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Looks at the advantages of dimensional management in improving quality and reducing cost through controlled variation and robost design as opposed to the more traditional tolerance assignment. Lists the limitations of tolerance assignment and details the six basic steps of the dimensional management process. Gives practical advice on how to undertake the process of dimensional management.

As part of a broader investigation into the training needs of rural doctors, the reasoning behind decisions of graduates to enter rural practice in North Queensland was explored. North Queensland is a growing and diverse region that is home to 500 000 people but has had no local production of medical graduates. While prior rural exposure was found to be a powerful influence on the decision of some, a small number of those interviewed entered rural practice almost by chance, liked it and stayed. Should this finding be confirmed in more formal investigation, workforce planners would need to continue initiatives to recruit graduates who have no prior connection to rural life.

Objective: To identify requirements for vocational training and continuing education programs in rural general practice. Design: A questionnaire was sent to all 487 rural doctors and 140 metropolitan and 140 provincial city general practitioners (GPs) in Queensland. A sample of medical educators, health professional and consumer representatives and rural doctors was also interviewed. Responses were compared by geographical area, practice characteristics and level of postgraduate training. Results: There are significant differences between rural and urban practice profiles. Rural doctors have to practise a range of clinical skills in an environment with restricted access to health professional support, although the need for advanced training in procedural or other skills depends on the type of rural practice. Rural and urban doctors want more influence in determining continuing medical education (CME) programs. Interactive learning methods were rated as the most effective education methods by both rural and urban GPs. Rural doctors were less likely to consider that they spent enough time on CME. Conclusion: Vocational training programs should accommodate various rural career objectives, including those requiring advanced levels of procedural work. There is a significant unmet demand for CME tailored to the needs of individual doctors, both rural and urban, but distance and isolation may make this more critical in rural practice. These issues need to be addressed as training opportunities can contribute to improved retention of the rural medical workforce.

— Twenty-one perennially affected atopic dogs with previous intradermal test reactivity to two or more environmental allergens were retested while receiving either a combination of evening primrose oil and fish oil (EfaVet Regular, Efamol Vet) or a concentrated supplement containing gammalinolenic acid and eicosapentaenoic acid (HGF capsules). Significant differences in the mean number of positive reactions before and during therapy were not found. In addition, the mean histamine, Dermatophagoides pteronyssinus and housedust wheal diameters before and during therapy were not significantly different. However, the mean human dander wheal diameter was significantly reduced (P < 0.05) at the second test, and the mean Dermatophagoides farinae wheal diameter was significantly reduced (P < 0.05) in a group of seven dogs which had received long-term essential fatty acid supplementation with HGF capsules. These results indicate that essential fatty acid supplementation does not abrogate but may reduce intradermal test reactivity in atopic dogs. Resume— Vingt et un chiens atopiques, presentant des symptomes non saisonniers, ayant eu des tests cutanes positifs a au moins un pneumallergene ont ete testes alors qu'ils recevaient une association d'huile d'onagre et d'huile de poisson (Efa Vet Regular, Efamol Vet) ou un supplement concentre d'acides gammalinolenique et eicosapentaenoique (capsules HGF). Aucune difference significative dans le nombre moyen de reactions positives avant et apres traitement n'a ete observee. En outre les diametres moyens des reactions a l'histamine. Dermatophagoides pteronyssinus et la poussere de maison avant et apres traitement n'etaient pas significativement differents. Toutefois, le diametre moyen des reactions aux squames humaines etaient significativement reduits (P < 0,05) lors du second test, et le diametre moyen des reactions aDermatophagoides farinaeetait significativement reduit (P < 0,05) dans un groupe de sept chiens ayant recu une supplementation a long terme de capsules HGF. Ces resultate montrent qu'une supplementation en acides gras essentiel n'anihile pas les tests cutanes mais peu moderer la reactivite cutanee chez certains chiens atopiques. Resumen Veintiun perros atopicos de tipo estacional que presentaban reactividad positiva en la prueba de inyacciones intradermicas con respecto a dos o mas alergenos ambientales, fueron sometidos a una segunda prueba recibiendo simultaneamente una combinacion de aceite de Evening Primrose y aceite de pescado (Efa Vet Regular, Efamol Vet) o un concentrado que contenia acidos gammalinoleico y ecosapentanoico (HGF capsulas). No se encontraron diferencias significativas en la media de las reacciones positivas antes y despues de la medicacion. Tampoco se encontraron diferencias significativas entre las medidas del diametro de la roncha producida por la histamina, el Dermatophagoides pteronyssinus y el alergeno del polvo. Sin embargo, la media del diametro producido por el alergeno de la caspa humana se vio considerablemente reducida en el segundo test (P < 0.05), asi como la del Dermatophagoides farinae (P < 0.05) en un grupo de siete perros los cuales recibieron suplementacion con acidos grasos esenciales a largo plato con HGF capsulas. Estos resultados indican que el uso de acidos grasos esenciales no produce supresion de las reacciones positivas del test intradermico en perros atopicos, pero si de las mismas.

EDITORIAL COMMENT": The Editorial Subcommittee of this journal agreed to publish this important curriculum statement for advanced obstetric training for rural general practitioners partly because we thought that general practitioner obstetricians who comprise more than half of our 5,000 subscribers will be interested to read this document carefully if for no other reason than to check their own clinical abilities in the various sections provided. Copyright

The relative shortage of both general practitioners and specialists providing medical services to rural areas disadvantages people living in the country. This maldistribution of the medical workforce is due in part to the medical education system. The selection and socialisation of medical students, the adequacy of training for rural practice and the continuing support of rural doctors must all be addressed. While progress is being made in vocational training and continuing support of rural practice, aspects of undergraduate education continue to contribute to the shortage of rural practitioners. The school and home addresses of 1991 school leavers in the 1992 intake into first year medicine at the University of Queensland were analysed and compared with those previously reported. Results indicated that students from rural backgrounds remain underrepresented despite previous recommendations to redress the disproportionately low number of rural students entering medical school. Changes to the selection of medical students aimed at increasing the number of rural students entering the course are discussed. This issue needs to be addressed in conjunction with many other factors contributing to the maldistribution of general practitioners if the shortage of rural medical practitioners is to be ultimately corrected. Copyright

The purpose of the Rural Health Education, Training and Research Network is to support the education and training of rural health practitioners and research in rural health through the optimum use of appropriate information and communication technologies to link and inform all individuals and organisation involved in the teaching, planning and delivery of health care in rural and remote Queensland. The health care of people in rural areas has the potential to be enhanced, through providing the rural and remote health professionals in Queensland with the same access to educational and training opportunities as their metropolitan colleagues. This consultative, coordinated approach should be cost‐effective through both increasing awareness and utilisation of existing and developing networks, and through more efficient and rational use of both the basic and sophisticated technologies which support them. Technological hardware, expertise and infrastructure are already in place in Queensland to support a Rural Health Education, Training and Research Network, but are not being used to their potential, more often due to a lack of awareness of their existence and utility than to their perceived costs. Development of the network has commenced through seeding funds provided by Queensland Health. Future expansion will ensure access by health professionals to existing networks within Queensland. This paper explores the issues and implications of a network for rural health professionals in Queensland and potentially throughout Australia, with a specific focus on the implications for rural and isolated health professional.

A patient who had previously undergone a modified radical mastoidectomy subsequently underwent cochlear implantation with good results. At surgery the mastoid cavity was partially obliterated to provide soft tissue cover for the implant cables. Following local infection the cable became exposed and we used a middle temporal artery local flap to provide cover for the cable. The anatomy of the flap and methods used are described here. The patient continues to have good hearing from the implant with a good coverage over the cable. Copyright © 2006 John Wiley & Sons, Ltd.

Articulating paper mark size has been widely accepted in the dental community to be descriptive of occlusal load. The objective of this study is to determine if any direct relationship exists between articulating paper mark area and applied occlusal load. A uniaxial testing machine repeatedly applied a compressive load, beginning at 25N and incrementally continuing up to 450N, to a pair of epoxy dental casts with articulating paper interposed. The resultant paper markings (n = 600) were photographed, and analyzed the mark area using a photographic image analysis and sketching program. A two-tailed Student's t-test for unequal variances compared the measured size of the mark area between twelve different teeth (p < 0.05). Graphical interpretation of the data indicated that the mark area increased non-linearly with increasing load. When the data was grouped to compare consistency of the mark area between teeth, a high variability of mark area was observed between different teeth at the same applied load. The Student's t-test found significant differences in the size of the mark area approximately 80% of the time. No direct relationship between paper mark area and applied load could be found, although the trend showed increasing mark area with elevating load. When selecting teeth to adjust, an operator should not assume the size of paper markings, accurately describing the markings' occlusal contact force content.

Black's Veterinary Dictionary, first published in 1928, is now in its 22nd edition. This sturdy hardback volume adopts a practical approach, is reasonably priced, and is a useful, informative addition to your bookshelf.

Although many physical limitations have been reached in modern micro-lithography, printed critical dimensions continue to shrink according to the International Technology Roadmap for Semiconductors (ITRS) [1]. To meet the demands imposed by this guideline, the traditional separation between design and manufacturing communities is being bridged. Many EDA tools package manufacturing data for delivery into established simulation engines for design verification. However, none of them provide practical implementations of design optimizations at an early stage in the design flow.This paper presents an automated layout modification flow for metal layers with the goal of enhancing manufacturability. It can easily be deployed in a current custom design flow in a way that is visible to designers. The result of this scheme is improvements to process windows and yield, while minimizing circuit performance detractors. The flow is verified through analyses of both the impact on circuit performance and the benefit to manufacturability. It has been implemented in a state-of-the-art 65 nm chip design. Both silicon yield and electrical performance data are currently being collected and analyzed.

This Case Study is continued online visit www.ukvet.co.uk to complete this free online Case Study. If you are a subscriber you will be able to access this and many more online-only Case Studies as part of your Continuing Professional Development. Visit www.ukvet.co.uk, log in and answer the multiple choice questions which lead you through the Case Study. Your answers will then be submitted and marked instantly to achieve a Certificate of Completion which can be printed off and kept as part of your CPD portfolio. Mark Craig BVSc CertSAD MRCVS

A pilot survey by telephone interview, followed by a questionnaire of all rural doctors identified in Queensland, was used develop both a definition of rural practice that distinguishes it from urban general practice and a classification of rural and remote practice which assists in sampling of rural doctors. Questionnaire responses in specific geographic areas were compared using chi-square and Mantel-Haenszel chi-square tests. Several factors were found to differentiate rural from urban general practice consistently, thereby enabling a functional definition of rural practice to be developed. Within the broad group of rural doctors, gradients in practice characteristics were found to differentiate doctors in larger rural centres from those in smaller, more remote communities. These gradients were related to the distance and time of travel from support services. They formed the basis of a complex classification of rural and remote general practice. This functional definition of rural and remote medical practice should be considered by researchers of rural medicine issues when sampling rural and remote doctors. The strategies used in this study could be adapted for use in considering practice characteristics of other rural health professions.

The Opticam®SM was designed1 in the early 1990’s for use in the investigation of microgrinding at the University of Rochester’s Center for Optics Manufacturing. A multi-axis flexible machining center was delivered2 to the University in mid-1992, and is now located at the Center’s site in Rochester. This first SM machine represented a milestone in the design of machine tools specific to the manufacture of spherical lenses. Based on the experience gained from the construction and use of the original SM, a design is now being prototyped for a new machine tool for general lens production. This presentation will describe the design of this new machine tool, the Microform®SM.

Micro-stepping position tests are often used to demonstrate the performance of ultraprecise machine tools. These tests record the ability of a machine tool to precisely move slides over very short distances. To optimize machine performance for these tests it is necessary to detune slide servo system characteristics from typical operating values. Therefore discreet micro-stepping tests are not representative of the dynamic contouring performance of ultraprecise machine tools.

Recent advances in machine tools for single point diamond turning have significantly improved the quality of machined surfaces available. The most recent generation of SPDT machines are producing optical surfaces suitable for many visible wavelength applications. This presentation will examine the quality of current SPDT surfaces and compare them with reasonable criteria for visible wavelength surface specifications.

This paper will investigate diamond turning ogive error. The equations that describe surfaces with ogive error will be derived from a simple Pythagorean model for tool offsets. The geometry of an ogive "sphere" will be reviewed and ogive form errors on aspheric surfaces will also be investigated. By considering the wavefront errors created by surfaces with ogive error the implications for optical tolerancing will be examined.

This paper will examine how optical designers can use diamond machining techniques to design, test, and construct multimirror optical systems. An unusual two-mirror telescope will be used to demonstrate the advantages of these techniques. A review of the use of non-traditional surface descriptions, a diamond machining approach to aspheric surface metrology, and techniques for system construction and assembly will be described.

This paper will discuss the use of aluminum alloy castings as diamond machining substrates for optical surfaces. Surface texture, infrared reflectivity, and temporal stability results from cast diamond machined samples will be presented. Physical data on these alloys will be given along with casting considerations.

A new technique for the testing of generalized rotationally-symmetric aspheric surfaces is presented. The technique utilizes commercially available interferometric equipment and unique aspheric compensating components. For each test, the aspheric compensating component is designed as a null reflective end-mirror in the interferometric cavity containing the aspheric surface under test. The aspheric compensating component can be produced by diamond-machining techniques. The design methodology, limitations of the technique and examples are presented.

This investigation will examine differences in the diamond machined surface structure of various mono and polycrystalline germanium material forms. Germanium substrates were machined under controlled conditions and evaluated for surface texture and subsurface damage. Results of the substrate evaluations along with details of the sample preparations and machining are given.