The pregnant applicant: normal alterations in physiologic parameters and testing

Pregnancy affects virtually every organ system, and "baseline" normal laboratory test levels change throughout gestation.     

Innovation at the speed of information

Conventional project-management tools--PERT charts and Gantt charts, for example--were created to help manage sequences of discrete tasks that make up large construction projects. Yet these tools don't capture clearly the back-and-forth of information that takes place in innovative processes, such as product development. Conventional tools are designed to answer the question, "What other tasks must be completed before I begin this one?" But product development planners, especially in high-tech businesses, need tools that answer a very different question: "What information do I need from other tasks before I can complete this one?" The author describes the Design Structure Matrix (DSM), a project management tool that focuses on representing the information flows of a project rather than its work flows. He explains how the DSM works and how to use it to make development processes more efficient. A project DSM can show which information exchanges involve design iteration and how well a process anticipates the need for rework. In addition, the author suggests four ways to improve a company's information flows: rearranging the sequence of tasks, reconsidering the organization of tasks, reducing the number of information exchanges, and managing unplannable work. By stripping away the mystery around information exchange during innovation, the DSM can give managers far more control over their most risky and expensive projects.     

Doppler echocardiographic changes found in diastolic dysfunction

Diastolic dysfunction may be associated with increased morbidity and mortality. In this article, an overview of the pathophysiology of diastolic dysfunction is discussed and the findings of Doppler echocardiography used to aid in its diagnosis are reviewed.     

Cocaine revisited

Insurance companies often test applicants for the presence of cocaine. Because a positive test may automatically preclude further consideration, such cases often never reach the medical director. The negative impact of cocaine use on insurability is reviewed.     

Capitalism's growth imperative

A capitalist firm operating in a competitive market is subjectto a growth imperative, because uncertainty about the profitrate under a no-growth policy makes the firm's prospects highlyunattractive in finite time and bankruptcy practically certainin the long run. A no-growth policy determines consumption andinvestment so that they and capital would remain constant overtime if the latter's expected return were realised with certainty.Simulation is used to arrive at the probability of bankruptcyby the end of t periods and the expected values of capital andmoney, for relevant combinations of time and uncertainty undersuccessively more realistic models of a no-growth firm in acompetitive market. The sensitivity of the results to variationin the parameters in each of the models is evaluated. Finally,we establish that a plausible growth policy may achieve growth,but the problem of bankruptcy is not resolved.     

Leapfrog standards: implications for nursing practice

Annually, thousands die unnecessarily as a result of preventable medical errors. Medical literature supports use of evidence-based standards to increase safety and improve the quality of health care. Nursing implications from three imposed standards are examined.