKenney, Assistant Managing Editor The peace following World War II was short- lived. Soviet forces never went home, kept occupied areas under domination, and threatened free nations worldwide. By 1946, Winston Churchill had declared, “An iron curtain has descended across the conti- nent.” Thus began a 45-year struggle between the diametrically opposed worldviews of the US and the Soviet Union. In 1948, the USSR cut off land access to free West Berlin, launch- ing the first major “battle” of the Cold War: the Berlin Airlift. Through decades of changes in strategy, tactics, locations, and technology, the Air Force was at the forefront. The Soviet Union was contained, and eventually, freedom won out. Bentwaters. Bitburg. Clark. Loring. Soes- terberg. Suwon. Wurtsmith—That so many Cold War bases are no longer USAF instal- lations is a tribute to how the airmen there did their jobs. While with the 333rd Tactical Fighter Training Squadron at Davis-Monthan AFB, Ariz., in 1975, Capt. Thomas McKee asked a friend to take this “hero shot” of him with an A-7. McKee flew the Corsair II as part of Tactical Air Command, at Myrtle Beach AFB, S.C. He was AFA National President and Chairman of the Board (1998-2002). Assigned to the 1st Strategic Reconnaissance Squadron, Beale AFB, Calif., RSO Maj. Thomas Veltri (right) and Maj. Duane Noll prepare for an SR-71 mission from RAF Mildenhall, UK, in the mid- 1980s. Veltri’s most memora- ble Blackbird sortie: “We lost an engine in the Baltic, north of Gotland Island, and ended up at 25,000 feet, with a dozen MiGs chasing us.” Retired Lt. -
Traveler's Diarrhea
Traveler’s Diarrhea JOHNNIE YATES, M.D., CIWEC Clinic Travel Medicine Center, Kathmandu, Nepal Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella are common causes of traveler’s diarrhea. Parasites and viruses are less common etiologies. Travel destination is the most significant risk factor for traveler’s diarrhea. The efficacy of pretravel counseling and dietary precautions in reducing the incidence of diarrhea is unproven. Empiric treatment of traveler’s diarrhea with antibiotics and loperamide is effective and often limits symptoms to one day. Rifaximin, a recently approved antibiotic, can be used for the treatment of traveler’s diarrhea in regions where noninvasive E. coli is the predominant pathogen. In areas where invasive organisms such as Campylobacter and Shigella are common, fluoroquinolones remain the drug of choice. Azithromycin is recommended in areas with qui- nolone-resistant Campylobacter and for the treatment of children and pregnant women. (Am Fam Physician 2005;71:2095-100, 2107-8. Copyright© 2005 American Academy of Family Physicians.) ILLUSTRATION BY SCOTT BODELL ▲ Patient Information: cute diarrhea is the most com- mised and those with lowered gastric acidity A handout on traveler’s mon illness among travelers. Up (e.g., patients taking histamine H block- diarrhea, written by the 2 author of this article, is to 55 percent of persons who ers or proton pump inhibitors) are more provided on page 2107. travel from developed countries susceptible to traveler’s diarrhea. -
Amoebic Dysentery
University of Nebraska Medical Center DigitalCommons@UNMC MD Theses Special Collections 5-1-1934 Amoebic dysentery H. C. Dix University of Nebraska Medical Center This manuscript is historical in nature and may not reflect current medical research and practice. Search PubMed for current research. Follow this and additional works at: https://digitalcommons.unmc.edu/mdtheses Part of the Medical Education Commons Recommended Citation Dix, H. C., "Amoebic dysentery" (1934). MD Theses. 320. https://digitalcommons.unmc.edu/mdtheses/320 This Thesis is brought to you for free and open access by the Special Collections at DigitalCommons@UNMC. It has been accepted for inclusion in MD Theses by an authorized administrator of DigitalCommons@UNMC. For more information, please contact [email protected]. A MOE B leD Y SEN T E R Y By H. c. Dix University of Nebraska College of Medicine Omaha, N~braska April 1934 Preface This paper is presented to the University of Nebraska College of MediCine to fulfill the senior requirements. The subject of amoebic dysentery wa,s chosen due to the interest aroused from the previous epidemic, which started in Chicago la,st summer (1933). This disea,se has previously been considered as a tropical disease, B.nd was rarely seen and recognized in the temperate zone. Except in indl vidu8,ls who had been in the tropics previously. In reviewing the literature, I find that amoebio dysentery may be seen in any part of the world, and from surveys made, the incidence is five in every hun- dred which harbor the Entamoeba histolytlca, it being the only pathogeniC amoeba of the human gastro-intes tinal tract. -
Gastroscopy and Gastric Photography with the Olympus GTF-A
Gut, 1970, 11, 176-181 Gut: first published as 10.1136/gut.11.2.176 on 1 February 1970. Downloaded from Gastroscopy and gastric photography with the Olympus GTF-A R. COCKEL AND C. F. HAWKINS From Queen Elizabeth Hospital, Birmingham SUMMARY One hundred patients were examined with the Olympus GTF-A fibregastroscope and gastrocamera. The entire stomach was seen in most cases; the technique permitting this is described in detail. The examination was most rewarding in patients with gastric haemor- rhage and when radiology was equivocal. Advantages and disadvantages of the instrument are discussed. http://gut.bmj.com/ Gastroscopy, once referred to as a 'narrow Description of Instrument peeping speciality' (Rogers, 1937), has been transformed by the development of new in- The Olympus GTF-A is 10.2 mm in diameter in struments (Morrissey, Tanaka, and Thorsen, the flexible part and 12.7 mm in diameter at the 1967). Now, instead of requiring long experience rigid tip of 6.5 cm where the camera is enclosed on September 27, 2021 by guest. Protected copyright. and persistent practice, gastroscopy can be (Figure 2). It is better than the Hirschowitz fibre- performed with little difficulty. A major advance scope because of the clearer view due to the was the application of fibreoptics to gastroscopy quality of fibre bundles, increased magnification, by Hirschowitz and his colleagues (Hirschowitz, and a wider angle of viewing which makes orien- Curtiss, Peters, and Pollard, 1958; Hirschowitz, tation easier. The intragastric camera has a photo- 1961; Hirschowitz, Balint, and Fulton, 1962), for graphing angle of 800, including the whole of the the flexible fibrescope reduces the patient's dis- area seen through the fibre bundle, so avoiding comfort and lessens the risk of oesophageal parallax.