Since its first publication in 1996, Marie Muller's Nursing Dynamics has become firmly established as an essential resource for nursing courses. This fifth edition addresses the latest challenges nursing professionals face and expands the focus to include all managers in healthcare service management. Nursing and midwifery educators who relied on earlier editions of this work will find that their discipline is still the core of this book, with the management aspects broadened to include general healthcare dynamics. Subjects range from professional regulation to governance, decision making, financial management, quality management and continuing professional development. New features include the introduction of digital elements including online student–lecturer support material and a digital portfolio of evidence to enrich the content. The practical application of principles has been formalised with the inclusion of case studies and assignments at the end of each chapter. These exercises follow a Head-Heart-Hands model, covering the knowledge behind the principle, the ethical and "duty of care" considerations, and the hands-on application.

This updated and improved edition of Healthcare Service Management presents the latest best practice guidelines related to the management of a healthcare organisation. The text examines those aspects of management that are specific to healthcare institutions, including health-related legislation, common law, and ethics. In addition to fulfilling the needs of the nursing student and lecturer, it will serve as a reference on healthcare service management for any practising manager.

Provides a broad overview of Industry 4.0 in SMEs, covering twelve countries in various national, historical, and geographical settings Describes barriers, drivers and opportunities for Industry 4.0 and related digitalization programs Consolidates the experiences of Industry 4.0 implementation in SMEs across different parts of the globe Compares firms of similar size and digitalization levels across the available data of various SMEs worldwide Includes descriptions of what is happening in SMEs in order to increase industrial competitiveness

An interdisciplinary environmental humanities volume that explores human-environment relationships on our permanently polluted planet. While toxicity and pollution are ever present in modern daily life, politicians, juridical systems, media outlets, scholars, and the public alike show great difficulty in detecting, defining, monitoring, or generally coming to terms with them. This volume's contributors argue that the source of this difficulty lies in the struggle to make sense of the intersecting temporal and spatial scales working on the human and more-than-human body, while continuing to acknowledge race, class, and gender in terms of global environmental justice and social inequality. The term toxic timescapes refers to this intricate intersectionality of time, space, and bodies in relation to toxic exposure. As a tool of analysis, it unpacks linear understandings of time and explores how harmful substances permeate temporal and physical space as both event and process. It equips scholars with new ways of creating data and conceptualizing the past, present, and future presence and possible effects of harmful substances and provides a theoretical framework for new environmental narratives. To think in terms of toxic timescapes is to radically shift our understanding of toxicants in the complex web of life. Toxicity, pollution, and modes of exposure are never static; therefore, dose, timing, velocity, mixture, frequency, and chronology matter as much as the geographic location and societal position of those exposed. Together, these factors create a specific toxic timescape that lies at the heart of each contributor's narrative. Contributors from the disciplines of history, human geography, science and technology studies, philosophy, and political ecology come together to demonstrate the complex reality of a toxic existence. Their case studies span the globe as they observe the intersection of multiple times and spaces at such diverse locations as former battlefields in Vietnam, aging nuclear-weapon storage facilities in Greenland, waste deposits in southern Italy, chemical facilities along the Gulf of Mexico, and coral-breeding laboratories across the world.

In recent years, digital business models have frequently been the subject of academic and practical discourse. The increasing interconnectivity across the entire supply chain, which is subsumed under the term Industry 4.0, can unlock even farther-reaching potentials for digital business models, affecting entire supply chains and ecosystems. This book examines the specific challenges and obstacles that supply chain and ecosystem management poses with regard to the development of digital business models. The top-quality contributions gathered here focus on the successful implementation of Industry 4.0 in digital business models for industrial organizations in a European context, making the book a valuable asset for researchers and practitioners alike.

This collection examines how the EU is seen in the two regions that are at the centre of its geopolitical interest. Focusing on Eastern Europe and sub-Saharan Africa, it provides a critical assessment of how their external perceptions relate to EU policy towards them.

This monograph is based on the third author's lectures on computer architecture, given in the summer semester 2013 at Saarland University, Germany. It contains a gate level construction of a multi-core machine with pipelined MIPS processor cores and a sequentially consistent shared memory. The book contains the first correctness proofs for both the gate level implementation of a multi-core processor and also of a cache based sequentially consistent shared memory. This opens the way to the formal verification of synthesizable hardware for multi-core processors in the future. Constructions are in a gate level hardware model and thus deterministic. In contrast the reference models against which correctness is shown are nondeterministic. The development of the additional machinery for these proofs and the correctness proof of the shared memory at the gate level are the main technical contributions of this work.

Protein transport events occurring at the endoplasmic reticulum (ER) of eukaryotic cells and the cytoplasmic membrane of prokaryotic organisms share many similarities. Resident proteins of both membranes span the lipid bilayer once or several times by a-helical stretches and their integration is usually mediated by uncleaved signal-anchor sequences. Proteins that are translocated across either membrane, collectively also termed secretory proteins, harbour cleavable N-terminal signal sequences. Prokaryotic and eukaryotic signal sequences have the same modular structure and are functionally exchangeable. Integration of membrane proteins and translocation of secretory proteins basically occur at the same sites (pores) within each membrane. In both types of membranes, these pores are c- posed of homologous components forming the Sec translocons. Parts of the Sec trans- cons are found populated by ribosomes, the membrane-bound ribosomes. Bacterial m- brane and eukaryotic secretory proteins are targeted to the Sec translocons by the same molecular mechanism involving signal recognition particle (SRP) and its receptor (SRP - ceptor, SR). Structure and assembly of the SRP The functional core of SRP The functional core of this ribonucleoprotein complex consists of the signal sequence binding subunit (SRP54 in eukaryotes and Ffh in prokaryotes) and the SRP RNA molecule (see Fig. 1). This core is conserved in all organisms, with the intriguing exception of chloroplasts, where the SRP lacks the RNA subunit.

The study of gouty arthritis has provided a common meeting ground for the research interests of both the basic scientist and the clinician. The interest of the chemist in gout began 1776 with the isolation of uric acid from a concretion of the urinary tract by the Swedish chemist SCHEELE. The same substance was subsequently extracted from a gouty tophus by the British chemist WOLLASTONE in 1797 and a half century later the cause of the deposits of sodium urate in such tophi was traced to a hyperuricemia in the serum of gouty patients by the British physician Alfred Baring GARROD who had also received training in the chemical laboratory and was therefore a fore-runner of many of today's clinician-investigators. The recent surge of progress in understanding of some of the causes of gout in terms of specific enzyme defects marks the entrance of the biochemist into this field of investigation. The identification of the first primary defect of purine metabolism associated with over-production of uric acid, a severe or partial deficiency of the enzyme hypoxanthine-guanine phospho ribosyltransferase was achieved less than a decade ago. The knowledge of the mechanism of purine over-production that it generated led shortly to the identification of families carrying a dominantly (possibly X-linked) inherited increase in the activity of the enzyme phosphoribosylpyrophosphate synthetase as a cause of purine over-production. Yet this is only a start as these two types of enzyme defects account for less than five per cent of gouty patients."

The study of gouty arthritis has provided a common meeting ground for the research interests of both the basic scientist and the clinician. The interest of the chemist in gout began 1776 with the isolation of uric acid from a concretion of the urinary tract by the Swedish chemist SCHEELE. The same substance was subsequently extracted from a gouty tophus by the British chemist WOLLASTONE in 1797 and a half century later the cause of the deposits of sodium urate In such tophi was traced to a hyperuricemia in the serum of gouty patients by the British physician Alfred Baring GARROD who had also received training in the chemical laboratory and was therefore a fore-runner of many of today's clinician-investigators. The recent surge of progress in understanding of some of the causes of gout in terms of specific enzyme defects marks the entrance of the biochemist into this field of investigation. The identification of the first primary defect of purine metabolism associated with over-production of uric acid, a severe or partial deficiency of the enzyme hypoxanthine-guanine phospho ribosyl transferase was achieved less than a decade ago. The knowledge of the mechanism of purine over-production that it generated led shortly to the identification of families carrying a dominantly (possibly X-linked) inherited increase in the activity of the enzyme phosphoribosylpyrophosphate synthetase as a cause of purine over-production. Yet this is only a start as these two types of enzyme defects account for less than five per cent of gouty patients."

Volume VIII of Acta Historiae Neerlandicae again presents studies on the history of the Low Countries which it is hoped will be of interest to foreign scholars. The intention has been to deal with a fairly long period, and many differing aspects, of the subject. So institutional, political, economic, social and cultural history all receive a fair share of attention, and together the studies cover a considerable number of centuries. It is, however, striking to note how even this restricted number of studies reflects prevailing viewpoints among today's Low Countries' historians. Clearly there is considerable stress on economic and social questions. Traditional studies such as those of former Belgian historians on medieval history, or those of the Dutch on the seventeenth century, are now giving way to works that are problem directed. Power structures, the position of the bourgeoisie, reactions of the intelli gentsia and theologians to societal problems, have now more attraction for scholars than the glories of late medieval wealth in Flanders or Holland's Golden Age. Terms such as Guerilla warfare, Struggle, Depression, typify today's critical approach to society in general.

Protein transport events occurring at the endoplasmic reticulum (ER) of eukaryotic cells and the cytoplasmic membrane of prokaryotic organisms share many similarities. Resident proteins of both membranes span the lipid bilayer once or several times by a-helical stretches and their integration is usually mediated by uncleaved signal-anchor sequences. Proteins that are translocated across either membrane, collectively also termed secretory proteins, harbour cleavable N-terminal signal sequences. Prokaryotic and eukaryotic signal sequences have the same modular structure and are functionally exchangeable. Integration of membrane proteins and translocation of secretory proteins basically occur at the same sites (pores) within each membrane. In both types of membranes, these pores are c- posed of homologous components forming the Sec translocons. Parts of the Sec trans- cons are found populated by ribosomes, the membrane-bound ribosomes. Bacterial m- brane and eukaryotic secretory proteins are targeted to the Sec translocons by the same molecular mechanism involving signal recognition particle (SRP) and its receptor (SRP - ceptor, SR). Structure and assembly of the SRP The functional core of SRP The functional core of this ribonucleoprotein complex consists of the signal sequence binding subunit (SRP54 in eukaryotes and Ffh in prokaryotes) and the SRP RNA molecule (see Fig. 1). This core is conserved in all organisms, with the intriguing exception of chloroplasts, where the SRP lacks the RNA subunit.

It is generally accepted that training in statistics must include some exposure to the mechanics of computational statistics. This learning guide is intended for beginners in computer-aided statistical data analysis. The prerequisites for XploRe - the statistical computing environment - are an introductory course in statistics or mathematics. The reader of this book should be familiar with basic elements of matrix algebra and the use of HTML browsers. This guide is designed to help students to XploRe their data, to learn (via data interaction) about statistical methods and to disseminate their findings via the HTML outlet. The XploRe APSS (Auto Pilot Support System) is a powerful tool for finding the appropriate statistical technique (quantlet) for the data under analysis. Homogeneous quantlets are combined in XploRe into quantlibs. The XploRe language is intuitive and users with prior experience of other sta tistical programs will find it easy to reproduce the examples explained in this guide. The quantlets in this guide are available on the CD-ROM as well as on the Internet. The statistical operations that the student is guided into range from basic one-dimensional data analysis to more complicated tasks such as time series analysis, multivariate graphics construction, microeconometrics, panel data analysis, etc. The guide starts with a simple data analysis of pullover sales data, then in troduces graphics. The graphics are interactive and cover a wide range of dis plays of statistical data."

This book presents a formal model for evaluating the cost effectiveness of computer architectures. The model can cope with a wide range of architectures, from CPU design to parallel supercomputers. To illustrate the formal procedure of trade-off analyses, several non-pipelined design alternatives for the well-known RISC architecture called DLX are analyzed quantitatively. It is formally proved that the interrupt mechanism proposed for the DLX architecture handles nested interrupts correctly.
In an appendix all programs to compute the cost and cycle time of the designs described are listed in C code. Running these simple C programs on a PC is sufficient to verify the results presented. The book addresses design professionals and students in computer architecture.

In recent years, digital business models have frequently been the subject of academic and practical discourse. The increasing interconnectivity across the entire supply chain, which is subsumed under the term Industry 4.0, can unlock even farther-reaching potentials for digital business models, affecting entire supply chains and ecosystems. This book examines the specific challenges and obstacles that supply chain and ecosystem management poses with regard to the development of digital business models. The top-quality contributions gathered here focus on the successful implementation of Industry 4.0 in digital business models for industrial organizations in a European context, making the book a valuable asset for researchers and practitioners alike.

In fast jedem klinischen Fachgebiet werden Blutprodukte angewendet. Dennoch kommt die Transfusionsmedizin in der arztlichen Ausbildung oft zu kurz. Dieses Buch bietet einen hervorragenden Uberblick fur den nichttransfusionsmedizinischen Facharzt bzw. Transfusionsbeauftragten im Umgang mit zellularen und plasmatischen Blutprodukten. Neben Produktbeschreibungen, Indikationshinweisen, pratransfusioneller Testbesprechung und Verabreichungshinweisen werden auch das Nebenwirkungsspektrum von Blutkomponenten und die konsekutiv dazu notwendigen Massnahmen, Transfusions-Notfalle behandelt. Ebenso thematisiert werden die CMV-Problematik, die perinatale / neonatale Bluttransfusion einschliesslich der Rhesusprophylaxe, Plasmaderivate, Hamovigilanz und Look back. Die Intention des Autors liegt in der bestmoglichen Vermittlung dieses speziellen klinischen Wissensbereiches und in der optimalen Nutzung blutgruppenserologisch-transfusionsmedizinischer Ressourcen."

Das Buch befasst sich mit der Bereitstellung von Daten und Verfahren fur analytische Zwecke (Planung, Entscheidung, Controlling sowie Fehlerruckverfolgung) in Unternehmen sowie der notwendigen Rechenleistungen. Die Autoren erlautern die Datenbereitstellung mittels Data Warehouses, Auswertung mittels OLAP-Operationalitat und geeignete Verfahren der explorativen Datenanalyse. Bei den Verfahren des Operations Research werden Simulation und Lineare Optimierung dargestellt. Neben erfolgreichen Anwendungen und Fallstudien steht das Verstandnis der zugrundeliegenden Algorithmen und Datenstrukturen, die fur das Erlernen der BI-Verfahren zwingend notwendig sind, im Vordergrund."

Das Buch geht zunachst auf den Hintergrund und die Entwicklung der EG-OEko-Audit-Verordnung ein. Anschliessend erfolgt eine breit gefacherte Analyse von Anspruch und Wirklichkeit des seit nunmehr 3 Jahren angewandten Systems sowie der Entwicklung von Umweltmanagementsystemen im allgemeinen. Die empirischen Untersuchungen und Analysen geben allen beruflich Betroffenen, Unternehmensvertretern und Wissenschaftlern einen umfassenden UEberblick zum Stand und zur Entwicklung normierter Umweltmanagementsysteme. Die abschliessende Diskussion von Einzelaspekten fur die anstehende Revision der EG-OEko-Audit-Verordnung rundet die kritische Auseinandersetzung mit dem Themenfeld 'normiertes Umweltmanagement' ab.

Die bisherigen Debatten um Intersectionality haben gezeigt, dass sich eine kontextunabhangige Definition von Intersektionalitat nicht angeben lasst. Daruber hinaus bezeugt das ungebrochene Interesse an dieser Debatte, dass es eines kritischen Reflexionsinstrumentes von Ungleichheit und Differenz in Wissenschaft und Politik bedarf. Was also ist das Verhaltnis von Intersektionalitat und Kritik respektive kann Intersektionalitat kritisch sein? Dieser Band behandelt die Frage in dreierlei Hinsicht: Erstens wird Intersectionality im Spannungsfeld von wissenschaftlichen und politischen Praktiken analysiert. Zweitens wird Intersectionality als Methodenreflexion, das heisst als Kritik an herkommlichen Methoden der jeweiligen Disziplinen, prasentiert. Drittens werden Ansatze diskutiert, die Intersectionality als kritisches Instrument fur die Reflexion von Geschichte und Gesellschaft fruchtbar machen."

Dies ist die erste Monographie uber die Bruche des distalen Unterschenkelsegmentes - vor allem die intraartikularen sogenannten Pilon-tibial-Frakturen. Diese wurden bisher aufgrund ihrer Seltenheit und Komplexitat noch nie in dieser Weise besprochen. Auch die Klassifikation, operative Therapie und Prognose werden dargestellt. Nach einer praxisorientierten anatomischen Einleitung wird anhand des vielfaltigen Krankengutes der AO-Dokumentationszentrale und gestutzt auf ausgedehnte eigene Erfahrungen zunachst die Klassifikation erarbeitet und erlautert. Diese schliesst sich eng an die von M.E. Muller et al. 1987 publizierte "Classification AO des Fractures" an. Das bei dieser Lokalisation sehr spezielle Problem der artikularen Impression wird eingehend behandelt. Es folgen eine Zusammenfassung der Geschichte dieser Verletzungen und eine Ubersicht der bisherigen Publikationen. Indikation, Technik und Problematik der oft schwierigen operativen Behandlung werden ausfuhrlich wiedergegeben. Spezielle Abschnitte uber neueste Auffassungen und Techniken, sekundare Eingriffe und Arthrodesen wurden von Mitarbeitern des Autors gestaltet. Ein Anhang enthalt die Detailanalyse des verwerteten Krankengutes unter besonderer Berucksichtigung der Prognose. Ziel des Buches ist es, traumatologisch aktive Chirurgen und Orthopaden moglichst umfassend uber eine Verletzung zu informieren, mit welcher sie nur relativ selten konfrontiert sind. Die Einfachheit der Einteilung soll eine korrekte Indikationsstellung und sorgfaltige Therapiewahl fordern unter Berucksichtigung von Komplikationen und Prognose.

"Palliativ" = "lindernd," d.h. eine Behandlung, die zwar die Symptome abschw{cht, ber nicht die Ursachen bek{mpft (bei Krebskranken in fortgeschrittenem Stadium oft die einzige Behandlungsm-glichkeit). Das bedeutet einen breiten thera- peutischen Ansatz, der von allgemein-{rztlichen Aufgaben ausgeht und }ber systematische und organbezogene Therapie zur Pflege, sozialen Integration und F}hrung von Sterbenden reicht. Diese Aspekte werden breit und interdisziplin{r dar- gestellt.

1m letzten Jahrzehnt seines Lebens hatte Max Miiller die nach der Emeritierung begonnene Niederschrift seiner "Erinnerungen" abgeschlossen und qualte sieh mit Uberlegungen, ob er sie selbst noch veroffentlichen solIe. Auch seine Freun- de wuBten keinen Rat. Was sie lasen, war etwas anderes als die gerade in diesen Jahren erschienenen Autobiographien, mit denen sieh andere Vertreter des Fa- ches einem breiteren Publikum durch literarische Gewandtheit, temperament- volle Selbstdarstellung, interessante Lebenslaufe und merkwiirdige FaIle emp- fahlen. Es war der eher schmucklose Bericht iiber das halbe Jahrhundert eines von einem unverstellt-kraftvollen Temperament in natiirlicher Weltoffenheit ge- lebten, aber zugleich selbstkritisch-eigenwillig und mit zweiflerischer Sensibilitat reflektierten Lebens - ein Bericht, der iiber die psychiatriegeschichtliche Aus- gangsperspektive hinaus ein halbes Jahrhundert Zeitgeschichte erfaBt hatte. In dem umfanglichen Manuskript waren Informationen festgehalten, die nieht ver- lorengehen durften. Man konnte aber auch die Stiirme voraussehen, die sich ge- gen den Autor, dessen auf eigene Schwachen und Fehler gerichtete Offenherzig- keit und gelegentliche Unverbliimtheit andere noch lebende Zeitgenossen nicht aussparte, bei einer Veroffentlichung erheben wiirden. Tilgen, zudecken und schonen wollte er nieht. Uber dem Hin und Her der Diskussion ist das fiir die Kenntnis der Psychiatrie seit dem Ende des ersten Weltkrieges wichtige Manu- skript liegengeblieben. Es wird jetzt herausgegeben, ohne Retuschen, doch mit manchen Streichungen, die von der Riicksicht auf Angehorige bestimmt waren, und erweitert urn einen Anhang, der im Text erwahnten Namen knappe ErUiute- rungen beifiigt.