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As with any general framework, the words used to describe each Ring can mean different things in different circumstances. For instance, the competencies in question might be competencies of technique, insight or recall of information. When the Rings are expressed for resources these might be human organs, money, beds, time or skilled people whatever might legitimately be considered a resource. Reality must give meaning to each Ring. Figure 30 is a simple representation of one way in which nursing activity might be limited by competence. It is better not to imagine a nurse jumping from one section of the Rings to another. Although the Rings as illustrated appear sharply divided, in reality different levels of competence shade into each other, just as a bold scarlet can fade slowly to the palest pink. The Rings are meant to convey a steady weakening of certainty as the nurse moves towards the outer edge. Different sorts of question are likely to arise dependent upon the nurse s perceived position. For example, is the nurse the only person in a position to offer help Should she intervene only with the advice and assistance of others Is the nurse s ability to help so limited that any intervention is ill-advised Imagine how Sally Smith might use the Rings. Sally is a nurse who has established a relationship with John Jones, a cancer patient who also suffers from moderate depression. Sally has used the Rings before and is able to picture herself actually and potentially within them. She knows that by thinking graphically she is sometimes able to reason more concretely. By using the Rings Sally can say if I do that, then I shall be standing in this position within the Rings of Uncertainty . In one sense this is to do no more than say if I do this, X will happen , but Sally has discovered that reference to the image can deepen her thought processes. John a bachelor of 31 has cancer of the bone. His doctors advise that an operation now would give him a 50% chance of a cure, but they will have to amputate his arm below the left elbow. John was distraught to learn this. To lose a limb has always been one of his biggest dreads, and to make matters worse he makes his living playing the guitar. John refused to consent to the operation and was told that any other treatment is probably useless. In shock he informs Sally that he wishes to discharge himself from hospital. Sally has an ethical problem to deal with, of course. However, in order to decide what to do she needs more than ethical theory. She really needs to work out where she stands in this situation, and thinks the Rings might help. She considers the Rings expressed for competence, as shown in Figure 30. Where does she see herself She is in the outer rings for medical knowledge, though she is by no means a novice in oncology. But she does not have special knowledge, and to do anything clinical for John she would clearly have to work with a team. However, she has specialised in counselling and communication, and is the most quali ed person in the department in this respect. She also knows John better than anyone else she is a similar age and they have had several chats over the last couple of days. If she had been a poor communicator and had pictured herself standing at the edges of the Rings expressed for competence in this regard she would probably have been best advised to let John leave, or to refer him on. However, not only is she in the centre ring but the doctors have little interest in John now they think he has made a bad
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MWjp is the capacity of unit j in node p. MaxLkp is the forecast of the annual peak load for year k in node p. RReqkp are the primary and secondary forecasted reserve requirements for year k in node p. 3. All constraints from Section 4.7, modi ed for the selected time blocks Remarks Note that the power ow problem, Phase 2 of Section 4.7, is not addressed. There is too great a computational time expense to include this in the analysis. Instead, the output from this problem should be used to perform a separate power ow analysis that can then be used to develop transmission plans. Aside from a power ow analysis, other studies must be performed as part of the development of transmission planning. These include studies that determine system stability in the event of equipment failure or other perturbations to the system, e.g., lightning strike. Transmission costs for system upgrades associated with new construction have not been addressed in the above formulations. As an estimate, one could associate these costs with the xed cost of construction.
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