Library

Notes: This paper presents the findings from a small–scale experiment investigating the presentation of a synchronous remote electronic examination. It discusses the students’ experiences of taking such an examination. The study confirms that the majority of participants found the experience at least as good as a conventional written examination. In addition, typing answers does not prevent students from producing answers in the time available. However, the pressure of time continues to be a major cause of anxiety for students. The paper discusses technical issues, particularly those related to the loss of communications during the 3–hour duration of the exam. Although software processes were available to save and restore students’ answers throughout the examination, problems still occurred and more robust software is required.

Notes: A patient is described who developed a pulmonary hypersensiiivity reaction to sulphasalatzine used in the treatment of his ulcerative colitis. Challenge testing demonstrated that the patient was sensitive to the sulphapyridine component of the drug. The pulmonary response consisted of an immediate bronchial obstructive reaction and a late parenchymal reaction with fall in gas transfer factor. Detailed immunological testing failed to define the mechanisms of drug toxicity.

Notes: Seasonal changes In oocyte growth and plasma estradiol, testosterone, thyroid hormones and vitellogenin levels were monitored in three captive adult female orangemouth corvina Cynoscion xanthulus subjected to a condensed (8 mo) seasonal cycle of photoperiod and water temperature. Plasma concentrations of estradiol and testosterone began to rise when temperature increased to 28 C and photoperiod to 15 h light (midsummer conditions). This was accompanied by elevated circulating levels of vitellogenin and the appearance of vitellogenic oocytes (diameter 〉 100 μm). Estradiol concentrations and mean oocyte size increased concurrently during late summer conditions and were maximum during fall conditions, approximately 8 wk after the beginning of ovarian recrudescence. In contrast, plasma levels of thyroid hormones did not show any distinct seasonal changes. Gonadally recrudesced females contained several size classes of vitellogenic oocytes. Injection of these fish with a luteinizing hormone-releasing hormone analog (LHRHa) caused maturation and spawning of the largest oocytes (mean diameter of follicles × 2500 μm). Another group of vitellogenic oocytes had been recruited into this size class by 2 wk after the end of spawning, which suggests that this species is capable of repeated spawning during the reproductive season. Injection of LHRHa resulted in increased plasma levels of gonadotropin and repeated spawning over several days. LHRHa-induced final oocyte maturation, ovulation and spawning were preceded by increases in plasma levels of two teleostean maturation-inducing steroids, 17α,20β, 21-trihydroxy-4-pregnen-3-one (20β-S) and 17α,20β-dihydroxy-4-pregnen-3-one (17α,20β-P4). The results provide preliminary evidence that oocyte growth is stimulated in orangemouth corvina subjected to an abbreviated seasonal cycle in captivity under midsummer photoperiod and temperature conditions and is associated with seasonal increases in plasma estradiol concentrations and vitellogenin production. However, the relative importance of 20β-S versus 17α, 20β-P4 in the control of final oocyte maturation in this species could not be determined from the results of the present study.

Notes: Purpose - The primary aim of this research is to explore buyer-supplier relationships within a service sector context. Design/methodology/approach - To address the primary aim, both quantitative and qualitative approaches were utilised. A questionnaire was issued to selected buyer and supplier groups in order to determine relationship issues associated with insurance claims. The questionnaire was complemented by a number of semi-structured interviews with buyers and suppliers across each spend category. Findings - The results of this research indicate that there are significant gaps between buyer and supplier expectations concerning how relationships should evolve and that the issues of power and trust will need to be explored in greater depth if relationships are to be optimised. Practical implications - This research is of practical use to service sector companies attempting to examine how to develop effective buyer-supplier relationships. It is of particular use to service buyer operations within the insurance sector, that is moving from the traditional cash compensation approach to a replacement goods approach. Originality/value - Very little has been written about buyer-supplier relationships in the insurance sector and as such this paper provides an insight into issues relating to such relationships within this unique service sector context.

Notes: We describe a new technique of intubation for use in difficult paediatric airway cases utilizing the laryngeal mask airway™, a Cook® Airway Exchange Catheter and a paediatric intubation fibrescope. This method has a number of potential advantages over previously described methods.

Notes: Background. Over recent years multi-sensory stimulation (MSS) has become an increasingly popular approach to care and is used in several centres throughout Europe. This popularity could be explained by the limited alternatives available to staff and a widely held belief that MSS is a friendly and highly humane approach. A randomized controlled trial was therefore essential to evaluate the effectiveness and extent of the benefits of MSS.Aim. To assess whether MSS is more effective in changing the behaviour, mood and cognition of older adults with dementia than a control of activity (playing card games, looking at photographs, doing quizzes, etc.).Methods. A total of 136 patients from three countries [United Kingdom (UK), the Netherlands and Sweden] were randomized to MSS or activity groups. Patients participated in eight 30-minute sessions over 4 weeks. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre-, mid-, post-trial and follow-up assessments were taken to investigate any generalization of effects to cognition and behaviour and mood at home/on the ward or at the day hospital.Results. There were limited short-term improvements for both the MSS and activity groups immediately after sessions, and limited short-term improvements between the groups during sessions. There were no significant differences between the groups when assessing change in behaviour, mood or cognition at home/on the ward or at the day hospital. In the UK, however, behaviour at the day hospital for both groups remained stable during the trial but deteriorated once the sessions had stopped, and active/disturbed behaviour at home improved but likewise deteriorated once sessions had stopped.Conclusions. Overall, MSS was found to be no more effective than an activity in changing the behaviour, mood or cognition of patients with dementia in the short- or long-term.