Posted on June 23, 2015

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Oban Radiology Critical Incident Review published

This Review was instigated as a result of the commencement of a major review of x ray reporting at two hospitals in Ireland involving a long term locum consultant radiologist at the hospital in Oban and the coincidental expression of concerns by a GP practice regarding the accuracy of a number of x ray reports by the same radiologist.

The review took the form of a ‘Look Back’ of all chest x rays, barium examinations and x rays of children under 12 performed within the review period. It was undertaken by an independent external consultant radiologist and consisted of the re reporting of a total of 1697 images. The aim of the review was to identify if there had been any missed pathology within the radiological reporting process and to ensure that patients had received appropriate care. possible significant missed pathology. All of these reports were clinically reviewed by the Locality Acute Clinical Director (a consultant physician), the Community Health Partnership (CHP) Clinical Director (a GP) and the relevant referring clinician. It is important to highlight that the level of missed pathology at 2.6% falls within the limits of professional acceptability previously laid down by the Royal College of Radiologists and other professional bodies.

The referring clinicians of all ultrasounds undertaken within the review period (totalling 435) were also requested to clinically review the cases and to consider whether these should be repeated. 92 patients were referred for repeat scans, 63 of whom accepted the offer. All of these scans were undertaken between July and October 2008 by Raigmore Hospital Radiologists or by the Oban Ultrasonographer.

The main observations from the Review highlight the following:

There were two cases where the diagnosis of lung cancer was delayed.

In the remaining 43 Category 3 cases, the reported radiological discrepancies did not impact on patient management, care or outcome.

The Look Back confirmed that two ultrasound scans identified ongoing morbidity which was likely to have been present at the initial investigation where there had been an effect on clinical management and outcome. In both cases this led to prolonged discomfort of the patients but did not affect their eventual recovery.

Dr Ian Bashford, NHS Highland Board Medical Director, said :

"A review of x ray and ultrasound investigations reported by two consultant radiologists at Lorn Islands Hospital in Oban was recently undertaken by NHS Highland.
discount ray bans This review was prompted by concerns among a GP Practice regarding the accuracy of a number of x rays and also because a hospital in Ireland had reviewed x rays carried out by a radiologist who subsequently worked as a locum radiologist in Oban.

"The Review re assessed all chest x rays, barium examinations, all x rays performed on children aged under 12 years and all ultrasound investigations reported by
fake ray bans consultant radiologists at the hospital from 16 October 2007 to 15 May 2008.

"The main aim was to establish whether there were any patient safety concerns, to provide reassurance that radiographs and scans had been read correctly, to ensure that patients had been managed appropriately and that no harm had occurred to any patient. It involved reviewing 1,697 x rays and 435 ultrasound scans.

"All patients affected directly by the review were contacted by NHS Highland and a helpline was set up via NHS24 for any members of the public who had any general concerns about the incident.

"The Review has now been completed and we are today publishing the findings in full to allow patients, members of the public and other interested parties an opportunity to read it for themselves.

"The main observations from the report highlight that there were 45 Category 3 cases where a discrepancy in reporting may have had a clinical significance with possible implications for
cheap ray bans patient outcome. Further investigation of these cases highlighted that in 43 of them the reported radiological discrepancies did not impact on patient management care or outcome. In the remaining two cases it was found that a diagnosis of lung cancer was delayed but according to the findings of the Report this did not significantly impact on the clinical care or outcome of the patient. At this stage it is also important to highlight that the overall
cheap ray bans incidence of potential missed pathology falls within the limits of professional acceptability previously laid down by the Royal College of Radiologists and other professional bodies.

"In addition to the above there were also two ultrasounds which identified ongoing morbidity that was likely to have been present at the initial investigation which led to prolonged discomfort for the patients concerned but did not affect their eventual recovery.

"The report also highlights a number of other more general observations and associated recommendations and actions which we will be looking at implementing as soon as possible.

"In conclusion, I would like to reassure patients and members of the public that we take seriously issues such as those that led to this Review being carried out in the first place and we have published the report in full to allow everyone an opportunity to look at the findings in more detail. However if anyone has any more questions or requires additional information then we would ask them to get in touch and we will do our utmost to deal with them."

Argyll Bute Community Health Partnership has also concluded its wide ranging review of the provision of its radiology services in conjunction with a range of users and clinicians and in collaboration with colleagues from NHS Greater Glasgow Clyde and Raigmore Hospital. This has resulted in plans to establish a sustainable, quality assured and cost effective outreach service provided from the team of Consultant Radiologists at Raigmore Hospital, with improved technology facilitating remote and timeous electronic reporting of images.Articles Connexes:

Posted on June 23, 2015

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government
cheap ray bans to start bragging

budget released this week will depend on what pulpit they’re preaching from. The "right" is mostly expressing joy over the black ink on the bottom line, while the "left" points to social shortfalls created by special favours for the business community.

Business people
replica ray ban sunglasses are pleased by the surplus. They see government debt as dollars that should be in people’s pockets, to be drawn from to spend on goods and services and generally boost the economy. People in the mining sector, eager to put the Mount Polley debacle behind them, are understandably happy the Christy Clark government has found money to aid exploration and development, as well as extending their tax credits despite the surplus. "bragging rights" over the rest of Canada. But conspicuously absent from this year’s bragging was the LNG windfall that was all over last year’s budget and its expectations of future surpluses. Instead, workers at ICBC and
fake ray bans BC Hydro point out a direct link between surpluses projected for the next three years and the money that the government is planning to extract from those Crown corporations in each of those three years.

While low income families get a boost
replica ray bans from an increase in the tax threshold for the Early Childhood Tax Benefit, the hidden MSP tax rises again: the right hand giveth, and the left hand taketh away.Articles Connexes:

Posted on June 23, 2015

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Police investigate death on waterfront

Morehead City police have released the identity of a man who died during a July 4 incident outside a waterfront bar. Thursday, police said.

According to a police department news release, the initial call came in as a subject in the water and Morehead City Fire and Rescue, assisted by Atlantic Beach Fire and EMS, responded for a water rescue. Morehead City police officers and the dive team responded after it was determined that the situation involved the recovery of a body.

Police Chief Wrenn Johnson said the investigation is ongoing and the department is still working to piece together Johnson’s cause of death and motive for the altercation.

She said there is a team of investigators working on the case and they had been interviewing witnesses all day and still had a number of others to talk to.

"People are still calling saying they saw this or that and we’re following up on them. We still have a lot of evidence and information to piece together," she said.

Morehead City police have released the identity of a man who died during a July 4 incident outside a waterfront bar. Thursday, police said.

According to a police department news release, the
cheap ray ban outlet initial call came in as a subject in the water and Morehead
fake ray bans City Fire and Rescue, assisted by Atlantic Beach Fire and EMS, responded for a water rescue. Morehead City police officers and the dive team responded after it was determined that the situation involved the recovery of a body.

Police Chief Wrenn Johnson said the investigation is ongoing and the department is still working to piece together Johnson’s cause of death and motive for the altercation.

She said there is a team of investigators working on the case and they had been interviewing
replica ray ban sunglasses witnesses all day and still had a number of others to talk to.

"People are still calling saying they saw this or that and we’re following up on them. We still have a lot of evidence and information to piece together," she said.

The incident occurred as the town’s annual Independence Day celebration was coming to a close.

The call originally came in as a subject in the water and Morehead City Fire and EMS assisted by Atlantic Beach Fire and EMS responded for a water rescue attempt. Morehead City Police officers and Dive Team responded for the recovery effort when it was determined
discount ray bans that the situation was no longer a water rescue, according to the information.Articles Connexes:

Posted on June 23, 2015

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How do vacuum cleaners work

Look at the various parts of your vacuum (hose, beater brushes, bag, handle, etc). What does a vacuum cleaner do?
discount ray bans What does each part do? Does the vacuum cleaner blow air out or suck air in? What does the vacuum cleaner pick up?

To prove that a vacuum cleaner uses air to pick up little bits of dirt, blow into the paper bag like a balloon and seal it with your hand. Feel the bag. What is inside the bag?

Add the sparkles, or the confetti to the bag.

Put the hose attachment of the vacuum cleaner into the opening of the bag and turn on the vacuum cleaner for a few seconds.
cheap ray bans What
cheap ray ban outlet happens to the bag?

Look inside the bag. What happened to the sparkles or the confetti? Where did they go?

Look inside the cannister or the bag of the vacuum to find them. What is in the bag? How did
cheap ray bans the sparkles get in the bag?

A vacuum cleaner is a form of technology. Technology is something that people create to solve problems. Vacuum cleaners pull air in and the air sucks up dirt and dust.

Inside vacuum cleaners a fan blows air (you can often feel it). In order for a fan to blow air, it needs to draw air in. This is the air that sucks up, or vacuums, the dirt and dust.

The low pressure air caused by the air going into the vacuum cleaner draws up small objects which then get trapped in bags, canisters or filters.

Why does it matter?

Vacuum cleaners use low air pressure to help us pick up small particles of dirt and dust. Vacuum suction is also used in many industries to move materials around. A milking machine uses low air pressure (vacuum pressure) to create suction to milk a cow.Articles Connexes:

Posted on June 23, 2015

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Natural Resources

The natural resources of an area are the building block upon which all development begins. An understanding of the basic natural environment is important to the planning process especially as the city looks to develop in a way that sustains the natural environment. It is situated on the western edge of the Piedmont Plateau, in the foothills of the Blue Ridge Mountains. Characterized by broad rolling hills and moderate slopes, Charlottesville has a mean temperature of 56.7 F and receives about 47 inches of precipitation in a typical year.

In winter, the city’s average temperature is 37.5 F. Charlottesville is considerably warmer than nearby localities having the same elevation. The Blue Ridge Mountains are the reason for the temperature difference. They act as a barrier to the Arctic air masses, lessening their severity. Temperatures fall below freezing only about 60 days out of the year. Winter precipitation is primarily in the form of rain, although Charlottesville receives an average of 15 inches of snow annually.

Summers in Charlottesville are warm and moist, with highs in the
discount ray bans mid 80′s and lows in the mid 60′s. Much of the 13 inches of precipitation that falls in the summer can be attributed to thunderstorms, whereas most of the precipitation throughout the rest of the year is the result of frontal systems. About 40 afternoon or evening thunderstorms occur during a typical summer.

The spring and fall are typically mild with highs in the upper 60′s and lows in the mid 40′s. Precipitation averages just below 13 inches for both seasons. The trees begin to blossom in March and fall foliage is usually at its peak between October 15th and 20th. (Source: Virginia State Climatology Office)Charlottesville is located on the western edge of the Piedmont Plateau, the largest physiographic province in Virginia. The humid climate is responsible for the deeply weathered bedrock that lies beneath a layer of soil and saprolite. Much of the bedrock in and around Charlottesville was formed sometime during the Proterozoic era (2500 544 million years ago) and Early Paleozoic era (544 245 mya) on the margin of ancient North America. Most of the bedrock is made up of igneous and metamorphic rocks.

The Charlottesville Foundation, which makes up over a third of the bedrock found beneath the city, contains fine grained metamorphic rocks that were created during the Precambrian Age. The formation contains large amounts of quartz biotite gneiss and a few beds of sericitic and graphitic gneiss. The Charlottesville formation is about one mile wide and runs through the center of the city in a southwest to northeast direction. Unweathered outcrops of gneiss can be seen on Rose Hill Drive where it crosses Schenks Branch.

Beneath the eastern part of Charlottesville lies Catoctin greenstone, a formation
cheap ray bans containing both igneous and metamorphic rock. The formation was created by a series of basaltic lava flows between which layers of sediment were deposited. Over time, the sedimentary rock and lava have metamorphosed. After the formation of the greenstone, molten lava containing orthoclase, microcline, and subordinate quartz pushed its way up through the Catoctin formation. An alaskite dike runs southwest to northeast from Fry’s Spring up through Greenbrier.

Between the Catoctin and Charlottesville formation lies the Swift Run formation. Made up of quartzitic sandstone, a sedimentary rock, the Swift Run formation contains
replica ray bans large blue quartz pebbles. The rock is 2,250 feet thick near Ridge Street.

Amphibolite dikes are found throughout the western half of Charlottesville. Two narrow dikes exist within the Swift Run formation near Ridge Street, and an 830 foot wide dike runs beneath the Lawn. The latter dike, appropriately named the University amphibolite dike, is bordered on both sides by faults. All of the amphibolite dikes are from the Precambrian Age.

A narrow strip of the Johnson Mill formation exists between the Charlottesville formation and the University amphibolite dike. This formation is made up of graphite slate with pyrite spread throughout. This metamorphic rock is between 240 and 400 feet thick and was created during the Cambrian Age.

The Lynchburg formation underlies several of the northwestern neighborhoods including Venable, Barracks/Rugby, and Meadows/Route 29. The formation is between 4,500 and 12,000 feet thick. The once fine grained silty sediments metamorphosed into medium to fine grained biotite quartz gneiss and graphitic and sericitic schist during the Precambrian Age.

Beneath the Lewis Mountain and Barracks neighborhoods lies the Rockfish conglomerate formation. Charlottesville’s soils are loams, meaning that they contain clay, sand, and a mixture of organic material. The loams are slightly to strongly acidic.

The most abundant soil in the western part of Charlottesville is Cecil loam, a grayish brown to light reddish brown mellow loam. Although it is susceptible to sheet erosion, the soil can be quite fertile if maintained properly. Cecil loam’s parent rock is granite.

Davidson clay loam makes up much of the soil in the Belmont, Woolen Mills, and Martha Jefferson neighborhoods. The reddish colored soil is well drained both internally and externally and is considered the most productive soil in the Piedmont Plateau. Davidson clay loam is underlain by basic rock such as diorite and amphibole.

Congaree silt loam is brown or grayish brown and is found in many streambeds throughout the city. The soil is well drained but is subject to overflow during a storm. Congaree is the most fertile soil in Albemarle County.

Lehigh silt loam is grayish brown floury silt loam that lies atop drab silty clay that is very tough and hard when dry and sticky when wet. Lehigh silt loam is underlain by graphitic schist or metamorphosed shale. This soil is found in a very small amount along Route 29 North.

Nason silt loam is grayish yellow in color and has a floury feel. The soil does not absorb rainwater and loses a lot of material due to severe washes. A reddish yellow silty clay subsoil is exposed where erosion has occurred. The parent material of Nason silt loam is schist. The vegetation found within the City of Charlottesville has been categorized according to the biological processes that affect the landscape. The city’s vegetation has been divided into four types: complex forest, developed understory, suburban cover and urban cover.

The first vegetation type is the complex forest. The
cheap ray ban outlet ecosystem processes in the forest remain intact. These forest fragments are characterized by their mature trees and may or may not have an understory. They are valuable ecosystems that provide homes to numerous species of plants and animals.

In the developed understory category are canopy species with most of the understory remaining. The biophysical processes in these areas operate in a limited fashion.

The third type of vegetation found within the city is suburban cover. It includes canopy trees and lawn. Invasive species thrive in these mostly human maintained ecosystems.

Urban cover is the final and least biodiverse of the four categories. It consists of singular trees or volunteer vegetation. Only specialized or highly adaptive species thrive in areas with urban cover and the vegetation is almost entirely maintained by humans.Articles Connexes: