Self-Regulated Learning in Virtual Communities

ERIC Educational Resources Information Center

Delfino, Manuela; Dettori, Giuliana; Persico, Donatella

2008-01-01

This paper investigates self-regulated learning (SRL) in a virtual learning community of adults interacting through asynchronous textual communication. The investigation method chosen is interaction analysis, a qualitative/quantitative approach allowing a systematic study of the contents of the messages exchanged within online communities. The…

Using Discursis to enhance the qualitative analysis of hospital pharmacist-patient interactions.

PubMed

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William N; Angus, Daniel J

2018-01-01

Pharmacist-patient communication during medication counselling has been successfully investigated using Communication Accommodation Theory (CAT). Communication researchers in other healthcare professions have utilised Discursis software as an adjunct to their manual qualitative analysis processes. Discursis provides a visual, chronological representation of communication exchanges and identifies patterns of interactant engagement. The aim of this study was to describe how Discursis software was used to enhance previously conducted qualitative analysis of pharmacist-patient interactions (by visualising pharmacist-patient speech patterns, episodes of engagement, and identifying CAT strategies employed by pharmacists within these episodes). Visual plots from 48 transcribed audio recordings of pharmacist-patient exchanges were generated by Discursis. Representative plots were selected to show moderate-high and low- level speaker engagement. Details of engagement were investigated for pharmacist application of CAT strategies (approximation, interpretability, discourse management, emotional expression, and interpersonal control). Discursis plots allowed for identification of distinct patterns occurring within pharmacist-patient exchanges. Moderate-high pharmacist-patient engagement was characterised by multiple off-diagonal squares while alternating single coloured squares depicted low engagement. Engagement episodes were associated with multiple CAT strategies such as discourse management (open-ended questions). Patterns reflecting pharmacist or patient speaker dominance were dependant on clinical setting. Discursis analysis of pharmacist-patient interactions, a novel application of the technology in health communication, was found to be an effective visualisation tool to pin-point episodes for CAT analysis. Discursis has numerous practical and theoretical applications for future health communication research and training. Researchers can use the software to support qualitative analysis where large data sets can be quickly reviewed to identify key areas for concentrated analysis. Because Discursis plots are easily generated from audio recorded transcripts, they are conducive as teaching tools for both students and practitioners to assess and develop their communication skills.

Quantitative and Qualitative Analysis of Biomarkers in Fusarium verticillioides

USDA-ARS?s Scientific Manuscript database

In this study, a combination HPLC-DART-TOF-MS system was utilized to identify and quantitatively analyze carbohydrates in wild type and mutant strains of Fusarium verticillioides. Carbohydrate fractions were isolated from F. verticillioides cellular extracts by HPLC using a cation-exchange size-excl...

Online Peer-to-Peer Communities in the Daily Lives of People With Chronic Illness: A Qualitative Systematic Review.

PubMed

Kingod, Natasja; Cleal, Bryan; Wahlberg, Ayo; Husted, Gitte R

2017-01-01

This qualitative systematic review investigated how individuals with chronic illness experience online peer-to-peer support and how their experiences influence daily life with illness. Selected studies were appraised by quality criteria focused upon research questions and study design, participant selection, methods of data collection, and methods of analysis. Four themes were identified: (a) illness-associated identity work, (b) social support and connectivity, (c) experiential knowledge sharing, and (d) collective voice and mobilization. Findings indicate that online peer-to-peer communities provide a supportive space for daily self-care related to chronic illness. Online communities provided a valued space to strengthen social ties and exchange knowledge that supported offline ties and patient-doctor relationships. Individuals used online communities to exchange experiential knowledge about everyday life with illness. This type of knowledge was perceived as extending far beyond medical care. Online communities were also used to mobilize and raise collective awareness about illness-specific concerns. © The Author(s) 2016.

A qualitative study of sign-out processes between primary and on-call residents: relationships in information exchange, responsibility and accountability.

PubMed

Lee, Soo-Hoon; Fisher, Dale A; Mah, Heidi; Goh, Wei-Ping; Phan, Phillip H

2017-10-01

To review a quality improvement event on the process of sign-outs between the primary and on-call residents. A retrospective qualitative study using semi-structured interviews. A tertiary academic medical center in Singapore with 283 inpatient Medicine beds served by 28 consultants, 29 registrars, 45 residents and 30 interns during the day but 5 residents and 3 interns at night. Residents, registrars and consultants. Quality improvement event on sign-out. Effectiveness of sign-out comprises exchange of patient information, professional responsibility and task accountability. The following process of sign-outs was noted. Primary teams were accountable to the on-call resident by selecting at-risk patients and preparing contingency plans for sign-out. Structured information exchanged included patient history, active problems and plans of care. On-call residents took ownership of at-risk patients by actively asking questions during sign-out and reporting back the agreed care plan. On-call residents were accountable to the primary team by reporting back at-risk patients the next day. A structured information exchange at sign-out increased the on-call resident's ability to care for at-risk patients when it was supported by two-way transfers of responsibility and accountability. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

In-School Suspension: An Effective Deterent of Student Misbehavior or Just Another Form of Discipline

ERIC Educational Resources Information Center

Roach, William Farris, Jr.

2012-01-01

This qualitative study sought to better understand the lived experiences of students, teachers, and administrators with regards to the In-School Suspension program. This study was grounded in a theoretical framework which included basic concepts of behaviorism and social exchange theory. With these theories this research study sought to explain…

The effect of a bidirectional exchange on faculty and institutional development in a global health collaboration.

PubMed

Bodnar, Benjamin E; Claassen, Cassidy W; Solomon, Julie; Mayanja-Kizza, Harriet; Rastegar, Asghar

2015-01-01

The MUYU Collaboration is a partnership between Mulago Hospital-Makerere University College of Health Sciences (M-MakCHS), in Kampala, Uganda, and the Yale University School of Medicine. The program allows Ugandan junior faculty to receive up to 1 year of subspecialty training within the Yale hospital system. The authors performed a qualitative study to assess the effects of this program on participants, as well as on M-MakCHS as an institution. Data was collected via semi-structured interviews with exchange participants. Eight participants (67% of those eligible as of 4/2012) completed interviews. Study authors performed data analysis using standard qualitative data analysis techniques. Analysis revealed themes addressing the benefits, difficulties, and opportunities for improvement of the program. Interviewees described the main benefit of the program as its effect on their fund of knowledge. Participants also described positive effects on their clinical practice and on medical education at M-MakCHS. Most respondents cited financial issues as the primary difficulty of participation. Post-participation difficulties included resource limitations and confronting longstanding institutional and cultural habits. Suggestions for programmatic improvement included expansion of the program, ensuring appropriate management of pre-departure expectations, and refinement of program mentoring structures. Participants also voiced interest in expanding post-exchange programming to ensure both the use of and the maintenance of new capacity. The MUYU Collaboration has benefitted both program participants and M-MakCHS, though these benefits remain difficult to quantify. This study supports the assertion that resource-poor to resource-rich exchanges have the potential to provide significant benefits to the resource-poor partner.

A qualitative study on the attributes of nurses' workplace social capital in Japan.

PubMed

Norikoshi, Kensuke; Kobayashi, Toshio; Tabuchi, Keiji

2018-01-01

To identify attributes of nurses' workplace social capital in Japan. Much attention has been paid to nurses' workplace social capital to improve the quality of the work environment; however, few studies are available on the attributes of nurses' workplace social capital. Semi-structured interviews were conducted with 32 nurses at seven hospitals. Nurses reported on the attributes of workplace social capital, such as characteristics facilitating individual positive action in an organisation, which were qualitatively analysed using the Kawakita Jiro method. The attributes of nurses' workplace social capital were organised into six groups: affirmation; exchange of appreciation; unrestricted information sharing; ability to trust; access to the strength; and altruistic reciprocity. The attributes of nurses' workplace social capital included a social structure that allowed nurses to make full use of their abilities both vertically and horizontally and were supported by a sense of security. In particular, newly emerged exchange of appreciation and altruistic reciprocity were important for nurses in Japan in building cooperative relationships with others. Managing human relationships, such as exchange of appreciation and altruistic reciprocity, in clinical settings based on nurses' workplace social capital may promote positive emotions in the organisation, positive ideas among staff and cooperative teamwork, which may lead to high-quality patient care. © 2017 John Wiley & Sons Ltd.

Knowledge exchange and integrated services: experiences from an integrated community intellectual (learning) disability service for adults.

PubMed

Farrington, C; Clare, I C H; Holland, A J; Barrett, M; Oborn, E

2015-03-01

This paper examines knowledge exchange dynamics in a specialist integrated intellectual (learning) disability service, comprising specialist healthcare provision with social care commissioning and management, and considers their significance in terms of integrated service delivery. A qualitative study focusing on knowledge exchange and integrated services. Semi-structured interviews (n = 25) were conducted with members of an integrated intellectual disability service in England regarding their perceptions of knowledge exchange within the service and the way in which knowledge exchange impinges on the operation of the integrated service. Exchange of 'explicit' (codifiable) knowledge between health and care management components of the service is problematic because of a lack of integrated clinical governance and related factors such as IT and care record systems and office arrangements. Team meetings and workplace interactions allowed for informal exchange of explicit and 'tacit' (non-codifiable) knowledge, but presented challenges in terms of knowledge exchange completeness and sustainability. Knowledge exchange processes play an important role in the functioning of integrated services incorporating health and care management components. Managers need to ensure that knowledge exchange processes facilitate both explicit and tacit knowledge exchange and do not rely excessively on informal, 'ad hoc' interactions. Research on integrated services should take account of micro-scale knowledge exchange dynamics and relationships between social dynamics and physical factors. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Critical Media Literacy in Pedagogy and in Practice: A Descriptive Study of Teacher Education Instructors and Their Students

ERIC Educational Resources Information Center

Funk, Steven Seth

2013-01-01

This qualitative study explored the exchange between post-secondary Critical Media Literacy instructors and their students, describing their understandings of Critical Media Literacy, as well as their pedagogical struggles, within the context of a teacher education program. The data suggested that the UCLA instructors understood Critical Media…

L2 Academic Discourse Socialization through Oral Presentations: An Undergraduate Student's Learning Trajectory in Study Abroad

ERIC Educational Resources Information Center

Kobayashi, Masaki

2016-01-01

The present study provides an in-depth, longitudinal account of an undergraduate student's L2 discourse socialization in an academic exchange program in Canada. By invoking Rogoff's (1995) notion of participatory appropriation, this qualitative case study examined an L2 student's task-related strategies and performance as they evolved over time in…

Learner Interpretations of Shared Space in Multilateral English Blogging

ERIC Educational Resources Information Center

Yang, Yu-Feng

2011-01-01

This qualitative study aims to understand how English learners interpret shared space in an online multilateral English blogging context and how their interpretations of shared space contribute to their multilateral exchange experience. Twenty-four Asian learners of English from two different universities--one in Japan and one in…

Factors That Impact How Civil Society Intermediaries Perceive Evidence

ERIC Educational Resources Information Center

Allen, William L.

2017-01-01

Civil society organisations increasingly mediate the creation and exchange of evidence in their activities with policy-makers and practitioners. This article extends knowledge on evidence in policy-making settings to civil society contexts. As an exploratory and qualitative study, it shows how nine UK-based organisations working on issues…

Exploring knowledge exchange: a useful framework for practice and policy.

PubMed

Ward, Vicky; Smith, Simon; House, Allan; Hamer, Susan

2012-02-01

Knowledge translation is underpinned by a dynamic and social knowledge exchange process but there are few descriptions of how this unfolds in practice settings. This has hampered attempts to produce realistic and useful models to help policymakers and researchers understand how knowledge exchange works. This paper reports the results of research which investigated the nature of knowledge exchange. We aimed to understand whether dynamic and fluid definitions of knowledge exchange are valid and to produce a realistic, descriptive framework of knowledge exchange. Our research was informed by a realist approach. We embedded a knowledge broker within three service delivery teams across a mental health organisation in the UK, each of whom was grappling with specific challenges. The knowledge broker participated in the team's problem-solving process and collected observational fieldnotes. We also interviewed the team members. Observational and interview data were analysed quantitatively and qualitatively in order to determine and describe the nature of the knowledge exchange process in more detail. This enabled us to refine our conceptual framework of knowledge exchange. We found that knowledge exchange can be understood as a dynamic and fluid process which incorporates distinct forms of knowledge from multiple sources. Quantitative analysis illustrated that five broadly-defined components of knowledge exchange (problem, context, knowledge, activities, use) can all be in play at any one time and do not occur in a set order. Qualitative analysis revealed a number of distinct themes which better described the nature of knowledge exchange. By shedding light on the nature of knowledge exchange, our findings problematise some of the linear, technicist approaches to knowledge translation. The revised model of knowledge exchange which we propose here could therefore help to reorient thinking about knowledge exchange and act as a starting point for further exploration and evaluation of the knowledge exchange process. Copyright © 2011 Elsevier Ltd. All rights reserved.

Influences of Scholarship Aid on the Social Exchange Cycle: A Qualitative Exploration of Scholarship Recipients and Direct Reciprocity

ERIC Educational Resources Information Center

Forrest, Jeannie

2010-01-01

Social exchange theory asserts that individuals who receive a gift will be pressed by an internal sense of obligation to give back in turn (Mauss, 2002). While there is a great deal of literature devoted to giving, there is little literature about the receiving end of the exchange cycle. Deeply impacted by the effects of direct reciprocity are…

Qualitative Collection Analysis: The Conspectus Methodology. SPEC Kit 151.

ERIC Educational Resources Information Center

Jakubs, Deborah

The introduction to this Systems and Procedures Exchange Center (SPEC) kit explains the Conspectus method, which was developed in 1980 by the Research Libraries Group (RLG) as a means of systematically and qualitatively evaluating large library collections. The discussion considers advantages and disadvantages of this tool, which evaluates past…

17 CFR 229.305 - (Item 305) Quantitative and qualitative disclosures about market risk.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false (Item 305) Quantitative and... Information § 229.305 (Item 305) Quantitative and qualitative disclosures about market risk. (a) Quantitative information about market risk. (1) Registrants shall provide, in their reporting currency, quantitative...

17 CFR 229.305 - (Item 305) Quantitative and qualitative disclosures about market risk.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false (Item 305) Quantitative and... Information § 229.305 (Item 305) Quantitative and qualitative disclosures about market risk. (a) Quantitative information about market risk. (1) Registrants shall provide, in their reporting currency, quantitative...

17 CFR 229.305 - (Item 305) Quantitative and qualitative disclosures about market risk.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false (Item 305) Quantitative and... Information § 229.305 (Item 305) Quantitative and qualitative disclosures about market risk. (a) Quantitative information about market risk. (1) Registrants shall provide, in their reporting currency, quantitative...

17 CFR 229.305 - (Item 305) Quantitative and qualitative disclosures about market risk.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 3 2014-04-01 2014-04-01 false (Item 305) Quantitative and... Information § 229.305 (Item 305) Quantitative and qualitative disclosures about market risk. (a) Quantitative information about market risk. (1) Registrants shall provide, in their reporting currency, quantitative...

17 CFR 229.305 - (Item 305) Quantitative and qualitative disclosures about market risk.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false (Item 305) Quantitative and... Information § 229.305 (Item 305) Quantitative and qualitative disclosures about market risk. (a) Quantitative information about market risk. (1) Registrants shall provide, in their reporting currency, quantitative...

Qualitative Research on "Mediated Dialogism" among Educators and Pupils

ERIC Educational Resources Information Center

Hansson, Thomas

2004-01-01

The relevance of qualitative research to virtual practices rests on subject knowledge and practical know-how on operations for exchange, growth, learning, and dialogue. Highlighting the discursive perspective, this paper covers theory on emerging didactics for online learning. In doing so, the contents show how computer-mediated learning…

A comprehensive review of milk fouling on heated surfaces.

PubMed

Sadeghinezhad, E; Kazi, S N; Dahari, M; Safaei, Mohammad Reza; Sadri, Rad; Badarudin, A

2015-01-01

Heat exchanger performance degrades rapidly during operation due to formation of deposits on heat transfer surfaces which ultimately reduces service life of the equipment. Due to scaling, product deteriorates which causes lack of proper heating. Chemistry of milk scaling is qualitatively understood and the mathematical models for fouling at low temperatures have been produced but the behavior of systems at ultra high temperature processing has to be studied further to understand in depth. In diversified field, the effect of whey protein fouling along with pressure drop in heat exchangers were conducted by many researchers. Adding additives, treatment of heat exchanger surfaces and changing of heat exchanger configurations are notable areas of investigation in milk fouling. The present review highlighted information about previous work on fouling, influencing parameters of fouling and its mitigation approach and ends up with recommendations for retardation of milk fouling and necessary measures to perform the task.

Access to Health Care Services among Young People Exchanging Sex in Detroit.

PubMed

Knittel, Andrea K; Graham, Louis F; Peterson, Jerry; Lopez, William; Snow, Rachel C

2018-04-05

Within the related epidemics of sex exchange, drug use, and poverty, access to health care is shaped by intersecting identities, policy, and infrastructure. This study uses a unique survey sample of young adults in Detroit, who are exchanging sex on the street, in strip clubs, and at after-hours parties and other social clubs. Factors predicting access to free or affordable health care services, such as venue, patterns of sexual exchange influence, drug use and access to transportation, were examined using multivariable logistic regression and qualitative comparative analysis. The most significant predictors of low access to health care services were unstable housing and lack of access to reliable transportation. In addition, working on the street was associated with decreased access to services. Coordinated policy and programming changes are needed to increase health care access to this group, including improved access to transportation, housing, and employment, and integration of health care services.

A Qualitative Study on Knowledge Transfer among Members of the United States Intelligence Community

ERIC Educational Resources Information Center

Keshavarz-Nia, Navid R.

2011-01-01

This study sought to examine the relationship between social interaction and tacit knowledge transfer, as a dyadic exchange of critical knowledge between a Subject Matter Expert (SME) and a Knowledge Recipient (KR). Knowledge was defined as information and know-how, not merely as organized data or a system, but an active social process that was…

International Student Mobility Programs and Effects on Student Teachers' Perceptions and Beliefs about Education and Their Role as Future Educators

ERIC Educational Resources Information Center

Richardson, Rachel; Munday, Jennifer

2013-01-01

The aim of this study was to examine the value and benefits obtained from a semester length academic exchange for Australian early childhood teacher education students in equivalent programs in selected European sites. The data obtained from interviews conducted in this qualitative study indicate that students involved in the international…

Exploring the Critical Dialogical Process: Psychological and Physical Spaces Creating Conditions Conducive to Multi-System Collective Action in Higher Education

ERIC Educational Resources Information Center

Pittman-Adkins, Pamela

2015-01-01

Purpose: The purpose of this study is to explore physical and psychological elements conducive to engaging educators from K-12 and higher education in meaningful exchanges that lead to collective action. Research Design: Through a qualitative case study of two higher education sites focused on advancing academically-based service learning…

Charged particle measurements on a 30-CM diameter mercury ion engine thrust beam

NASA Technical Reports Server (NTRS)

Sellen, J. M., Jr.; Komatsu, G. K.; Hoffmaster, D. K.; Kemp, R. F.

1974-01-01

Measurements of both thrust ions and charge exchange ions were made in the beam of a 30 centimeter diameter electron bombardment mercury ion thruster. A qualitative model is presented which describes magnitudes of charge exchange ion formation and motions of these ions in the weak electric field structure of the neutralized thrust beam plasma. Areas of agreement and discrepancy between observed and modeled charge exchange properties are discussed.

Pen Pal Writing: A Holistic and Socio-Cultural Approach to Adult English Literacy

ERIC Educational Resources Information Center

Larrotta, Clarena; Serrano, Arlene F.

2012-01-01

This qualitative study reports the findings implementing a pen pal letter exchange project between adult English language learners and volunteer native English speakers. The pen pal project was implemented using a holistic and socio-cultural approach to English literacy development. This article presents pen pal writing as an authentic language…

In and out of Synch: Infant Childcare Teachers' Adaptations to Infants' Developmental Changes

ERIC Educational Resources Information Center

Recchia, Susan L.; Shin, Minsun

2012-01-01

This qualitative multi-case study explored the social exchanges and responsive connections between infants and their infant childcare teachers within a group care context. Infants' naturally occurring behaviours were videotaped purposefully at two separate time points, near the end of their first year and approximately six months later. Findings…

The Characteristic Mobile Learning Engagement Strategies of International School Middle-Years Students

ERIC Educational Resources Information Center

Arnold, Bradley A.

2018-01-01

The purpose of this qualitative case study was to develop descriptions of how teenage students remain engaged in learning while using mobile technology. Developments in technology have expanded learning contexts and provided learners with improved capacities to connect with others to exchange, gain, and construct knowledge. Developments in…

What You Get when You Give: How Graduate Students Benefit from Serving as Mentors

ERIC Educational Resources Information Center

Reddick, Richard J.; Griffin, Kimberly A.; Cherwitz, Richard A.; Cerda-Prazak, Aida A.; Bunch, Nathan

2012-01-01

This study utilizes a social exchange framework to analyze the qualitative narratives of 81 graduate student mentors participating in the Intellectual Entrepreneurship Pre-Graduate Internship at The University of Texas at Austin. Findings suggest that in addition to personal benefits, mentorship has four major professional benefits: a deeper…

Using Discursis to enhance the qualitative analysis of hospital pharmacist-patient interactions

PubMed Central

Barras, Michael A.; Angus, Daniel J.

2018-01-01

Introduction Pharmacist-patient communication during medication counselling has been successfully investigated using Communication Accommodation Theory (CAT). Communication researchers in other healthcare professions have utilised Discursis software as an adjunct to their manual qualitative analysis processes. Discursis provides a visual, chronological representation of communication exchanges and identifies patterns of interactant engagement. Aim The aim of this study was to describe how Discursis software was used to enhance previously conducted qualitative analysis of pharmacist-patient interactions (by visualising pharmacist-patient speech patterns, episodes of engagement, and identifying CAT strategies employed by pharmacists within these episodes). Methods Visual plots from 48 transcribed audio recordings of pharmacist-patient exchanges were generated by Discursis. Representative plots were selected to show moderate-high and low- level speaker engagement. Details of engagement were investigated for pharmacist application of CAT strategies (approximation, interpretability, discourse management, emotional expression, and interpersonal control). Results Discursis plots allowed for identification of distinct patterns occurring within pharmacist-patient exchanges. Moderate-high pharmacist-patient engagement was characterised by multiple off-diagonal squares while alternating single coloured squares depicted low engagement. Engagement episodes were associated with multiple CAT strategies such as discourse management (open-ended questions). Patterns reflecting pharmacist or patient speaker dominance were dependant on clinical setting. Discussion and conclusions Discursis analysis of pharmacist-patient interactions, a novel application of the technology in health communication, was found to be an effective visualisation tool to pin-point episodes for CAT analysis. Discursis has numerous practical and theoretical applications for future health communication research and training. Researchers can use the software to support qualitative analysis where large data sets can be quickly reviewed to identify key areas for concentrated analysis. Because Discursis plots are easily generated from audio recorded transcripts, they are conducive as teaching tools for both students and practitioners to assess and develop their communication skills. PMID:29787568

Promoting medical competencies through international exchange programs: benefits on communication and effective doctor-patient relationships

PubMed Central

2014-01-01

Background Universities are increasingly organizing international exchange programs to meet the requirements of growing globalisation in the field of health care. Analyses based on the programs’ fundamental theoretical background are needed to confirm the learning value for participants. This study investigated the extent of sociocultural learning in an exchange program and how sociocultural learning affects the acquisition of domain-specific competencies. Methods Sociocultural learning theories were applied to study the learning effect for German medical students from the LMU Munich, Munich, Germany, of participation in the medical exchange program with Jimma University, Jimma, Ethiopia. First, we performed a qualitative study consisting of interviews with five of the first program participants. The results were used to develop a questionnaire for the subsequent, quantitative study, in which 29 program participants and 23 matched controls performed self-assessments of competencies as defined in the Tuning Project for Health Professionals. The two interrelated studies were combined to answer three different research questions. Results The participants rated their competence significantly higher than the control group in the fields of doctor-patient relationships and communication in a medical context. Participant responses in the two interrelated studies supported the link between the findings and the suggested theoretical background. Conclusion Overall, we found that the exchange program affected the areas of doctor-patient relationships and effective communication in a medical context. Vygotsky’s sociocultural learning theory contributed to explaining the learning mechanisms of the exchange program. PMID:24589133

Promoting medical competencies through international exchange programs: benefits on communication and effective doctor-patient relationships.

PubMed

Jacobs, Fabian; Stegmann, Karsten; Siebeck, Matthias

2014-03-04

Universities are increasingly organizing international exchange programs to meet the requirements of growing globalisation in the field of health care. Analyses based on the programs' fundamental theoretical background are needed to confirm the learning value for participants. This study investigated the extent of sociocultural learning in an exchange program and how sociocultural learning affects the acquisition of domain-specific competencies. Sociocultural learning theories were applied to study the learning effect for German medical students from the LMU Munich, Munich, Germany, of participation in the medical exchange program with Jimma University, Jimma, Ethiopia. First, we performed a qualitative study consisting of interviews with five of the first program participants. The results were used to develop a questionnaire for the subsequent, quantitative study, in which 29 program participants and 23 matched controls performed self-assessments of competencies as defined in the Tuning Project for Health Professionals. The two interrelated studies were combined to answer three different research questions. The participants rated their competence significantly higher than the control group in the fields of doctor-patient relationships and communication in a medical context. Participant responses in the two interrelated studies supported the link between the findings and the suggested theoretical background. Overall, we found that the exchange program affected the areas of doctor-patient relationships and effective communication in a medical context. Vygotsky's sociocultural learning theory contributed to explaining the learning mechanisms of the exchange program.

The use of conferencing technologies to support drug policy group knowledge exchange processes: an action case approach.

PubMed

Househ, Mowafa Said; Kushniruk, Andre; Maclure, Malcolm; Carleton, Bruce; Cloutier-Fisher, Denise

2011-04-01

To describe experiences, lessons and the implications related to the use of conferencing technology to support three drug policy research groups within a three-year period, using the action case research method. An action case research field study was executed. Three different drug policy groups participated: research, educator, and decision-maker task groups. There were a total of 61 participants in the study. The study was conducted between 2004 and 2007. Each group used audio-teleconferencing, web-conferencing or both to support their knowledge exchange activities. Data were collected over three years and consisted of observation notes, interviews, and meeting transcripts. Content analysis was used to analyze the data using NIVIO qualitative data analysis software. The study found six key lessons regarding the impact of conferencing technologies on knowledge exchange within drug policy groups. We found that 1) groups adapt to technology to facilitate group communication, 2) web-conferencing communication is optimal under certain conditions, 3) audio conferencing is convenient, 4) web-conferencing forces group interactions to be "within text", 5) facilitation contributes to successful knowledge exchange, and 6) technology impacts information sharing. This study highlights lessons related to the use of conferencing technologies to support distant knowledge exchange within drug policy groups. Key lessons from this study can be used by drug policy groups to support successful knowledge exchange activities using conferencing technologies. 2010 Elsevier Ireland Ltd. All rights reserved.

Heat flux exchange estimation by using ATSR SST data in TOGA area

NASA Astrophysics Data System (ADS)

Xue, Yong; Lawrence, Sean P.; Llewellyn-Jones, David T.

1995-12-01

The study of phenomena such as ENSO requires consideration of the dynamics and thermodynamics of the coupled ocean-atmosphere system. The dynamic and thermal properties of the atmosphere and ocean are directly affected by air-sea transfers of fluxes of momentum, heat and moisture. In this paper, we present results of turbulent heat fluxes calculated by using two years (1992 and 1993) monthly average TOGA data and ATSR SST data in TOGA area. A comparison with published results indicates good qualitative agreement. Also, we compared the results of heat flux exchange by using ATSR SST data and by using the TOGA bucket SST data. The ATSR SST data set has been shown to be useful in helping to estimate the large space scale heat flux exchange.

Hysteresis behaviors in a ferrimagnetic Ising nanotube with hexagonal core-shell structure

NASA Astrophysics Data System (ADS)

Liu, Ying; Wang, Wei; Lv, Dan; Zhao, Xue-ru; Huang, Te; Wang, Ze-yuan

2018-07-01

Monte Carlo simulation has been employed to study the hysteresis behaviors of a ferrimagnetic mixed-spin (1, 3/2) Ising nanotube with hexagonal core-shell structure. The effects of different single-ion anisotropies, exchange couplings and temperature on the hysteresis loops of the system and sublattices are discussed in detail. Multiple hysteresis loops such as triple loops have been observed in the system under certain physical parameters. It is found that the anisotropy, the exchange coupling and the temperature strongly affect the coercivities and the remanences of the system and the sublattices. Comparing our results with other theoretical and experimental studies, a satisfactory agreement can be achieved qualitatively.

Oklahoma Retailers' Perspectives on Mutual Benefit Exchange to Limit Point-of-Sale Tobacco Advertisements.

PubMed

Chan, Andie; Douglas, Malinda Reddish; Ling, Pamela M

2015-09-01

Businesses changing their practices in ways that support tobacco control efforts recently have gained interest, as demonstrated by CVS Health's voluntary policy to end tobacco sales. Point-of-sale (POS) advertisements are associated with youth smoking initiation, increased tobacco consumption, and reduced quit attempts among smokers. There is interest in encouraging retailers to limit tobacco POS advertisements voluntarily. This qualitative exploratory study describes Oklahoma tobacco retailers' perspectives on a mutual benefit exchange approach, and preferred message and messenger qualities that would entice them to take voluntary action to limit tobacco POS advertisements. This study found that mutual benefit exchange could be a viable option along with education and law as strategies to create behavior change among tobacco retailers. Many retailers stated that they would be willing to remove noncontractual POS advertisements for a 6-month commitment period when presented with mutual exchange benefit, tailored message, and appropriate messenger. Mutual benefit exchange, as a behavior change strategy to encourage voluntary removal of POS tobacco advertisements, was acceptable to retailers, could enhance local tobacco control in states with preemption, and may contribute to setting the foundation for broader legislative efforts. © 2015 Society for Public Health Education.

Oklahoma Retailers’ Perspectives on Mutual Benefit Exchange to Limit Point-of-Sale Tobacco Advertisements

PubMed Central

Chan, Andie; Douglas, Malinda Reddish; Ling, Pamela M.

2015-01-01

Businesses changing their practices in ways that support tobacco control efforts recently have gained interest, as demonstrated by CVS Health’s voluntary policy to end tobacco sales. Point of sale (POS) advertisements are associated with youth smoking initiation, increased tobacco consumption, and reduced quit attempts among smokers. There is interest in encouraging retailers to limit tobacco POS advertisements voluntarily. This qualitative exploratory study describes Oklahoma tobacco retailers’ perspectives on a mutual benefit exchange approach, and preferred message and messenger qualities that would entice them to take voluntary action to limit tobacco POS advertisements. This study found mutual benefit exchange could be a viable option along with education and law as strategies to create behavior change among tobacco retailers. Many retailers stated that they would be willing to remove non-contractual POS advertisements for a six-month commitment period when presented with mutual exchange benefit, tailored message, and appropriate messenger. Mutual benefit exchange, as a behavior change strategy to encourage voluntary removal of POS tobacco advertisements, was acceptable to retailers, could enhance local tobacco control in states with preemption, and may contribute to setting the foundation for broader legislative efforts. PMID:25767197

Engineering Research Teams: The Role of Social Networks in the Formation of Research Skills for Postgraduate Students

ERIC Educational Resources Information Center

Sampson, Kaylene; Comer, Keith

2011-01-01

This study explores learner experiences regarding skills acquisition of a cohort of engineering doctoral students enrolled in a New Zealand university. Employing a qualitative methodology, we interviewed 28 PhD students about the range of experiences and exchanges that comprised their pathways to skill acquisition. Students reported that research…

"Not the Romantic, All Happy, Coochy Coo Experience": A Qualitative Analysis of Interactions on an Irish Parenting Web Site

ERIC Educational Resources Information Center

Brady, Ellen; Guerin, Suzanne

2010-01-01

Support groups in online communities provide an anonymous place to exchange information and advice. Previous research has suggested that these groups offer a safe, nonjudgmental forum for new parents to share experiences and interact anonymously. This study investigated how participants in online parenting groups experience support via the…

Authentic Tasks to Foster Oral Production among English as a Foreign Language Learners

ERIC Educational Resources Information Center

Ramírez Ortiz, Sandra Milena; Artunduaga Cuéllar, Marco Tulio

2018-01-01

Attaining oral production is a challenge for most English language teachers because most of the strategies implemented in class do not engage students in speaking activities. Tasks are an optimal alternative to engage learners in communicative exchanges. This article presents the results of a qualitative action research study examining the effects…

Extending the Borders of Community and Learning with Electronic Mail Discussion Lists.

ERIC Educational Resources Information Center

Yungbluth, Stephen C.; Bertino, Sissy

A qualitative study determined the impact electronic mail (e-mail) discussion lists can have on a college classroom. The theoretical concepts explored are "community" and "roles." Community is defined by the boundaries it possesses, the dialogue exchanged, and the people interacting in the community. Roles may be defined by the interactions among…

Social Exchange Practices among Mexican-Origin Women in Nogales, Arizona: Prospects for Education Acquisition

ERIC Educational Resources Information Center

O'Leary, Anna Ochoa

2006-01-01

This paper summarizes quantitative and qualitative findings from a 1999 study of Mexican-origin households in Nogales, Arizona. It finds that women's educational progress is facilitated by social support and, even more important, that a household's investment in the education of its members is significantly raised with an increase in the education…

Chief Information Officer's Role in Adopting an Interoperable Electronic Health Record System for Medical Data Exchange

ERIC Educational Resources Information Center

Akpabio, Akpabio Enebong Ema

2013-01-01

Despite huge growth in hospital technology systems, there remains a dearth of literature examining health care administrator's perceptions of the efficacy of interoperable EHR systems. A qualitative research methodology was used in this multiple-case study to investigate the application of diffusion of innovations theory and the technology…

Reaction limited aggregation in surfactant-mediated epitaxy

NASA Astrophysics Data System (ADS)

Wu, Jing; Liu, Bang-Gui; Zhang, Zhenyu; Wang, E. G.

2000-05-01

A theoretical model for reaction limited aggregation (RLA) is introduced to study the effect of a monolayer of surfactant on the formation of two-dimensional islands in heteroepitaxial and homoepitaxial growth. In this model the basic atomic processes are considered as follows. A stable island consists of the adatoms that have exchanged positions with the surfactant atoms beneath them. Movable active adatoms may (a) diffuse on the surfactant terrace, (b) exchange positions with the surfactant atoms beneath them and become island seeds (seed exchange), or (c) stick to stable islands and become stuck but still active adatoms. The rate-limiting step for the formation of a stable island is the seed exchange. Furthermore, a stuck but still active adatom must overcome a sizable potential-energy barrier to exchange positions with the surfactant atom beneath it and become a member of the stable island (aided exchange). The seed exchange process can occur with an adatom or collectively with an addimer. In the case of dimer exchange, the diffusing adatoms on the surfactant terrace can meet and (after exchanging) form stable dimers, which can then become island seeds. Systematic kinetic Monte Carlo simulations and rate-equation analysis of the model are carried out. The key finding of these simulations is that a counterintuitive fractal-to-compact island shape transition can be induced either by increasing deposition flux or by decreasing growth temperature. This major qualitative conclusion is valid for both the monomer and the dimer seed exchanges and for two different substrate lattices (square and triangular, respectively), although there are some quantitative differences in the flux and temperature dependence of the island density. The shape transition observed is contrary to the prediction of the classic diffusion-limited aggregation (DLA) theory, but in excellent qualitative agreement with recent experiments. In rationalizing the main finding, it is crucial to realize that the adatoms stuck to a stable island edge are still active and are surrounded by the surfactant atoms. Therefore, these stuck atoms cannot capture incoming adatoms before they join the island through aided exchange. As a result, an incoming adatom must on average hit the island many times before it finally finds a free edge site to stick to. This search is effectively equivalent to edge diffusion in DLA theory. The stuck adatoms thus act as shields which prevent other mobile adatoms from sticking to the stable islands. This shielding effect, determined by the aided exchange barrier and the density of the mobile adatoms, plays an essential role in inducing the above shape transition in surfactant-mediated epitaxial growth.

A student's analysis of the Moi University-Linköping University exchange programme.

PubMed

Mwenda, A S

2012-11-01

Introduction : Moi University College of Health Sciences was established in 1989. It is comprised of the schools of medicine, nursing, public health and dentistry. Since its inception, the college has been in collaboration with Linköping University in Sweden. This collaboration has taken the form of student and staff exchanges, as well as infrastructure and library improvements. This study was carried out to analyse the exchange programme and highlight some of the strengths that the exchange programme brings to the students' academic experience. Methods : A qualitative cross-sectional survey was conducted among the students who participated in the elective/exchange programme in the years 2009, 2010 and 2011. Self-administered questionnaires were completed by the participants. Additional data were obtained from the recommendations and conclusions from the reports that the students wrote after their participation in the exchange programme. Focus group discussions and key informant interviews were also carried out. Results : A total of 46 students participated in the exchange programme: 27 from Moi University and 19 from Linköping University. The disciplines of students reflected the undergraduate courses offered by these universities. The exchange programme's strengths were exposing students to new cultural settings, different healthcare system organisation and influencing future academic and personal lives, as well as making education global. The main challenge facing the exchange programme was language. Discussion : This study shows the exchange programme as a strong pillar of the medical education curriculum, enabling students to get a global perspective on their education, while exposing them to significant cultural and healthcare organisation diversity. There is a need to expand the collaboration so that more students have the opportunity to experience the overseas exchange programme.

Characterization of cross-linked cellulosic ion-exchange adsorbents: 2. Protein sorption and transport.

PubMed

Angelo, James M; Cvetkovic, Aleksandar; Gantier, Rene; Lenhoff, Abraham M

2016-03-18

Adsorption behavior in the HyperCel family of cellulosic ion-exchange materials (Pall Corporation) was characterized using methods to assess, quantitatively and qualitatively, the dynamics of protein uptake as well as static adsorption as a function of ionic strength and protein concentration using several model proteins. The three exchangers studied all presented relatively high adsorptive capacities under low ionic strength conditions, comparable to commercially available resins containing polymer functionalization aimed at increasing that particular characteristic. The strong cation- and anion-exchange moieties showed higher sensitivity to increasing salt concentrations, but protein affinity on the salt-tolerant STAR AX HyperCel exchanger remained strong at ionic strengths normally used in downstream processing to elute material fully during ion-exchange chromatography. Very high uptake rates were observed in both batch kinetics experiments and time-series confocal laser scanning microscopy, suggesting low intraparticle transport resistances relative to external film resistance, even at higher bulk protein concentrations where the opposite is typically observed. Electron microscopy imaging of protein adsorbed phases provided additional insight into particle structure that could not be resolved in previous work on the bare resins. Copyright © 2016 Elsevier B.V. All rights reserved.

Hydrogen/deuterium exchange, a unique and effective method for MS fragmentation behavior elucidation of ginkgolides and its application to systematic research in Ginkgo biloba.

PubMed

Niu, Xingliang; Luo, Jun; Xu, Deran; Zou, Hongyan; Kong, Lingyi

2017-02-05

Ginkgolides, the main active constituents of Ginkgo biloba, possess significant selectively inhibition on platelet-activating factor and pancreatic lipase and attract wide attention in pharmacological research area. In our study, an effective hydrogen/deuterium (H/D) exchange method was developed by exchanging the α-Hs of lactone groups in ginkgolides with Ds, which was very useful for the elucidation of the fragmentation patterns of ginkgolides in Quadrupole Time-of-flight Mass Spectrometry (Q-TOF-MS), especially in accurately distinguishing the type and position of substituent in framework of ginkgolides. Then, a systematic research strategy for qualitative and quantitative analysis of ginkgolides, based on H/D exchange, tandem solid-phase extraction and LC-Q-TOF-MS, was developed, which was successfully applied in each medicinal part of G. biloba, which indicated that ginkgolide B was the most abundant ginkgolide in the seeds of G. biloba (60.6μg/g). This research was the successful application of H/D exchange in natural products, and proved that H/D exchange is a potential method for analysis research of complex TCMs active constituents. Copyright © 2016 Elsevier B.V. All rights reserved.

Spatially variable stage-driven groundwater-surface water interaction inferred from time-frequency analysis of distributed temperature sensing data

USGS Publications Warehouse

Mwakanyamale, Kisa; Slater, Lee; Day-Lewis, Frederick D.; Elwaseif, Mehrez; Johnson, Carole D.

2012-01-01

Characterization of groundwater-surface water exchange is essential for improving understanding of contaminant transport between aquifers and rivers. Fiber-optic distributed temperature sensing (FODTS) provides rich spatiotemporal datasets for quantitative and qualitative analysis of groundwater-surface water exchange. We demonstrate how time-frequency analysis of FODTS and synchronous river stage time series from the Columbia River adjacent to the Hanford 300-Area, Richland, Washington, provides spatial information on the strength of stage-driven exchange of uranium contaminated groundwater in response to subsurface heterogeneity. Although used in previous studies, the stage-temperature correlation coefficient proved an unreliable indicator of the stage-driven forcing on groundwater discharge in the presence of other factors influencing river water temperature. In contrast, S-transform analysis of the stage and FODTS data definitively identifies the spatial distribution of discharge zones and provided information on the dominant forcing periods (≥2 d) of the complex dam operations driving stage fluctuations and hence groundwater-surface water exchange at the 300-Area.

A System for the Exchange of Information on Instructional Materials: An Evaluation for Planned Change in Australian Education.

ERIC Educational Resources Information Center

Watt, Michael G.

This evaluation project presents a plan for a program to establish a clearinghouse for exchanging qualitative and quantitative data on instructional materials used in Australian schools. A range of elements necessary to plan a program suited to Australian requirements and conditions was investigated. Focus was on: the program's mission,…

Girls' Sexual Development in the Inner City: From Compelled Childhood Sexual Contact to Sex-for-Things Exchanges

ERIC Educational Resources Information Center

Dunlap, Eloise; Golub, Andrew; Johnson, Bruce D.

2003-01-01

Child Sexual Abuse (CSA) has been linked to a wide variety of adverse psychological and behavioral outcomes. This paper describes girls' sexual development in the inner city based on qualitative material from a long-term ethnographic (observational) study. For many inner-city girls, early and then continued experiences of being compelled to have…

Turkish University Students' Hopes and Fears about Travel to the West

ERIC Educational Resources Information Center

Brown, Lorraine; Aktas, Gurhan

2012-01-01

The aim of this article is to explore the perceptions and attitudes of Turkish university students about to embark on a European exchange trip. This qualitative study sheds light on their hopes and fears about travelling to and living for a period of three months in a western country. The article shows how participants shared common aspirations…

The embodied nurse: Interdisciplinary knowledge exchange between compassionate nursing and recent developments in embodied leadership studies.

PubMed

Koya, Kushwanth; Anderson, Jane; Sice, Petia

2017-12-01

To report a potential knowledge exchange between nursing studies and the results obtained from a study conducted into the attributes of embodied leadership. Leadership theories have been applied to evaluate, improve, and train nursing practitioners in several previous studies. However, leadership research has entered a new phase where the focus is to produce sustainable leaders through authenticity and compassion, the same two characteristics identified as being of most success in emergent nursing practice. There are few studies that have indicated a knowledge exchange between the latest developments in leadership studies and nursing. An exploratory and qualitative study. Between February 2012 - July 2012, a focused sample of 14 medical care professionals was interviewed across a chain of hospitals. The aim was to evaluate embodied leadership characteristics and understand the factors that contribute to the manifestation of these characteristics. The transcribed interviews were analysed using thematic analysis. Several factors that contribute to the characteristics of embodied leadership have been identified in the interviews and in subsequent literature searches on the characteristics and contributing factors found to be associated with nursing research. These could prompt a knowledge exchange. The results suggest common ground between nursing and contemporary leadership research in the exposition of behaviours; namely, being non-judgmental, listening actively, reflective practice and embracing uncertainty. Several implications can therefore be expected through the exchange of knowledge resulting from collaboration between researchers in the two disciplines. © 2017 John Wiley & Sons Ltd.

Simple full micromagnetic model of exchange bias behavior in ferro/antiferromagnetic layered structures (abstract)

NASA Astrophysics Data System (ADS)

Koon, Norman C.

1997-04-01

It is shown using full micromagnetic relaxation calculations that exchange bias behavior is predicted for single-crystal ferro/antiferromagnetic layers with a fully compensated interface. The particular example most fully studied has a bcc/bct lattice structure with a fully compensated (110) interface plane. Only bilinear Heisenberg exchange was assumed, with anisotropy only in the antiferromagnet. In spite of the intuitive notion that exchange coupling between a ferromagnet and an antiferromagnet across a fully compensated plane of the antiferromagnet should be zero, we find strong coupling, comparable to the bilinear exchange, with a 90° angle between the ferromagnetic and antiferromagnetic axes of layers far from the interface in absence of an applied field. Even though the 90° coupling has characteristics resembling "biquadratic" exchange, it originates entirely from frustrated bilinear exchange. The development of exchange bias is found to originate from the formation of a domain wall in the antiferromagnet via the strong 90° exchange coupling and pinning of the wall by the magnetocrystalline anisotropy in the antiferromagnet. Because the large demagnetizing factor of the ferromagnet tends to confine its magnetization to the plane, the exchange bias is found to depend mainly on the strength and the symmetry of the in-plane component of anisotropy. Although little effort was made to analyze specific systems, the model reproduces many of the qualitative features observed in real exchange bias systems and gives reasonable semiquantitative estimates for the bias field when exchange and anisotropy values consistent with real systems are used.

Semi-Local DFT Functionals with Exact-Exchange-Like Features: Beyond the AK13

NASA Astrophysics Data System (ADS)

Armiento, Rickard

The Armiento-Kümmel functional from 2013 (AK13) is a non-empirical semi-local exchange functional on generalized gradient approximation form (GGA) in Kohn-Sham (KS) density functional theory (DFT). Recent works have established that AK13 gives improved electronic-structure exchange features over other semi-local methods, with a qualitatively improved orbital description and band structure. For example, the Kohn-Sham band gap is greatly extended, as it is for exact exchange. This talk outlines recent efforts towards new exchange-correlation functionals based on, and extending, the AK13 design ideas. The aim is to improve the quantitative accuracy, the description of energetics, and to address other issues found with the original formulation. Swedish e-Science Research Centre (SeRC).

Key characteristics of knowledge transfer and exchange in healthcare: integrative literature review.

PubMed

Pentland, Duncan; Forsyth, Kirsty; Maciver, Donald; Walsh, Mike; Murray, Richard; Irvine, Linda; Sikora, Simon

2011-07-01

This paper presents the results of a review of literature relating to knowledge transfer and exchange in healthcare. Treatment, planning and policy decisions in contemporary nursing and healthcare should be based on sound evidence wherever possible, but research knowledge remains generally underused. Knowledge transfer and exchange initiatives aim to facilitate the accessibility, application and production of evidence and may provide solutions to this challenge. This review was conducted to help inform the design and implementation of knowledge transfer and exchange activities for a large healthcare organization. Databases: ASSIA, Business Source Premier, CINAHL, PsychInfo, Medline and the Cochrane Database of Systematic Reviews. An integrative literature review was carried out including an extensive literature search. English language systematic reviews, literature reviews, primary quantitative and qualitative papers and grey literature of high relevance evaluating, describing or discussing knowledge transfer or exchange activities in healthcare were included for review (January 1990-September 2009). Thirty-three papers were reviewed (four systematic reviews, nine literature reviews, one environmental scan, nine empirical studies and ten case studies). Robust research into knowledge transfer and exchange in healthcare is limited. Analysis of a wide range of evidence indicates a number of commonly featured characteristics but further evaluation of these activities would benefit their application in facilitating evidence-based practice in nursing. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Barrier versus tilt exchange gate operations in spin-based quantum computing

NASA Astrophysics Data System (ADS)

Shim, Yun-Pil; Tahan, Charles

2018-04-01

We present a theory for understanding the exchange interaction between electron spins in neighboring quantum dots, either by changing the detuning of the two quantum dots or independently tuning the tunneling barrier between quantum dots. The Hubbard model and a more realistic confining-potential model are used to investigate how the tilting and barrier control affect the effective exchange coupling and thus the gate fidelity in both the detuning and symmetric regimes. We show that the exchange coupling is less sensitive to the charge noise through tunnel barrier control (while allowing for exchange coupling operations on a sweet spot where the exchange interaction has zero derivative with respect to the detuning). Both GaAs and Si quantum dots are considered, and we compare our results with experimental data showing qualitative agreements. Our results answer the open question of why barrier gates are preferable to tilt gates for exchange-based gate operations.

Turbulence and wave breaking effects on air-water gas exchange

PubMed

Boettcher; Fineberg; Lathrop

2000-08-28

We present an experimental characterization of the effects of turbulence and breaking gravity waves on air-water gas exchange in standing waves. We identify two regimes that govern aeration rates: turbulent transport when no wave breaking occurs and bubble dominated transport when wave breaking occurs. In both regimes, we correlate the qualitative changes in the aeration rate with corresponding changes in the wave dynamics. In the latter regime, the strongly enhanced aeration rate is correlated with measured acoustic emissions, indicating that bubble creation and dynamics dominate air-water exchange.

Exploring Health Information Exchange Implementation Using Qualitative Assessments of Nursing Home Leaders

PubMed Central

Alexander, Gregory L.; Popejoy, Lori; Lyons, Vanessa; Shumate, Sue; Mueller, Jessica; Galambos, Colleen; Vogelsmeier, Amy; Rantz, Marilyn; Flesner, Marcia

2016-01-01

Objectives Limited research exists on nursing home information technologies, such as health information exchange (HIE) systems. Capturing the experiences of early HIE adopters provides vital information about how these systems are used. In this study, we conduct a secondary analysis of qualitative data captured during interviews with 15 nursing home leaders representing 14 nursing homes in the midwestern United States that are part of the Missouri Quality Improvement Initiative (MOQI) national demonstration project. Methods The interviews were conducted as part of an external evaluation of the HIE vendor contracting with the MOQI initiative with the purpose of understanding the challenges and successes of HIE implementation, with a particular focus on Direct HIE services. Results Emerging themes included (1) incorporating HIE into existing work processes, (2) participation inside and outside the facility, (3) appropriate training and retraining, (4) getting others to use the HIE, (5) getting the HIE operational, and 6) putting policies for technology into place. Discussion Three essential areas should be considered for nursing homes considering HIE adoption: readiness to adopt technology, availability of technology resources, and matching of new clinical workflows. PMID:27843423

How to govern physician-hospital exchanges: contractual and relational issues in Belgian hospitals.

PubMed

Trybou, Jeroen; Gemmel, Paul; Annemans, Lieven

2014-07-01

Our aim was to investigate contractual mechanisms in physician-hospital exchanges. The concepts of risk-sharing and the nature of physician-hospital exchanges - transactional versus relational - were studied. Two qualitative case studies were performed in Belgium. Hospital executives and physicians were interviewed to develop an in-depth understanding of contractual and relational issues that shape physician-hospital contracting in acute care hospitals. The underlying theoretical concepts of agency theory and social exchange theory were used to analyse the data. Our study found that physician-hospital contracting is highly complex. The contract is far more than an economic instrument governing financial aspects. The effect of the contract on the nature of exchange - whether transactional or relational - also needs to be considered. While it can be argued that contractual governance methods are increasingly necessary to overcome the difficulties that arise from the fragmented payment framework by aligning incentives and sharing financial risk, they undermine the necessary relational governance. Relational qualities such as mutual trust and an integrative view on physician-hospital exchanges are threatened, and may be difficult to sustain, given the current fragmentary payment framework. Since health care policy makers are increasing the financial risk borne by health care providers, it can be argued that this also increases the need to share financial risk and to align incentives between physician and hospital. However, our study demonstrates that while economic alignment is important in determining physician-hospital contracts, the corresponding impact on working relationships should also be considered. Moreover, it is important to avoid a relationship between hospital and physician predominantly characterized by transactional exchanges thereby fostering an unhealthy us-and-them divide and mentality. Relational exchange is a valuable alternative to contractual exchange, stimulating an integrated hospital-physician relationship. Unfortunately, the fragmented payment framework characterized by unaligned incentives is perceived as an obstacle to realize effective collaboration. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

An Exploration of What Happens when Second and Third Graders in Two Countries Interact through a Technology Enhanced Multicultural Collaboration

ERIC Educational Resources Information Center

Richards, Brenda Eklund

2010-01-01

This study used qualitative methodology to document what happened when two groups of children--a second grade class in Columbia, South Carolina, U.S.A. and a third grade class in Amman, Jordan--collaborated on a technology enhanced cultural exchange. Key aspects of this project included dialogic collaboration based upon Short's (2003) model of…

Diffusive and Arrestedlike Dynamics in Currency Exchange Markets

NASA Astrophysics Data System (ADS)

Clara-Rahola, J.; Puertas, A. M.; Sánchez-Granero, M. A.; Trinidad-Segovia, J. E.; de las Nieves, F. J.

2017-02-01

This work studies the symmetry between colloidal dynamics and the dynamics of the Euro-U.S. dollar currency exchange market (EURUSD). We consider the EURUSD price in the time range between 2001 and 2015, where we find significant qualitative symmetry between fluctuation distributions from this market and the ones belonging to colloidal particles in supercooled or arrested states. In particular, we find that models used for arrested physical systems are suitable for describing the EURUSD fluctuation distributions. Whereas the corresponding mean-squared price displacement (MSPD) to the EURUSD is diffusive for all years, when focusing in selected time frames within a day, we find a two-step MSPD when the New York Stock Exchange market closes, comparable to the dynamics in supercooled systems. This is corroborated by looking at the price correlation functions and non-Gaussian parameters and can be described by the theoretical model. We discuss the origin and implications of this analogy.

The development of a health information exchange to enhance care and improve patient outcomes among HIV+ individuals in rural North Carolina.

PubMed

Messer, Lynne C; Parnell, Heather; Huffaker, Renee; Wooldredge, Rich; Wilkin, Aimee

2012-10-01

The Regional Health Information Integration Project (RHIIP) has developed the Carolina HIV Information Cooperative regional health information organization (CHIC RHIO). The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically disconnected networks of HIV care providers in rural North Carolina. CHIC RHIO comprises one medical clinic and five AIDS Service Organizations (ASOs) serving clients in eight rural counties. Communication among the CHIC RHIO members is facilitated by CAREWare software. The RHIIP team assessed organizational readiness to change, facilitated relationship-building for CHIC RHIO, created the CHIC RHIO and used both qualitative and quantitative approaches to evaluate the process-related effects of implementing a data-sharing intervention. We found the CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which most likely contributed to its successful adoption. The qualitative findings indicate that CHIC RHIO members personally benefited - and perceived their clients benefited - from participation in the information exchange. The quantitative results echoed the qualitative findings; following the CHIC RHIO intervention, quality improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived level of patient care. Furthermore, hopes for what data sharing would accomplish were overly high at the beginning of the project, thus requiring a recalibration of expectations as the project came to a close. Innovative strategies for health information exchange can be implemented in rural communities to increase communication among providers. With this increased communication comes the potential for improved health outcomes and, in turn, healthier communities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

“Nothing is free”: A qualitative study of sex trading among methamphetamine users in Cape Town, South Africa

PubMed Central

Watt, Melissa H.; Kimani, Stephen M.; Skinner, Donald; Meade, Christina S.

2015-01-01

South Africa is facing an established epidemic of methamphetamine, known locally as “tik”. Globally, methamphetamine has been linked to high rates of sexual risk behaviors, including sex trading. The goal of this study was to qualitatively examine the experiences of sex trading among methamphetamine users in Cape Town, South Africa. Individual in-depth interviews were conducted with 30 active methamphetamine users (17 men and 13 women) recruited from the community. Interviews were conducted in local languages using a semi-structured guide that included questions on sex trading experiences and perceptions of sex trading among methamphetamine users. Interviews were audio-recorded, transcribed, and analyzed using analytic memos and coding with constant comparison techniques. The data revealed that in a setting of high levels of addiction and poverty, sex was an important commodity for acquiring methamphetamine. Women were more likely to use sex to acquire methamphetamine, but men reported opportunistic cases of trading sex for methamphetamine. Four models of sex trading emerged: negotiated exchange, implicit exchange, relationships based on resources, and facilitating sex exchange for others. The expectation of sex trading created a context in which sexual violence against female methamphetamine users was common. Multiple sexual partners and inconsistent condom use in acts of sex trading put methamphetamine users at high risk of HIV. Interventions in this setting should address addiction, which is the primary driver of sex trading among methamphetamine users. Harm reduction interventions may include education about HIV and other sexually transmitted infections, availability of condoms and HIV testing, and sexual violence prevention. PMID:25567071

"Nothing Is Free": A Qualitative Study of Sex Trading Among Methamphetamine Users in Cape Town, South Africa.

PubMed

Watt, Melissa H; Kimani, Stephen M; Skinner, Donald; Meade, Christina S

2016-05-01

South Africa is facing an established epidemic of methamphetamine, known locally as "tik." Globally, methamphetamine has been linked to high rates of sexual risk behaviors, including sex trading. The goal of this study was to qualitatively examine the experiences of sex trading among methamphetamine users in Cape Town, South Africa. Individual in-depth interviews were conducted with 30 active methamphetamine users (17 men and 13 women) recruited from the community. Interviews were conducted in local languages using a semi-structured guide that included questions on sex trading experiences and perceptions of sex trading among methamphetamine users. Interviews were audio-recorded, transcribed, and analyzed using analytic memos and coding with constant comparison techniques. The data revealed that in a setting of high levels of addiction and poverty, sex was an important commodity for acquiring methamphetamine. Women were more likely to use sex to acquire methamphetamine, but men reported opportunistic cases of trading sex for methamphetamine. Four models of sex trading emerged: negotiated exchange, implicit exchange, relationships based on resources, and facilitating sex exchange for others. The expectation of sex trading created a context in which sexual violence against female methamphetamine users was common. Multiple sexual partners and inconsistent condom use in acts of sex trading put methamphetamine users at high risk of HIV. Interventions in this setting should address addiction, which is the primary driver of sex trading among methamphetamine users. Harm reduction interventions may include education about HIV and other sexually transmitted infections, availability of condoms and HIV testing, and sexual violence prevention.

Natural radium and radon tracers to quantify water exchange and movement in reservoirs

USGS Publications Warehouse

Smith, Christopher G.; Baskaran, Mark

2011-01-01

Radon and radium isotopes are routinely used to quantify exchange rates between different hydrologic reservoirs. Since their recognition as oceanic tracers in the 1960s, both radon and radium have been used to examine processes such as air-sea exchange, deep oceanic mixing, benthic inputs, and many others. Recently, the application of radon-222 and the radium-quartet (223,224,226,228Ra) as coastal tracers has seen a revelation with the growing interest in coastal groundwater dynamics. The enrichment of these isotopes in benthic fluids including groundwater makes both radium and radon ideal tracers of coastal benthic processes (e.g. submarine groundwater discharge). In this chapter we review traditional and recent advances in the application of radon and radium isotopes to understand mixing and exchange between various hydrologic reservoirs, specifically: (1) atmosphere and ocean, (2) deep and shallow oceanic water masses, (3) coastal groundwater/benthic pore waters and surface ocean, and (4) aquifer-lakes. While the isotopes themselves and their distribution in the environment provide qualitative information about the exchange processes, it is mixing/exchange and transport models for these isotopes that provide specific quantitative information about these processes. Brief introductions of these models and mixing parameters are provided for both historical and more recent studies.

Room temperature exchange bias in multiferroic BiFeO3 nano- and microcrystals with antiferromagnetic core and two-dimensional diluted antiferromagnetic shell

NASA Astrophysics Data System (ADS)

Zhang, Chuang; Wang, Shou Yu; Liu, Wei Fang; Xu, Xun Ling; Li, Xiu; Zhang, Hong; Gao, Ju; Li, De Jun

2017-05-01

Exchange bias (EB) of multiferroics presents many potential opportunities for magnetic devices. However, instead of using low-temperature field cooling in the hysteresis loop measurement, which usually shows an effective approach to obtain obvious EB phenomenon, there are few room temperature EB. In this article, extensive studies on room temperature EB without field cooling were observed in BiFeO3 nano- and microcrystals. Moreover, with increasing size the hysteresis loops shift from horizontal negative exchange bias (NEB) to positive exchange bias (PEB). In order to explain the tunable EB behaviors with size dependence, a phenomenological qualitative model based on the framework of antiferromagnetic (AFM) core-two-dimensional diluted antiferromagnet in a field (2D-DAFF) shell structure was proposed. The training effect (TE) ascertained the validity of model and the presence of unstable magnetic structure using Binek's model. Experimental results show that the tunable EB effect can be explained by the competition of ferromagnetic (FM) exchange coupling and AFM exchange coupling interaction between AFM core and 2D-DAFF shell. Additionally, the local distortion of lattice fringes was observed in hexagonal-shaped BiFeO3 nanocrystals with well-dispersed behavior. The electrical conduction properties agreed well with the space charge-limited conduction mechanism.

Data sharing for public health research: A qualitative study of industry and academia.

PubMed

Saunders, Pamela A; Wilhelm, Erin E; Lee, Sinae; Merkhofer, Elizabeth; Shoulson, Ira

2014-01-01

Data sharing is a key biomedical research theme for the 21st century. Biomedical data sharing is the exchange of data among (non)affiliated parties under mutually agreeable terms to promote scientific advancement and the development of safe and effective medical products. Wide sharing of research data is important for scientific discovery, medical product development, and public health. Data sharing enables improvements in development of medical products, more attention to rare diseases, and cost-efficiencies in biomedical research. We interviewed 11 participants about their attitudes and beliefs about data sharing. Using a qualitative, thematic analysis approach, our analysis revealed a number of themes including: experiences, approaches, perceived challenges, and opportunities for sharing data.

Exploring the role of physician communication about adjuvant endocrine therapy among breast cancer patients on active treatment: a qualitative analysis.

PubMed

Farias, Albert J; Ornelas, India J; Hohl, Sarah D; Zeliadt, Steven B; Hansen, Ryan N; Li, Christopher I; Thompson, Beti

2017-01-01

To better understand how physicians communicate with breast cancer patients about adjuvant endocrine therapy (AET), we explored, from the breast cancer patient's perspective, dimensions of the patient-provider communication among women who were on active AET treatment. Qualitative methods using semi-structured in-depth interviews were conducted with breast cancer patients (n = 22) who filled a prescription for AET in the previous 12 months. Interview questions aimed to elicit experiences with AET. We reviewed and coded interview transcripts using qualitative principles of inductive reasoning to identify concepts and themes from interview data. We grouped emergent themes into four major functions of physician-patient communication: (1) information exchange, (2) decision-making to take and continue AET, (3) enabling patient self-management and monitoring potential side effects, and (4) emotional support. Physicians exchanged information with patients in a way that they understood and enhanced patient's health literacy regarding the benefits and knowledge of AET. Physicians empowered patients to make decisions about their care. Patients expressed trust and confidence in their physician which helped them seek care when needed. Patients reported a high degree of self-efficacy to self-manage AET and were continuing treatment despite potential side effects. The results from our study suggest that women's interactions and communication with their physician may be an important factor that contributes to the continued use of AET. Physicians who can communicate information about AET treatment benefits, purpose, and expectations in a way that patients can understand is a critical aspect of care that needs to be further studied.

Qualitative and Quantitative Analyses of Glycogen in Human Milk.

PubMed

Matsui-Yatsuhashi, Hiroko; Furuyashiki, Takashi; Takata, Hiroki; Ishida, Miyuki; Takumi, Hiroko; Kakutani, Ryo; Kamasaka, Hiroshi; Nagao, Saeko; Hirose, Junko; Kuriki, Takashi

2017-02-22

Identification as well as a detailed analysis of glycogen in human milk has not been shown yet. The present study confirmed that glycogen is contained in human milk by qualitative and quantitative analyses. High-performance anion exchange chromatography (HPAEC) and high-performance size exclusion chromatography with a multiangle laser light scattering detector (HPSEC-MALLS) were used for qualitative analysis of glycogen in human milk. Quantitative analysis was carried out by using samples obtained from the individual milks. The result revealed that the concentration of human milk glycogen varied depending on the mother's condition-such as the period postpartum and inflammation. The amounts of glycogen in human milk collected at 0 and 1-2 months postpartum were higher than in milk collected at 3-14 months postpartum. In the milk from mothers with severe mastitis, the concentration of glycogen was about 40 times higher than that in normal milk.

Social marketing and MARTIN: tools for organizing, analyzing, and interpreting qualitative data.

PubMed

Higgins, J W

1998-11-01

The purpose of this article is to discuss how the computer software program MARTIN and social marketing concepts (understanding the consumer perspective, exchange, marketing mix, and segmentation) were used as organizational, analytical, and interpretive tools for qualitative data. The qualitative data are from a case study on citizen participation in a health reform policy in British Columbia. The concept of broad-based public participation is a fundamental element of health promotion and citizenship. There is a gap, however, between the promise and reality of citizen participation in health promotion. Emerging from the analysis was an understanding of the societal circumstances that inhibited or fostered participation. This article describes how the code-based, theory-building attributes of the MARTIN software facilitated a new conceptualization of participatory citizenship and generated new insights into understanding why some people participate and others do not.

Energy Conversion Alternatives Study (ECAS), Westinghouse phase 1. Volume 2: Materials considerations. [materials used in boilers and heat exchangers of energy conversion systems for electric power plants using coal

NASA Technical Reports Server (NTRS)

Thomas, D. E.

1976-01-01

Extensive studies are presented which were carried out on materials behavior in nine advanced energy conversion systems employing coal and coal-derived fuels. The areas of materials behavior receiving particular attention in this regard are: (1) fireside corrosion and erosion in boiler and heat exchanger materials, (2) oxidation and hot corrosion of gas turbine materials, (3) liquid metal corrosion and mass transport, (4) high temperature steam corrosion, (5) compatability of materials with coal slag and MHD seed, (6) reaction of materials with impure helium, (7) allowable stresses for boiler and heat exchanger materials, (8) environmental effects on mechanical properties, and (9) liquid metal purity control and instrumentation. Such information was then utilized in recommending materials for use in the critical components of the power systems, and at the same time to identify materials problem areas and to evaluate qualitatively the difficulty of solving those problems. Specific materials recommendations for critical components of the nine advanced systems under study are contained in summary tables.

Exploring conceptualizations of knowledge translation, transfer and exchange across public health in one UK region: a qualitative mapping study.

PubMed

Visram, S; Goodall, D; Steven, A

2014-06-01

Knowledge translation (KT) is becoming common vocabulary, but as a concept it is not clearly defined. Many related terms exist; these are often used interchangeably and given multiple interpretations. While there is a growing body of literature exploring these concepts, using it to inform public health practice, strategy, research and education is challenging given the range of sources and need for local 'contextual fit'. This study explores how various public health stakeholders make sense of, and experience, KT and related concepts. A qualitative mapping study using a phenomenographic approach. Thirty-four academics, students and practitioners working in public health across the north east of England participated in six focus groups and five one-to-one interviews. Discussions were audio-recorded, transcribed and analysed using a thematic framework approach. The framework drew on findings from reviews of the existing literature, whilst allowing unanticipated issues to emerge. Three main themes were identified from the stakeholder discussions: This study has enabled further development of theoretical understandings of the KT discourses at play in public health, and identified the ways in which these may be bound by discipline and context. Ironically, the findings suggest that terms such as knowledge translation, transfer and exchange are seen as themselves requiring translation, or at least debate and discussion. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

PubMed Central

2012-01-01

Background Medication incident reporting (MIR) is a key safety critical care process in residential aged care facilities (RACFs). Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation) in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a) design MIR artefacts that facilitate identification of the root causes of medication incidents, b) integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c) support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes. PMID:23122411

The relevance of qualitative research for clinical programs in psychiatry.

PubMed

Goering, Paula; Boydell, Katherine M; Pignatiello, Antonio

2008-03-01

It is time to move beyond education about qualitative research theory and methods to using them to understand and improve psychiatric practice. There is a good fit between this agenda and current thinking about research use that broadens definitions of evidence beyond the results of experiments. This paper describes a qualitative program evaluation to illustrate what kind of useful knowledge is generated and how it can be created through a clinician-researcher partnership. The linkage and exchange model of effective knowledge translation described involves interaction between clinicians and researchers throughout the research process and results in mutual learning through the planning, disseminating, and application of existing or new qualitative research in decision making.

Multiconfiguration Pair-Density Functional Theory Outperforms Kohn-Sham Density Functional Theory and Multireference Perturbation Theory for Ground-State and Excited-State Charge Transfer.

PubMed

Ghosh, Soumen; Sonnenberger, Andrew L; Hoyer, Chad E; Truhlar, Donald G; Gagliardi, Laura

2015-08-11

The correct description of charge transfer in ground and excited states is very important for molecular interactions, photochemistry, electrochemistry, and charge transport, but it is very challenging for Kohn-Sham (KS) density functional theory (DFT). KS-DFT exchange-correlation functionals without nonlocal exchange fail to describe both ground- and excited-state charge transfer properly. We have recently proposed a theory called multiconfiguration pair-density functional theory (MC-PDFT), which is based on a combination of multiconfiguration wave function theory with a new type of density functional called an on-top density functional. Here we have used MC-PDFT to study challenging ground- and excited-state charge-transfer processes by using on-top density functionals obtained by translating KS exchange-correlation functionals. For ground-state charge transfer, MC-PDFT performs better than either the PBE exchange-correlation functional or CASPT2 wave function theory. For excited-state charge transfer, MC-PDFT (unlike KS-DFT) shows qualitatively correct behavior at long-range with great improvement in predicted excitation energies.

Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study

PubMed Central

2011-01-01

Background Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular. Methods The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis. Results Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general. Conclusions The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and confidentiality of electronic information exchange can be improved by developing tools to evaluate the legitimacy of access to electronic records, by increasing health care providers' awareness of the need to be careful when using patient data, and by measures to limit access to sensitive patient data. Improving health care providers' recording behaviour is important to improve the reliability and quality of electronically exchanged patient data. PMID:21982395

Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study.

PubMed

Zwaanswijk, Marieke; Verheij, Robert A; Wiesman, Floris J; Friele, Roland D

2011-10-07

Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular. The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis. Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general. The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and confidentiality of electronic information exchange can be improved by developing tools to evaluate the legitimacy of access to electronic records, by increasing health care providers' awareness of the need to be careful when using patient data, and by measures to limit access to sensitive patient data. Improving health care providers' recording behaviour is important to improve the reliability and quality of electronically exchanged patient data.

Everyday drug diversions: a qualitative study of the illicit exchange and non-medical use of prescription stimulants on a university campus.

PubMed

Vrecko, Scott

2015-04-01

This article investigates everyday experiences and practises that are associated with processes of pharmaceuticalization and with practices of 'drug diversion'--that is, the illicit exchange and non-medical use of prescription drugs. It reports results from a qualitative study that was designed to examine the everyday dimensions of non-medical prescription stimulant use among students on an American university campus, which involved 38 semi-structured interviews with individuals who used prescription stimulants as a means of improving academic performance. While discussions of drug diversion are often framed in terms of broad, population-level patterns and demographic trends, the present analysis provides a complementary sociocultural perspective that is attuned to the local and everyday phenomena. Results are reported in relation to the acquisition of supplies of medications intended for nonmedical use. An analysis is provided which identifies four different sources of diverted medications (friends; family members; black-market vendors; deceived clinicians), and describes particular sets of understandings, practices and experiences that arise in relation to each different source. Findings suggest that at the level of everyday experience and practice, the phenomenon of prescription stimulant diversion is characterised by a significant degree of complexity and heterogeneity. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

An emigration versus a globalization perspective of the Lebanese physician workforce: a qualitative study

PubMed Central

2012-01-01

Background Lebanon is witnessing an increased emigration of physicians. The objective of this study was to understand the perceptions of Lebanese policymakers of this emigration, and elicit their proposals for future policies and strategies to deal with this emigration. Methods We conducted semi-structured individual interviews with the deans of Lebanon’s seven medical schools, the presidents of the two physicians professional associations, and governmental officials. We analyzed the results qualitatively. Results Participants differed in the assessment of the extent and gravity of emigration. Lebanon has a surplus of physicians, driven largely by the over-production of graduates by a growing number of medical schools. Participants cited advantages and disadvantages of the emigration on the personal, financial, medical education system, healthcare system, and national levels. Proposed strategies included limiting the number of students entering medical schools, creating job opportunities for graduating students, and implementing quality standards. Most participants acknowledged the globalization of the Lebanese physician workforce, including exchanges with the Gulf region, exchanges with developed countries, and the involvement of North American medical education institutions in the region. Conclusion Many Lebanese policy makers, particularly deans of medical schools, perceive the emigration of the physician workforce as an opportunity in the context of the globalization of the profession. PMID:22646478

Everyday drug diversions: A qualitative study of the illicit exchange and non-medical use of prescription stimulants on a university campus

PubMed Central

Vrecko, Scott

2015-01-01

This article investigates everyday experiences and practises that are associated with processes of pharmaceuticalization and with practices of ‘drug diversion’—that is, the illicit exchange and non-medical use of prescription drugs. It reports results from a qualitative study that was designed to examine the everyday dimensions of non-medical prescription stimulant use among students on an American university campus, which involved 38 semi-structured interviews with individuals who used prescription stimulants as a means of improving academic performance. While discussions of drug diversion are often framed in terms of broad, population-level patterns and demographic trends, the present analysis provides a complementary sociocultural perspective that is attuned to the local and everyday phenomena. Results are reported in relation to the acquisition of supplies of medications intended for nonmedical use. An analysis is provided which identifies four different sources of diverted medications (friends; family members; black-market vendors; deceived clinicians), and describes particular sets of understandings, practices and experiences that arise in relation to each different source. Findings suggest that at the level of everyday experience and practice, the phenomenon of prescription stimulant diversion is characterised by a significant degree of complexity and heterogeneity. PMID:25455480

An emigration versus a globalization perspective of the Lebanese physician workforce: a qualitative study.

PubMed

Akl, Elie A; Maroun, Nancy; Rahbany, Aline; Hagopian, Amy

2012-05-30

Lebanon is witnessing an increased emigration of physicians. The objective of this study was to understand the perceptions of Lebanese policymakers of this emigration, and elicit their proposals for future policies and strategies to deal with this emigration. We conducted semi-structured individual interviews with the deans of Lebanon's seven medical schools, the presidents of the two physicians professional associations, and governmental officials. We analyzed the results qualitatively. Participants differed in the assessment of the extent and gravity of emigration. Lebanon has a surplus of physicians, driven largely by the over-production of graduates by a growing number of medical schools. Participants cited advantages and disadvantages of the emigration on the personal, financial, medical education system, healthcare system, and national levels. Proposed strategies included limiting the number of students entering medical schools, creating job opportunities for graduating students, and implementing quality standards. Most participants acknowledged the globalization of the Lebanese physician workforce, including exchanges with the Gulf region, exchanges with developed countries, and the involvement of North American medical education institutions in the region. Many Lebanese policy makers, particularly deans of medical schools, perceive the emigration of the physician workforce as an opportunity in the context of the globalization of the profession.

Analytical aspects of hydrogen exchange mass spectrometry

PubMed Central

Engen, John R.; Wales, Thomas E.

2016-01-01

The analytical aspects of measuring hydrogen exchange by mass spectrometry are reviewed. The nature of analytical selectivity in hydrogen exchange is described followed by review of the analytical tools required to accomplish fragmentation, separation, and the mass spectrometry measurements under restrictive exchange quench conditions. In contrast to analytical quantitation that relies on measurements of peak intensity or area, quantitation in hydrogen exchange mass spectrometry depends on measuring a mass change with respect to an undeuterated or deuterated control, resulting in a value between zero and the maximum amount of deuterium that could be incorporated. Reliable quantitation is a function of experimental fidelity and to achieve high measurement reproducibility, a large number of experimental variables must be controlled during sample preparation and analysis. The method also reports on important qualitative aspects of the sample, including conformational heterogeneity and population dynamics. PMID:26048552

Online Social Support for Patients with Multiple Sclerosis: A Thematic Analysis of Messages Posted to a Virtual Support Community.

PubMed

Shavazi, Masoumeh Abbasi; Morowatisharifabad, Mohammad Ali; Shavazi, Mohammad Taghi Abbasi; Mirzaei, Masoud; Ardekani, Ali Mellat

2016-07-01

Currently with the emergence of the Internet, patients have an opportunity to exchange social support online. However, little attention has been devoted to different dimensions of online social support exchanged in virtual support communities for patients with multiple sclerosis (MS). To provide a rich insight, the aim of this qualitative study was to explore and categorize different dimensions of online social support in messages exchanged in a virtual support community for patients with MS. A total of 548 posted messages created during one year period were selected using purposive sampling to consider the maximum variation sampling. Prior-research-driven thematic analysis was then conducted. In this regard, we used the Cutruna and Suhr's coding system. The messages that could not be categorized with the used coding system were thematically analyzed to explore new additional social support themes. The results showed that various forms of social support including informational, emotional, network, esteem and tangible support were exchanged. Moreover, new additional social support themes including sharing personal experiences, sharing coping strategies and spiritual support emerged in this virtual support community. The wide range of online social support exchanged in the virtual support community can be regarded as a supplementary source of social support for patients with MS. Future researches can examine online social support more comprehensively considering additional social support themes emerging in the present study.

Dissociation of diatomic molecules and the exact-exchange Kohn-Sham potential: the case of LiF

NASA Astrophysics Data System (ADS)

Makmal, Adi; Kuemmel, Stephan; Kronik, Leeor

2011-03-01

The incorrect fractional-charge dissociation of stretched diatomic molecules, predicted by semi-local exchange-correlation functionals, is revisited. This difficulty can be overcome with asymptotically correct non-local potential operators, but should also be absent in exact Kohn-Sham theory, where the potential is local. Here, we show, for the illustrative case of the LiF dimer, that the exact-exchange local Kohn-Sham potential, constructed within the Krieger, Li, and Iafrate (KLI) approximation, can lead to binding energy and charge dissociation curves that are qualitatively correct. This correct behavior is traced back to a characteristic ``step'' structure in the local exchange potential and its relation to the Kohn-Sham eigenvalues is analyzed.

Interdisciplinary Practice Models for Older Adults With Back Pain: A Qualitative Evaluation.

PubMed

Salsbury, Stacie A; Goertz, Christine M; Vining, Robert D; Hondras, Maria A; Andresen, Andrew A; Long, Cynthia R; Lyons, Kevin J; Killinger, Lisa Z; Wallace, Robert B

2018-03-19

Older adults seek health care for low back pain from multiple providers who may not coordinate their treatments. This study evaluated the perceived feasibility of a patient-centered practice model for back pain, including facilitators for interprofessional collaboration between family medicine physicians and doctors of chiropractic. This qualitative evaluation was a component of a randomized controlled trial of 3 interdisciplinary models for back pain management: usual medical care; concurrent medical and chiropractic care; and collaborative medical and chiropractic care with interprofessional education, clinical record exchange, and team-based case management. Data collection included clinician interviews, chart abstractions, and fieldnotes analyzed with qualitative content analysis. An organizational-level framework for dissemination of health care interventions identified norms/attitudes, organizational structures and processes, resources, networks-linkages, and change agents that supported model implementation. Clinicians interviewed included 13 family medicine residents and 6 chiropractors. Clinicians were receptive to interprofessional education, noting the experience introduced them to new colleagues and the treatment approaches of the cooperating profession. Clinicians exchanged high volumes of clinical records, but found the logistics cumbersome. Team-based case management enhanced information flow, social support, and interaction between individual patients and the collaborating providers. Older patients were viewed positively as change agents for interprofessional collaboration between these provider groups. Family medicine residents and doctors of chiropractic viewed collaborative care as a useful practice model for older adults with back pain. Health care organizations adopting medical and chiropractic collaboration can tailor this general model to their specific setting to support implementation.

Patient safety culture and associated factors: A quantitative and qualitative study of healthcare workers' view in Jimma zone Hospitals, Southwest Ethiopia.

PubMed

Wami, Sintayehu Daba; Demssie, Amsalu Feleke; Wassie, Molla Mesele; Ahmed, Ansha Nega

2016-09-20

Patient safety culture is an important aspect for quality healthcare delivery and is an issue of high concern globally. In Ethiopia health system little is known and information is limited in scope about patient safety culture. Therefore, the aim of this study was to assess the level of patient safety culture and associated factors in Jimma zone Hospitals, southwest Ethiopia. Facility based cross sectional quantitative study triangulated with qualitative approaches was employed from March to April 30/2015. Stratified sampling technique was used to select 637 study participants among 4 hospitals. The standardized tool which measures 12 patient safety culture composites was used for data collection. Bivariate and multivariate linear regression analyses were performed using SPSS version 20. Significance level was obtained at 95 % CI and p-value < 0.05. Semi structured guide in depth interview was used to collect the qualitative data. Content analysis of the interview was performed. The overall level of patient safety culture was 46.7 % (95 % CI: 43.0, 51.2). Hours worked per week (β =-0.06, 95 % CI:-0.12,-0.001), reporting adverse event (β = 3.34, 95 % CI: 2.12, 4.57), good communication (β = 2.78, 95 % CI: 2.29, 3.28), teamwork within hospital (β = 1.91, 95 % CI: 1.37, 2.46), level of staffing (β = 1.32, 95 % CI: 0.89, 1.75), exchange of feedback about error (β = 1.37, 95 % CI: 0.91, 1.83) and participation in patient safety program (β = 1.3, 95 % CI: 0.57, 2.03) were factors significantly associated with the patient safety culture. The in depth interview indicated incident reporting, resources, healthcare worker attitude and patient involvement as important factors that influence patient safety culture. The overall level of patient safety culture was low. Working hours, level of staffing, teamwork, communications openness, reporting an event and exchange of feedback about error were associated with patient safety culture. Therefore, interventions of systemic approach through facilitating opportunities for communication openness, cooperation and exchange of ideas between healthcare workers are needed to improve the level of patient safety culture.

Quantifying humpback whale song sequences to understand the dynamics of song exchange at the ocean basin scale.

PubMed

Garland, Ellen C; Noad, Michael J; Goldizen, Anne W; Lilley, Matthew S; Rekdahl, Melinda L; Garrigue, Claire; Constantine, Rochelle; Daeschler Hauser, Nan; Poole, M Michael; Robbins, Jooke

2013-01-01

Humpback whales have a continually evolving vocal sexual display, or "song," that appears to undergo both evolutionary and "revolutionary" change. All males within a population adhere to the current content and arrangement of the song. Populations within an ocean basin share similarities in their songs; this sharing is complex as multiple variations of the song (song types) may be present within a region at any one time. To quantitatively investigate the similarity of song types, songs were compared at both the individual singer and population level using the Levenshtein distance technique and cluster analysis. The highly stereotyped sequences of themes from the songs of 211 individuals from populations within the western and central South Pacific region from 1998 through 2008 were grouped together based on the percentage of song similarity, and compared to qualitatively assigned song types. The analysis produced clusters of highly similar songs that agreed with previous qualitative assignments. Each cluster contained songs from multiple populations and years, confirming the eastward spread of song types and their progressive evolution through the study region. Quantifying song similarity and exchange will assist in understanding broader song dynamics and contribute to the use of vocal displays as population identifiers.

Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use

PubMed Central

Johnson, Kevin B; Lorenzi, Nancy M

2011-01-01

Objective The goal of this study was to develop an in-depth understanding of how a health information exchange (HIE) fits into clinical workflow at multiple clinical sites. Materials and Methods The ethnographic qualitative study was conducted over a 9-month period in six emergency departments (ED) and eight ambulatory clinics in Memphis, Tennessee, USA. Data were collected using direct observation, informal interviews during observation, and formal semi-structured interviews. The authors observed for over 180 h, during which providers used the exchange 130 times. Results HIE-related workflow was modeled for each ED site and ambulatory clinic group and substantial site-to-site workflow differences were identified. Common patterns in HIE-related workflow were also identified across all sites, leading to the development of two role-based workflow models: nurse based and physician based. The workflow elements framework was applied to the two role-based patterns. An in-depth description was developed of how providers integrated HIE into existing clinical workflow, including prompts for HIE use. Discussion Workflow differed substantially among sites, but two general role-based HIE usage models were identified. Although providers used HIE to improve continuity of patient care, patient–provider trust played a significant role. Types of information retrieved related to roles, with nurses seeking to retrieve recent hospitalization data and more open-ended usage by nurse practitioners and physicians. User and role-specific customization to accommodate differences in workflow and information needs may increase the adoption and use of HIE. Conclusion Understanding end users' perspectives towards HIE technology is crucial to the long-term success of HIE. By applying qualitative methods, an in-depth understanding of HIE usage was developed. PMID:22003156

Therapeutic Alliance and Retention in Brief Strategic Family Therapy: A Mixed-Methods Study.

PubMed

Sheehan, Alyson H; Friedlander, Myrna L

2015-10-01

We explored how the therapeutic alliance contributed to retention in Brief Strategic Family Therapy by analyzing videotapes of eight-first sessions in which four therapists worked with one family that stayed in treatment and one family that dropped out. Although behavioral exchange patterns between clients and therapists did not differ by retention status, positive therapist alliance-related behavior followed negative client alliance behavior somewhat more frequently in the retained cases. In the qualitative aspect of the study, four family therapy experts each viewed two randomly assigned sessions and commented on their quality without knowing the families' retention status. A qualitative analysis of the audiotaped commentaries revealed 18 alliance-related themes that were more characteristic of either the retained or the nonretained cases. © 2015 American Association for Marriage and Family Therapy.

Can knowledge exchange support the implementation of a health-promoting schools approach? Perceived outcomes of knowledge exchange in the COMPASS study.

PubMed

Brown, Kristin M; Elliott, Susan J; Robertson-Wilson, Jennifer; Vine, Michelle M; Leatherdale, Scott T

2018-03-13

Despite the potential population-level impact of a health-promoting schools approach, schools face challenges in implementation, indicating a gap between school health research and practice. Knowledge exchange provides an opportunity to reduce this gap; however, there has been limited evaluation of these initiatives. This research explored researchers' and knowledge users' perceptions of outcomes associated with a knowledge exchange initiative within COMPASS, a longitudinal study of Canadian secondary students and schools. Schools received annual tailored summaries of their students' health behaviours and suggestions for action and were linked with knowledge brokers to support them in taking action to improve student health. Qualitative semi-structured interviews were conducted with COMPASS researchers (n = 13), school staff (n = 13), and public health stakeholders (n = 4) to explore their experiences with COMPASS knowledge exchange. Key issues included how knowledge users used school-specific findings, perceived outcomes of knowledge exchange, and suggestions for change. Outcomes for both knowledge users and researchers were identified; interestingly, knowledge users attributed more outcomes to using school-specific findings than knowledge brokering. School and public health participants indicated school-specific findings informed their programming and planning. Importantly, knowledge exchange provided a platform for partnerships between researchers, schools, and public health units. Knowledge brokering allowed researchers to gain feedback from knowledge users to enhance the study and a better understanding of the school environment. Interestingly, COMPASS knowledge exchange outcomes aligned with Samdal and Rowling's eight theory-driven implementation components for health-promoting schools. Hence, knowledge exchange may provide a mechanism to help schools implement a health-promoting schools approach. This research contributes to the limited literature regarding outcomes of knowledge brokering in public health and knowledge exchange in school health research. However, since not all schools engaged in knowledge brokering, and not all schools that engaged discussed these outcomes, further research is needed to determine the amount of engagement required for change and examine the process of COMPASS knowledge brokering to consider how to increase school engagement.

Immobilization of Acetobacter aceti on cellulose ion exchangers: adsorption isotherms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bar, R.; Gainer, J.L.; Kirwan, D.J.

1986-08-01

The adsorptive behavior of cells of Acetobacter aceti, ATCC 23746, on DEAE-, TEAE-, and DEHPAE-cellulose ion exchangers in a modified Hoyer's medium at 30 degrees Centigrade was investigated. The maximum observed adsorption capacities varied from 46 to 64 mg dry wt/g resin. The Langmuir isotherm form was used to fit the data, since the cells formed a monolayer on the resin and exhibited saturation. The equilibrium constant in the Langmuir expression was qualitatively correlated with the surface charge density of the resin. The adsorption was also ''normalized'' by considering the ionic capacities of the resins. The exceptionally high normalized adsorptionmore » capacity of ECTEOLA-cellulose, 261 mg dry/meq, may be explained by an interaction between the cell wall and the polyglyceryl chains of the exchanging groups in addition to the electrostatic effects. The effect of pH on the bacterial adsorption capacity of ECTEOLA-, TEAE-, and phosphate-cellulose resins was studied and the pH of the bacteria was estimated to be 3.0. 17 references.« less

Cultural Mechanisms in the Exchange of Social Support Among Puerto Ricans After a Natural Disaster

PubMed Central

Rivera, Fernando I.

2012-01-01

In this study, I uncovered the dynamics involved in the exchange (or lack) of social support among a group of Puerto Ricans who experienced a natural disaster. I coded and analyzed 12 semistructured qualitative interviews. My analysis of the interviews revealed that a reported high degree of need was not associated with any type of help seeking from the respondents' social support networks. Relevant issues that arose in explaining the lack of social support exchanges were level of comfort in help seeking and cultural issues. My findings point to the importance of culture in shaping patterns of help-seeking behavior in the aftermath of a disaster. Two of the most salient cultural explanations as to why disaster victims were reluctant to ask for help from family and friends were the issues of confianza (trust) and pena (embarrassment). I discuss the results with reference to how they might help in planning and establishing programs to maximize help seeking among Latinos/as in an emergency situation. PMID:22232298

Cultural mechanisms in the exchange of social support among Puerto Ricans after a natural disaster.

PubMed

Rivera, Fernando I

2012-06-01

In this study, I uncovered the dynamics involved in the exchange (or lack) of social support among a group of Puerto Ricans who experienced a natural disaster. I coded and analyzed 12 semistructured qualitative interviews. My analysis of the interviews revealed that a reported high degree of need was not associated with any type of help seeking from the respondents' social support networks. Relevant issues that arose in explaining the lack of social support exchanges were level of comfort in help seeking and cultural issues. My findings point to the importance of culture in shaping patterns of help-seeking behavior in the aftermath of a disaster. Two of the most salient cultural explanations as to why disaster victims were reluctant to ask for help from family and friends were the issues of confianza (trust) and pena (embarrassment). I discuss the results with reference to how they might help in planning and establishing programs to maximize help seeking among Latinos/as in an emergency situation.

The formation of excited atoms during charge exchange between hydrogen ions and alkali atoms. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Nieman, R. A.

1971-01-01

The charge exchange cross sections for protons and various alkali atoms are calculated using the classical approximation of Gryzinski. It is assumed that the hydrogen atoms resulting from charge exchange exist in all possible excited states. Charge transfer collisions between protons and potassium as well as protons and sodium atoms are studied. The energy range investigated is between 4 and 30 keV. The theoretical calculations of the capture cross section and the cross section for the creation of metastable 2S hydrogen are compared to experimental values. Good quantitative agreement is found for the capture cross section but only qualitative agreement for the metastable cross section. Analysis of the Lyman alpha window in molecular oxygen suggests that measured values of the metastable cross section may be in error. Thick alkali target data are also presented. This allows the determination of the total electron loss cross section. Finally, some work was done with H2(+).

Physicians' opinions of a health information exchange.

PubMed

Hincapie, Ana Lucia; Warholak, Terri L; Murcko, Anita C; Slack, Marion; Malone, Daniel C

2011-01-01

Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE). To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs. A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding. A total of 29 clinicians participated in the study. The attendance rate was 66% (N=19) for the first and last month of focus-group meetings and 52% (N=15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of "doctor shopping"; (2) averting duplicative testing; and (3) increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system. Respondents reported that AMIE had the potential to improve care, but they felt that AMIE impact was limited due to the data available.

Applications of health information exchange information to public health practice.

PubMed

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-01-01

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health.

Applications of Health Information Exchange Information to Public Health Practice

PubMed Central

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-01-01

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health. PMID:25954386

Cultural consensus modeling to measure transactional sex in Swaziland: Scale building and validation.

PubMed

Fielding-Miller, Rebecca; Dunkle, Kristin L; Cooper, Hannah L F; Windle, Michael; Hadley, Craig

2016-01-01

Transactional sex is associated with increased risk of HIV and gender based violence in southern Africa and around the world. However the typical quantitative operationalization, "the exchange of gifts or money for sex," can be at odds with a wide array of relationship types and motivations described in qualitative explorations. To build on the strengths of both qualitative and quantitative research streams, we used cultural consensus models to identify distinct models of transactional sex in Swaziland. The process allowed us to build and validate emic scales of transactional sex, while identifying key informants for qualitative interviews within each model to contextualize women's experiences and risk perceptions. We used logistic and multinomial logistic regression models to measure associations with condom use and social status outcomes. Fieldwork was conducted between November 2013 and December 2014 in the Hhohho and Manzini regions. We identified three distinct models of transactional sex in Swaziland based on 124 Swazi women's emic valuation of what they hoped to receive in exchange for sex with their partners. In a clinic-based survey (n = 406), consensus model scales were more sensitive to condom use than the etic definition. Model consonance had distinct effects on social status for the three different models. Transactional sex is better measured as an emic spectrum of expectations within a relationship, rather than an etic binary relationship type. Cultural consensus models allowed us to blend qualitative and quantitative approaches to create an emicly valid quantitative scale grounded in qualitative context. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effective process or dangerous precipice: qualitative comparative embedded case study with young people with epilepsy and their parents during transition from children’s to adult services

PubMed Central

2013-01-01

Background Transition from children’s to adult epilepsy services is known to be challenging. Some young people partially or completely disengage from contact with services, thereby risking their health and wellbeing. We conducted a mixed-method systematic review that showed current epilepsy transition models enabling information exchange and developing self-care skills were not working well. We used synthesised evidence to develop a theoretical framework to inform this qualitative study. The aim was to address a critical research gap by exploring communication, information needs, and experiences of knowledge exchange in clinical settings by young people and their parents, during transition from children’s to adult epilepsy services. Method Qualitative comparative embedded Case study with 2 'transition’ cases (epilepsy services) in two hospitals. Fifty-eight participants: 30 young people (13–19 years) and 28 parents were interviewed in-depth (individual or focus group). Clinical documents/guidelines were collated. 'Framework’ thematic analysis was used. The theoretical framework was tested using themes, pattern matching and replication logic. Theory-based evaluation methods were used to understand how and why different models of service delivery worked. Results A joint epilepsy clinic for young people 14–17 years coordinated by children’s and adult services was more likely to influence young people’s behaviour by facilitating more positive engagement with adult healthcare professionals and retention of epilepsy-related self-care information. Critical success factors were continuity of care, on-going and consistent age-appropriate and person centred communication and repeated information exchange. Three young people who experienced a single handover clinic disengaged from services. Psychosocial care was generally inadequate and healthcare professionals lacked awareness of memory impairment. Parents lacked knowledge, skills and support to enable their child to independently self-care. Translation of transition policies/guidelines into practice was weak. Conclusion Findings make a significant contribution to understanding why young people disengage from epilepsy services, why some parents prevent independent self-care, and what constitutes good communication and transition from the perspective of young people and parents. The type of service configuration, delivery and organisation influenced the behaviours of young people at transition to adult services. The novel theoretical framework was substantially supported, underwent further post-hoc development and can be used in future practice/intervention development and research. PMID:24131769

Online Social Support for Patients with Multiple Sclerosis: A Thematic Analysis of Messages Posted to a Virtual Support Community

PubMed Central

Shavazi, Masoumeh Abbasi; Morowatisharifabad, Mohammad Ali; Shavazi, Mohammad Taghi Abbasi; Mirzaei, Masoud; Ardekani, Ali Mellat

2016-01-01

Background: Currently with the emergence of the Internet, patients have an opportunity to exchange social support online. However, little attention has been devoted to different dimensions of online social support exchanged in virtual support communities for patients with multiple sclerosis (MS). Methods: To provide a rich insight, the aim of this qualitative study was to explore and categorize different dimensions of online social support in messages exchanged in a virtual support community for patients with MS. A total of 548 posted messages created during one year period were selected using purposive sampling to consider the maximum variation sampling. Prior-research-driven thematic analysis was then conducted. In this regard, we used the Cutruna and Suhr’s coding system. The messages that could not be categorized with the used coding system were thematically analyzed to explore new additional social support themes. Results: The results showed that various forms of social support including informational, emotional, network, esteem and tangible support were exchanged. Moreover, new additional social support themes including sharing personal experiences, sharing coping strategies and spiritual support emerged in this virtual support community. Conclusion: The wide range of online social support exchanged in the virtual support community can be regarded as a supplementary source of social support for patients with MS. Future researches can examine online social support more comprehensively considering additional social support themes emerging in the present study. PMID:27382585

[Intensification of the penicillin drying process based on the theory of short-term contact of material with a heat-exchange surface].

PubMed

Sadykov, R A; Migunov, V V

1987-01-01

The process of potassium benzylpenicillin vacuum drying was investigated. The kinetics of the process showed that a larger period of the drying process was needed for eliminating bound moisture. The influence of the angular velocity of the drier drum rotation on drying duration was studied in a short-term contact model. It was shown that intensity of drying increased with increasing velocity of the drum rotation. Experimental trials confirmed the conclusion and revealed adequacy of the relationship between the drying time and dispersion intensity in the short-term contact model. A qualitative dependence of the coefficient of convective heat exchange between the heating surface and the product on the angular velocity of the drier drum rotation was constructed.

Saying goodbye: The nature, causes, and consequences of employee resignation styles.

PubMed

Klotz, Anthony C; Bolino, Mark C

2016-10-01

Although much is known about why employees decide to resign from their jobs, scant research has examined what occurs after employees decide to leave their jobs but before they exit their organizations. As such, employee resignations are not well understood. This is unfortunate, because the manner in which employees resign from their jobs may have important implications for both individuals and organizations. In this paper, we use social exchange theory to argue that exchange-based correlates of employee turnover influence the manner in which employees resign, and that resignation styles affect managers' emotional reactions to employee resignation. We test our hypotheses in 4 studies. In Study 1, we inductively identify a taxonomy of resignation styles among full-time MBA students who have recently resigned from a job. In Study 2, we qualitatively examine the extent to which this taxonomy of resignation styles is represented in the accounts of supervisors of recently resigned employees. In Study 3, using a sample of recently resigned professionals, we demonstrate that employees' exchange relationships with their organizations and their supervisors influence their resignation styles. Finally, in Study 4, we provide evidence that resignation styles affect supervisors' emotional reactions in a sample of managers. Directions for future research on resignation and practical implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

IMPLEMENTING AN ATTACHMENT-BASED PARENTING INTERVENTION WITHIN HOME-BASED EARLY HEAD START: HOME-VISITORS' PERCEPTIONS AND EXPERIENCES.

PubMed

West, Allison L; Aparicio, Elizabeth M; Berlin, Lisa J; Jones Harden, Brenda

2017-07-01

Implementation of evidence-based interventions in "real-world" settings is enhanced when front-line staff view the intervention as acceptable, appropriate, and feasible. This qualitative study addresses Early Head Start (EHS) home visitors' perceptions and experiences of an evidence-based parenting intervention, the Attachment and Biobehavioral Catch-up program (M. Dozier, O. Lindhiem, & J. Ackerman, 2005), when added to EHS services as usual within the context of a research-practice partnership. Thematic analysis of in-depth, qualitative interviews indicates that home visitors experienced the intervention as positive and helpful for EHS families. Some challenges included scheduling and uncertainty regarding the goals of the intervention. Concerns over participation in the research centered on information exchange, confidentiality, and time limitations. © 2017 Michigan Association for Infant Mental Health.

Spontaneous nucleotide exchange in low molecular weight GTPases by fluorescently labeled γ-phosphate-linked GTP analogs

PubMed Central

Korlach, Jonas; Baird, Daniel W.; Heikal, Ahmed A.; Gee, Kyle R.; Hoffman, Gregory R.; Webb, Watt W.

2004-01-01

Regulated guanosine nucleotide exchange and hydrolysis constitute the fundamental activities of low molecular weight GTPases. We show that three guanosine 5′-triphosphate analogs with BODIPY fluorophores coupled via the gamma phosphate bind to the GTPases Cdc42, Rac1, RhoA, and Ras and displace guanosine 5′-diphosphate with high intrinsic exchange rates in the presence of Mg2+ ions, thereby acting as synthetic, low molecular weight guanine nucleotide exchange factors. The accompanying large fluorescence enhancements (as high as 12-fold), caused by a reduction in guanine quenching of the environmentally sensitive BODIPY dye fluorescence on protein binding, allow for real-time monitoring of this spontaneous nucleotide exchange in the visible spectrum with high signal-to-noise ratios. Binding affinities increased with longer aliphatic linkers connecting the nucleotide and BODIPY fluorophore and were in the 10–100 nM range. Steady-state and time-resolved fluorescence spectroscopy showed an inverse relationship between linker length and fluorescence enhancement factors and differences in protein-bound fluorophore mobilities, providing optimization criteria for future applications of such compounds as efficient elicitors and reporters of nucleotide exchange. EDTA markedly enhanced nucleotide exchange, enabling rapid loading of GTPases with these probes. Differences in active site geometries, in the absence of Mg2+, caused qualitatively different reporting of the bound state by the different analogs. The BODIPY analogs also prevented the interaction of Cdc42 with p21 activated kinase. Together, these results validate the use of these analogs as valuable tools for studying GTPase functions and for developing potent synthetic nucleotide exchange factors for this important class of signaling molecules. PMID:14973186

A population ecology perspective on the functioning and future of health information organizations.

PubMed

Vest, Joshua R; Menachemi, Nir

2017-11-01

Increasingly, health care providers need to exchange information to meet policy expectations and business needs. A variety of health information organizations (HIOs) provide services to facilitate health information exchange (HIE). However, the future of these organizations is unclear. The aim of this study was to explore the environmental context, potential futures, and survivability of community HIOs, enterprise HIEs, and electronic health record vendor-mediated exchange using the population ecology theory. Qualitative interviews with 33 key informants representing each type of HIE organization were analyzed using template analysis. Community HIOs, enterprise HIEs, and electronic health record vendors exhibited a high degree of competition for resources, especially in the area of exchange infrastructure services. Competition resulted in closures in some areas. In response to environmental pressures, each organizational type was endeavoring to differentiate its services and unique use case, as well as pursing symbiotic relationships or attempting resource partitioning. HIOs compete for similar resources and are reacting to environmental pressures to better position themselves for continued survival and success. Our ecological research perspective helps move the discourse away from situation of a single exchange organization type toward a view of the broader dynamics and relationships of all organizations involved in facilitating HIE activities. HIOs are attempting to partition the environment and differentiate services. HIE options should not be construed as an "either/or" decision, but one where multiple and complementary participation may be required.

Knowledge transfer and exchange processes for environmental health issues in Canadian Aboriginal communities.

PubMed

Jack, Susan M; Brooks, Sandy; Furgal, Chris M; Dobbins, Maureen

2010-02-01

Within Canadian Aboriginal communities, the process for utilizing environmental health research evidence in the development of policies and programs is not well understood. This fundamental qualitative descriptive study explored the perceptions of 28 environmental health researchers, senior external decision-makers and decision-makers working within Aboriginal communities about factors influencing knowledge transfer and exchange, beliefs about research evidence and Traditional Knowledge and the preferred communication channels for disseminating and receiving evidence. The results indicate that collaborative relationships between researchers and decision-makers, initiated early and maintained throughout a research project, promote both the efficient conduct of a study and increase the likelihood of knowledge transfer and exchange. Participants identified that empirical research findings and Traditional Knowledge are different and distinct types of evidence that should be equally valued and used where possible to provide a holistic understanding of environmental issues and support decisions in Aboriginal communities. To facilitate the dissemination of research findings within Aboriginal communities, participants described the elements required for successfully crafting key messages, locating and using credible messengers to deliver the messages, strategies for using cultural brokers and identifying the communication channels commonly used to disseminate and receive this type of information.

An example of demographic anthropology, the study of matrimonial exchanges--endogamy, choice of spouse and preferential marriage.

PubMed

Cazes, Marie-Hélène

2006-09-01

The development of demographic studies in anthropology is directly linked to the success of population genetics. The anthropodemographic or anthropogenetic approach is thus underpinned by questions of genetics. While demographers focus on population dynamics and renewal in quantitative terms, population geneticists refer not to individuals but to the sets of genes carried by individuals in a population. Their aim is to detect the factors and processes which influence the genetic evolution of a group, i.e. which modify gene frequencies from one generation to the next. Among them are the factors which affect modes of reproduction. To illustrate the association of these three approaches, i.e. demographic, anthropological and genetic, I use here the example of matrimonial exchanges--which lie at the heart of the population renewal process--among the Dogon of Boni, a Malian ethnic group living in the southern Sahel. We can see how successive analyses--starting with endogamy at macroscopic level and moving down to the individual with choice of spouse and preferential marriage-- combining both quantitative and qualitative approaches, can be used to obtain a detailed description of matrimonial exchanges which shed light upon and complement the three different viewpoints.

Knowledge Transfer and Exchange Processes for Environmental Health Issues in Canadian Aboriginal Communities

PubMed Central

Jack, Susan M.; Brooks, Sandy; Furgal, Chris M.; Dobbins, Maureen

2010-01-01

Within Canadian Aboriginal communities, the process for utilizing environmental health research evidence in the development of policies and programs is not well understood. This fundamental qualitative descriptive study explored the perceptions of 28 environmental health researchers, senior external decision-makers and decision-makers working within Aboriginal communities about factors influencing knowledge transfer and exchange, beliefs about research evidence and Traditional Knowledge and the preferred communication channels for disseminating and receiving evidence. The results indicate that collaborative relationships between researchers and decision-makers, initiated early and maintained throughout a research project, promote both the efficient conduct of a study and increase the likelihood of knowledge transfer and exchange. Participants identified that empirical research findings and Traditional Knowledge are different and distinct types of evidence that should be equally valued and used where possible to provide a holistic understanding of environmental issues and support decisions in Aboriginal communities. To facilitate the dissemination of research findings within Aboriginal communities, participants described the elements required for successfully crafting key messages, locating and using credible messengers to deliver the messages, strategies for using cultural brokers and identifying the communication channels commonly used to disseminate and receive this type of information. PMID:20616996

Theoretical modeling of the electronic structure and exchange interactions in Cu(II)Pc

NASA Astrophysics Data System (ADS)

Wu, Wei; Fisher, A. J.; Harrison, N. M.; Wang, Hai; Wu, Zhenlin; Gardener, Jules; Heutz, Sandrine; Jones, Tim; Aeppli, Gabriel

2012-12-01

We calculate the electronic structure and exchange interactions in a copper(II)phthalocyanine (Cu(II)Pc) crystal as a one-dimensional molecular chain using hybrid exchange density functional theory (DFT). In addition, the intermolecular exchange interactions are also calculated in a molecular dimer using Green's function perturbation theory (GFPT) to illustrate the underlying physics. We find that the exchange interactions depend strongly on the stacking angle, but weakly on the sliding angle (defined in the text). The hybrid DFT calculations also provide an insight into the electronic structure of the Cu(II)Pc molecular chain and demonstrate that on-site electron correlations have a significant effect on the nature of the ground state, the band gap and magnetic excitations. The exchange interactions predicted by our DFT calculations and GFPT calculations agree qualitatively with the recent experimental results on newly found η-Cu(II)Pc and the previous results for the α- and β-phases. This work provides a reliable theoretical basis for the further application of Cu(II)Pc to molecular spintronics and organic-based quantum information processing.

Theoretical modeling of the electronic structure and exchange interactions in a Cu(II)Pc one-dimensional chain

NASA Astrophysics Data System (ADS)

Wu, Wei; Fisher, A. J.; Harrison, N. M.

2011-07-01

We calculate the electronic structure and exchange interactions in a copper(II)phthalocyanine [Cu(II)Pc] crystal as a one-dimensional molecular chain using hybrid exchange density functional theory (DFT). In addition, the intermolecular exchange interactions are also calculated in a molecular dimer using Green’s function perturbation theory (GFPT) to illustrate the underlying physics. We find that the exchange interactions depend strongly on the stacking angle, but weakly on the sliding angle (defined in the text). The hybrid DFT calculations also provide an insight into the electronic structure of the Cu(II)Pc molecular chain and demonstrate that on-site electron correlations have a significant effect on the nature of the ground state, the band gap, and magnetic excitations. The exchange interactions predicted by our DFT calculations and GFPT calculations agree qualitatively with the recent experimental results on newly found η-Cu(II)Pc and the previous results for the α and β phases. This work provides a reliable theoretical basis for the further application of Cu(II)Pc to molecular spintronics and organic-based quantum information processing.

Detrended cross-correlation analysis on RMB exchange rate and Hang Seng China Enterprises Index

NASA Astrophysics Data System (ADS)

Ruan, Qingsong; Yang, Bingchan; Ma, Guofeng

2017-02-01

In this paper, we investigate the cross-correlations between the Hang Seng China Enterprises Index and RMB exchange markets on the basis of a cross-correlation statistic test and multifractal detrended cross-correlation analysis (MF-DCCA). MF-DCCA has, at best, serious limitations for most of the signals describing complex natural processes and often indicates multifractal cross-correlations when there are none. In order to prevent these false multifractal cross-correlations, we apply MFCCA to verify the cross-correlations. Qualitatively, we find that the return series of the Hang Seng China Enterprises Index and RMB exchange markets were, overall, significantly cross-correlated based on the statistical analysis. Quantitatively, we find that the cross-correlations between the stock index and RMB exchange markets were strongly multifractal, and the multifractal degree of the onshore RMB exchange markets was somewhat larger than the offshore RMB exchange markets. Moreover, we use the absolute return series to investigate and confirm the fact of multifractality. The results from the rolling windows show that the short-term cross-correlations between volatility series remain high.

Creating community life among immigrant survivors of torture and their allies.

PubMed

Bothne, Nancy; Keys, Christopher B

2016-01-01

This qualitative study describes how immigrant survivors of torture in the United States built relationships among each other to form a psychological sense of community. Eight men and seven women from 11 different countries were recruited through a torture treatment center and a survivor-led advocacy and support coalition. This qualitative study explored how participants described their experiences of community life. An advisory group that included torture survivors, torture treatment practitioners, abolition advocates and academic experts guided the study. Data was analyzed using inductive and phenomenological theories. The construct of psychological sense of community articulated by McMillan and Chavis1 provided the conceptual framework for the evaluation of how a psychological sense of community was developed. Torture survivors with their allies formed community boundaries based on a deep understanding of the impact of torture. The safety afforded through the community boundaries was reinforced by shared condemnation of torture in all circumstances. Within the security of the community's boundaries, members shared their experiences to enable their own and others' recovery from torture. As community members exchanged advice and support, survivors met one another's needs, providing physical and emotional relief from the effects of their torture. As individuals and a community, they influenced each other's identities as survivors rather than victims. Advocating for those who remained vulnerable to torture was important to their identification as survivors. Through these exchanges, community members influenced one another and developed trusting relationships and emotional bonds. This study illuminates how community life enabled survivors to contribute to, and benefit from, each other's journeys.

Lanthanides-clay nanocomposites: Synthesis, characterization and optical properties

DOE Office of Scientific and Technical Information (OSTI.GOV)

Celedon, Salvador; Quiroz, Carolina; Gonzalez, Guillermo

2009-05-06

Complexes of Europium(III) and Terbium(III) with 2,2-bipyridine and 1,10-phenanthroline were inserted into Na-bentonite by ion exchange reactions at room temperature. The products display interlaminar distances and stoichiometries in agreement with the ion exchange capacity and the interlayer space available in the clay. The optical properties of the intercalates, being qualitatively similar to those of the free complexes, are additionally improved with respect to exchange processes with the medium, especially in a moist environment. The protection again hydrolysis, together with the intensity of the optical transition {sup 5}D{sub 0}-{sup 5}F{sub 2} observed in the nanocomposite, makes these products promising for themore » development of novel optical materials.« less

A model for foreign exchange markets based on glassy Brownian systems

PubMed Central

Trinidad-Segovia, J. E.; Clara-Rahola, J.; Puertas, A. M.; De las Nieves, F. J.

2017-01-01

In this work we extend a well-known model from arrested physical systems, and employ it in order to efficiently depict different currency pairs of foreign exchange market price fluctuation distributions. We consider the exchange rate price in the time range between 2010 and 2016 at yearly time intervals and resolved at one minute frequency. We then fit the experimental datasets with this model, and find significant qualitative symmetry between price fluctuation distributions from the currency market, and the ones belonging to colloidal particles position in arrested states. The main contribution of this paper is a well-known physical model that does not necessarily assume the independent and identically distributed (i.i.d.) restrictive condition. PMID:29206868

Pursuing Authenticity From Process to Outcome in a Community-Based Participatory Research Study of Intimate Partner Violence and HIV Vulnerability in North Karnataka, India

PubMed Central

Blanchard, Andrea Katryn; Sangha, Chaitanya AIDS Tadegattuva Mahila; Nair, Sapna G.; Thalinja, Raghavendra; Srikantamurthy, H.S.; Ramanaik, Satyanaryana; Javalkar, Prakash; Pillai, Priya; Isac, Shajy; Collumbien, Martine; Heise, Lori; Bhattacharjee, Parinita; Bruce, Sharon Gail

2016-01-01

Community-based participatory research has been seen to hold great promise by researchers aiming to bridge research and action in global health programs and practice. However, there is still much debate around whether achieving authenticity in terms of in-depth collaboration between community and academic partners is possible while pursuing academic expectations for quality. This article describes the community-based methodology for a qualitative study to explore intimate partner violence and HIV/AIDS among women in sex work, or female sex workers, and their male partners in Karnataka, South India. Developed through collaborative processes, the study methodology followed an interpretive approach to qualitative inquiry, with three key components including long-term partnerships, knowledge exchange, and orientation toward action. We then discuss lessons learned on how to pursue authenticity in terms of truly collaborative processes with inherent value that also contribute to, rather than hinder, the instrumental goal of enhancing the quality and relevance of the research outcomes. PMID:27378133

Stabilization of magnetic skyrmions by RKKY interactions

NASA Astrophysics Data System (ADS)

Bezvershenko, Alla V.; Kolezhuk, Alexei K.; Ivanov, Boris A.

2018-02-01

We study the stabilization of an isolated magnetic skyrmion in a magnetic monolayer on a nonmagnetic conducting substrate via the Ruderman-Kittel-Kasuya-Yosida (RKKY) exchange interaction. Two different types of the substrate are considered, usual normal metal and single-layer graphene. While the full stability analysis for skyrmions in the presence of the RKKY coupling requires a separate effort that is outside the scope of this work, we are able to study the radial stability (stability of a skyrmion against collapse) using variational energy estimates obtained within first-order perturbation theory, with the unperturbed Hamiltonian describing the isotropic Heisenberg magnet, and the two perturbations being the RKKY exchange and the easy-axis anisotropy. We show that a proper treatment of the long-range nature of the RKKY interaction leads to a qualitatively different stabilization scenario compared to previous studies, where solitons were stabilized by the frustrated exchange coupling (leading to terms with the fourth power of the magnetization gradients) or by the Dzyaloshinskii-Moriya interaction (described by terms linear in the magnetization gradients). In the case of a metallic substrate, the skyrmion stabilization is possible under restrictive conditions on the Fermi surface parameters, while in the case of a graphene substrate the stabilization is naturally achieved in several geometries with a lattice-matching of graphene and magnetic layer.

Finite-T correlations and free exchange-correlation energy of quasi-one-dimensional electron gas

NASA Astrophysics Data System (ADS)

Garg, Vinayak; Sharma, Akariti; Moudgil, R. K.

2018-02-01

We have studied the effect of temperature on static density-density correlations and plasmon excitation spectrum of quasi-one-dimensional electron gas (Q1DEG) using the random phase approximation (RPA). Numerical results for static structure factor, pair-correlation function, static density susceptibility, free exchange-correlation energy and plasmon dispersion are presented over a wide range of temperature and electron density. As an interesting result, we find that the short-range correlations exhibit a non-monotonic dependence on temperature T, initially growing stronger (i.e. the pair-correlation function at small inter-electron spacing assuming relatively smaller values) with increasing T and then weakening above a critical T. The cross-over temperature is found to increase with increasing coupling among electrons. Also, the q = 2kF peak in the static density susceptibility χ(q,ω = 0,T) at T = 0 K smears out with rising T. The free exchange-correlation energy and plasmon dispersion show a significant variation with T, and the trend is qualitatively the same as in higher dimensions.

Physicians' opinions of a health information exchange

PubMed Central

Warholak, Terri L; Murcko, Anita C; Slack, Marion; Malone, Daniel C

2010-01-01

Background Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE). Objective To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs. Measurements A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding. Results A total of 29 clinicians participated in the study. The attendance rate was 66% (N=19) for the first and last month of focus-group meetings and 52% (N=15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of “doctor shopping”; (2) averting duplicative testing; and (3) increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system. Conclusion Respondents reported that AMIE had the potential to improve care, but they felt that AMIE impact was limited due to the data available. PMID:21106994

Collaboration and communication in colorectal cancer care: a qualitative study of the challenges experienced by patients and health care professionals

PubMed Central

Kamradt, Martina; Baudendistel, Ines; Längst, Gerda; Kiel, Marion; Eckrich, Felicitas; Winkler, Eva; Szecsenyi, Joachim; Ose, Dominik

2015-01-01

Background. Colorectal cancer is becoming a chronic condition. This has significant implications for the delivery of health care and implies the involvement of a range of health care professionals (HCPs) from different settings to ensure the needed quality and continuity of care. Objectives. To explore the challenges that patients and HCPs experience in the course of colorectal cancer care and the perceived consequences caused by these challenges. Methods. Ten semi-structured focus groups were conducted including patients receiving treatment for colorectal cancer, representatives of patient support groups, physicians and other non-physician HCPs from different health care settings. Participants were asked to share their experiences regarding colorectal cancer care. All data were audio- and videotaped, transcribed verbatim and thematically analysed using qualitative content analysis. Results. Patients and HCPs (total N = 47) experienced collaboration and communication as well as exchange of information between HCPs as challenging. Particularly communication and information exchange with GPs appeared to be lacking. The difficulties identified restricted a well-working coordination of care and seemed to cause inappropriate health care. Conclusion. Colorectal cancer care seems to require an effective, well-working collaboration and communication between the different HCPs involved ensuring the best possible care to suit patients’ individual needs. However, the perceived challenges and consequences of our participants seem to restrict the delivery of the needed quality of care. Therefore, it seems crucial (i) to include all HCPs involved, especially the GP, (ii) to support an efficient and standardized exchange of health-related information and (iii) to focus on the patients’ entire pathway of care. PMID:26311705

Qualitative inquiry and the debate between hermeneutics and critical theory.

PubMed

Shaw, James A; DeForge, Ryan T

2014-11-01

Two issues have been central to ongoing disputes about judgments of quality in qualitative inquiry: (a) the ways in which paradigmatic orientations are understood to guide procedural decisions and (b) the meaning and intelligibility of paradigmatic incommensurability. In this article, we address these two key issues through an exploration of the debates between hermeneutics and critical social theory, including the exchanges between Hans-Georg Gadamer and Jurgen Habermas, and between Richard Rorty and Thomas McCarthy. We suggest that the key epistemological issue addressed in these debates is the nature of interpretation, separating the two philosophical camps based on beliefs about whether foundational knowledge is possible to achieve. We conclude the article by discussing the implications of these different positions for beliefs about quality in qualitative inquiry, and comment on the role of judgment in assessments of the value and quality of different approaches to qualitative research. © The Author(s) 2014.

Failure of the Nernst-Einstein equation to correlate electrical resistances and rates of ionic self-exchange across certain fixed charge membranes.

PubMed

Gottlieb, M H; Sollner, K

1968-05-01

The electrical resistances and rates of self-exchange of univalent critical ions across several types of collodion matrix membranes of high ionic selectivity were studied over a wide range of conditions. The relationship which was observed between these quantities with membranes of a certain type, namely those activated with poly-2-vinyl-N-methyl pyridinium bromide, cannot be explained on the basis of current concepts of the movement of ions across ion exchange membranes. Rates of self-exchange across these membranes were several times greater than those calculated from the electrical resistances of the membranes on the basis of an expression derived by the use of the Nernst-Einstein equation. The magnitude of the discrepancy was greatest at low concentrations of the ambient electrolyte solution and was independent of the species of both critical and noncritical ions. The data obtained with other types of collodion matrix membranes were, at least approximately, in agreement with the predictions based on the Nernst-Einstein equation. Self-exchange rates across the anion permeable protamine collodion membranes, and across the cation permeable polystyrene sulfonic acid collodion membranes, were about 20% less than those calculated from the electrical resistances. The direction and magnitude of these differences, also observed by other investigators, are qualitatively understood as an electroosmotic effect. With cation permeable membranes prepared by the oxidation of preformed collodion membranes, almost exact agreement was obtained between measured and calculated self-exchange rates; the cause of the apparent absence of an electroosmotic effect with these membranes is unknown.

Failure of the Nernst-Einstein Equation to Correlate Electrical Resistances and Rates of Ionic Self-Exchange across Certain Fixed Charge Membranes

PubMed Central

Gottlieb, Melvin H.; Sollner, Karl

1968-01-01

The electrical resistances and rates of self-exchange of univalent critical ions across several types of collodion matrix membranes of high ionic selectivity were studied over a wide range of conditions. The relationship which was observed between these quantities with membranes of a certain type, namely those activated with poly-2-vinyl-N-methyl pyridinium bromide, cannot be explained on the basis of current concepts of the movement of ions across ion exchange membranes. Rates of self-exchange across these membranes were several times greater than those calculated from the electrical resistances of the membranes on the basis of an expression derived by the use of the Nernst-Einstein equation. The magnitude of the discrepancy was greatest at low concentrations of the ambient electrolyte solution and was independent of the species of both critical and noncritical ions. The data obtained with other types of collodion matrix membranes were, at least approximately, in agreement with the predictions based on the Nernst-Einstein equation. Self-exchange rates across the anion permeable protamine collodion membranes, and across the cation permeable polystyrene sulfonic acid collodion membranes, were about 20% less than those calculated from the electrical resistances. The direction and magnitude of these differences, also observed by other investigators, are qualitatively understood as an electroosmotic effect. With cation permeable membranes prepared by the oxidation of preformed collodion membranes, almost exact agreement was obtained between measured and calculated self-exchange rates; the cause of the apparent absence of an electroosmotic effect with these membranes is unknown. PMID:5699793

Interweaving interactions in virtual worlds: a case study.

PubMed

Cantamesse, Matteo; Galimberti, Carlo; Giacoma, Gianandrea

2011-01-01

The aim of this study was to examine the effect of playing the online game World of Warcraft (WoW), both on adolescent's (effective) social interaction and on the competence they developed on it. Social interactions within the game environment have been investigated by integrating qualitative and quantitative methods: conversation analysis and social network analysis (SNA). From a psychosocial point of view, the in-game interactions, and in particular conversational exchanges, turn out to be a collaborative path of the joint definition of identities and social ties, with reflection on in-game processes and out-game relationship.

Intergroup variation in robbing and bartering by long-tailed macaques at Uluwatu Temple (Bali, Indonesia).

PubMed

Brotcorne, Fany; Giraud, Gwennan; Gunst, Noëlle; Fuentes, Agustín; Wandia, I Nengah; Beudels-Jamar, Roseline C; Poncin, Pascal; Huynen, Marie-Claude; Leca, Jean-Baptiste

2017-10-01

Robbing and bartering (RB) is a behavioral practice anecdotally reported in free-ranging commensal macaques. It usually occurs in two steps: after taking inedible objects (e.g., glasses) from humans, the macaques appear to use them as tokens, returning them to humans in exchange for food. While extensively studied in captivity, our research is the first to investigate the object/food exchange between humans and primates in a natural setting. During a 4-month study in 2010, we used both focal and event sampling to record 201 RB events in a population of long-tailed macaques (Macaca fascicularis), including four neighboring groups ranging freely around Uluwatu Temple, Bali (Indonesia). In each group, we documented the RB frequency, prevalence and outcome, and tested the underpinning anthropogenic and demographic determinants. In line with the environmental opportunity hypothesis, we found a positive qualitative relation at the group level between time spent in tourist zones and RB frequency or prevalence. For two of the four groups, RB events were significantly more frequent when humans were more present in the environment. We also found qualitative partial support for the male-biased sex ratio hypothesis [i.e., RB was more frequent and prevalent in groups with higher ratios of (sub)adult males], whereas the group density hypothesis was not supported. This preliminary study showed that RB is a spontaneous, customary (in some groups), and enduring population-specific practice characterized by intergroup variation in Balinese macaques. As such, RB is a candidate for a new behavioral tradition in this species.

Up-Skilling through E-Collaboration

ERIC Educational Resources Information Center

Huc-Hepher, Saskia; Barros, Elsa Huertas

2016-01-01

This paper presents an e-collaboration project involving real-time videoconferencing exchanges between students from the University of Westminster and the Université Catholique de Lille. Students drew on diverse resources, including written quantitative data and first-hand qualitative data in French/English to complete weekly tasks. Follow-up work…

Asymmetry of inverted-topology repeats in the AE1 anion exchanger suggests an elevator-like mechanism

PubMed Central

Faraldo-Gómez, José D.

2017-01-01

The membrane transporter anion exchanger 1 (AE1), or band 3, is a key component in the processes of carbon-dioxide transport in the blood and urinary acidification in the renal collecting duct. In both erythrocytes and the basolateral membrane of the collecting-duct α-intercalated cells, the role of AE1 is to catalyze a one-for-one exchange of chloride for bicarbonate. After decades of biochemical and functional studies, the structure of the transmembrane region of AE1, which catalyzes the anion-exchange reaction, has finally been determined. Each protomer of the AE1 dimer comprises two repeats with inverted transmembrane topologies, but the structures of these repeats differ. This asymmetry causes the putative substrate-binding site to be exposed only to the extracellular space, consistent with the expectation that anion exchange occurs via an alternating-access mechanism. Here, we hypothesize that the unknown, inward-facing conformation results from inversion of this asymmetry, and we propose a model of this state constructed using repeat-swap homology modeling. By comparing this inward-facing model with the outward-facing experimental structure, we predict that the mechanism of AE1 involves an elevator-like motion of the substrate-binding domain relative to the nearly stationary dimerization domain and to the membrane plane. This hypothesis is in qualitative agreement with a wide range of biochemical and functional data, which we review in detail, and suggests new avenues of experimentation. PMID:29167180

Statistical mapping of zones of focused groundwater/surface-water exchange using fiber-optic distributed temperature sensing

USGS Publications Warehouse

Mwakanyamale, Kisa; Day-Lewis, Frederick D.; Slater, Lee D.

2013-01-01

Fiber-optic distributed temperature sensing (FO-DTS) increasingly is used to map zones of focused groundwater/surface-water exchange (GWSWE). Previous studies of GWSWE using FO-DTS involved identification of zones of focused GWSWE based on arbitrary cutoffs of FO-DTS time-series statistics (e.g., variance, cross-correlation between temperature and stage, or spectral power). New approaches are needed to extract more quantitative information from large, complex FO-DTS data sets while concurrently providing an assessment of uncertainty associated with mapping zones of focused GSWSE. Toward this end, we present a strategy combining discriminant analysis (DA) and spectral analysis (SA). We demonstrate the approach using field experimental data from a reach of the Columbia River adjacent to the Hanford 300 Area site. Results of the combined SA/DA approach are shown to be superior to previous results from qualitative interpretation of FO-DTS spectra alone.

Issues associated with modelling of proton exchange membrane fuel cell by computational fluid dynamics

NASA Astrophysics Data System (ADS)

Bednarek, Tomasz; Tsotridis, Georgios

2017-03-01

The objective of the current study is to highlight possible limitations and difficulties associated with Computational Fluid Dynamics in PEM single fuel cell modelling. It is shown that an appropriate convergence methodology should be applied for steady-state solutions, due to inherent numerical instabilities. A single channel fuel cell model has been taken as numerical example. Results are evaluated for quantitative as well qualitative points of view. The contribution to the polarization curve of the different fuel cell components such as bi-polar plates, gas diffusion layers, catalyst layers and membrane was investigated via their effects on the overpotentials. Furthermore, the potential losses corresponding to reaction kinetics, due to ohmic and mas transport limitations and the effect of the exchange current density and open circuit voltage, were also investigated. It is highlighted that the lack of reliable and robust input data is one of the issues for obtaining accurate results.

Flow Quality Studies of the NASA Glenn Research Center Icing Research Tunnel Circuit (1995 Tests)

NASA Technical Reports Server (NTRS)

Arrington, E. Allen; Kee-Bowling, Bonnie A.; Gonsalez, Jose C.

2000-01-01

The purpose of conducting the flow-field surveys described in this report was to more fully document the flow quality in several areas of the tunnel circuit in the NASA Glenn Research Center Icing Research Tunnel. The results from these surveys provide insight into areas of the tunnel that were known to exhibit poor flow quality characteristics and provide data that will be useful to the design of flow quality improvements and a new heat exchanger for the facility. An instrumented traversing mechanism was used to survey the flow field at several large cross sections of the tunnel loop over the entire speed range of the facility. Flow-field data were collected at five stations in the tunnel loop, including downstream of the fan drive motor housing, upstream and downstream of the heat exchanger, and upstream and downstream of the spraybars located in the settling chamber upstream of the test section. The data collected during these surveys greatly expanded the data base describing the flow quality in each of these areas. The new data matched closely the flow quality trends recorded from earlier tests. Data collected downstream of the heat exchanger and in the settling chamber showed how the configuration of the folded heat exchanger affected the pressure, velocity, and flow angle distributions in these areas. Smoke flow visualization was also used to qualitatively study the flow field in an area downstream of the drive fan and in the settling chamber/contraction section.

A structural coarse-grained model for clays using simple iterative Boltzmann inversion

NASA Astrophysics Data System (ADS)

Schaettle, Karl; Ruiz Pestana, Luis; Head-Gordon, Teresa; Lammers, Laura Nielsen

2018-06-01

Cesium-137 is a major byproduct of nuclear energy generation and is environmentally threatening due to its long half-life and affinity for naturally occurring micaceous clays. Recent experimental observations of illite and phlogopite mica indicate that Cs+ is capable of exchanging with K+ bound in the anhydrous interlayers of layered silicates, forming sharp exchange fronts, leading to interstratification of Cs- and K-illite. We present here a coarse-grained (CG) model of the anhydrous illite interlayer developed using iterative Boltzmann inversion that qualitatively and quantitatively reproduces features of a previously proposed feedback mechanism of ion exchange. The CG model represents a 70-fold speedup over all-atom models of clay systems and predicts interlayer expansion for K-illite near ion exchange fronts. Contrary to the longstanding theory that ion exchange in a neighboring layer increases the binding of K in lattice counterion sites leading to interstratification, we find that the presence of neighboring exchanged layers leads to short-range structural relaxations that increase basal spacing and decrease cohesion of the neighboring K-illite layers. We also provide evidence that the formation of alternating Cs- and K-illite interlayers (i.e., ordered interstratification) is both thermodynamically and mechanically favorable compared to exchange in adjacent interlayers.

76 FR 27710 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Order Granting Approval of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-12

... 8, 2010.\\3\\ The Commission subsequently extended the time period in which to either approve the... BX Venture Market will have minimal quantitative listing standards, but will have qualitative... another national securities exchange for failure to meet quantitative listing standards (including price...

The Decision to Remain in an Involuntarily Celibate Relationship

ERIC Educational Resources Information Center

Donnelly, Denise A; Burgess, Elisabeth O

2008-01-01

Based upon qualitative data from a sample of 77 married or long-term cohabiting heterosexuals self-defining as involuntarily celibate, we used social exchange theory to develop a model for understanding the causes and consequences of sexual inactivity in committed relationships. Although reported consequences of involuntary celibacy tended to be…

How an Exchange of Perspectives Led to Tentative Ethical Guidelines for Visual Ethnography

ERIC Educational Resources Information Center

Pope, Clive C.; De Luca, Rosemary; Tolich, Martin

2010-01-01

Qualitative research, especially visual ethnography, is an iterative not a linear process, replete with good intentions, false starts, mistaken assumptions, miscommunication and a continually revised statement of the problem. That the camera freezes everything and everyone in the frame only complicates ethical considerations. This work, jointly…

Growth of Internet Use by Language Professionals.

ERIC Educational Resources Information Center

Fidelman, Carolyn G.

1998-01-01

Presents results of a survey showing increased use of the Internet by language professionals (e.g., language teachers, translators, interpreters). Results of the survey show a qualitative improvement in the Internet for information retrieval, teaching, and idea exchange. If K-12 foreign-language teachers receive appropriate equipment and training,…

Systemic Planning: An Annotated Bibliography and Literature Guide. Exchange Bibliography No. 91.

ERIC Educational Resources Information Center

Catanese, Anthony James

Systemic planning is an operational approach to using scientific rigor and qualitative judgment in a complementary manner. It integrates rigorous techniques and methods from systems analysis, cybernetics, decision theory, and work programing. The annotated reference sources in this bibliography include those works that have been most influential…

Methodological Gravitism

ERIC Educational Resources Information Center

Zaman, Muhammad

2011-01-01

In this paper the author presents the case of the exchange marriage system to delineate a model of methodological gravitism. Such a model is not a deviation from or alteration to the existing qualitative research approaches. I have adopted culturally specific methodology to investigate spouse selection in line with the Grounded Theory Method. This…

The Gas Exchange Experiment for life detection - The Viking Mars Lander.

NASA Technical Reports Server (NTRS)

Oyama, V. I.

1972-01-01

The Gas Exchange Experiment of the Viking mission accepts a sample of Martian soil, incubates this soil with nutrient medium, and periodically samples the enclosed atmosphere over this soil for the gases H2, N2, O2, Kr, and CO2. These gases are analyzed by an automated gas chromatograph, and the data are transmitted to earth. The design of the experiment and the qualitative and quantitative changes, if any, of gas composition should allow conclusions to be made on the presence of life on Mars. Data and theory substantiating this approach are presented.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Song, Young-Ho; Lazauskas, Rimantas; Park, Tae-Sun

M1 properties, comprising magnetic moments and radiative capture of thermal neutron observables, are studied in two- and three-nucleon systems. We use meson exchange current derived up to N{sup 3}LO using heavy baryon chiral perturbation theory a la Weinberg. Calculations have been performed for several qualitatively different realistic nuclear Hamiltonians, which permits us to analyze model dependence of our results. Our results are found to be strongly correlated with the effective range parameters such as binding energies and the scattering lengths. Taking into account such correlations, the results are in good agreement with the experimental data with small model dependence.

Expanding the conceptual toolkit of organ gifting.

PubMed

M Shaw, Rhonda

2015-07-01

In jurisdictions where the sale of body tissue and organs is illegal, organ transplantation is often spoken of as a gift of life. In the social sciences and bioethics this concept has been subject to critique over the course of the last two decades for failing to reflect the complexities of organ and tissue exchange. I suggest that a new ethical model of organ donation and transplantation is needed to capture the range of experiences in this domain. The proposed model is both analytical and empirically oriented, and draws on research findings linking a series of qualitative sociological studies undertaken in New Zealand between 2007 and 2013. The studies were based on document analysis, field notes and 127 semi-structured in-depth interviews with people from different cultural and constituent groups directly involved in organ transfer processes. The aim of the article is to contribute to sociological knowledge about organ exchange and to expand the conceptual toolkit of organ donation to include the unconditional gift, the gift relation, gift exchange, body project, and body work. The rationale for the proposed model is to provide an explanatory framework for organ donors and transplant recipients and to assist the development of ethical guidelines and health policy discourse. © 2015 Foundation for the Sociology of Health & Illness.

Measurement with microscopic MRI and simulation of flow in different aneurysm models.

PubMed

Edelhoff, Daniel; Walczak, Lars; Frank, Frauke; Heil, Marvin; Schmitz, Inge; Weichert, Frank; Suter, Dieter

2015-10-01

The impact and the development of aneurysms depend to a significant degree on the exchange of liquid between the regular vessel and the pathological extension. A better understanding of this process will lead to improved prediction capabilities. The aim of the current study was to investigate fluid-exchange in aneurysm models of different complexities by combining microscopic magnetic resonance measurements with numerical simulations. In order to evaluate the accuracy and applicability of these methods, the fluid-exchange process between the unaltered vessel lumen and the aneurysm phantoms was analyzed quantitatively using high spatial resolution. Magnetic resonance flow imaging was used to visualize fluid-exchange in two different models produced with a 3D printer. One model of an aneurysm was based on histological findings. The flow distribution in the different models was measured on a microscopic scale using time of flight magnetic resonance imaging. The whole experiment was simulated using fast graphics processing unit-based numerical simulations. The obtained simulation results were compared qualitatively and quantitatively with the magnetic resonance imaging measurements, taking into account flow and spin-lattice relaxation. The results of both presented methods compared well for the used aneurysm models and the chosen flow distributions. The results from the fluid-exchange analysis showed comparable characteristics concerning measurement and simulation. Similar symmetry behavior was observed. Based on these results, the amount of fluid-exchange was calculated. Depending on the geometry of the models, 7% to 45% of the liquid was exchanged per second. The result of the numerical simulations coincides well with the experimentally determined velocity field. The rate of fluid-exchange between vessel and aneurysm was well-predicted. Hence, the results obtained by simulation could be validated by the experiment. The observed deviations can be caused by the noise in the measurement and by the limited resolution of the simulation. The resulting differences are small enough to allow reliable predictions of the flow distribution in vessels with stents and for pulsed blood flow.

Negotiating multisectoral evidence: a qualitative study of knowledge exchange at the intersection of transport and public health.

PubMed

Guell, Cornelia; Mackett, Roger; Ogilvie, David

2017-01-05

For the prevention and control of chronic diseases, two strategies are frequently highlighted: that public health should be evidence based, and that it should develop a multisectoral approach. At the end of a natural experimental study of the health impacts of new transport infrastructure, we took the opportunity of a knowledge exchange forum to explore how stakeholders assessed, negotiated and intended to apply multisectoral evidence in policy and practice at the intersection of transport and health. We aimed to better understand the challenges they faced in knowledge exchange, as well as their everyday experiences with working in multisectoral remits. In 2015, we conducted participant observation during an interactive event with 41 stakeholders from national and local government, the third sector and academia in Cambridge, UK. Formal and informal interactions between stakeholders were recorded in observational field notes. We also conducted 18 semistructured interviews reflecting on the event and on knowledge exchange in general. We found that stakeholders negotiated a variety of challenges. First, stakeholders had to negotiate relatively new formal and informal multisectoral remits; and how to reconcile the differing expectations of transport specialists, who tended to emphasise the importance of precedence in guiding action, and health specialists' concern for the rigour and synthesis of research evidence. Second, research in this field involved complex study designs, and often produced evidence with uncertain transferability to other settings. Third, health outcomes of transport schemes had political traction and were used strategically but not easily translated into cost-benefit ratios. Finally, knowledge exchange meant multiple directions of influence. Stakeholders were concerned that researchers did not always have skills to translate their findings into understandable evidence, and some stakeholders would welcome opportunities to influence research agendas. This case study of stakeholders' experiences indicates that multisectoral research, practice and policymaking requires the ability and capacity to locate, understand and communicate complex evidence from a variety of disciplines, and integrate different types of evidence into clear business cases beyond sectoral boundaries.

It's hard to play ball: A qualitative study of knowledge exchange and silo effects in public health.

PubMed

Johnson, Rebecca; Grove, Amy; Clarke, Aileen

2018-01-02

Partnerships in public health form an important component of commissioning and implementing services, in England and internationally. In this research, we examine the views of staff involved in a City-wide health improvement programme which ran from 2009 to 2013 in England. We examine the practicalities of partnership work in community settings, and we describe some of barriers faced when implementing a large, multi-organisation health improvement programme. Qualitative, semi-structured interviews were performed. Purposive sampling was used to identify potential participants in the programme: programme board of directors, programme and project managers and intervention managers. Interviews were conducted one-to-one. We conducted a thematic analysis using the 'one sheet of paper' technique. This involved analysing data deductively, moving from initial to axial coding, developing categories and then identifying emerging themes. Fifteen interviews were completed. Three themes were identified. The first theme reflects how poor communication approaches hindered the ability of partnerships to deliver their aims and objectives in a range of ways and for a range of reasons. Our second theme reflects how a lack of appropriate knowledge exchange hindered decision-making, affected trust and contributed to protectionist approaches to working. This lack of shared, and communicated, understanding of what type of knowledge is most appropriate and in which circumstance made meaningful knowledge exchange challenging for decision-making and partnership-working in the City-wide health improvement programme. Theme three demonstrates how perceptions about silos in partnership-working could be problematic, but silos themselves were at times beneficial to partnerships. This revealed a mismatch between rhetoric and a realistic understanding of what components of the programme were functional and which were more hindrance than help. There were high expectations placed on the concept of what partnership work was, or how it should be done. We found our themes to be interdependent, and reflective of the 'dynamic fluid process' discussed within the knowledge mobilisation literature. We contend that reframing normal and embedded processes of silos and silo-working already in use might ease resistance to some knowledge exchange processes and contribute to better long-term functioning of public health partnerships.

Numerical investigation of transient behaviour of the recuperative heat exchanger in a MR J-T cryocooler using different heat transfer correlations

NASA Astrophysics Data System (ADS)

Damle, R. M.; Ardhapurkar, P. M.; Atrey, M. D.

2016-12-01

In J-T cryocoolers operating with mixed refrigerants (nitrogen-hydrocarbons), the recuperative heat exchange takes place under two-phase conditions. Simultaneous boiling of the low pressure stream and condensation of the high pressure stream results in higher heat transfer coefficients. The mixture composition, operating conditions and the heat exchanger design are crucial for obtaining the required cryogenic temperature. In this work, a one-dimensional transient algorithm is developed for the simulation of the two-phase heat transfer in the recuperative heat exchanger of a mixed refrigerant J-T cryocooler. Modified correlation is used for flow boiling of the high pressure fluid while different condensation correlations are employed with and without the correction for the low pressure fluid. Simulations are carried out for different mixture compositions and numerical predictions are compared with the experimental data. The overall heat transfer is predicted reasonably well and the qualitative trends of the temperature profiles are also captured by the developed numerical model.

Exchanging narratives-A qualitative study of peer support among surgical lung cancer patients.

PubMed

Borregaard, Britt; Ludvigsen, Mette Spliid

2018-01-01

The aim of this study was to examine how hospitalised, surgical lung cancer patients experience talking to a former patient, and how the former patient experiences the role as supportive. During hospitalisation, patients often create a community in which they can engage with fellow patients. The exchange of experiences with others in a similar situation might increase opportunities for support and complement nursing care, but there is a need for more evidence and understanding on the topic. The methodological framework is based on the French philosopher Paul Ricoeur's text interpretation theory. Qualitative interviews were conducted with nine patients, including a peer informant, using a narrative structure. The analysis was conducted on three levels: (i) naïve reading, (ii) structural analysis and (iii) critical interpretation . Four themes were developed from the analysis of the interviews: Exchanging emotional thoughts is easier with a peer; Talking to a peer reduces loneliness; Being ambiguous about a relationship with fellow patients; and Being the main person in the conversation with a peer. Sharing stories about having similar symptoms and undergoing similar journeys predominated, and the key feature of the contact between patients was the commonality of their stories. Telling one's story to a former patient, and thereby creating a joint, common story, is the essence of this study. The support received in this process can be empowering because knowledge of the illness experience is shared and increased. This can help create new coping strategies. The contact with a former patient offered a way to confirm one's thoughts and to find a way out of the illness perspective, by seeing how the former patient had recovered. The nursing field faces challenges in the relational aspect of caring because of ever greater efficient and shortened hospital stays; therefore, the peer support concept is becoming increasingly relevant. Patient peers offer each other their own perspectives, and it is important to raise awareness of the value of this and incorporate it into patient stays in hospital. © 2017 John Wiley & Sons Ltd.

Improving policy and practice to promote equity and social justice - a qualitative comparative analysis building on key learnings from a twinning exchange between England and the US.

PubMed

Blanchard, Claire; Narle, Ginder; Gibbs, Martin; Ruddock, Charmaine; Grady, Michael; Brookes, Chris; Hopkins, Trevor; Norwood, Jayne

2013-12-01

Community health promotion interventions, targeted at marginalised populations and focusing on addressing the social determinants of health (SDH) to reduce health inequalities and addressing the processes of exclusion, are an important strategy to prevent and control non-communicable diseases (NCDs) and promote the health of underprivileged and under-resourced groups. This article builds on key lessons learnt from a learning exchange between Communities for Health in England and the Racial and Ethnic Approaches to Community Health across the US (REACH US) communities that are tackling health inequities. It presents a qualitative analysis further capturing information about specific community interventions involved in the exchange and identifying lessons learnt. This exchange was led by a partnership between the US Centers for Disease Control and Prevention, the International Union for Health Promotion and Education, the Department of Health of England, Health Action Partnership International, and Learning for Public Health West Midlands. These efforts provide interesting insights for further research, priority areas of action for policy and practice to address the SDH and to promote and sustain equity and social justice globally. The article highlights some key lessons about the use of data, assets-based community interventions and the importance of good leadership in times of crisis and adversity. Whilst complex and time-consuming to arrange, such programmes have the potential to offer other countries including the global south new insights and perspectives that will in turn contribute to the SDH field and provide concrete strategies and actions that effectively reduce inequities and promote the health of our societies. The key learnings have the potential to contribute to the global community and growing documentation on evidence of effective efforts in the reduction of health inequities.

Enantiodiscrimination of flexible cyclic solutes using NMR spectroscopy in polypeptide chiral mesophases: investigation of cis-decalin and THF.

PubMed

Aroulanda, Christie; Lafon, Olivier; Lesot, Philippe

2009-08-06

The conformational dynamics and orientational behavior of two model cyclic molecules, cis-decalin (cis-dec) and tetrahydrofurane (THF), dissolved in weakly ordering, polypeptidic chiral liquid crystals (CLCs) are theoretically discussed and experimentally investigated using deuterium and carbon-13 NMR spectroscopies. The analysis of enantiomeric and enantiotopic discriminations in these compounds is shown to depend on the rate of conformational exchange regime, slow or fast. The slow exchange regime is illustrated through the case of cis-dec at low temperature (243 K). We show that the deuterium NMR spectra in this regime can be qualitatively and quantitatively interpreted by restricting the conformational pathway of cis-dec to two enantiomeric conformers of C(2)-symmetry. The orientational order parameters of these interconverting enantiomers are calculated by matching the (2)H quadrupolar splittings with calculated conformer structures. The fast exchange regime is investigated through the examples of cis-dec at high temperature (356 K) and THF at room temperature (300 K). The (2)H NMR spectra above the coalescence temperature are analyzed by introducing the concept of "average molecular structure". This fictitious structure allows easily identifying NMR equivalences of solutes dissolved in CLC. However, it cannot be applied to determine consistent orientational order parameters. This study emphasizes that enantiotopic discriminations observed for flexible molecules in the fast exchange regime can be quantitatively interpreted only by considering the orientational order of each conformer.

Analytical equation for outflow along the flow in a perforated fluid distribution pipe

PubMed Central

Liu, Huanfang; Lv, Hongxing; Jin, Jin

2017-01-01

Perforated fluid distribution pipes have been widely used in agriculture, water supply and drainage, ventilation, the chemical industry, and other sectors. The momentum equation for variable mass flow with a variable exchange coefficient and variable friction coefficient was developed by using the momentum conservation method under the condition of a certain slope. The change laws of the variable momentum exchange coefficient and the variable resistance coefficient along the flow were analyzed, and the function of the momentum exchange coefficient was given. According to the velocity distribution of the power function, the momentum equation of variable mass flow was solved for different Reynolds numbers. The analytical solution contains components of pressure, gravity, friction and momentum and reflects the influence of various factors on the pressure distribution along the perforated pipe. The calculated results of the analytical solution were compared with the experimental values of the study by Jin et al. 1984 and Wang et al. 2001 with the mean errors 8.2%, 3.8% and 2.7%, and showed that the analytical solution of the variable mass momentum equation was qualitatively and quantitatively consistent with the experimental results. PMID:29065112

International exchange program: findings from Taiwanese graduate nursing students.

PubMed

Shieh, Carol

2004-01-01

This study explored Taiwanese graduate nursing students' transcultural experiences in the United States during an international exchange program. A qualitative method with content analysis was used to analyze journal entries on perceptions of American culture, American nursing, and reflections on personal and professional growth written by nine graduate nursing students from Taiwan. The mean age of the participants was 32 (range, 29-45). Taiwanese nursing students perceived American culture as full of hospitality and patriotism, valuing human rights and social welfare, and favoring direct and expressive affection. American nursing was viewed as a combination of independence, confidence, autonomy, and knowledge, with caring being the core element, fostered by an environment conducive to patient care. In personal and professional growth, three themes surfaced: reinforcement of holistic care, nursing without borders, and lifelong learning and changing. American culture and nursing were perceived by Taiwanese students as a paradigm of Western culture valuing individual rights, autonomy, and independence. A caring and supportive patient care environment was a positive perception of American nursing; it was the desired practice standard that was lacking in these students' homeland. Overall, the exchange program was thought by these students to foster their personal and professional growth.

[Community health in primary health care teams: a management objective].

PubMed

Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex

2016-12-01

To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Effects of communication on the performance of nursing students during the simulation of an emergency situation.

PubMed

Chapelain, Pascal; Morineau, Thierry; Gautier, Claudie

2015-11-01

To explore how nursing performance is impacted by different forms of team communication including a message transmitted through an earpiece which triggers reflective thinking in the simulation of a deteriorating patient situation. Communication can either support team performance or produce interruptions potentially leading to error. Today, technology offers the opportunity to use devices that can permit communication. An experimental protocol was used with quantitative and qualitative analyses. Pairs of nursing students (N = 26) were dispatched to either an experimental group having to wear an earpiece priming reflective thinking, or to a control group. The study was conducted between October 2013-April 2014. The number of spontaneous information exchanges between pairs of participants was positively correlated with overall performance (actions performed and physician call) and with actions performed at the right moment. The number of questions in the team was positively correlated with overall action performance. No quantitative effect of the earpiece message on the performance indicators was found. But, a qualitative observation showed that this message can allow for error avoidance. Subjective evaluation of the earpiece as an aid was negatively correlated with overall action performance. Its evaluation as a disturbance was also negatively correlated with the measurement of actions performed at the right moment. The ability to exchange information and to ask questions seems to contribute to performance in care delivery. The use of communication devices to trigger reflective thinking must be studied in more depth to assess their capacity to improve performance. © 2015 John Wiley & Sons Ltd.

Asking, Giving, Receiving: Friendship as Survival Strategy among Accra's Street Children

ERIC Educational Resources Information Center

Mizen, Phillip; Ofosu-Kusi, Yaw

2010-01-01

This article considers friendship among street children in Accra. Drawing upon the findings of a three-year qualitative research project, the article argues that friendship is a neglected element of research yet cooperation, mutuality and exchange between friends are essential to street children's survival. Living within the extremities of the…

75 FR 82098 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing of Amendment No. 1 to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

....\\4\\ The Commission subsequently extended the time period in which to either approve the proposed rule... Market.'' The BX Venture Market will have minimal quantitative listing standards, but have qualitative... securities exchange for failure to meet quantitative listing standards (including price or other market value...

Marriageable Women: A Focus on Participants in a Community Healthy Marriage Program

ERIC Educational Resources Information Center

Manning, Wendy D.; Trella, Deanna; Lyons, Heidi; Du Toit, Nola Cora

2010-01-01

Although disadvantaged women are the targets of marriage programs, little attention has been paid to women's marriage constraints and their views of marriage. Drawing on an exchange framework and using qualitative data collected from single women participating in a marriage initiative, we introduce the concept of marriageable women--the notion…

Pursuing Authenticity From Process to Outcome in a Community-Based Participatory Research Study of Intimate Partner Violence and HIV Vulnerability in North Karnataka, India.

PubMed

Blanchard, Andrea Katryn; Sangha, Chaitanya Aids Tadegattuva Mahila; Nair, Sapna G; Thalinja, Raghavendra; Srikantamurthy, H S; Ramanaik, Satyanaryana; Javalkar, Prakash; Pillai, Priya; Isac, Shajy; Collumbien, Martine; Heise, Lori; Bhattacharjee, Parinita; Bruce, Sharon Gail

2017-01-01

Community-based participatory research has been seen to hold great promise by researchers aiming to bridge research and action in global health programs and practice. However, there is still much debate around whether achieving authenticity in terms of in-depth collaboration between community and academic partners is possible while pursuing academic expectations for quality. This article describes the community-based methodology for a qualitative study to explore intimate partner violence and HIV/AIDS among women in sex work, or female sex workers, and their male partners in Karnataka, South India. Developed through collaborative processes, the study methodology followed an interpretive approach to qualitative inquiry, with three key components including long-term partnerships, knowledge exchange, and orientation toward action. We then discuss lessons learned on how to pursue authenticity in terms of truly collaborative processes with inherent value that also contribute to, rather than hinder, the instrumental goal of enhancing the quality and relevance of the research outcomes. © The Author(s) 2016.

"You still need to give her a token of appreciation": the meaning of the exchange of money in the sexual relationships of out-of-school adolescents in rural southwest Uganda.

PubMed

Nobelius, Ann-Maree; Kalina, Bessie; Pool, Robert; Whitworth, Jimmy; Chesters, Janice; Power, Robert

2010-09-01

This article challenges the pervasive assumption that exchanging gifts and money in adolescent sexual relationships is transactional. Data were derived from a multi-method, qualitative sexual health needs assessment of 31 out-of-school adolescents in rural southwest Uganda. Grounded theory analysis allows contextual meanings of exchange to emerge. Adolescents have developed gendered courting and exchange models that parallel marital relationships in this cultural context. Whereas exchange is considered transactional and immoral in some types of relationships, in adolescent relationships, it is not. Young women are not ashamed of, or stigmatized by, the exchange; they are proud of it. The exchange signifies several things: self-respect and a partner's willingness to wait for the relationships to become sexual and, therefore, that they are valued and respected by their partners. This demonstrates commitment from a partner, whose role is as a provider. To expect no gift or to have sex for pleasure are the hallmarks of the worst kind of woman-a malaya. "Need" is the only acceptable rationale for extramartial sex for any woman in this sexual value system. Interventions promoting longer courting and sustained support for one partner would encourage a delay in debut for young women and encourage greater monogamy in young men.

The nature of three-body interactions in DFT: Exchange and polarization effects

NASA Astrophysics Data System (ADS)

Hapka, Michał; Rajchel, Łukasz; Modrzejewski, Marcin; Schäffer, Rainer; Chałasiński, Grzegorz; Szcześniak, Małgorzata M.

2017-08-01

We propose a physically motivated decomposition of density functional theory (DFT) 3-body nonadditive interaction energies into the exchange and density-deformation (polarization) components. The exchange component represents the effect of the Pauli exclusion in the wave function of the trimer and is found to be challenging for density functional approximations (DFAs). The remaining density-deformation nonadditivity is less dependent upon the DFAs. Numerical demonstration is carried out for rare gas atom trimers, Ar2-HX (X = F, Cl) complexes, and small hydrogen-bonded and van der Waals molecular systems. None of the tested semilocal, hybrid, and range-separated DFAs properly accounts for the nonadditive exchange in dispersion-bonded trimers. By contrast, for hydrogen-bonded systems, range-separated DFAs achieve a qualitative agreement to within 20% of the reference exchange energy. A reliable performance for all systems is obtained only when the monomers interact through the Hartree-Fock potential in the dispersion-free Pauli blockade scheme. Additionally, we identify the nonadditive second-order exchange-dispersion energy as an important but overlooked contribution in force-field-like dispersion corrections. Our results suggest that range-separated functionals do not include this component, although semilocal and global hybrid DFAs appear to imitate it in the short range.

[Online Activities to Support Networking in Mental Health Practices in Quebec].

PubMed

Michaud, Dominique; Briand, Catherine; Thibault, Véronique; Charbonneau, Karine

2015-01-01

To support knowledge application of evidence-based practices in mental health rehabilitation in Quebec, the Centre for Studies on Rehabilitation, Recovery and Social Inclusion (CÉRRIS--www.cerrisweb.com) has set up a community of practice and has organized online activities. In this article, the authors present the community of practice (457 members to date) and the results of a three-year experience aimed at evaluating their appreciation with two online activities of dissemination and knowledge exchange: Web conference and debate blog. The methodology used in this publication is part of a process of program evaluation. More specifically, a research mixed method was used (concurrent triangulation design). Qualitative data (from qualitative questionnaires) and quantitative data (from Google analytics -participation and attendance data) were collected in parallel and incorporated into analysis step. Forty qualitative questionnaires were completed to identify the benefits, barriers, challenges and facilitators encountered during their participation in the activity. The participants are members of the community of practice of the CÉRRIS and are people with mental illness, family members, practitioners, researchers, students, managers and policy makers in the field of mental health rehabilitation and come from different regions of Quebec, Canada and French speaking areas of Europe. Quantitative data on participation and attendance were collected and analyzed throughout the first three years of implementation of the CÉRRIS. Qualitative data from the questionnaires were analyzed following a content analysis process. Quantitative data were analyzed using Excel. Since September 2010, 14,061 unique visitors navigated on the CÉRRIS website (23,391 visits) and 2,278 people visited the blog (10,393 visits). Ninety-nine members of the community of practice attended at least one of the 13 Web conferences. Web conference allows a) access to evidence-based practices, b) networking and contact between individuals of different areas and c) access to continuing education remotely. A total of 62 members of the community of practice have actively taken part in one of the 5 debates on the blog. The activity of debate blog a) promotes egalitarian exchanges between different actors in mental health sector, b) encourages diversity of viewpoints and c) create a forum for dialogue and reduce stigma towards people with mental illnesses. For both types of Web activities, technological barriers (network security, outdated computer equipment, etc.) restrained the full participation of the participants. However, the assistance received from organizations and their openness towards new technologies has facilitated the experience of participants in both activities. Online activities as Web conference and debate blog are interesting avenues to facilitate access to knowledge and support exchanges between clinical, academic, community-based communities, people who use mental health services and their families.

Interlayer exchange coupling in complex magnetic multilayers

NASA Astrophysics Data System (ADS)

Xiang-dong, Zhang; Lie-ming, Li; Bo-zang, Li; Fu-cho, Pu

1998-07-01

We extend the hole confinement model of Edwards et al. to the problem of two kinds of complex magnetic sandwich structures. One is the magnetic sandwich covered on both sides by nonmagnetic films (case 1) and the other is that covered by magnetic films (case 2). The interlayer exchange coupling and the angular dependence of coupling energy in the two cases are investigated systematically. For case 1, our results show that the magnetic and outer nonmagnetic films influence significantly the oscillation behavior of exchange coupling and the appearance of noncollinear exchange coupling is very sensitive to the thickness of magnetic and outer nonmagnetic layers. Our results also show that the nonoscillatory component of the coupling generally varies with the thickness of magnetic (outer nonmagnetic) films and the results in the case where the thickness of both magnetic (outer nonmagnetic) films vary simultaneously are significantly different from that in the case where the thickness of one of the two magnetic (outer nonmagnetic) films is fixed while the other is varied, which is qualitatively in agreement with the experimental measurements. For case 2, the exponential dependence of exchange coupling on the thickness of the intermagnetic layer has been obtained, similar to the Parkin's experimental results for giant magnetoresistance.

Tilt engineering of exchange coupling at G-type SrMnO3/(La,Sr)MnO3 interfaces

NASA Astrophysics Data System (ADS)

Li, F.; Song, C.; Wang, Y. Y.; Cui, B.; Mao, H. J.; Peng, J. J.; Li, S. N.; Wang, G. Y.; Pan, F.

2015-11-01

With the recent realization of hybrid improper ferroelectricity and room-temperature multiferroic by tilt engineering, “functional” octahedral tilting has become a novel concept in multifunctional perovskite oxides, showing great potential for property manipulation and device design. However, the control of magnetism by octahedral tilting has remained a challenging issue. Here a qualitative and quantitative tilt engineering of exchange coupling, one of the magnetic properties, is demonstrated at compensated G-type antiferromagnetic/ferromagnetic (SrMnO3/La2/3Sr1/3MnO3) interfaces. According to interfacial Hamiltonian, exchange bias (EB) in this system originates from an in-plane antiphase rotation (a-) in G-type antiferromagnetic layer. Based on first-principles calculation, tilt patterns in SrMnO3 are artificially designed in experiment with different epitaxial strain and a much stronger EB is attained in the tensile heterostructure than the compressive counterpart. By controlling the magnitude of octahedral tilting, the manipulation of exchange coupling is even performed in a quantitative manner, as expected in the theoretical estimation. This work realized the combination of tilt engineering and exchange coupling, which might be significant for the development of multifunctional materials and antiferromagnetic spintronics.

A conceptual model of Verbal Exchange Health Literacy

PubMed Central

Harrington, Kathleen F.; Valerio, Melissa A.

2014-01-01

Objective To address a gap in understanding of verbal exchange (oral and aural) health literacy by describing the systematic development of a verbal exchange health literacy (VEHL) definition and model which hypothesizes the role of VEHL in health outcomes. Methods Current health literacy and communication literature was systematically reviewed and combined with qualitative patient and provider data that were analyzed using a grounded theory approach. Results Analyses of current literature and formative data indicated the importance of verbal exchange in the clinical setting and revealed various factors associated with the patient-provider relationship and their characteristics that influence decision making and health behaviors. VEHL is defined as the ability to speak and listen that facilitates exchanging, understanding, and interpreting of health information for health-decision making, disease management and navigation of the healthcare system. A model depiction of mediating and influenced factors is presented. Conclusion A definition and model of VEHL is a step towards addressing a gap in health literacy knowledge and provides a foundation for examining the influence of VEHL on health outcomes. Practice Implications VEHL is an extension of current descriptions of health literacy and has implications for patient-provider communication and health decision making. PMID:24291145

Internet suicide in Japan: a qualitative content analysis of a suicide bulletin board.

PubMed

Ikunaga, Ai; Nath, Sanjay R; Skinner, Kenneth A

2013-04-01

Netto shinju, or Internet group suicide, is a contemporary form of Japanese suicide where strangers connect on the Internet and make plans to commit suicide together. In the past decade, numerous incidents have occurred whereby young Japanese make contact on the Internet, exchange tips on suicide methods, and make plans to meet offline for group/individual suicide. A systematic qualitative content/thematic analysis of online communications posted on a popular Japanese suicide bulletin board yielded a textured, thematic understanding of this phenomenon. Themes identified reflected Shneidman's theory of suicide but with an emphasis on interpersonal concerns that are embedded in Japanese culture.

A Converter from the Systems Biology Markup Language to the Synthetic Biology Open Language.

PubMed

Nguyen, Tramy; Roehner, Nicholas; Zundel, Zach; Myers, Chris J

2016-06-17

Standards are important to synthetic biology because they enable exchange and reproducibility of genetic designs. This paper describes a procedure for converting between two standards: the Systems Biology Markup Language (SBML) and the Synthetic Biology Open Language (SBOL). SBML is a standard for behavioral models of biological systems at the molecular level. SBOL describes structural and basic qualitative behavioral aspects of a biological design. Converting SBML to SBOL enables a consistent connection between behavioral and structural information for a biological design. The conversion process described in this paper leverages Systems Biology Ontology (SBO) annotations to enable inference of a designs qualitative function.

Prevalence and meanings of exchange of money or gifts for sex in unmarried adolescent sexual relationships in sub-Saharan Africa.

PubMed

Moore, Ann M; Biddlecom, Ann E; Zulu, Eliya M

2007-12-01

Using national survey data collected in 2004 in Burkina Faso, Ghana, Malawi, and Uganda with 12-19 year olds, we examine the prevalence of sex in exchange for money or gifts in the 12 months prior to the survey and its association with adolescents' social and economic vulnerability and condom use. Receiving something in exchange for sex is very common among sexually active, unmarried female adolescents and there are no significant differences by household economic status, orphan status, level of schooling completed or age difference between partners. Condom use at last sex in the 12 months prior to the survey is not associated with receiving gifts or money. Qualitative data based on focus group discussions and in-depth interviews collected in 2003 with adolescents suggest that receiving money or gifts for sex is not necessarily a coercive force, but rather can be a routine aspect of dating.

Reconciling incongruous qualitative and quantitative findings in mixed methods research: exemplars from research with drug using populations.

PubMed

Wagner, Karla D; Davidson, Peter J; Pollini, Robin A; Strathdee, Steffanie A; Washburn, Rachel; Palinkas, Lawrence A

2012-01-01

Mixed methods research is increasingly being promoted in the health sciences as a way to gain more comprehensive understandings of how social processes and individual behaviours shape human health. Mixed methods research most commonly combines qualitative and quantitative data collection and analysis strategies. Often, integrating findings from multiple methods is assumed to confirm or validate the findings from one method with the findings from another, seeking convergence or agreement between methods. Cases in which findings from different methods are congruous are generally thought of as ideal, whilst conflicting findings may, at first glance, appear problematic. However, the latter situation provides the opportunity for a process through which apparently discordant results are reconciled, potentially leading to new emergent understandings of complex social phenomena. This paper presents three case studies drawn from the authors' research on HIV risk amongst injection drug users in which mixed methods studies yielded apparently discrepant results. We use these case studies (involving injection drug users [IDUs] using a Needle/Syringe Exchange Program in Los Angeles, CA, USA; IDUs seeking to purchase needle/syringes at pharmacies in Tijuana, Mexico; and young street-based IDUs in San Francisco, CA, USA) to identify challenges associated with integrating findings from mixed methods projects, summarize lessons learned, and make recommendations for how to more successfully anticipate and manage the integration of findings. Despite the challenges inherent in reconciling apparently conflicting findings from qualitative and quantitative approaches, in keeping with others who have argued in favour of integrating mixed methods findings, we contend that such an undertaking has the potential to yield benefits that emerge only through the struggle to reconcile discrepant results and may provide a sum that is greater than the individual qualitative and quantitative parts. Copyright © 2011 Elsevier B.V. All rights reserved.

Reconciling incongruous qualitative and quantitative findings in mixed methods research: exemplars from research with drug using populations

PubMed Central

Wagner, Karla D.; Davidson, Peter J.; Pollini, Robin A.; Strathdee, Steffanie A.; Washburn, Rachel; Palinkas, Lawrence A.

2011-01-01

Mixed methods research is increasingly being promoted in the health sciences as a way to gain more comprehensive understandings of how social processes and individual behaviours shape human health. Mixed methods research most commonly combines qualitative and quantitative data collection and analysis strategies. Often, integrating findings from multiple methods is assumed to confirm or validate the findings from one method with the findings from another, seeking convergence or agreement between methods. Cases in which findings from different methods are congruous are generally thought of as ideal, while conflicting findings may, at first glance, appear problematic. However, the latter situation provides the opportunity for a process through which apparently discordant results are reconciled, potentially leading to new emergent understandings of complex social phenomena. This paper presents three case studies drawn from the authors’ research on HIV risk among injection drug users in which mixed methods studies yielded apparently discrepant results. We use these case studies (involving injection drug users [IDUs] using a needle/syringe exchange program in Los Angeles, California, USA; IDUs seeking to purchase needle/syringes at pharmacies in Tijuana, Mexico; and young street-based IDUs in San Francisco, CA, USA) to identify challenges associated with integrating findings from mixed methods projects, summarize lessons learned, and make recommendations for how to more successfully anticipate and manage the integration of findings. Despite the challenges inherent in reconciling apparently conflicting findings from qualitative and quantitative approaches, in keeping with others who have argued in favour of integrating mixed methods findings, we contend that such an undertaking has the potential to yield benefits that emerge only through the struggle to reconcile discrepant results and may provide a sum that is greater than the individual qualitative and quantitative parts. PMID:21680168

Young women's perceptions of transactional sex and sexual agency: a qualitative study in the context of rural South Africa.

PubMed

Ranganathan, Meghna; MacPhail, Catherine; Pettifor, Audrey; Kahn, Kathleen; Khoza, Nomhle; Twine, Rhian; Watts, Charlotte; Heise, Lori

2017-08-22

Evidence shows that HIV prevalence among young women in sub-Saharan Africa increases almost five-fold between ages 15 and 24, with almost a quarter of young women infected by their early-to mid-20s. Transactional sex or material exchange for sex is a relationship dynamic that has been shown to have an association with HIV infection. Using five focus group discussions and 19 in-depth interviews with young women enrolled in the HPTN 068 conditional cash transfer trial (2011-2015), this qualitative study explores young women's perceptions of transactional sex within the structural and cultural context of rural South Africa. The analysis also considers the degree to which young women perceive themselves as active agents in such relationships and whether they recognise a link between transactional sex and HIV risk. Young women believe that securing their own financial resources will ultimately improve their bargaining position in their sexual relationships, and open doors to a more financially independent future. Findings suggest there is a nuanced relationship between sex, love and gifts: money has symbolic meaning, and money transfers, when framed as gifts, indicates a young woman's value and commitment from the man. This illustrates the complexity of transactional sex; the way it is positioned in the HIV literature ignores that "exchanges" serve as fulcrums around which romantic relationships are organised. Finally, young women express agency in their choice of partner, but their agency weakens once they are in a relationship characterised by exchange, which may undermine their ability to translate perceived agency into STI and HIV risk reduction efforts. This research underscores the need to recognise that transactional sex is embedded in adolescent romantic relationships, but that certain aspects make young women particularly vulnerable to HIV. This is especially true in situations of restricted choice and circumscribed employment opportunities. HIV prevention educational programmes could be coupled with income generation trainings, in order to leverage youth resilience and protective skills within the confines of difficult economic and social circumstances. This would provide young women with the knowledge and means to more successfully navigate safer sexual relationships.

Mutual Learning and Exchange of Health Informatics Experiences from Around the World - Evaluation of a Massive Open Online Course in eHealth.

PubMed

Koch, Sabine; Hägglund, Maria

2017-01-01

We report our experiences from the Massive Open Online Course (MOOC), "eHealth - Opportunities and Challenges", run by Karolinska Institutet using the edx platform both as session-based and self-paced versions between 2015 and 2016. In total, 13,302 students from 162 different countries were enrolled in our courses during the two-year period whereof 573 completed them. 331 students answered an exit survey after finishing the course which was analysed using quantitative and qualitative methods. As positive outcomes of the course, students highlighted set-up and content of the course, the pedagogical approach and the consistent international focus. Students lacked more practical case studies, more interactive discussions and proposed advanced follow-up courses on certain topics. Faculty lacked better functions for management of the discussion forum. Major advantages of the MOOC were mutual learning and exchange of health informatics experiences from around the world that would have been difficult to achieve in traditional learning contexts.

Information retrieval pathways for health information exchange in multiple care settings.

PubMed

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-11-01

To determine which health information exchange (HIE) technologies and information retrieval pathways healthcare professionals relied on to meet their information needs in the context of laboratory test results, radiological images and reports, and medication histories. Primary data was collected over a 2-month period across 3 emergency departments, 7 primary care practices, and 2 public health clinics in New York state. Qualitative research methods were used to collect and analyze data from semi-structured interviews and participant observation. The study reveals that healthcare professionals used a complex combination of information retrieval pathways for HIE to obtain clinical information from external organizations. The choice for each approach was setting- and information-specific, but was also highly dynamic across users and their information needs. Our findings about the complex nature of information sharing in healthcare provide insights for informatics professionals about the usage of information; indicate the need for managerial support within each organization; and suggest approaches to improve systems for organizations and agencies working to expand HIE adoption.

Infrared imaging - A validation technique for computational fluid dynamics codes used in STOVL applications

NASA Technical Reports Server (NTRS)

Hardman, R. R.; Mahan, J. R.; Smith, M. H.; Gelhausen, P. A.; Van Dalsem, W. R.

1991-01-01

The need for a validation technique for computational fluid dynamics (CFD) codes in STOVL applications has led to research efforts to apply infrared thermal imaging techniques to visualize gaseous flow fields. Specifically, a heated, free-jet test facility was constructed. The gaseous flow field of the jet exhaust was characterized using an infrared imaging technique in the 2 to 5.6 micron wavelength band as well as conventional pitot tube and thermocouple methods. These infrared images are compared to computer-generated images using the equations of radiative exchange based on the temperature distribution in the jet exhaust measured with the thermocouple traverses. Temperature and velocity measurement techniques, infrared imaging, and the computer model of the infrared imaging technique are presented and discussed. From the study, it is concluded that infrared imaging techniques coupled with the radiative exchange equations applied to CFD models are a valid method to qualitatively verify CFD codes used in STOVL applications.

Magnetic structure and excitation spectrum of the hyperhoneycomb Kitaev magnet β -Li2IrO3

NASA Astrophysics Data System (ADS)

Ducatman, Samuel; Rousochatzakis, Ioannis; Perkins, Natalia B.

2018-03-01

We present a theoretical study of the static and dynamical properties of the three-dimensional, hyperhoneycomb Kitaev magnet β -Li2IrO3 . We argue that the observed incommensurate order can be understood in terms of a long-wavelength twisting of a nearby commensurate period-3 state, with the same key qualitatively features. The period-3 state shows very different structure when either the Kitaev interaction K or the off-diagonal exchange anisotropy Γ is dominant. A comparison of the associated static spin structure factors with reported scattering experiments in zero and finite fields gives strong evidence that β -Li2IrO3 lies in the regime of dominant Kitaev coupling, and that the Heisenberg exchange J is much weaker than both K and Γ . Our predictions for the magnon excitation spectra, the dynamical spin structure factors, and their polarization dependence provide additional distinctive fingerprints that can be checked experimentally.

Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state

PubMed Central

Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

2014-01-01

Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626

Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state.

PubMed

Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

2014-02-01

Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version.

The future of qualitative research in psychology--a discussion with Svend Brinkmann, Günter Mey, Luca Tateo, and Anete Strand.

PubMed

Demuth, Carolin; Terkildsen, Thomas

2015-06-01

In May 2014, a workshop on "The future of qualitative research in psychology" took place at Aalborg University (Denmark), Department of Communication & Psychology organized by Carolin Demuth. Participants from Aalborg University engaged in a lively exchange with the two invited discussants Svend Brinkmann (Aalborg University) and Günter Mey (Stendal University of Applied Science). The discussion started out by addressing the specifics of qualitative research in the field of psychology, its historical development and the perils of recent trends of standardization and neo-positivistic orientations. In light of the discrepancy of what could be potentially achieved with qualitative methods for psychological research and how they are actually currently applied, an emphasis was made that we need to return to an understanding of qualitative methods as a craft skill and to take into account the subjectivity of the researcher in the process of scientific knowledge production. Finally, a re-focus on experience as the genuine object of psychological research, as well as a transdisciplinary approach to our understanding of human psychological functioning within a socially co-constructed, biological, as well as material world was discussed.

Comparative assessment of the methods for exchangeable acidity measuring

NASA Astrophysics Data System (ADS)

Vanchikova, E. V.; Shamrikova, E. V.; Bespyatykh, N. V.; Zaboeva, G. A.; Bobrova, Yu. I.; Kyz"yurova, E. V.; Grishchenko, N. V.

2016-05-01

A comparative assessment of the results of measuring the exchangeable acidity and its components by different methods was performed for the main mineral genetic horizons of texturally-differentiated gleyed and nongleyed soddy-podzolic and gley-podzolic soils of the Komi Republic. It was shown that the contents of all the components of exchangeable soil acidity determined by the Russian method (with potassium chloride solution as extractant, c(KCl) = 1 mol/dm3) were significantly higher than those obtained by the international method (with barium chloride solution as extractant, c(BaCl2) = 0.1 mol/dm3). The error of the estimate of the concentration of H+ ions extracted with barium chloride solution equaled 100%, and this allowed only qualitative description of this component of the soil acidity. In the case of the extraction with potassium chloride, the error of measurements was 50%. It was also shown that the use of potentiometric titration suggested by the Russian method overestimates the results of soil acidity measurement caused by the exchangeable metal ions (Al(III), Fe(III), and Mn(II)) in comparison with the atomic emission method.

Impact of Relativistic Electron Beam on Hole Acoustic Instability in Quantum Semiconductor Plasmas

NASA Astrophysics Data System (ADS)

Siddique, M.; Jamil, M.; Rasheed, A.; Areeb, F.; Javed, Asif; Sumera, P.

2018-01-01

We studied the influence of the classical relativistic beam of electrons on the hole acoustic wave (HAW) instability exciting in the semiconductor quantum plasmas. We conducted this study by using the quantum-hydrodynamic model of dense plasmas, incorporating the quantum effects of semiconductor plasma species which include degeneracy pressure, exchange-correlation potential and Bohm potential. Analysis of the quantum characteristics of semiconductor plasma species along with relativistic effect of beam electrons on the dispersion relation of the HAW is given in detail qualitatively and quantitatively by plotting them numerically. It is worth mentioning that the relativistic electron beam (REB) stabilises the HAWs exciting in semiconductor (GaAs) degenerate plasma.

Measurement with microscopic MRI and simulation of flow in different aneurysm models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Edelhoff, Daniel, E-mail: daniel.edelhoff@tu-dortmund.de; Frank, Frauke; Heil, Marvin

2015-10-15

Purpose: The impact and the development of aneurysms depend to a significant degree on the exchange of liquid between the regular vessel and the pathological extension. A better understanding of this process will lead to improved prediction capabilities. The aim of the current study was to investigate fluid-exchange in aneurysm models of different complexities by combining microscopic magnetic resonance measurements with numerical simulations. In order to evaluate the accuracy and applicability of these methods, the fluid-exchange process between the unaltered vessel lumen and the aneurysm phantoms was analyzed quantitatively using high spatial resolution. Methods: Magnetic resonance flow imaging was usedmore » to visualize fluid-exchange in two different models produced with a 3D printer. One model of an aneurysm was based on histological findings. The flow distribution in the different models was measured on a microscopic scale using time of flight magnetic resonance imaging. The whole experiment was simulated using fast graphics processing unit-based numerical simulations. The obtained simulation results were compared qualitatively and quantitatively with the magnetic resonance imaging measurements, taking into account flow and spin–lattice relaxation. Results: The results of both presented methods compared well for the used aneurysm models and the chosen flow distributions. The results from the fluid-exchange analysis showed comparable characteristics concerning measurement and simulation. Similar symmetry behavior was observed. Based on these results, the amount of fluid-exchange was calculated. Depending on the geometry of the models, 7% to 45% of the liquid was exchanged per second. Conclusions: The result of the numerical simulations coincides well with the experimentally determined velocity field. The rate of fluid-exchange between vessel and aneurysm was well-predicted. Hence, the results obtained by simulation could be validated by the experiment. The observed deviations can be caused by the noise in the measurement and by the limited resolution of the simulation. The resulting differences are small enough to allow reliable predictions of the flow distribution in vessels with stents and for pulsed blood flow.« less

A reinterpretation of the data from the NASA Stratosphere-Troposphere Exchange Project

NASA Astrophysics Data System (ADS)

Newman, Paul A.; Schoeberl, Mark R.

Data obtained during the NASA Stratosphere Troposphere Exchange Project (STEP) Mid-Latitude Field Experiment displayed laminae of ozone, water, and condensation nuclei in the stratosphere in association with a mid-latitude stratosphere-troposphere folding event. Danielsen et al. (1991) constructed cross sections of these observations, and interpreted these quasi-horizontal laminae as evidence of ultra-low frequency gravity waves. We use a new technique to show that these laminae could have resulted from differential advection, rather than transport by ultra-low frequency gravity waves. This new technique uses reverse domain filling back trajectories on multiple isentropic surfaces in conjunction with modified potential vorticity to reveal the qualitative details of the constituent laminae.

[AC-STB: dedicated software for managed healthcare of chronic headache patients].

PubMed

Wallasch, T-M; Bek, J; Pabel, R; Modahl, M; Demir, M; Straube, A

2009-04-01

This paper examines a new approach to managed healthcare where a network of care providers exchanges patient information through the internet. Integrating networks of clinical specialists and general care providers promises to achieve qualitative and economic improvements in the German healthcare system. In practice, problems related to patient management and data exchange between the managing clinic and assorted caregivers arise. The implementation and use of a cross-spectrum computerized solution for the management of patients and their care is the key for a successful managed healthcare system. This paper documents the managed healthcare of chronic headache patients and the development of an IT-solution capable of providing distributed patient care and case management.

Knowledge flow and exchange in interdisciplinary primary health care teams (PHCTs): an exploratory study

PubMed Central

Sibbald, Shannon L.; Wathen, C. Nadine; Kothari, Anita; Day, Adam M. B.

2013-01-01

Objective: Improving the process of evidence-based practice in primary health care requires an understanding of information exchange among colleagues. This study explored how clinically oriented research knowledge flows through multidisciplinary primary health care teams (PHCTs) and influences clinical decisions. Methods: This was an exploratory mixed-methods study with members of six PHCTs in Ontario, Canada. Quantitative data were collected using a questionnaire and analyzed with social network analysis (SNA) using UCINet. Qualitative data were collected using semi-structured interviews and analyzed with content analysis procedures using NVivo8. Results: It was found that obtaining research knowledge was perceived to be a shared responsibility among team members, whereas its application in patient care was seen as the responsibility of the team leader, usually the senior physician. PHCT members acknowledged the need for resources for information access, synthesis, interpretation, or management. Conclusion: Information sharing in interdisciplinary teams is a complex and multifaceted process. Specific interventions need to be improved such as formalizing modes of communication, better organizing knowledge-sharing activities, and improving the active use of allied health professionals. Despite movement toward team-based models, senior physicians are often gatekeepers of uptake of new evidence and changes in practice. PMID:23646028

Pre-departure preparation and co-curricular activities for Students' intercultural exchange: A mixed-methods study.

PubMed

Chan, E Angela; Liu, Justina Yat Wa; Fung, Keith Hin Kee; Tsang, Pak Lik; Yuen, John

2018-04-01

Nurses are required to be culturally competent to provide quality care to an increasingly diverse and ageing population. International exchange programmes were developed to support the traditional nursing curriculum. These programmes have often overlooked the importance of pre-departure preparation and co-curricular activities to the development of intercultural competency. To explore the influence of pre-departure and co-curricular activities on the intercultural learning experiences of both exchange and host students in a short-term international summer programme. A mixed-methods study. Students were recruited from international and mainland exchange partners, with host students as ambassadors. The international summer programme involved a week of online pre-departure activities and two weeks of face-to-face meetings. A convenience sample of 62 students from diverse cultural backgrounds was recruited on a voluntary basis. The participants were aged between 19 and 27. Data were collected from students' pre- and post-visit questionnaires, discussions within the workshops, their online discussion threads, and focus group discussions. The quantitative findings suggested that students' cultural intelligence improved significantly after the exchange programme. Qualitatively, three themes emerged as: 1) Students' motivation to engage in intercultural learning; 2) Barriers to intercultural communication; 3) Enablers of intercultural communication. Pre-departure preparation enabled students to discuss their common goals and expectations, while exploring differences, asked for practical living information, and used the basic intercultural concepts in their discussion on the care of elderly. This virtual encounter has lay the foundation for students' subsequent discussions about the why and how the differences that inform their own practices and about global ageing and poverty issues during their co-curricular activities. While the pre-departure preparation could serve as a stimulus, the value of this programme for intercultural learning also rests with the importance of debriefing to further students' reflective and experiential learning. Copyright © 2018 Elsevier Ltd. All rights reserved.

The silicon-glass microreactor with embedded sensors—technology and results of preliminary qualitative tests, toward intelligent microreaction plant

NASA Astrophysics Data System (ADS)

Knapkiewicz, P.

2013-03-01

The technology and preliminary qualitative tests of silicon-glass microreactors with embedded pressure and temperature sensors are presented. The concept of microreactors for leading highly exothermic reactions, e.g. nitration of hydrocarbons, and design process-included computer-aided simulations are described in detail. The silicon-glass microreactor chip consisting of two micromixers (multistream micromixer), reaction channels, cooling/heating chambers has been proposed. The microreactor chip was equipped with a set of pressure and temperature sensors and packaged. Tests of mixing quality, pressure drops in channels, heat exchange efficiency and dynamic behavior of pressure and temperature sensors were documented. Finally, two applications were described.

Feedback in Clinical Education, Part II: Approved Clinical Instructor and Student Perceptions of and Influences on Feedback

PubMed Central

Nottingham, Sara; Henning, Jolene

2014-01-01

Context: Approved Clinical Instructors (ACIs; now known as preceptors) are expected to provide feedback to athletic training students (ATSs) during clinical education experiences. Researchers in other fields have found that clinical instructors and students often have different perceptions of actual and ideal feedback and that several factors may influence the feedback exchanges between instructors and students. However, understanding of these issues in athletic training education is minimal. Objective: To investigate the current characteristics and perceptions of and the influences on feedback exchanges between ATSs and ACIs. Design: Qualitative study. Setting: One entry-level master's degree program accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants: Four ACIs and 4 second-year ATSs. Data Collection and Analysis: Individual, semistructured interviews were conducted with participants and integrated with field notes and observations for analysis. We used the constant comparative approach to inductively analyze data and develop codes and categories. Member checking, triangulation, and peer debriefing were used to promote trustworthiness of the study. Results: Participants described that feedback plays an important role in clinical education and has several purposes related to improving performance. The ACIs and ATSs also discussed several preferred characteristics of feedback. Participants identified 4 main influences on their feedback exchanges, including the ACI, the ATS, personalities, and the learning environment. Conclusions: The ACIs and ATSs had similar perceptions of ideal feedback in addition to the actual feedback that was provided during their clinical education experiences. Most of the preferences for feedback were aligned with recommendations in the literature, suggesting that existing research findings are applicable to athletic training clinical education. Several factors influenced the feedback exchanges between ACIs and ATSs, which clinical education coordinators should consider when selecting clinical sites and training ACIs. PMID:24151809

Feedback in clinical education, part II: Approved clinical instructor and student perceptions of and influences on feedback.

PubMed

Nottingham, Sara; Henning, Jolene

2014-01-01

Approved Clinical Instructors (ACIs; now known as preceptors) are expected to provide feedback to athletic training students (ATSs) during clinical education experiences. Researchers in other fields have found that clinical instructors and students often have different perceptions of actual and ideal feedback and that several factors may influence the feedback exchanges between instructors and students. However, understanding of these issues in athletic training education is minimal. To investigate the current characteristics and perceptions of and the influences on feedback exchanges between ATSs and ACIs. Qualitative study. One entry-level master's degree program accredited by the Commission on Accreditation of Athletic Training Education. Four ACIs and 4 second-year ATSs. Individual, semistructured interviews were conducted with participants and integrated with field notes and observations for analysis. We used the constant comparative approach to inductively analyze data and develop codes and categories. Member checking, triangulation, and peer debriefing were used to promote trustworthiness of the study. Participants described that feedback plays an important role in clinical education and has several purposes related to improving performance. The ACIs and ATSs also discussed several preferred characteristics of feedback. Participants identified 4 main influences on their feedback exchanges, including the ACI, the ATS, personalities, and the learning environment. The ACIs and ATSs had similar perceptions of ideal feedback in addition to the actual feedback that was provided during their clinical education experiences. Most of the preferences for feedback were aligned with recommendations in the literature, suggesting that existing research findings are applicable to athletic training clinical education. Several factors influenced the feedback exchanges between ACIs and ATSs, which clinical education coordinators should consider when selecting clinical sites and training ACIs.

Barriers to the widespread adoption of health data standards: an exploratory qualitative study in tertiary healthcare organizations in Saudi Arabia.

PubMed

Alkraiji, Abdullah; Jackson, Thomas; Murray, Ian

2013-04-01

Although health data standards are perceived to be the essential solution for interoperability barriers within medical IT systems, the level of adoption of those standards still remains frustratingly low. Little is known about the barriers facing their adoption within the healthcare organizations context. In addressing this gap in the literature, based on IT related standards adoption theories such as Diffusion of Innovation Theory and the theories surrounding the Economics of Standards, a qualitative multiple-case study was undertaken in Saudi Arabia to investigate those barriers. The results exposed that few standards were adopted because of four broad reasons, managerial, technical, educational and governmental. While some of the findings can be rooted to those related standards theories, others can be underpinned through the normative literature. Core barriers are the lack of a national regulator and a data exchange plan, and the lack of an adequate policy regarding medical IT systems and information management and national healthcare system; also important are technical barriers and the switching costs to the standards. The outcome of this study can be used in forming effective interventions when planning to use health data standards and, in particular those in developing countries.

Exchange Bias Optimization by Controlled Oxidation of Cobalt Nanoparticle Films Prepared by Sputter Gas Aggregation

PubMed Central

Antón, Ricardo López; González, Juan A.; Andrés, Juan P.; Normile, Peter S.; Canales-Vázquez, Jesús; Muñiz, Pablo; Riveiro, José M.; De Toro, José A.

2017-01-01

Porous films of cobalt nanoparticles have been obtained by sputter gas aggregation and controllably oxidized by air annealing at 100 °C for progressively longer times (up to more than 1400 h). The magnetic properties of the samples were monitored during the process, with a focus on the exchange bias field. Air annealing proves to be a convenient way to control the Co/CoO ratio in the samples, allowing the optimization of the exchange bias field to a value above 6 kOe at 5 K. The occurrence of the maximum in the exchange bias field is understood in terms of the density of CoO uncompensated spins and their degree of pinning, with the former reducing and the latter increasing upon the growth of a progressively thicker CoO shell. Vertical shifts exhibited in the magnetization loops are found to correlate qualitatively with the peak in the exchange bias field, while an increase in vertical shift observed for longer oxidation times may be explained by a growing fraction of almost completely oxidized particles. The presence of a hummingbird-like form in magnetization loops can be understood in terms of a combination of hard (biased) and soft (unbiased) components; however, the precise origin of the soft phase is as yet unresolved. PMID:28336895

Exchange Bias Optimization by Controlled Oxidation of Cobalt Nanoparticle Films Prepared by Sputter Gas Aggregation.

PubMed

Antón, Ricardo López; González, Juan A; Andrés, Juan P; Normile, Peter S; Canales-Vázquez, Jesús; Muñiz, Pablo; Riveiro, José M; De Toro, José A

2017-03-11

Porous films of cobalt nanoparticles have been obtained by sputter gas aggregation and controllably oxidized by air annealing at 100 °C for progressively longer times (up to more than 1400 h). The magnetic properties of the samples were monitored during the process, with a focus on the exchange bias field. Air annealing proves to be a convenient way to control the Co/CoO ratio in the samples, allowing the optimization of the exchange bias field to a value above 6 kOe at 5 K. The occurrence of the maximum in the exchange bias field is understood in terms of the density of CoO uncompensated spins and their degree of pinning, with the former reducing and the latter increasing upon the growth of a progressively thicker CoO shell. Vertical shifts exhibited in the magnetization loops are found to correlate qualitatively with the peak in the exchange bias field, while an increase in vertical shift observed for longer oxidation times may be explained by a growing fraction of almost completely oxidized particles. The presence of a hummingbird-like form in magnetization loops can be understood in terms of a combination of hard (biased) and soft (unbiased) components; however, the precise origin of the soft phase is as yet unresolved.

Sexual and reproductive health and HIV/AIDS risk perception in the Malawi tourism industry.

PubMed

Bisika, Thomas

2009-06-01

Malawi has for a long time relied on agriculture for the generation of foreign exchange. Due to varied reasons like climate change, the Malawi government has, therefore, identified tourism as one way of boosting foreign exchange earnings and is already in the process of developing the sector especially in the area of ecotourism. However, tourism is associated with increasing prostitution, drug abuse and a whole range of other sexual and reproductive health (SRH) problems such as teenage pregnancies, HIV/AIDS and sexually transmitted infections (STIs). This paper examines the knowledge, attitudes, practices and behaviour as well as risk perceptions associated with HIV/AIDS, sexually transmitted infections and unwanted pregnancies among staff in the tourism industry and communities around tourist facilities in Malawi. The study was descriptive in nature and used both qualitative and quantitative research methods. The qualitative methods involved in-depth interviews and focus group discussions. The quantitative technique employed a survey of 205 purposively selected subjects from the tourism sector. The study concludes that people in the tourism sector are at high risk of HIV/AIDS, sexually transmitted infections and unwanted pregnancies and should be considered as a vulnerable group. The study further observes that this group of people has not adopted behaviours that can protect them from HIV/AIDS, sexually transmitted infections and unwanted pregnancies although there is high demand for voluntary counselling and testing (VCT) which offers a very good entry point for HIV prevention and treatment in the tourism sector. The study recommends that a comprehensive tourism policy covering tourists, employees and communities around tourist facilities is required. Such a policy should address the rights of HIV infected employees and the provision of prevention and treatment services for HIV/AIDS and STIs as well as a broad range of SRH and family planning services especially the condom which offers dual protection for pregnancy and STIs including HIV.

Quality of life among dermatology patients: a systematic review of investigations using qualitative methods.

PubMed

Singh, Sanminder; Ehsani-Chimeh, Nazanin; Kornmehl, Heather; Armstrong, April W

2017-07-13

Quality of life may be assessed using quantitative or qualitative methods. Quantitative methods are commonly used in research settings; however, they may fail to capture the full range of patient experiences and impact on quality of life. Qualitative methods may be used to address this limitation. In this systematic review, we aim to synthesize data from articles utilizing qualitative methods to assess quality of life in dermatology patients. We performed a systematic review search using the MEDLINE, EMBASE, and SCOPUS databases. The search was conducted using the following search criteria: ("Dermatology" [MeSH]) AND ("Quality of Life" [MeSH]), AND ("Qualitative Research" [MeSH]), searching literature spanning from January 1, 1946- October 5, 2016. The systematic review of 15 articles included 533 dermatology patients. Patients expressed frustration over the unpredictability of disease symptoms and having to compensate for the subsequent limitations by altering their daily routines. Patients also reported profound helplessness due to chronic skin disease and social isolation in an effort to hide their disease. Patients noted the patient-provider relationship as a source of support and information exchange, with the goal to form easy to use treatment plans that met both physician and patient expectations. Qualitative assessment of patient quality of life can provide new insights into the patient experience and the impact of their skin disease. Qualitative methodology may capture meaningful information that may be overlooked by quantitative methods, and it should be included in quality of life research.

Active and hibernating turbulence in drag-reducing plane Couette flows

NASA Astrophysics Data System (ADS)

Pereira, Anselmo S.; Mompean, Gilmar; Thais, Laurent; Soares, Edson J.; Thompson, Roney L.

2017-08-01

In this paper we analyze the active and hibernating turbulence in drag-reducing plane Couette flows using direct numerical simulations of the viscoelastic finitely extensible nonlinear elastic model with the Peterlin approximation fluids. The polymer-turbulence interactions are studied from an energetic standpoint for a range of Weissenberg numbers (from 2 up to 30), fixing the Reynolds number based on the plate velocities at 4000, the viscosity ratio at 0.9, and the maximum polymer molecule extensibility at 100. The qualitative picture that emerges from this investigation is a cyclic mechanism of energy exchange between the polymers and turbulence that drives the flow through an oscillatory behavior.

Restricted amide rotation with steric hindrance induced multiple conformations

NASA Astrophysics Data System (ADS)

Krishnan, V. V.; Vazquez, Salvador; Maitra, Kalyani; Maitra, Santanu

2017-12-01

The Csbnd N bond character is dependent directly upon the resonance-contributor structure population driven by the delocalized nitrogen lone-pair of electrons. In the case of N, N-dibenzyl-ortho-toluamide (o-DBET), the molecule adopts subpopulations of conformers with distinct NMR spectral features, particularly at low temperatures. This conformational adaptation is unique to o-DBET, while the corresponding meta- and para- forms do not show such behavior. Variable-temperature (VT) NMR, two-dimensional exchange spectroscopy (EXSY), and qualitative molecular modeling studies are used to demonstrate how multiple competing interactions such as restricted amide rotation and steric hindrance effects can lead to versatile molecular adaptations in the solution state.

Fluid Transport in Porous Media probed by Relaxation-Exchange NMR

NASA Astrophysics Data System (ADS)

Olaru, A. M.; Kowalski, J.; Sethi, V.; Blümich, B.

2011-12-01

The characterization of fluid transport in porous media represents a matter of high interest in fields like the construction industry, oil exploitation, and soil science. Moisture migration or flow at low rates, such as those occurring in soil during rain are difficult to characterize by classical high-field NMR velocimetry due to the dedicated hardware and elaborate techniques required for adequate signal encoding. The necessity of field studies raises additional technical problems, which can be solved only by the use of portable low-field NMR instruments. In this work we extend the use of low-field relaxation exchange experiments from the study of diffusive transport to that of advection. Relaxation exchange experiments were performed using a home-built Halbach magnet on model porous systems with controlled pore-size distributions and on natural porous systems (quartz sand with a broad pore-size distribution) exposed to unidirectional flow. Different flow rates leave distinctive marks on the exchange maps obtained by inverse Laplace transformation of the time domain results, due to the superposition of exchange, diffusion and inflow/outflow in multiple relaxation sites of the liquids in the porous media. In the case of slow velocities there is no loss of signal due to outflow, and the relaxation-exchange effects prevail, leading to a tilt of the diagonal distribution around a pivot point with increasing mixing time. The tilt suggests an asymmetry in the exchange between relaxation sites of large and small decay rates. Another observed phenomenon is the presence of a bigger number of exchange cross-peaks compared to the exchange maps obtained for the same systems in zero-flow conditions. We assume that this is due to enhanced exchange caused by the superposition of flow. For high velocities the outflow effects dominate and the relaxation-time distribution collapses towards lower values of the average relaxation times. In both cases the pore-size distribution has a strong effect on the results, the asymmetries being more obvious in the natural porous systems than in the glass bead packs used as models, while the enhanced exchange phenomenon appears predominantly in the maps obtained on the model systems. This is probably due to diffusion occurring in the presence of different internal field gradients. Shifts and tilts in the exchange maps can be simulated by solving the relaxation site-averaged Bloch-Torrey system forward in time and assuming an asymmetric closure for the transport, which might be realistic for preferential flow phenomena or for pore-size distributions with two or more clearly distinct pore size classes. When comparing the simulations results with the experimental data we observed a correspondence of signal collapse and translation towards lower relaxation times. The asymmetries could be qualitatively reproduced by making further assumptions on the pore structure, but further work is required to characterize and model the physical phenomenon behind. The results obtained reveal the possibility of characterizing advective fluid transport in porous systems by simple correlation experiments performed with inexpensive and mobile hardware.

From laws of inference to protein folding dynamics.

PubMed

Tseng, Chih-Yuan; Yu, Chun-Ping; Lee, H C

2010-08-01

Protein folding dynamics is one of major issues constantly investigated in the study of protein functions. The molecular dynamic (MD) simulation with the replica exchange method (REM) is a common theoretical approach considered. Yet a trade-off in applying the REM is that the dynamics toward the native configuration in the simulations seems lost. In this work, we show that given REM-MD simulation results, protein folding dynamics can be directly derived from laws of inference. The applicability of the resulting approach, the entropic folding dynamics, is illustrated by investigating a well-studied Trp-cage peptide. Our results are qualitatively comparable with those from other studies. The current studies suggest that the incorporation of laws of inference and physics brings in a comprehensive perspective on exploring the protein folding dynamics.

A system dynamics evaluation model: implementation of health information exchange for public health reporting

PubMed Central

Merrill, Jacqueline A; Deegan, Michael; Wilson, Rosalind V; Kaushal, Rainu; Fredericks, Kimberly

2013-01-01

Objective To evaluate the complex dynamics involved in implementing electronic health information exchange (HIE) for public health reporting at a state health department, and to identify policy implications to inform similar implementations. Materials and methods Qualitative data were collected over 8 months from seven experts at New York State Department of Health who implemented web services and protocols for querying, receipt, and validation of electronic data supplied by regional health information organizations. Extensive project documentation was also collected. During group meetings experts described the implementation process and created reference modes and causal diagrams that the evaluation team used to build a preliminary model. System dynamics modeling techniques were applied iteratively to build causal loop diagrams representing the implementation. The diagrams were validated iteratively by individual experts followed by group review online, and through confirmatory review of documents and artifacts. Results Three casual loop diagrams captured well-recognized system dynamics: Sliding Goals, Project Rework, and Maturity of Resources. The findings were associated with specific policies that address funding, leadership, ensuring expertise, planning for rework, communication, and timeline management. Discussion This evaluation illustrates the value of a qualitative approach to system dynamics modeling. As a tool for strategic thinking on complicated and intense processes, qualitative models can be produced with fewer resources than a full simulation, yet still provide insights that are timely and relevant. Conclusions System dynamics techniques clarified endogenous and exogenous factors at play in a highly complex technology implementation, which may inform other states engaged in implementing HIE supported by federal Health Information Technology for Economic and Clinical Health (HITECH) legislation. PMID:23292910

A system dynamics evaluation model: implementation of health information exchange for public health reporting.

PubMed

Merrill, Jacqueline A; Deegan, Michael; Wilson, Rosalind V; Kaushal, Rainu; Fredericks, Kimberly

2013-06-01

To evaluate the complex dynamics involved in implementing electronic health information exchange (HIE) for public health reporting at a state health department, and to identify policy implications to inform similar implementations. Qualitative data were collected over 8 months from seven experts at New York State Department of Health who implemented web services and protocols for querying, receipt, and validation of electronic data supplied by regional health information organizations. Extensive project documentation was also collected. During group meetings experts described the implementation process and created reference modes and causal diagrams that the evaluation team used to build a preliminary model. System dynamics modeling techniques were applied iteratively to build causal loop diagrams representing the implementation. The diagrams were validated iteratively by individual experts followed by group review online, and through confirmatory review of documents and artifacts. Three casual loop diagrams captured well-recognized system dynamics: Sliding Goals, Project Rework, and Maturity of Resources. The findings were associated with specific policies that address funding, leadership, ensuring expertise, planning for rework, communication, and timeline management. This evaluation illustrates the value of a qualitative approach to system dynamics modeling. As a tool for strategic thinking on complicated and intense processes, qualitative models can be produced with fewer resources than a full simulation, yet still provide insights that are timely and relevant. System dynamics techniques clarified endogenous and exogenous factors at play in a highly complex technology implementation, which may inform other states engaged in implementing HIE supported by federal Health Information Technology for Economic and Clinical Health (HITECH) legislation.

Laypersons' views of material incentives for enhancing colorectal cancer screening.

PubMed

Hagoel, Lea; Rennert, Gad; Feder-Bubis, Paula

2015-10-01

Colorectal cancer (CRC) early detection improves health outcomes; screening programmes invest efforts in initiating invitations to target populations to be tested. Enhanced adherence is essential for reduction of morbidity and mortality. Participation rates in Israel are still relatively low. To explore lay views regarding the concept of receiving material incentives in exchange for enhanced adherence to CRC screening. Qualitative study. Between November 2009 and February 2010 six focus group discussions were carried out in two urban, middle and low socio-economic status primary care clinics in a Northern city in Israel. Participants were eligible individuals for CRC screening, aged 50-68 (N = 24). Data analysis followed the principles of grounded theory, supported by qualitative software. Participants found administering incentives in exchange for CRC screening inappropriate on rational and moral grounds. They valued their relations with the medical team and the health system more than the potential gain expected. Individuals eligible for CRC screening perceived themselves as responsible for their health, admitting difficulties in realizing this responsibility. Incentives were reported unsuitable for solving reported screening difficulties and a potential harm to the doctor-patient relationship. Focus group participants expressed an unconventional voice towards the use of material incentives. They pointed to the need for focused support of health behaviour change and valued their autonomy. While a proportion of the invitees in the target population see the importance of screening and appreciate the HMO's initiative to invite them for testing, they also expressed their need for support from the HMO in realizing the recommended health behaviour. © 2013 John Wiley & Sons Ltd.

Beyond bridging the know-do gap: a qualitative study of systemic interaction to foster knowledge exchange in the public health sector in The Netherlands.

PubMed

van den Driessen Mareeuw, Francine; Vaandrager, Lenneke; Klerkx, Laurens; Naaldenberg, Jenneken; Koelen, Maria

2015-09-19

Despite considerable attention currently being given to facilitating the use of research results in public health practice, several concerns remain, resulting in the so-called know-do gap. This article aims to identify the key tensions causing the know-do gap from a broad perspective by using a systemic approach and considering the public health sector as an innovation system. An exploratory qualitative design including in-depth semi-structured interviews was used, with 33 interviewees from different actor categories in the Dutch public health innovation system. The analyses employed an innovation system matrix to highlight the principal tensions causing the know-do gap. Seven key tensions were identified, including: research priorities determined by powerful players; no consensus about criteria for knowledge quality; different perceptions about the knowledge broker role; competition engendering fragmentation; thematic funding engendering fragmentation; predominance of passive knowledge sharing; and lack of capacity among users to use and influence research. The identified tensions indicate that bridging the know-do gap requires much more than linking research to practice or translating knowledge. An innovation system perspective is crucial in providing information on the total picture of knowledge exchange within the Dutch public health sector. Such a system includes broader stakeholder involvement as well as the creation of social, economic, and contextual conditions (achieving shared visions, building networks, institutional change, removing financial and infrastructural barriers), as these create conducive factors at several system levels and induce knowledge co-creation and innovation.

Evaluation of the free, open source software WordPress as electronic portfolio system in undergraduate medical education.

PubMed

Avila, Javier; Sostmann, Kai; Breckwoldt, Jan; Peters, Harm

2016-06-03

Electronic portfolios (ePortfolios) are used to document and support learning activities. E-portfolios with mobile capabilities allow even more flexibility. However, the development or acquisition of ePortfolio software is often costly, and at the same time, commercially available systems may not sufficiently fit the institution's needs. The aim of this study was to design and evaluate an ePortfolio system with mobile capabilities using a commercially free and open source software solution. We created an online ePortfolio environment using the blogging software WordPress based on reported capability features of such software by a qualitative weight and sum method. Technical implementation and usability were evaluated by 25 medical students during their clinical training by quantitative and qualitative means using online questionnaires and focus groups. The WordPress ePortfolio environment allowed students a broad spectrum of activities - often documented via mobile devices - like collection of multimedia evidences, posting reflections, messaging, web publishing, ePortfolio searches, collaborative learning, knowledge management in a content management system including a wiki and RSS feeds, and the use of aid tools for studying. The students' experience with WordPress revealed a few technical problems, and this report provides workarounds. The WordPress ePortfolio was rated positively by the students as a content management system (67 % of the students), for exchange with other students (74 %), as a note pad for reflections (53 %) and for its potential as an information source for assessment (48 %) and exchange with a mentor (68 %). On the negative side, 74 % of the students in this pilot study did not find it easy to get started with the system, and 63 % rated the ePortfolio as not being user-friendly. Qualitative analysis indicated a need for more introductory information and training. It is possible to build an advanced ePortfolio system with mobile capabilities with the free and open source software WordPress. This allows institutions without proprietary software to build a sophisticated ePortfolio system adapted to their needs with relatively few resources. The implementation of WordPress should be accompanied by introductory courses in the use of the software and its apps in order to facilitate its usability.

Water diffusion-exchange effect on the paramagnetic relaxation enhancement in off-resonance rotating frame

NASA Astrophysics Data System (ADS)

Zhang, Huiming; Xie, Yang; Ji, Tongyu

2007-06-01

The off-resonance rotating frame technique based on the spin relaxation properties of off-resonance T1 ρ can significantly increase the sensitivity of detecting paramagnetic labeling at high magnetic fields by MRI. However, the in vivo detectable dimension for labeled cell clusters/tissues in T1 ρ-weighted images is limited by the water diffusion-exchange between mesoscopic scale compartments. An experimental investigation of the effect of water diffusion-exchange between compartments on the paramagnetic relaxation enhancement of paramagnetic agent compartment is presented for in vitro/ in vivo models. In these models, the size of paramagnetic agent compartment is comparable to the mean diffusion displacement of water molecules during the long RF pulses that are used to generate the off-resonance rotating frame. The three main objectives of this study were: (1) to qualitatively correlate the effect of water diffusion-exchange with the RF parameters of the long pulse and the rates of water diffusion, (2) to explore the effect of water diffusion-exchange on the paramagnetic relaxation enhancement in vitro, and (3) to demonstrate the paramagnetic relaxation enhancement in vivo. The in vitro models include the water permeable dialysis tubes or water permeable hollow fibers embedded in cross-linked proteins gels. The MWCO of the dialysis tubes was chosen from 0.1 to 15 kDa to control the water diffusion rate. Thin hollow fibers were chosen to provide sub-millimeter scale compartments for the paramagnetic agents. The in vivo model utilized the rat cerebral vasculatures as a paramagnetic agent compartment, and intravascular agents (Gd-DTPA) 30-BSA were administrated into the compartment via bolus injections. Both in vitro and in vivo results demonstrate that the paramagnetic relaxation enhancement is predominant in the T1 ρ-weighted image in the presence of water diffusion-exchange. The T1 ρ contrast has substantially higher sensitivity than the conventional T1 contrast in detecting paramagnetic agents, especially at low paramagnetic agent volumetric fractions, low paramagnetic agent concentrations, and low RF amplitudes. Short pulse duration, short pulse recycle delay and efficient paramagnetic relaxation can reduce the influence of water diffusion-exchange on the paramagnetic enhancement. This study paves the way for the design of off-resonance rotating experiments to detect labeled cell clusters/tissue compartments in vivo at a sub-millimeter scale.

Putting Ourselves on the Line: The Epistemology of the Hyphen, Intersubjectivity and Social Responsibility in Qualitative Research

ERIC Educational Resources Information Center

Granek, Leeat

2013-01-01

As researchers, we are intertwined in our research relationships in two ways that put us on the line. First, our very beings are co-constituted and developed in an intersubjective exchange with the people we work with. Acknowledging our interdependence frees us to take an empathetic and hermeneutic stance that I have termed the "epistemology…

Analysis of effect of the solubility on gas exchange in nonhomogeneous lungs

NASA Technical Reports Server (NTRS)

Colburn, W. E., Jr.; Evans, J. W.; West, J. B.

1974-01-01

A comparison is made of the gas exchange in nonhomogeneous lung models and in homogeneous lung models with the same total blood flow and ventilation. It is shown that the ratio of the rate of gas transfer of the inhomogeneous lung model over the rate of gas transfer of the homogeneous lung model as a function of gas solubility always has the qualitative features for gases with linear dissociation curves. This ratio is 1 for a gas with zero solubility and decreases to a single minimum. It subsequently rises to approach 1 as the solubility tends to infinity. The early portion of the graph of this function is convex, then after a single inflection point it is concave.

User-Centered Design, Experience, and Usability of an Electronic Consent User Interface to Facilitate Informed Decision-Making in an HIV Clinic.

PubMed

Ramos, S Raquel

2017-11-01

Health information exchange is the electronic accessibility and transferability of patient medical records across various healthcare settings and providers. In some states, patients have to formally give consent to allow their medical records to be electronically shared. The purpose of this study was to apply a novel user-centered, multistep, multiframework approach to design and test an electronic consent user interface, so patients with HIV can make more informed decisions about electronically sharing their health information. This study consisted of two steps. Step 1 was a cross-sectional, descriptive, qualitative study that used user-centric design interviews to create the user interface. This informed Step 2. Step 2 consisted of a one group posttest to examine perceptions of usefulness, ease of use, preference, and comprehension of a health information exchange electronic consent user interface. More than half of the study population had college experience, but challenges remained with overall comprehension regarding consent. The user interface was not independently successful, suggesting that in addition to an electronic consent user interface, human interaction may also be necessary to address the complexities associated with consenting to electronically share health information. Comprehension is key factor in the ability to make informed decisions.

Elders' Life Stories: Impact on the Next Generation of Health Professionals

PubMed Central

2013-01-01

The purpose of this study was to pilot an enhanced version of the “Share your Life Story” life review writing workshop. The enhanced version included the addition of an intergenerational exchange, based on the content of seniors' writings, with students planning careers in the health sciences. The researcher employed a mixed methods design. Preliminary results using descriptive analysis revealed an increase in positive images of aging and a decrease in negative images of aging among the five student participants. Qualitative results revealed six themes that illuminate the hows and whys of the quantitative results as well as additional program benefits. Feedback from students and seniors helped to refine the intergenerational protocol for a larger scale study. PMID:24027579

Prevalence and meanings of exchange of money or gifts for sex in unmarried adolescent sexual relationships in sub-Saharan Africa

PubMed Central

Moore, Ann M.; Biddlecom, Ann E.; Zulu, Eliya M.

2008-01-01

Using national survey data collected in 2004 in Burkina Faso, Ghana, Malawi, and Uganda with 12–19 year olds, we examine the prevalence of sex in exchange for money or gifts in the 12 months prior to the survey and its association with adolescents’ social and economic vulnerability and condom use. Receiving something in exchange for sex is very common among sexually active, unmarried female adolescents and there are no significant differences by household economic status, orphan status, level of schooling completed or age difference between partners. Condom use at last sex in the 12 months prior to the survey is not associated with receiving gifts or money. Qualitative data based on focus group discussions and in-depth interviews collected in 2003 with adolescents suggest that receiving money or gifts for sex is not necessarily a coercive force, but rather can be a routine aspect of dating. PMID:18458736

Computational techniques for flows with finite-rate condensation

NASA Technical Reports Server (NTRS)

Candler, Graham V.

1993-01-01

A computational method to simulate the inviscid two-dimensional flow of a two-phase fluid was developed. This computational technique treats the gas phase and each of a prescribed number of particle sizes as separate fluids which are allowed to interact with one another. Thus, each particle-size class is allowed to move through the fluid at its own velocity at each point in the flow field. Mass, momentum, and energy are exchanged between each particle class and the gas phase. It is assumed that the particles do not collide with one another, so that there is no inter-particle exchange of momentum and energy. However, the particles are allowed to grow, and therefore, they may change from one size class to another. Appropriate rates of mass, momentum, and energy exchange between the gas and particle phases and between the different particle classes were developed. A numerical method was developed for use with this equation set. Several test cases were computed and show qualitative agreement with previous calculations.

Transplant professionals' proposals for the implementation of an altruistic unbalanced paired kidney exchange program.

PubMed

Durand, Céline; Duplantie, Andrée; Fortin, Marie-Chantal

2014-10-15

Kidney recipients in the O blood group are at a disadvantage in kidney exchange programs (KEPs) because they can only receive an organ from O blood group donors. A way to remedy this unfair situation is through altruistic unbalanced paired kidney exchange (AUPKE) where a compatible pair (CP) consisting of an O donor and a non-O recipient is invited to participate in a KEP. There is no established AUPKE program in Canada. The aim of this study was to gather transplant professionals' views on the conditions necessary for the implementation of an AUPKE program. Nineteen Canadian transplant professionals took part in semistructured interviews. The content of these interviews was analyzed using a qualitative data analysis method. Respondents' recommendations focused on the following: (i) the logistics of AUPKE (e.g., not delaying the transplantation for the CP, retrieving organs locally, providing a good quality organ to the CP, and maintaining anonymity); (ii) the transplantation teams (e.g., establishing a consensus among members and ensuring sufficient resources); (iii) information provided to CPs; and (iv) research (e.g., looking into all transplant options for O recipients, studying all potential impacts of KEPs and AUPKE). The respondents in our study made the following recommendations for the implementation of an AUPKE program: (i) CPs should not be disadvantaged, (ii) measures should be taken to ensure that all transplant team members agree to participate and that there are sufficient resources for implementation, (iii) comprehensive information should be provided to the CP, and (iv) further research is needed on AUPKE.

Adsorption and Exchange Dynamics in Aging Hydroxyethylcellulose Layers on Silica.

PubMed

Mubarekyan; Santore

2000-07-15

The adsorption kinetics of hydroxyethylcellulose (HEC) on silica and relaxations in adsorbed HEC layers were probed using total internal reflectance fluorescence and near-Brewster reflectivity. Like many random-coil polymers, HEC was found to adsorb at the transport-limited rate. Relaxations occurred at nearly constant interfacial mass when HEC layers were exposed to aqueous solvent, causing the subsequent exchange of chains between the layer and the free solution to become increasingly hindered. Eventually, on the time scale of a day, layers became immobilized and unable to accommodate chains from free solution. A continued fluorescence decay, beyond time scales that could be probed with self exchange, suggested further relaxations of the adsorbed HEC. The polydisperse HEC system (with an average molecular weight near 450,000) behaved qualitatively similar to molecular weight standard polyethylene oxide (PEO) layers on silica. For instance, relaxations in PEO layers occurred on a time scale of 10-20 h, like the HEC layers. Young layers of the latter, however, exhibited self-exchange kinetics that were an order of magnitude slower than PEO layers of similar age. This difference in adsorbed layer dynamics was attributed to HEC's stiffer backbone, compared with flexible PEO. Copyright 2000 Academic Press.

Effects of polymer graft properties on protein adsorption and transport in ion exchange chromatography: a multiscale modeling study.

PubMed

Basconi, Joseph E; Carta, Giorgio; Shirts, Michael R

2015-04-14

Multiscale simulation is used to study the adsorption of lysozyme onto ion exchangers obtained by grafting charged polymers into a porous matrix, in systems with various polymer properties and strengths of electrostatic interaction. Molecular dynamics simulations show that protein partitioning into the polymer-filled pore space increases with the overall charge content of the polymers, while the diffusivity in the pore space decreases. However, the combination of greatly increased partitioning and modestly decreased diffusion results in macroscopic transport rates that increase as a function of charge content, as the large concentration driving force due to enhanced pore space partitioning outweighs the reduction in the pore space diffusivity. Matrices having greater charge associated with the grafted polymers also exhibit more diffuse intraparticle concentration profiles during transient adsorption. In systems with a high charge content per polymer and a low protein loading, the polymers preferentially partition toward the surface due to favorable interactions with the surface-bound protein. These results demonstrate the potential of multiscale modeling to illuminate qualitative trends between molecular properties and the adsorption equilibria and kinetic properties observable on macroscopic scales.

Daughter-initiated health advice to mothers: perceptions of African–American and Latina daughters

PubMed Central

Mosavel, M.; Thomas, T.

2009-01-01

The prevailing paradigm of health exchange within the family is for health advice to flow from parent to child. Consistent with this pattern of exchange, most research has focused on the one-directional influence of the parent on the child and there is thus an absence of literature that explores the ability of adolescents to influence their parents’ health behaviors. This qualitative study addressed this gap by exploring the feasibility of daughters providing health advice to their mothers. Twelve focus groups were conducted with 78 African–American and Latina daughters between the ages of 12 and 17 from low-income neighborhoods in a Mid-Western city in the United States. This study utilized a grounded theory approach to examine the focus group data. The findings indicate that many daughters report that they are already giving their mothers a wide spectrum of advice, including health advice. Differences were found in the reported willingness of African–American daughters when compared to Latina daughters to provide their mothers with specific cancer advice. These data suggest that some of these daughters have the potential to be valuable health education conveyers in the family. PMID:19339373

A qualitative analysis of information sharing for children with medical complexity within and across health care organizations.

PubMed

Quigley, Laura; Lacombe-Duncan, Ashley; Adams, Sherri; Hepburn, Charlotte Moore; Cohen, Eyal

2014-06-30

Children with medical complexity (CMC) are characterized by substantial family-identified service needs, chronic and severe conditions, functional limitations, and high health care use. Information exchange is critically important in high quality care of complex patients at high risk for poor care coordination. Written care plans for CMC are an excellent test case for how well information sharing is currently occurring. The purpose of this study was to identify the barriers to and facilitators of information sharing for CMC across providers, care settings, and families. A qualitative study design with data analysis informed by a grounded theory approach was utilized. Two independent coders conducted secondary analysis of interviews with parents of CMC and health care professionals involved in the care of CMC, collected from two studies of healthcare service delivery for this population. Additional interviews were conducted with privacy officers of associated organizations to supplement these data. Emerging themes related to barriers and facilitators to information sharing were identified by the two coders and the research team, and a theory of facilitators and barriers to information exchange evolved. Barriers to information sharing were related to one of three major themes; 1) the lack of an integrated, accessible, secure platform on which summative health care information is stored, 2) fragmentation of the current health system, and 3) the lack of consistent policies, standards, and organizational priorities across organizations for information sharing. Facilitators of information sharing were related to improving accessibility to a common document, expanding the use of technology, and improving upon a structured communication plan. Findings informed a model of how various barriers to information sharing interact to prevent optimal information sharing both within and across organizations and how the use of technology to improve communication and access to information can act as a solution.

Perceptions of patients and physiotherapists on patient participation: a narrative synthesis of qualitative studies.

PubMed

Schoeb, Veronika; Bürge, Elisabeth

2012-06-01

Patient participation is nowadays considered important for high quality patient care. Although the literature on health care professions provides some insights into this topic, specific aspects in the field of physiotherapy are less known. The objective of this review was to investigate how patients and physiotherapists perceive patient participation, especially in regards to what it means for them and the role patients play during physiotherapy treatment sessions. We used a narrative synthesis of qualitative studies. We conducted a systematic search in six databases using a set of key words, extracted relevant data, performed quality assessment and synthesized findings from the selected studies. Out of 160 studies, 11 were retained. Two main themes emerged: the conceptualization of patient participation and the patients' role preferences. Patient participation included various activities including goal setting, information exchange, decision-making and exercise training and often influenced the power relation between patient and physiotherapist. Patients' willingness to participate varied, and they often did not play their desired role. Patients and physiotherapists perceived participation to be valuable yet challenging. Problems of conceptualization, power inequalities, lack of health professionals' skills and lack of the right attitude to share power and responsibility from both sides were some of the barriers that impeded optimal participation. Copyright © 2011 John Wiley & Sons, Ltd.

What Do We Know about the Chemistry of Strawberry Aroma?

PubMed

Ulrich, Detlef; Kecke, Steffen; Olbricht, Klaus

2018-04-04

The strawberry, with its unique aroma, is one of the most popular fruits worldwide. The demand for specific knowledge of metabolism in strawberries is increasing. This knowledge is applicable for genetic studies, plant breeding, resistance research, nutritional science, and the processing industry. The molecular basis of strawberry aroma has been studied for more than 80 years. Thus far, hundreds of volatile organic compounds (VOC) have been identified. The qualitative composition of the strawberry volatilome remains controversial though considerable progress has been made during the past several decades. Between 1997 and 2016, 25 significant analytical studies were published. Qualitative VOC data were harmonized and digitized. In total, 979 VOC were identified, 590 of which were found since 1997. However, 659 VOC (67%) were only listed once (single entries). Interestingly, none of the identified compounds were consistently reported in all of the studies analyzed. The present need of data exchange between "omic" technologies requires high quality and robust metabolic data. Such data are unavailable for the strawberry volatilome thus far. This review discusses the divergence of published data regarding both the biological material and the analytical methods. The VOC extraction method is an essential step that restricts interlaboratory comparability. Finally, standardization of sample preparation and data documentation are suggested to improve consistency for VOC quantification and measurement.

Research’s Practice and Barriers of Knowledge Translation in Iran

PubMed Central

NEDJAT, Saharnaz; GHOLAMI, Jaleh; YAZDIZADEH, Bahareh; NEDJAT, Sima; MALEKI, Katayoun; MAJDZADEH, Reza

2014-01-01

Abstract Background Knowledge Translation is a process that includes synthesis, dissemination, exchange and application of knowledge to improve the health, services and products In this study we have attempted to examine the knowledge translation practice and its perceived barriers on the universalities and research institutes (research sector) in Iran. Methods Both qualitative and quantitative approaches were used. In the quantitative section, a questionnaire had prepared for this study was completed by 88 authors country wide from randomly selected papers. In the qualitative section 13 in-depth interviews and 6 focus group discussions were held with managers and policy makers, clinical and health service providers, and researchers. Results Twenty four percent of the authors had no interaction whatsoever with the target audience. Lack of expectation toward creating change in the target audience, researchers’ incentives, low level of trust among researchers and decision makers, absence of a predefined mechanism for delivery of research results and inappropriate research priorities were among the most important barriers identified in the qualitative section. Conclusion Translation of research findings into some concrete outputs which can affect health of people is not in mandate of researchers and subsequently they are not prepared for this as well. Based on the barriers identified, it seems that the following interventions are necessary: cooperation among policy makers at macro and meso (organizational) level and the research sector; establishing networks for researchers and decision makers in choosing the research topic, priority setting, and building trust among researchers and policy makers. PMID:25909064

Reliability and validity evidence of the Assessment of Language Use in Social Contexts for Adults (ALUSCA).

PubMed

Valente, Ana Rita S; Hall, Andreia; Alvelos, Helena; Leahy, Margaret; Jesus, Luis M T

2018-04-12

The appropriate use of language in context depends on the speaker's pragmatic language competencies. A coding system was used to develop a specific and adult-focused self-administered questionnaire to adults who stutter and adults who do not stutter, The Assessment of Language Use in Social Contexts for Adults, with three categories: precursors, basic exchanges, and extended literal/non-literal discourse. This paper presents the content validity, item analysis, reliability coefficients and evidences of construct validity of the instrument. Content validity analysis was based on a two-stage process: first, 11 pragmatic questionnaires were assessed to identify items that probe each pragmatic competency and to create the first version of the instrument; second, items were assessed qualitatively by an expert panel composed by adults who stutter and controls, and quantitatively and qualitatively by an expert panel composed by clinicians. A pilot study was conducted with five adults who stutter and five controls to analyse items and calculate reliability. Construct validity evidences were obtained using the hypothesized relationships method and factor analysis with 28 adults who stutter and 28 controls. Concerning content validity, the questionnaires assessed up to 13 pragmatic competencies. Qualitative and quantitative analysis revealed ambiguities in items construction. Disagreement between experts was solved through item modification. The pilot study showed that the instrument presented internal consistency and temporal stability. Significant differences between adults who stutter and controls and different response profiles revealed the instrument's underlying construct. The instrument is reliable and presented evidences of construct validity.

The efficiency and effectiveness of utilizing diagrams in interviews: an assessment of participatory diagramming and graphic elicitation.

PubMed

Umoquit, Muriah J; Dobrow, Mark J; Lemieux-Charles, Louise; Ritvo, Paul G; Urbach, David R; Wodchis, Walter P

2008-08-08

This paper focuses on measuring the efficiency and effectiveness of two diagramming methods employed in key informant interviews with clinicians and health care administrators. The two methods are 'participatory diagramming', where the respondent creates a diagram that assists in their communication of answers, and 'graphic elicitation', where a researcher-prepared diagram is used to stimulate data collection. These two diagramming methods were applied in key informant interviews and their value in efficiently and effectively gathering data was assessed based on quantitative measures and qualitative observations. Assessment of the two diagramming methods suggests that participatory diagramming is an efficient method for collecting data in graphic form, but may not generate the depth of verbal response that many qualitative researchers seek. In contrast, graphic elicitation was more intuitive, better understood and preferred by most respondents, and often provided more contemplative verbal responses, however this was achieved at the expense of more interview time. Diagramming methods are important for eliciting interview data that are often difficult to obtain through traditional verbal exchanges. Subject to the methodological limitations of the study, our findings suggest that while participatory diagramming and graphic elicitation have specific strengths and weaknesses, their combined use can provide complementary information that would not likely occur with the application of only one diagramming method. The methodological insights gained by examining the efficiency and effectiveness of these diagramming methods in our study should be helpful to other researchers considering their incorporation into qualitative research designs.

The evidence does not speak for itself: The role of research evidence in shaping policy change for the implementation of publicly funded syringe exchange programs in three US cities.

PubMed

Allen, Sean T; Ruiz, Monica S; O'Rourke, Allison

2015-07-01

A breadth of literature exists that explores the utilization of research evidence in policy change processes. From this work, a number of studies suggest research evidence is applied to change processes by policy change stakeholders primarily through instrumental, conceptual, and/or symbolic applications, or is not used at all. Despite the expansiveness of research on policy change processes, a deficit exists in understanding the role of research evidence during change processes related to the implementation of structural interventions for HIV prevention among injection drug users (IDU). This study examined the role of research evidence in policy change processes for the implementation of publicly funded syringe exchange services in three US cities: Baltimore, MD, Philadelphia, PA, and Washington, DC. In-depth qualitative interviews were conducted with key stakeholders (n=29) from each of the study cities. Stakeholders were asked about the historical, social, political, and scientific contexts in their city during the policy change process. Interviews were transcribed and analyzed for common themes pertaining to applications of research evidence. In Baltimore and Philadelphia, the typological approaches (instrumental and symbolic/conceptual, respectively) to the applications of research evidence used by harm reduction proponents contributed to the momentum for securing policy change for the implementation of syringe exchange services. Applications of research evidence were less successful in DC because policymakers had differing ideas about the implications of syringe exchange program implementation and because opponents of policy change used evidence incorrectly or not at all in policy change discussions. Typological applications of research evidence are useful for understanding policy change processes, but their efficacy falls short when sociopolitical factors complicate legislative processes. Advocates for harm reduction may benefit from understanding how to effectively integrate research evidence into policy change processes in ways that confront the myriad of factors that influence policy change. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

A Poisson-like closed-form expression for the steady-state wealth distribution in a kinetic model of gambling

NASA Astrophysics Data System (ADS)

Garcia, Jane Bernadette Denise M.; Esguerra, Jose Perico H.

2017-08-01

An approximate but closed-form expression for a Poisson-like steady state wealth distribution in a kinetic model of gambling was formulated from a finite number of its moments, which were generated from a βa,b(x) exchange distribution. The obtained steady-state wealth distributions have tails which are qualitatively similar to those observed in actual wealth distributions.

Exchange-dominated eigenmodes in sub-100 nm permalloy dots: A micromagnetic study at finite temperature

NASA Astrophysics Data System (ADS)

Carlotti, G.; Gubbiotti, G.; Madami, M.; Tacchi, S.; Stamps, R. L.

2014-05-01

Micromagnetic simulations at room temperature (300 K) have been carried out in order to analyse the magnetic eigenmodes (frequency and spatial profile) in elliptical dots with sub-100 nm lateral size. Features are found that are qualitatively different from those typical of larger dots because of the dominant role played by the exchange-energy. These features can be understood most simply in terms of nodal planes defined relative to the orientation of the static magnetization. A new, generalized labeling scheme is proposed that simplifies discussion and comparison of modes from different geometries. It is shown that the lowest-frequency mode for small dots is characterized by an in-phase precession of spins, without nodal planes, but with a maximum amplitude at the edges. This mode softens at an applied switching field with magnitude comparable to the coercive field and determines specific aspects of magnetization reversal. This characteristic behavior can be relevant for optimization of microwave assisting switching as well as for maximizing interdot coupling in dense arrays of dots.

Superconducting state parameters of bulk amorphous alloys

NASA Astrophysics Data System (ADS)

Vora, A. M.

2012-12-01

Well recognized empty core pseudopotential of Ashcroft is used to investigate the superconducting state parameters viz; electron-phonon coupling strength λ, Coulomb pseudopotential μ*, transition temperature T C , isotope effect exponent α and effective interaction strength N O V of some (Ni33Zr67)1- x V x ( x = 0, 0.05, 0.1, 0.15) bulk amorphous alloys. We have incorporated five different types of local field correction functions, proposed by Hartree (H), Taylor (T), Ichimaru-Utsumi (IU), Farid et al. (F) and Sarkar et al. (S) to show the effect of exchange and correlation on the aforesaid properties. Very strong influence of the various exchange and correlation functions is concluded from the present study. The T C obtained from local field correction function proposed by Sarkar et al. (S) is in excellent agreement with available theoretical data. Quadratic T C equation has been proposed providing successfully the T C values of bulk amorphous alloys under consideration. Also, the present results are found in qualitative agreement with other such earlier reported data, which confirm the superconducting phase in the s bulk amorphous alloys.

Modeling Excited States in TiO2 Nanoparticles: On the Accuracy of a TD-DFT Based Description

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berardo, Enrico; Hu, Hanshi; Shevlin, S. A.

2014-03-11

We have investigated the suitability of Time-Dependent Density Functional Theory (TD-DFT) to describe vertical low-energy excitations in naked and hydrated titanium dioxide nanoparticles through a comparison with results from Equation-of-Motion Coupled Cluster (EOM-CC) quantum chemistry methods. We demonstrate that for most TiO2 nanoparticles TD-DFT calculations with commonly used exchange-correlation (XC-)potentials (e.g. B3LYP) and EOM-CC methods give qualitatively similar results. Importantly, however, we also show that for an important subset of structures, TD-DFT gives qualitatively different results depending upon the XC-potential used and that in this case only TD-CAM-B3LYP and TD-BHLYP calculations yield results that are consistent with those obtained usingmore » EOM-CC theory. Moreover, we demonstrate that the discrepancies for such structures arise from a particular combination of defects, excitations involving which are charge-transfer excitations and hence are poorly described by XC-potentials that contain no or low fractions of Hartree-Fock like exchange. Finally, we discuss that such defects are readily healed in the presence of ubiquitously present water and that as a result the description of vertical low-energy excitations for hydrated TiO2 nanoparticles is hence non-problematic.« less

Nuclear quantum effects in water exchange around lithium and fluoride ions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilkins, David M.; Manolopoulos, David E.; Dang, Liem X.

2015-02-14

We employ classical and ring polymer molecular dynamics simulations to study the effect of nuclear quantum fluctuations on the structure and the water exchange dynamics of aqueous solutions of lithium and fluoride ions. While we obtain reasonably good agreement with experimental data for solutions of lithium by augmenting the Coulombic interactions between the ion and the water molecules with a standard Lennard-Jones ion-oxygen potential, the same is not true for solutions of fluoride, for which we find that a potential with a softer repulsive wall gives much better agreement. A small degree of destabilization of the first hydration shell ismore » found in quantum simulations of both ions when compared with classical simulations, with the shell becoming less sharply defined and the mean residence time of the water molecules in the shell decreasing. In line with these modest differences, we find that the mechanisms of the exchange processes are unaffected by quantization, so a classical description of these reactions gives qualitatively correct and quantitatively reasonable results. We also find that the quantum effects in solutions of lithium are larger than in solutions of fluoride. This is partly due to the stronger interaction of lithium with water molecules, partly due to the lighter mass of lithium and partly due to competing quantum effects in the hydration of fluoride, which are absent in the hydration of lithium.« less

Design and evaluation of a peer network to support adherence to a web-based intervention for adolescents

PubMed Central

Ho, Joyce; Corden, Marya E.; Caccamo, Lauren; Tomasino, Kathryn Noth; Duffecy, Jenna; Begale, Mark; Mohr, David C.

2016-01-01

Background Depression during adolescence is common but can be prevented. Behavioral intervention technologies (BITs) designed to prevent depression in adolescence, especially standalone web-based interventions, have shown mixed outcomes, likely due to poor intervention adherence. BIT research involving adults has shown that the presence of coaches or peers promotes intervention use. Developmentally, adolescence is a time when peer-based social relationships take precedence. This study examines whether peer-networked support may promote adherence to BITs in this age group. Objective Adopting the framework of the Supportive Accountability model, which defines the types of human support and interactions required to maintain engagement and persistence with BITs, this paper presents a feasibility study of a peer-networked online intervention for depression prevention among adolescents. We described the development of the peer network, the evaluation of participant use of the peer networking features, and qualitative user feedback to inform continued BIT development. Method Two groups of adolescents (N = 13) participated in 10-week programs of the peer networked based online intervention. Adolescents had access to didactic lessons, CBT based mood management tools, and peer networking features. The peer networking features are integrated into the site by making use expectations explicit, allow network members to monitor the activities of others, and to supportively hold each other accountable for meeting use expectations. The study collected qualitative feedback from participants as well as usage of site features and tools. Results Participants logged in an average of 12.8 sessions over an average of 10.4 unique days during the 10-week program. On average, 66% of all use sessions occurred within the first 3 weeks of use. The number of “exchange comments”, that is, comments posted that were part of an exchange between two or more participants, was significantly positively correlated with mean time spent on site (r = 0.62, p = 0.032), use of the Activity Tracker (r = 0.70, p = 0.012) and Didactic Lesson (r = 0.73, p = 0.007). Qualitative interviews revealed that adolescents generally liked and were motivated by the peer networking features during the first weeks of the intervention when general site use by group members was high. However, the decrease of site use by group members during the subsequent weeks negatively affected participants’ desire to log on or engage with group members. Conclusions This pilot study highlights the potential that a BIT designed to harness the connection among a peer network, thereby promoting supportive accountability, may improve adolescent adherence to BITs for depression prevention. PMID:27722095

Surgical center: challenges and strategies for nurses in managerial activities.

PubMed

Martins, Fabiana Zerbieri; Dall'Agnoll, Clarice Maria

2017-02-23

Analyze the challenges and strategies of nurses performing managerial activities in a surgical center. Exploratory, descriptive study with a qualitative approach, involving six nurses by means of the Focus Group Technique, between April and August 2013. Data were submitted to thematic content analysis. The main challenges noted were deficiency of material resources, communication noise, adequacy of personnel downsizing, and relationships with the multidisciplinary team. Key strategies include construction of co-management spaces to promote integration among professionals, conflict resolution and exchange of knowledge. Managerial activities involve the promotion of dialogic moments to coordinate the different processes in the surgical center to provide inputs to expand safety and quality of services provided.

Methodologies used by Warsaw Pact countries (except USSR) in obtaining US technologies. Student report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cheeseman, R.J.

1987-04-01

The Warsaw Pact countries obtain U.S. technologies by legal and illegal means. Methods of collection include espionage, overt collection, acquisition by scientific and educational exchange participants, and illegal trade activities. Examples of methods used by the Warsaw Pact countries (except the USSR) are provided. The US faces barriers to preventing loss of its technologies. Among these are resistance from US business interests, insufficient cooperation between US government agencies and overseas allies, lack of US counterintelligence personnel, and the openess of American society. The study concludes that the Warsaw Pact's countries have narrowed NATO's qualitative lead in weaponry as a resultmore » of the Warsaw Pact's acquisition effort.« less

'It's because I like things… it's a status and he buys me airtime': exploring the role of transactional sex in young women's consumption patterns in rural South Africa (secondary findings from HPTN 068).

PubMed

Ranganathan, Meghna; Heise, Lori; MacPhail, Catherine; Stöckl, Heidi; Silverwood, Richard J; Kahn, Kathleen; Selin, Amanda; Xavier Gómez-Olivé, F; Watts, Charlotte; Pettifor, Audrey

2018-05-29

'Transactional sex', defined as a non-marital, non-commercial sexual relationship in which money or material goods are exchanged for sex, is associated with young women's increased vulnerability to HIV infection. Existing research illustrates that the motivations for transactional sex are complex. The fulfilment of psycho-social needs such as the need to belong to a peer group are important factors underlying young women's desires to obtain certain consumption items and thus engage in transactional sex. We use a mixed-methods approach to explore the relationship between transactional sex and consumption patterns among young women in rural Mpumalanga province, South Africa. In the secondary analysis of 693 sexually active young women, we use factor analysis to group the different consumption items and we use multivariable logistic regression to demonstrate the relationship between transactional sex and consumption patterns. The qualitative study uses five focus group discussions and 19 in-depth interviews to explore further young women's motivations for acquiring different consumption items. The quantitative results show that young women that engage in transactional sex have higher odds of consuming items for entertainment (e.g., movie tickets) than on practical items (e.g., food and groceries). The qualitative findings also revealed that young women's perceptions of items that were considered a 'need' were strongly influenced by peer pressure and a desire for improved status. Further, there was a perception that emerged from the qualitative data that relationships with sugar daddies offered a way to acquire consumer goods associated with a 'modern lifestyle', such as items for personal enhancement and entertainment. However, young women seem aware of the risks associated with such relationships. More importantly, they also develop relationship with partners of similar age, albeit with the continued expectation of material exchange, despite engaging in the relationship for love. This study shows that young women are willing to take certain risks in order to have a degree of financial independence. Interventions that provide alternative methods of attaining this independence, such as the provision of cash transfers may have potential in preventing them from engaging in transactional relationships. Further, the psycho-social reasons that drive young women's motivations for consumption items resulting in risky sexual behaviours need to be better understood.

A study of mapping exogenous knowledge representations into CONFIG

NASA Technical Reports Server (NTRS)

Mayfield, Blayne E.

1992-01-01

Qualitative reasoning is reasoning with a small set of qualitative values that is an abstraction of a larger and perhaps infinite set of quantitative values. The use of qualitative and quantitative reasoning together holds great promise for performance improvement in applications that suffer from large and/or imprecise knowledge domains. Included among these applications are the modeling, simulation, analysis, and fault diagnosis of physical systems. Several research groups continue to discover and experiment with new qualitative representations and reasoning techniques. However, due to the diversity of these techniques, it is difficult for the programs produced to exchange system models easily. The availability of mappings to transform knowledge from the form used by one of these programs to that used by another would open the doors for comparative analysis of these programs in areas such as completeness, correctness, and performance. A group at the Johnson Space Center (JSC) is working to develop CONFIG, a prototype qualitative modeling, simulation, and analysis tool for fault diagnosis applications in the U.S. space program. The availability of knowledge mappings from the programs produced by other research groups to CONFIG may provide savings in CONFIG's development costs and time, and may improve CONFIG's performance. The study of such mappings is the purpose of the research described in this paper. Two other research groups that have worked with the JSC group in the past are the Northwest University Group and the University of Texas at Austin Group. The former has produced a qualitative reasoning tool named SIMGEN, and the latter has produced one named QSIM. Another program produced by the Austin group is CC, a preprocessor that permits users to develop input for eventual use by QSIM, but in a more natural format. CONFIG and CC are both based on a component-connection ontology, so a mapping from CC's knowledge representation to CONFIG's knowledge representation was chosen as the focus of this study. A mapping from CC to CONFIG was developed. Due to differences between the two programs, however, the mapping transforms some of the CC knowledge to CONFIG as documentation rather than as knowledge in a form useful to computation. The study suggests that it may be worthwhile to pursue the mappings further. By implementing the mapping as a program, actual comparisons of computational efficiency and quality of results can be made between the QSIM and CONFIG programs. A secondary study may reveal that the results of the two programs augment one another, contradict one another, or differ only slightly. If the latter, the qualitative reasoning techniques may be compared in other areas, such as computational efficiency.

Characterization of Low-Molecular-Weight Heparins by Strong Anion-Exchange Chromatography.

PubMed

Sadowski, Radosław; Gadzała-Kopciuch, Renata; Kowalkowski, Tomasz; Widomski, Paweł; Jujeczka, Ludwik; Buszewski, Bogusław

2017-11-01

Currently, detailed structural characterization of low-molecular-weight heparin (LMWH) products is an analytical subject of great interest. In this work, we carried out a comprehensive structural analysis of LMWHs and applied a modified pharmacopeial method, as well as methods developed by other researchers, to the analysis of novel biosimilar LMWH products; and, for the first time, compared the qualitative and quantitative composition of commercially available drugs (enoxaparin, nadroparin, and dalteparin). For this purpose, we used strong anion-exchange (SAX) chromatography with spectrophotometric detection because this method is more helpful, easier, and faster than other separation techniques for the detailed disaccharide analysis of new LMWH drugs. In addition, we subjected the obtained results to statistical analysis (factor analysis, t-test, and Newman-Keuls post hoc test).

Synthesis and characterization of sulfonate polystyrene-lignosulfonate-alumina (SPS-LS-Al{sub 2}O{sub 3}) polyblends as electrolyte membranes for fuel cell

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gonggo, Siang Tandi, E-mail: standigonggo@yahoo.com

2015-09-30

The new type of electrolyte membrane materials has been prepared by blend sulfonated polystyrene (SPS), lignosulfonate (LS), and alumina (SPS-LS-Al{sub 2}O{sub 3}) by casting polymer solution. The resulting polymer electrolyte membranes were then characterized by functional groups analysis, mechanical properties, water uptake, ion exchange capacity, and proton conductivity. SPS-LS-Al{sub 2}O{sub 3} membranes with alumina composition various have been proven qualitatively by analysis of functional groups. Increasing the Al{sub 2}O{sub 3} ratio resulted in higher ion exchange capacity (IEC), mechanical strength and proton conductivity, but water uptake decreased. The SPS-LS-Al{sub 2}O{sub 3} blend showed higher proton conductivity than Nafion 117.

Family caregivers' views on coordination of care in Huntington's disease: a qualitative study.

PubMed

Røthing, Merete; Malterud, Kirsti; Frich, Jan C

2015-12-01

Collaboration between family caregivers and health professionals in specialised hospitals or community-based primary healthcare systems can be challenging. During the course of severe chronic disease, several health professionals might be involved at a given time, and the patient's illness may be unpredictable or not well understood by some of those involved in the treatment and care. The aim of this study was to explore the experiences and expectations of family caregivers for persons with Huntington's disease concerning collaboration with healthcare professionals. To shed light on collaboration from the perspectives of family caregivers, we conducted an explorative, qualitative interview study with 15 adult participants experienced from caring for family members in all stages of Huntington's disease. Data were analysed with systematic text condensation, a cross-case method for thematic analysis of qualitative data. We found that family caregivers approached health services hoping to understand the illness course and to share their concerns and stories with skilled and trustworthy professionals. Family caregivers felt their involvement in consultations and access to ongoing exchanges of knowledge were important factors in improved health services. They also felt that the clarity of roles and responsibilities was crucial to collaboration. Family caregivers should be acknowledged for their competences and should be involved as contributors in partnerships with healthcare professionals. Our study suggests that building respectful partnerships with family caregivers and facilitating the mutual sharing of knowledge may improve the coordination of care. It is important to establish clarity of roles adjusted to caregivers' individual resources for managing responsibilities in the care process. © 2015 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries

PubMed Central

den Herder-van der Eerden, Marlieke; van Wijngaarden, Jeroen; Preston, Nancy; Linge-Dahl, Lisa; Radbruch, Lukas; Van Beek, Karen; Menten, Johan; Busa, Csilla; Csikos, Agnes; Vissers, Kris; van Gurp, Jelle; Hasselaar, Jeroen

2018-01-01

Background: Integrated palliative care aims at improving coordination of palliative care services around patients’ anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. Aim: To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Design: Qualitative group interview design. Setting/participants: A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses (n = 66; 46%) and physicians (n = 50; 35%). Results: The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Conclusion: Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings. PMID:29436279

The guideline implementability research and application network (GIRAnet): an international collaborative to support knowledge exchange: study protocol.

PubMed

Gagliardi, Anna R; Brouwers, Melissa C; Bhattacharyya, Onil K

2012-04-02

Modifying the format and content of guidelines may facilitate their use and lead to improved quality of care. We reviewed the medical literature to identify features desired by different users and associated with guideline use to develop a framework of implementability and found that most guidelines do not contain these elements. Further research is needed to develop and evaluate implementability tools. We are launching the Guideline Implementability Research and Application Network (GIRAnet) to enable the development and testing of implementability tools in three domains: Resource Implications, Implementation, and Evaluation. Partners include the Guidelines International Network (G-I-N) and its member guideline developers, implementers, and researchers. In phase one, international guidelines will be examined to identify and describe exemplar tools. Indication-specific and generic tools will populate a searchable repository. In phase two, qualitative analysis of cognitive interviews will be used to understand how developers can best integrate implementability tools in guidelines and how health professionals use them for interpreting and applying guidelines. In phase three, a small-scale pilot test will assess the impact of implementability tools based on quantitative analysis of chart-based behavioural outcomes and qualitative analysis of interviews with participants. The findings will be used to plan a more comprehensive future evaluation of implementability tools. Infrastructure funding to establish GIRAnet will be leveraged with the in-kind contributions of collaborating national and international guideline developers to advance our knowledge of implementation practice and science. Needs assessment and evaluation of GIRAnet will provide a greater understanding of how to develop and sustain such knowledge-exchange networks. Ultimately, by facilitating use of guidelines, this research may lead to improved delivery and outcomes of patient care.

Gender, cancer experience and internet use: a comparative keyword analysis of interviews and online cancer support groups.

PubMed

Seale, Clive; Ziebland, Sue; Charteris-Black, Jonathan

2006-05-01

A new method, comparative keyword analysis, is used to compare the language of men and women with cancer in 97 research interviews and two popular internet based support groups for people with cancer. The method is suited to the conjoint qualitative and quantitative analysis of differences between large bodies of text, an alternative to the 'code and retrieval' approach used in much thematic analysis of qualitative materials. Web forums are a rich source of data about illness experience and gender differences. Marked differences in the performance of gender are evident. These differences follow linguistic and other behavioural patterns (such as social network differences) established in other contexts. Men with prostate cancer indicate in research interviews that they are more likely to seek information on the internet; women with breast cancer that they are more likely to seek social and emotional support. Men's concerns cluster around treatment information, medical personnel and procedures. Their experience of disease is more localised on particular areas of the body, while women's experience is more holistic. Women's forum postings orientate much more towards the exchange of emotional support, including concern with the impact of illness on a wide range of other people. Women's use of superlatives as well as words referring to feelings indicate their enactment of greater emotional expressivity. Web forums are platforms for an intensification of men's knowledge gathering activities. Web forums, though actually quite publicly visible, appear to be subjectively experienced by both sexes as relatively private places for the exchange of intimate personal information. The 'privacy' of the breast cancer forum facilitated interactions found in other studies to be characteristic of women's friendship groups.

Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries.

PubMed

den Herder-van der Eerden, Marlieke; van Wijngaarden, Jeroen; Payne, Sheila; Preston, Nancy; Linge-Dahl, Lisa; Radbruch, Lukas; Van Beek, Karen; Menten, Johan; Busa, Csilla; Csikos, Agnes; Vissers, Kris; van Gurp, Jelle; Hasselaar, Jeroen

2018-06-01

Integrated palliative care aims at improving coordination of palliative care services around patients' anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Qualitative group interview design. A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses ( n = 66; 46%) and physicians ( n = 50; 35%). The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings.

Courses offered by the Minas Health Channel: perception of primary care workers.

PubMed

Pereira, Lizziane D' Ávila; Sena, Roseni Rosângela de

2016-06-01

To analyse how primary healthcare workers perceive the impact of the Health Channel Mines courses in their work process. This is a descriptive exploratory qualitative study conducted with 38 professionals working in primary health care units of three municipalities in the state of Minas Gerais, Brazil. Data were collected in 2014 by means of semi-structured interviews and subjected to thematic content analysis. Data analysis revealed the following three categories: interest in training and its contribution to professional practice; factors that alter professional practices; and proposals for improvement. The study data demonstrated that the Mines Health Channel courses cannot single-handedly change professional practices. Continued and refresher education resources that enable the exchange and articulation of knowledge between the various specialities are needed to transform professional practices.

Magnetic and thermodynamic properties of a ferromagnetic mixed-spin (1/2, 1, 3/2) three-layer film superlattice

NASA Astrophysics Data System (ADS)

Lv, Dan; Ma, Ye; Jiang, Wei; Si, Xiu-li; Gao, Wei-chun

2018-07-01

Using the Monte Carlo simulation, we have studied the magnetic and thermodynamic properties of a ferromagnetic three-layer film mixed-spin (1/2, 1, 3/2) system. We have discussed the influence of intralayer and interfacial exchange couplings, film thickness, magnetic atom concentration and temperature on the magnetization of the superlattice system, magnetic susceptibility, internal energy and specific heat of the system. The phase diagrams in various parameters planes are obtained. Loads of interesting magnetic behaviors have been found, such as double-peak and triple-peak phenomena in the susceptibility and specific heat curves as well as obvious finite size effects for small layer thickness. Through a comparison, there is qualitatively a good agreement between our results and those of other theoretical and experimental studies.

Redox reactions with empirical potentials: atomistic battery discharge simulations.

PubMed

Dapp, Wolf B; Müser, Martin H

2013-08-14

Batteries are pivotal components in overcoming some of today's greatest technological challenges. Yet to date there is no self-consistent atomistic description of a complete battery. We take first steps toward modeling of a battery as a whole microscopically. Our focus lies on phenomena occurring at the electrode-electrolyte interface which are not easily studied with other methods. We use the redox split-charge equilibration (redoxSQE) method that assigns a discrete ionization state to each atom. Along with exchanging partial charges across bonds, atoms can swap integer charges. With redoxSQE we study the discharge behavior of a nano-battery, and demonstrate that this reproduces the generic properties of a macroscopic battery qualitatively. Examples are the dependence of the battery's capacity on temperature and discharge rate, as well as performance degradation upon recharge.

Theoretical study of the magnetic exchange coupling behavior substituting Cr(III) with Mo(III) in cyano-bridged transition metal complexes

NASA Astrophysics Data System (ADS)

Zhang, Yi-Quan; Luo, Cheng-Lin

Molecular magnetism in a series of cyano-bridged first and second transition metal complexes has been investigated using density functional theory (DFT) combined with the broken-symmetry (BS) approach. Several exchange-correlation (XC) functionals in the ADF package were used to investigate complexes I [-(Me3tacn)2(cyclam)NiMo2(CN)6]2+, II [-(Me3tacn)2(cyclam)Ni-Cr2(CN)6]2+, III [(Me3tacn)6MnMo6(CN)18]2+, and IV [(Me3tacn)6MnCr6(CN)18]2+ (Me3tacn = N,N?,N‴-trimethyl-1,4,7-triazacyclononane). For models A (the molded structure of complex I) and B (the modeled structure of complex II), all the XCs given qualitatively reasonable results and predict ferromagnetic coupling character between M (M = MoIII for A or CrIII for B) and NiII in coincidence with the experimental results (see Tables and ). The calculated using Operdew, OPBE, O3LYP, and B3LYP functionals and experimental J values show that substituting CrIII with MoIII will enhance the ferromagnetic exchange coupling interactions. But VWN, PW91, PBE, VSXC, and tau-HCTH functionals have no way to differentiate the relative strength of the intramolecular magnetic exchange coupling interactions of A and B correctly. For models C (the modeled structure of complex III) and D (the modeled structure of complex IV), all the XCs in ADF and B3LYP in Gaussian 03 with several basis sets show that substituting CrIII with MoIII will enhance the antiferromagnetic exchange coupling interactions. From the above calculations, the substitution of CrIII by MoIII will enhance the magnetic coupling interactions, whether the magnetic coupling interactions are ferro- or antiferromagnetic. Moreover, Kahn's model was applied to investigate the above facts.

Quantifiable outcomes from corporate and higher education learning collaborations

NASA Astrophysics Data System (ADS)

Devine, Thomas G.

The study investigated the existence of measurable learning outcomes that emerged out of the shared strengths of collaborating sponsors. The study identified quantifiable learning outcomes that confirm corporate, academic and learner participation in learning collaborations. Each of the three hypotheses and the synergy indicator quantitatively and qualitatively confirmed learning outcomes benefiting participants. The academic-indicator quantitatively confirmed that learning outcomes attract learners to the institution. The corporate-indicator confirmed that learning outcomes include knowledge exchange and enhanced workforce talents for careers in the energy-utility industry. The learner-indicator confirmed that learning outcomes provide professional development opportunities for employment. The synergy-indicator confirmed that best learning practices in learning collaborations emanate out of the sponsors' shared strengths, and that partnerships can be elevated to strategic alliances, going beyond response to the desires of sponsors to create learner-centered cultures. The synergy-indicator confirmed the value of organizational processes that elevate sponsors' interactions to sharing strength, to create a learner-centered culture. The study's series of qualitative questions confirmed prior success factors, while verifying the hypothesis results and providing insight not available from quantitative data. The direct benefactors of the study are the energy-utility learning-collaboration participants of the study, and corporation, academic institutions, and learners of the collaboration. The indirect benefactors are the stakeholders of future learning collaborations, through improved knowledge of the existence or absence of quantifiable learning outcomes.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maes, Dries, E-mail: Dries.Maes@uhasselt.be; Van Passel, Steven, E-mail: Steven.Vanpassel@uhasselt.be

Innovative bioenergy projects show a growing diversity in biomass pathways, transformation technologies and end-products, leading to complex new processes. Existing energy-based indicators are not designed to include multiple impacts and are too constrained to assess the sustainability of these processes. Alternatively, indicators based on exergy, a measure of “qualitative energy”, could allow a more holistic view. Exergy is increasingly applied in analyses of both technical and biological processes. But sustainability assessments including exergy calculations, are not very common and are not generally applicable to all types of impact. Hence it is important to frame the use of exergy for inclusionmore » in a sustainability assessment. This paper reviews the potentials and the limitations of exergy calculations, and presents solutions for coherent aggregation with other metrics. The resulting approach is illustrated in a case study. Within the context of sustainability assessment of bioenergy, exergy is a suitable metric for the impacts that require an ecocentric interpretation, and it allows aggregation on a physical basis. The use of exergy is limited to a measurement of material and energy exchanges with the sun, biosphere and lithosphere. Exchanges involving services or human choices are to be measured in different metrics. This combination provides a more inclusive and objective sustainability assessment, especially compared to standard energy- or carbon-based indicators. Future applications of this approach in different situations are required to clarify the potential of exergy-based indicators in a sustainability context. -- Highlights: • Innovative bioenergy projects require more advanced sustainability assessments to incorporate all environmental impacts. • Exergy-based indicators provide solutions for objective and robust measurements. • The use of exergy in a sustainability assessment is limited to material exchanges, excluding exchanges with society. • The combination of exergy-based indicators with other indicators is very appropriate. • But this is only rarely applied.« less

Enhanced picture of protein-folding intermediates using organic solvents in H/D exchange and quench-flow experiments

PubMed Central

Nishimura, Chiaki; Dyson, H. Jane; Wright, Peter E.

2005-01-01

Hydrogen/deuterium exchange followed by trapping of the labeled species in the aprotic solvent DMSO has been used to elucidate structure in both the burst-phase molten globule-folding intermediate of apomyoglobin and in an equilibrium intermediate that models the kinetic intermediate. Precise estimates can be made of exchange times in an interrupted exchange-out experiment at pH 4 followed by analysis in DMSO solution, giving extensive sequence-specific information about the structure of the equilibrium intermediate. In addition, the use of DMSO as a solvent for NMR measurements after quench-flow pH-pulse labeling experiments gives a greatly increased data set for the elucidation of the kinetic folding pathway. Interestingly, differences are observed in some regions of apomyoglobin between the equilibrium and kinetic intermediates. These differences are quantitative rather than qualitative; that is, the overall patterns of labeling and secondary structure formation remain similar between the two species. However, local differences are observed, which probably reflect the difference in the solution conditions for the equilibrium experiment (pH 4) vs. the kinetic experiment (pH 6) and the change in the status of the stabilizing hydrogen bond between the side chains of His-24 and His-119. PMID:15769860

Barriers and facilitators to health information exchange in low- and middle-income country settings: a systematic review.

PubMed

Akhlaq, Ather; McKinstry, Brian; Muhammad, Khalid Bin; Sheikh, Aziz

2016-11-01

The exchange and use of health information can help healthcare professionals and policymakers make informed decisions on ways of improving patient and population health. Many low- and middle-income countries (LMICs) have however failed to embrace the approaches and technologies to facilitate health information exchange (HIE). We sought to understand the barriers and facilitators to the implementation and adoption of HIE in LMICs. Two reviewers independently searched 11 academic databases for published and on-going qualitative, quantitative and mixed-method studies and searched for unpublished work through the Google search engine. The searches covered the period from January 1990 to July 2014 and were not restricted by language. Eligible studies were independently, critically appraised and then thematically analysed. The searches yielded 5461 citations after de-duplication of results. Of these, 56 articles, three conference abstracts and four technical reports met the inclusion criteria. The lack of importance given to data in decision making, corruption and insecurity, lack of training and poor infrastructure were considered to be major challenges to implementing HIE, but strong leadership and clear policy direction coupled with the financial support to acquire essential technology, improve the communication network, and provide training for staff all helped to promote implementation. The body of work also highlighted how implementers of HIE needed to take into account local needs to ensure that stakeholders saw HIE as relevant and advantageous. HIE interventions implemented through leapfrog technologies such as telehealth/telemedicine and mHealth in Brazil, Kenya, and South Africa, provided successful examples of exchanging health information in LMICs despite limited resources and capability. It is important that implementation of HIE is aligned with national priorities and local needs. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Morphological Pulmonary Diffusion Capacity for Oxygen of Burmese Pythons (Python molurus): a Comparison of Animals in Healthy Condition and with Different Pulmonary Infections.

PubMed

Starck, J M; Weimer, I; Aupperle, H; Müller, K; Marschang, R E; Kiefer, I; Pees, M

2015-11-01

A qualitative and quantitative morphological study of the pulmonary exchange capacity of healthy and diseased Burmese pythons (Python molurus) was carried out in order to test the hypothesis that the high morphological excess capacity for oxygen exchange in the lungs of these snakes is one of the reasons why pathological processes extend throughout the lung parenchyma and impair major parts of the lungs before clinical signs of respiratory disease become apparent. Twenty-four Burmese pythons (12 healthy and 12 diseased) were included in the study. A stereology-based approach was used to quantify the lung parenchyma using computed tomography. Light microscopy was used to quantify tissue compartments and the respiratory exchange surface, and transmission electron microscopy was used to measure the thickness of the diffusion barrier. The morphological diffusion capacity for oxygen of the lungs and the anatomical diffusion factor were calculated. The calculated anatomical diffusion capacity was compared with published values for oxygen consumption of healthy snakes, and the degree to which the exchange capacity can be obstructed before normal physiological function is impaired was estimated. Heterogeneous pulmonary infections result in graded morphological transformations of pulmonary parenchyma involving lymphocyte migration into the connective tissue and thickening of the septal connective tissue, increasing thickness of the diffusion barrier and increasing transformation of the pulmonary epithelium into a columnar pseudostratified or stratified epithelium. The transformed epithelium developed by hyperplasia of ciliated cells arising from the tip of the faveolar septa and by hyperplasia of type II pneumocytes. These results support the idea that the lungs have a remarkable overcapacity for oxygen consumption and that the development of pulmonary disease continuously reduces the capacity for oxygen consumption. However, due to the overcapacity of the lungs, this reduction does not result in clinical signs and disease can progress unrecognized for an extended period. Copyright © 2015 Elsevier Ltd. All rights reserved.

Focus groups to explore healthcare professionals' experiences of care coordination: towards a theoretical framework for the study of care coordination.

PubMed

Van Houdt, Sabine; Sermeus, Walter; Vanhaecht, Kris; De Lepeleire, Jan

2014-12-24

Strategies to improve care coordination between primary and hospital care do not always have the desired results. This is partly due to incomplete understanding of the key concepts of care coordination. An in-depth analysis of existing theoretical frameworks for the study of care coordination identified 14 interrelated key concepts. In another study, these 14 key concepts were further explored in patients' experiences. Additionally, "patient characteristics" was identified as a new key concept in patients' experiences and the previously identified key concept "quality of relationship" between healthcare professionals was extended to "quality of relationship" with the patient. Together, these 15 interrelated key concepts resulted in a new theoretical framework. The present study aimed at improving our understanding of the 15 previously identified key concepts and to explore potentially previous unidentified key concepts and the links between these by exploring how healthcare professionals experience care coordination. A qualitative design was used. Six focus groups were conducted including primary healthcare professionals involved in the care of patients who had breast cancer surgery at three hospitals in Belgium. Data were analyzed using constant comparative analysis. All 15 previously identified key concepts of care coordination were further explored in healthcare professionals' experiences. Links between these 15 concepts were identified, including 9 newly identified links. The concept "external factors" was linked with all 6 concepts relating to (inter)organizational mechanisms; "task characteristics", "structure", "knowledge and information technology", "administrative operational processes", "cultural factors" and "need for coordination". Five of these concepts related to 3 concepts of relational coordination; "roles", "quality of relationship" and "exchange of information". The concept of "task characteristics" was only linked with "roles" and "exchange of information". The concept "patient characteristics" related with the concepts "need for coordination" and "patient outcome". Outcome was influenced by "roles", "quality of relationship" and "exchange of information". External factors and the (inter)organizational mechanism should enhance "roles" and "quality of relationship" between healthcare professionals and with the patient as well as "exchange of information", and setting and sharing of common "goals" to improve care coordination and quality of care.

The efficiency and effectiveness of utilizing diagrams in interviews: an assessment of participatory diagramming and graphic elicitation

PubMed Central

Umoquit, Muriah J; Dobrow, Mark J; Lemieux-Charles, Louise; Ritvo, Paul G; Urbach, David R; Wodchis, Walter P

2008-01-01

Background This paper focuses on measuring the efficiency and effectiveness of two diagramming methods employed in key informant interviews with clinicians and health care administrators. The two methods are 'participatory diagramming', where the respondent creates a diagram that assists in their communication of answers, and 'graphic elicitation', where a researcher-prepared diagram is used to stimulate data collection. Methods These two diagramming methods were applied in key informant interviews and their value in efficiently and effectively gathering data was assessed based on quantitative measures and qualitative observations. Results Assessment of the two diagramming methods suggests that participatory diagramming is an efficient method for collecting data in graphic form, but may not generate the depth of verbal response that many qualitative researchers seek. In contrast, graphic elicitation was more intuitive, better understood and preferred by most respondents, and often provided more contemplative verbal responses, however this was achieved at the expense of more interview time. Conclusion Diagramming methods are important for eliciting interview data that are often difficult to obtain through traditional verbal exchanges. Subject to the methodological limitations of the study, our findings suggest that while participatory diagramming and graphic elicitation have specific strengths and weaknesses, their combined use can provide complementary information that would not likely occur with the application of only one diagramming method. The methodological insights gained by examining the efficiency and effectiveness of these diagramming methods in our study should be helpful to other researchers considering their incorporation into qualitative research designs. PMID:18691410

Hospice nurses’ emotional challenges in their encounters with the dying

PubMed Central

Ingebretsen, Lina Paola; Sagbakken, Mette

2016-01-01

The purpose of this study was to explore nurses’ emotional challenges when caring for the dying in hospices. The study has a qualitative design, and knowledge was developed through a dialectical exchange between theory and data. Ten individual in-depth interviews were conducted with nurses recruited from two hospices in Denmark. Although all of the nurses said that they experienced emotional challenges or felt emotionally touched during their work, the study found a variety of opinions related to the extent to which their emotional reactions should be revealed in their role as a hospice professional. The participants described their emotional challenges as being simultaneously draining and enriching experiences leading to personal and professional growth and development. The study may contribute to increased awareness of emotional challenges for hospice nurses, which involve continuous reflection and balancing between meeting the dying as a human being and meeting the dying as a hospice professional. PMID:27258584

Health information exchange implementation: lessons learned and critical success factors from a case study.

PubMed

Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

2014-08-15

Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders' perspectives across technical, organizational, and governance dimensions. Several challenges, successes, and lessons learned during the implementation of a health system to the statewide HIE were found. The most significant perceived success was accomplishing the implementation, although many interviewees also underscored the value of a project champion with decision-making power. In terms of lessons learned, social reasons were found to be very significant motivators for early implementation, frequently outweighing economic motivations. It was clear that understanding the guides early in the project would have mitigated some of the challenges that emerged, and early communication with the electronic health record vendor so that they have a solid understanding of the undertaking was critical. An HIE implementations evaluation framework was found to be useful for assessing challenges, motivations, value propositions for participating, and success factors to consider for future implementations. This case study illuminates five critical success factors for implementation of a health system onto a statewide HIE. This study also reveals that organizations have varied motivations and value proposition perceptions for engaging in the exchange of health information, few of which, at the early stages, are economically driven.

Health Information Exchange Implementation: Lessons Learned and Critical Success Factors From a Case Study

PubMed Central

2014-01-01

Background Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. Objective The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. Methods We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders’ perspectives across technical, organizational, and governance dimensions. Results Several challenges, successes, and lessons learned during the implementation of a health system to the statewide HIE were found. The most significant perceived success was accomplishing the implementation, although many interviewees also underscored the value of a project champion with decision-making power. In terms of lessons learned, social reasons were found to be very significant motivators for early implementation, frequently outweighing economic motivations. It was clear that understanding the guides early in the project would have mitigated some of the challenges that emerged, and early communication with the electronic health record vendor so that they have a solid understanding of the undertaking was critical. An HIE implementations evaluation framework was found to be useful for assessing challenges, motivations, value propositions for participating, and success factors to consider for future implementations. Conclusions This case study illuminates five critical success factors for implementation of a health system onto a statewide HIE. This study also reveals that organizations have varied motivations and value proposition perceptions for engaging in the exchange of health information, few of which, at the early stages, are economically driven. PMID:25599991

ICU nurses and physicians dialogue regarding patients clinical status and care options—a focus group study

PubMed Central

Kvande, Monica; Lykkeslet, Else; Storli, Sissel Lisa

2017-01-01

ABSTRACT Nurses and physicians work side-by-side in the intensive care unit (ICU). Effective exchanges of patient information are essential to safe patient care in the ICU. Nurses often rate nurse-physician communication lower than physicians and report that it is difficult to speak up, that disagreements are not resolved and that their input is not well received. Therefore, this study explored nurses’ dialogue with physicians regarding patients’ clinical status and the prerequisites for effective and accurate exchanges of information. We adopted a qualitative approach, conducting three focus group discussions with five to six nurses and physicians each (14 total). Two themes emerged. The first theme highlighted nurses’ contributions to dialogues with physicians; nurses’ ongoing observations of patients were essential to patient care discussions. The second theme addressed the prerequisites of accurate and effective dialogue regarding care options, comprising three subthemes: nurses’ ability to speak up and present clinical changes, establishment of shared goal and clinical understanding, and open dialogue and willingness to listen to each other. Nurses should understand their essential role in conducting ongoing observations of patients and their right to be included in care-related decision-making processes. Physicians should be willing to listen to and include nurses’ clinical observations and concerns. PMID:28452605

ICU nurses and physicians dialogue regarding patients clinical status and care options-a focus group study.

PubMed

Kvande, Monica; Lykkeslet, Else; Storli, Sissel Lisa

2017-12-01

Nurses and physicians work side-by-side in the intensive care unit (ICU). Effective exchanges of patient information are essential to safe patient care in the ICU. Nurses often rate nurse-physician communication lower than physicians and report that it is difficult to speak up, that disagreements are not resolved and that their input is not well received. Therefore, this study explored nurses' dialogue with physicians regarding patients' clinical status and the prerequisites for effective and accurate exchanges of information. We adopted a qualitative approach, conducting three focus group discussions with five to six nurses and physicians each (14 total). Two themes emerged. The first theme highlighted nurses' contributions to dialogues with physicians; nurses' ongoing observations of patients were essential to patient care discussions. The second theme addressed the prerequisites of accurate and effective dialogue regarding care options, comprising three subthemes: nurses' ability to speak up and present clinical changes, establishment of shared goal and clinical understanding, and open dialogue and willingness to listen to each other. Nurses should understand their essential role in conducting ongoing observations of patients and their right to be included in care-related decision-making processes. Physicians should be willing to listen to and include nurses' clinical observations and concerns.

Effect of the spin-twist structure on the spin-wave dynamics in Fe{sub 55}Pt{sub 45}/Ni{sub 80}Fe{sub 20} exchange coupled bi-layers with varying Ni{sub 80}Fe{sub 20} thickness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pal, Semanti; Barman, Saswati, E-mail: saswati@bose.res.in; Barman, Anjan, E-mail: abarman@bose.res.in

2014-05-07

We have investigated optically induced ultrafast magnetization dynamics of a series of Fe{sub 55}Pt{sub 45}/Ni{sub 80}Fe{sub 20} exchange spring bi-layers with varying Ni{sub 80}Fe{sub 20} thickness. Rich spin-wave spectra are observed; whose frequency shows a strong dependence on the Ni{sub 80}Fe{sub 20} layer thickness. Micromagnetic simulations based on a simplified magnetic microstructure were able to reproduce the experimental data qualitatively. The spin twist structure introduced in the Ni{sub 80}Fe{sub 20} layer gives rise to new modes in the composite system as opposed to the bare Ni{sub 80}Fe{sub 20} films.

A Task Is a Task Is a Task Is a Task... Or Is It? Researching Telecollaborative Teacher Competence Development--The Need for More Qualitative Research

ERIC Educational Resources Information Center

Müller-Hartmann, Andreas

2016-01-01

The concept of task has become central not only to an understanding of language learning per se, but also to the design and research of Online Intercultural Exchanges (OIEs). While research on the design of tasks in OIEs has been very productive, we still lack insights into how teachers develop competences in task design on the micro-level.…

Support for and From Aging Mothers Whose Adult Daughters are Seriously Mentally Ill.

PubMed

Dunkle, Ruth E; Ingersoll-Dayton, Berit; Chadiha, Letha A

2015-01-01

This article discusses, from the grandmother's perspective, the ways in which support is exchanged in families coping with serious mental illness. A strengths perspective was utilized to identify ways in which family members help each other. Employing a qualitative approach, this study focuses on interviews obtained from a sample of 22 aging mothers, aged 52-90, who are in contact with their daughters who have a mental illness. Grandmothers provided several kinds of support to their mentally ill adult daughters and to their grandchildren, who also supported the aging mother in numerous ways. As social workers seek to assist individuals with mental illness, it is important to assess the existing strengths of their intergenerational family context.

Evaluating the Usability of a Free Electronic Health Record for Training

PubMed Central

Hoyt, Robert; Adler, Kenneth; Ziesemer, Brandy; Palombo, Georgina

2013-01-01

The United States will need to train a large workforce of skilled health information technology (HIT) professionals in order to meet the US government's goal of universal electronic health records (EHRs) for all patients and widespread health information exchange. The Health Information Technology for Economic and Clinical Health (HITECH) Act established several HIT workforce educational programs to accomplish this goal. Recent studies have shown that EHR usability is a significant concern of physicians and is a potential obstacle to EHR adoption. It is important to have a highly usable EHR to train both clinicians and students. In this article, we report a qualitative-quantitative usability analysis of a web-based EHR for training health informatics and health information management students. PMID:23805062

The magnetic ordering in high magnetoresistance Mn-doped ZnO thin films

DOE PAGES

Venkatesh, S.; Baras, A.; Lee, J. -S.; ...

2016-03-24

Here, we studied the nature of magnetic ordering in Mn-doped ZnO thin films that exhibited ferromagnetism at 300 K and superparamagnetism at 5 K. We directly inter-related the magnetisation and magnetoresistance by invoking the polaronpercolation theory and variable range of hopping conduction below the metal-to-insulator transition. By obtaining a qualitative agreement between these two models, we attribute the ferromagnetism to the s-d exchange-induced spin splitting that was indicated by large positive magnetoresistance (~40 %). Low temperature superparamagnetism was attributed to the localization of carriers and non-interacting polaron clusters. This analysis can assist in understanding the presence or absence of ferromagnetismmore » in doped/un-doped ZnO.« less

Optical properties of anthocyanins in the gas phase

NASA Astrophysics Data System (ADS)

Ge, Xiaochuan; Calzolari, Arrigo; Baroni, Stefano

2015-01-01

The gas-phase optical properties of the six most common anthocyanins are studied using time-dependent density-functional theory. Different anthocyanins are classified into three groups, according to the number of low-frequency peaks displayed in the UV-vis spectrum. This behavior is analyzed in terms of one-electron transitions and interaction effects, the latter being rationalized using a suitable double-pole model. Moving from PBE to hybrid exchange-correlation functionals results in a hypsochromic shift of the optical gap. While the colors thus predicted do not quite match those observed in solution, thus highlighting the importance of solvation effects, adoption of hybrid functionals remarkably determines a greater chromatic uniformity of different molecules, in qualitative agreement with experimental evidence in acidic solutions.

Police violence and sexual risk among female and transvestite sex workers in Serbia: qualitative study

PubMed Central

Simić, Milena; Baroš, Sladjana; Platt, Lucy; Žikić, Bojan

2008-01-01

Objective To explore female and transvestite sex workers’ perceptions of risk in the sex work environment in Serbia. Design Qualitative interview study. Setting Street based locations for sex work in Belgrade and Pancevo, Serbia. Participants 31 female and transvestite sex workers. Results Violence, including police violence, was reported as a primary concern in relation to risk. Violence was linked to unprotected sex and the reduced capacity for avoiding sexual risk. Participants reported that coerced sex was routinely provided to the police in exchange for freedom from detainment, arrest, or fine, and was enforced by the perceived threat of violence, sometimes realised. Accounts contained multiple instances of physical and sexual assault, presented as abuses of police authority, and described policing as a form of moral punishment. This was largely through non-physical means but was also enforced through physical violence, especially towards transvestite and Roma sex workers, whose experience of police violence was reported as relentless and brutal and connected with broader social forces of discrimination in this setting, especially towards Roma. Conclusion Preventing violence towards sex workers, which can link with vulnerability to sexually transmitted infections, is a priority in Serbia. This requires monitoring perpetrators of violence, providing legal support to sex workers, and creating safer environments for sex work. PMID:18667468

Police violence and sexual risk among female and transvestite sex workers in Serbia: qualitative study.

PubMed

Rhodes, Tim; Simic, Milena; Baros, Sladjana; Platt, Lucy; Zikic, Bojan

2008-07-30

To explore female and transvestite sex workers' perceptions of risk in the sex work environment in Serbia. Qualitative interview study. Street based locations for sex work in Belgrade and Pancevo, Serbia. 31 female and transvestite sex workers. Violence, including police violence, was reported as a primary concern in relation to risk. Violence was linked to unprotected sex and the reduced capacity for avoiding sexual risk. Participants reported that coerced sex was routinely provided to the police in exchange for freedom from detainment, arrest, or fine, and was enforced by the perceived threat of violence, sometimes realised. Accounts contained multiple instances of physical and sexual assault, presented as abuses of police authority, and described policing as a form of moral punishment. This was largely through non-physical means but was also enforced through physical violence, especially towards transvestite and Roma sex workers, whose experience of police violence was reported as relentless and brutal and connected with broader social forces of discrimination in this setting, especially towards Roma. Preventing violence towards sex workers, which can link with vulnerability to sexually transmitted infections, is a priority in Serbia. This requires monitoring perpetrators of violence, providing legal support to sex workers, and creating safer environments for sex work.

Understanding patient perceptions of shared decision making.

PubMed

Shay, L Aubree; Lafata, Jennifer Elston

2014-09-01

This study aims to develop a conceptual model of patient-defined SDM, and understand what leads patients to label a specific, decision-making process as shared. Qualitative interviews were conducted with 23 primary care patients following a recent appointment. Patients were asked about the meaning of SDM and about specific decisions that they labeled as shared. Interviews were coded using qualitative content analysis. Patients' conceptual definition of SDM included four components of an interactive exchange prior to making the decision: both doctor and patient share information, both are open-minded and respectful, patient self-advocacy, and a personalized physician recommendation. Additionally, a long-term trusting relationship helps foster SDM. In contrast, when asked about a specific decision labeled as shared, patients described a range of interactions with the only commonality being that the two parties came to a mutually agreed-upon decision. There is no one-size-fits all process that leads patients to label a decision as shared. Rather, the outcome of "agreement" may be more important than the actual decision-making process for patients to label a decision as shared. Studies are needed to better understand how longitudinal communication between patient and physicians and patient self-advocacy behaviors affect patient perceptions of SDM. Published by Elsevier Ireland Ltd.

Evaluation of an innovative nursing exchange programme: health counselling skills and cultural awareness.

PubMed

Lee, Regina L T; Pang, Samantha M C; Wong, Thomas K S; Chan, M F

2007-11-01

In 2006, a two-week summer exchange programme was conducted for nursing students from 15 institutes and/or universities, including places in Taiwan, Macau, Chinese mainland and Hong Kong. This paper evaluates a summer exchange programme focusing on nursing students' professional and personal development within the context of learning health counselling skills and studying cultural aspects of the host Region. The programme was evaluated using a mixed method of both quantitative and qualitative research design. Three dimensions include students' exchange perspective, professional development and personal development were evaluated at the end of the two-week programme. Data for this evaluation were derived from the results of questionnaires completed by the 64 nursing students enrolled in this programme, and from the analysis of five focus group interviews. Overall, students (98%) reported that they were very positive about their experiences during the programme, and felt they had gained a greater awareness of effective health counselling skills, of the latest developments in advanced nursing technology within the host School, and of cultural diversity in relation to their personal and professional development. Comparison of sub-total mean scores and standard deviations (mean+/-SD) of the three dimensions among students from Taiwan, Chinese mainland and Hong Kong/Macau, revealing significant differences in the exchange perspective (Taiwan: 18.6+/-1.4; Chinese mainland: 18.8+/-1.4; and Hong Kong/Macau: 16.5+/-1.1) professional development (Taiwan: 18.4+/-1.6; Chinese mainland: 18.2+/-1.5; and Hong Kong/Macau: 16.2+/-2.0) and personal development dimensions (Taiwan: 18.9+/-1.0; Chinese mainland: 18.6+/-1.4; and Hong Kong/Macau: 17.3+/-1.1) among these three places (p<0.001). For paired comparison (post-hoc test), the findings also show that the sub-total mean scores of the students from Taiwan and Chinese mainland were significantly higher than those of students from Hong Kong and Macau in the exchange perspective (Taiwan versus Hong Kong/Macau, p<0.001; Chinese mainland versus Hong Kong/Macau, p<0.001), professional development (Taiwan versus Hong Kong/Macau, p=0.001; Chinese mainland versus Hong Kong/Macau, p<0.001), and personal development (Taiwan versus Hong Kong/Macau, p<0.001; Chinese mainland versus Hong Kong/Macau, p=0.002). Although the findings cannot be generalized, the programme evaluation highlights the positive impact on one's exchange perspective and professional and personal development of a culturally integrated exchange programme for nursing students, with emphasis on skill practices and cultural diversity.

X-ray magneto-optic KERR effect studies of spring magnet heterostructures.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kortright, J. B.; Kim, S.-K.; Fullerton, E. E.

2000-11-01

The complex 3-dimensional magnetization reversal behavior of Sin-Co/Fe exchange spring films is used to test the sensitivity of different resonant soft x-ray magneto-optical Kerr effect (MOKE) measurements to changes in longitudinal and transverse moments within the SOIIFe layer and to changes in these moments in depth within the Fe layer. As in the visible MOKE, changes in longitudinal and net transverse moments are resolved by measuring both Kerr rotation and intensity loops in the near the Fe 2p core resonance. These x-ray MOKE signals measured using linear incident polarization are more directly interpreted in terms of longitudinal and transverse momentsmore » than are the same signals measured using elliptical polarization. Varying photon energy near the Fe L3line is shown to be an effective means of resolving distinctly different reversal behavior at the top and bottom of the 20 nm thick Fe layer resulting from the strong exchange coupling at the Sin-Co/Fe interface. Measured x-ray MOKE spectra and signals are in qualitative agreement with those calculated using standard magneto-optical formalisms incorporating interference between different layers and measured helicity-dependent magneto-optical constants for Fe.« less

Experimental evidence for importance of Hund's exchange interaction for incoherence of charge carriers in iron-based superconductors

NASA Astrophysics Data System (ADS)

Fink, J.; Rienks, E. D. L.; Thirupathaiah, S.; Nayak, J.; van Roekeghem, A.; Biermann, S.; Wolf, T.; Adelmann, P.; Jeevan, H. S.; Gegenwart, P.; Wurmehl, S.; Felser, C.; Büchner, B.

2017-04-01

Angle-resolved photoemission spectroscopy is used to study the scattering rates of charge carriers from the hole pockets near Γ in the iron-based high-Tc hole-doped superconductors KxBa1 -xFe2As2 , x =0.4 , and KxEu1 -xFe2As2 , x =0.55 , and the electron-doped compound Ba (Fe1-xCox) 2As2 , x =0.075 . The scattering rate for any given band is found to depend linearly on the energy, indicating a non-Fermi-liquid regime. The scattering rates in the hole-doped compound are considerably higher than those in the electron-doped compounds. In the hole-doped systems the scattering rate of the charge carriers of the inner hole pocket is about three times higher than the binding energy, indicating that the spectral weight is heavily incoherent. The strength of the scattering rates and the difference between electron- and hole-doped compounds signals the importance of Hund's exchange coupling for correlation effects in these iron-based high-Tc superconductors. The experimental results are in qualitative agreement with theoretical calculations in the framework of combined density functional dynamical mean-field theory.

Availability, fermentability, and energy value of resistant maltodextrin: modeling of short-term indirect calorimetric measurements in healthy adults.

PubMed

Goda, Toshinao; Kajiya, Yuya; Suruga, Kazuhito; Tagami, Hiroyuki; Livesey, Geoffrey

2006-06-01

Determination of the metabolizable (ME) and net metabolizable (NME) energy of total carbohydrate requires estimation of its available (AC) and fermentable (FC) carbohydrate content. Modeling of indirect calorimetric observations (respiratory gas exchange) and breath hydrogen would appear to make it possible to estimate noninvasively these nutritional quantities and the approximate time-course of availability. We assessed the time-course of metabolism and energy availability from resistant maltodextrin (RMD) by modeling of respiratory gases after a single oral dose. Seventeen healthy adults (13 M, 4 F; aged 25-46 y) were randomly assigned to treatments (water, maltodextrin, or RMD) in a multiple-crossover, single-blinded trial with > or = 7 d washout. We monitored 8-h nitrogen-corrected oxygen and carbon dioxide exchanges and breath hydrogen. All treatment groups took low-carbohydrate meals at 3 and 6 h. Indirect calorimetry alone provided only qualitative information about the nutritional values of carbohydrate. In contrast, modeling of gaseous exchanges along with the use of central assumptions showed that 17 +/- 2% of RMD was AC and 40 +/- 4% was FC. As compared with 17 kJ gross energy/g RMD, mean (+/- SE) energy values were 7.3 +/- 0.6 kJ ME/g and 6.3 +/- 0.5 kJ NME/g. The fiber fraction of RMD provided 5.2 +/- 0.7 kJ ME/g and 4.1 +/- 0.6 kJ NME/g. Modeling with the use of this noninvasive and widely available respiratory gas-monitoring technique yields nutritional values for carbohydrate that are supported by enzymatic, microbial, and animal studies and human fecal collection studies. Improvement in this approach is likely and testable across laboratories.

Preferential Flow Paths and Recirculation-Disrupting Jets in the Leeside of Self-Forming Coarse-Grained Laboratory Bedforms

NASA Astrophysics Data System (ADS)

Lichtner, D.; Christensen, K. T.; Best, J.; Blois, G.

2014-12-01

Exchange of fluid in the near-subsurface of a streambed is influenced by turbulence in the free flow, as well as by bed topography and permeability. Macro-roughness elements such as bedforms are known to produce pressure gradients that drive fluid into the streambed on their stoss sides and out of the bed on their lee sides. To study the modification of the near-bed flow field by self-forming permeable bedforms, laboratory experiments were conducted in a 5 mm wide flume filled with 1.3 mm glass beads. The narrow width of the flume permitted detailed examination of the fluid exiting the bed immediately downstream of a bedform. Dense 2-D velocity field measurements were gathered using particle image velocimetry (PIV). In up to 8% of instantaneous PIV realizations, the flow at the near-bed presented a component perpendicular to the streambed, indicating flow across the interface. At the downstream side of the bedform, such flow disrupted the mean recirculation pattern that is typically observed in finer sediment beds. It is hypothesized that the coarse grain size and the resulting high bed permeability promote such near-surface jet events. A qualitative analysis of raw image frames indicated that an in-place jostling of sediment is associated with these jets thus suggesting that subsurface flow may be characterized by impulsive events. These observations are relevant to hyporheic exchange rates in coarse sediments and can have strong morphodynamic implications as they can explain the lack of ripples and characteristics of dunes in high permeability gravels. Overall, further study of the flow structure over highly permeable streambeds is needed to understand subsurface exchange and bedform initiation.

A Qualitative Exploration of Gender in the Context of Injection Drug Use in Two US–Mexico Border Cities

PubMed Central

Cruz, Michelle Firestone; Mantsios, Andrea; Ramos, Rebeca; Case, Patricia; Brouwer, Kimberly C.; Ramos, Maria Elena; Fraga, Wendy Davila; Latkin, Carl A.; Miller, Cari L.; Strathdee, Steffanie A.

2009-01-01

Injection drug use is of increasing concern along the U.S.–Mexico border where Tijuana and Ciudad (Cd.) Juarez are located. We conducted a qualitative study to explore the context of drug use, with a focus on gender differences. In-depth interviews were conducted with 10 male and 10 female injection drug users (IDUs) in Tijuana and 15 male and 8 female IDUs in Cd. Juarez. Topics included types of drugs used, injection settings, access to sterile needles and environmental influences. Interviews were taped, transcribed and translated. Content analysis was conducted to identify themes. Several themes emerged with respect to gender: (a) how drugs were obtained; (b) where drugs were used; (c) relationship dynamics surrounding drug use; and (d) sex in exchange for money or drugs. Men reported buying and injecting in shooting galleries and other locations, whereas women tended to buy and inject drugs with people they knew and trusted. All men reported having shared syringes in shooting galleries, often with strangers. In these two cities, venue-based interventions may be more appropriate for male IDUs, whereas personal network interventions may be more appropriate among female IDUs. PMID:16865542

Microcanonical model for interface formation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rucklidge, A.; Zaleski, S.

1988-04-01

We describe a new cellular automaton model which allows us to simulate separation of phases. The model is an extension of existing cellular automata for the Ising model, such as Q2R. It conserves particle number and presents the qualitative features of spinodal decomposition. The dynamics is deterministic and does not require random number generators. The spins exchange energy with small local reservoirs or demons. The rate of relaxation to equilibrium is investigated, and the results are compared to the Lifshitz-Slyozov theory.

Magnetic properties and energy-mapping analysis.

PubMed

Xiang, Hongjun; Lee, Changhoon; Koo, Hyun-Joo; Gong, Xingao; Whangbo, Myung-Hwan

2013-01-28

The magnetic energy levels of a given magnetic solid are closely packed in energy because the interactions between magnetic ions are weak. Thus, in describing its magnetic properties, one needs to generate its magnetic energy spectrum by employing an appropriate spin Hamiltonian. In this review article we discuss how to determine and specify a necessary spin Hamiltonian in terms of first principles electronic structure calculations on the basis of energy-mapping analysis and briefly survey important concepts and phenomena that one encounters in reading the current literature on magnetic solids. Our discussion is given on a qualitative level from the perspective of magnetic energy levels and electronic structures. The spin Hamiltonian appropriate for a magnetic system should be based on its spin lattice, i.e., the repeat pattern of its strong magnetic bonds (strong spin exchange paths), which requires one to evaluate its Heisenberg spin exchanges on the basis of energy-mapping analysis. Other weaker energy terms such as Dzyaloshinskii-Moriya (DM) spin exchange and magnetocrystalline anisotropy energies, which a spin Hamiltonian must include in certain cases, can also be evaluated by performing energy-mapping analysis. We show that the spin orientation of a transition-metal magnetic ion can be easily explained by considering its split d-block levels as unperturbed states with the spin-orbit coupling (SOC) as perturbation, that the DM exchange between adjacent spin sites can become comparable in strength to the Heisenberg spin exchange when the two spin sites are not chemically equivalent, and that the DM interaction between rare-earth and transition-metal cations is governed largely by the magnetic orbitals of the rare-earth cation.

The lambda mechanism of the 0nbb-decay

NASA Astrophysics Data System (ADS)

Šimkovic, Fedor; Štefánik, Dušan; Dvornický, Rastislav

2017-11-01

The lambda mechanism (WL-WR exchange) of the neutrinoless double beta decay (0nbb-decay), which has origin in left-right symmetric model with right-handed gauge boson at TeV scale, is investigated. The revisited formalism of the 0nbb-decay, which includes higher order terms of nucleon current, is exploited. The corresponding nuclear matrix elements are calculated within quasiparticle random phase approximation with partial restoration of the isospin symmetry for nuclei of experimental interest. A possibility to distinguish between the conventional light neutrino mass (WL-WL exchange) and lambda mechanisms by observation of the 0nbb-decay in several nuclei is discussed. A qualitative comparison of effective lepton number violating couplings associated with these two mechanisms is performed. By making viable assumption about the seesaw type mixing of light and heavy neutrinos it is concluded that there is a dominance of the conventional light neutrino mass mechanism in the decay rate.

Insights from mathematical modeling of renal tubular function.

PubMed

Weinstein, A M

1998-01-01

Mathematical models of proximal tubule have been developed which represent the important solute species within the constraints of known cytosolic concentrations, transport fluxes, and overall epithelial permeabilities. In general, model simulations have been used to assess the quantitative feasibility of what appear to be qualitatively plausible mechanisms, or alternatively, to identify incomplete rationalization of experimental observations. The examples considered include: (1) proximal water reabsorption, for which the lateral interspace is a locus for solute-solvent coupling; (2) ammonia secretion, for which the issue is prioritizing driving forces - transport on the Na+/H+ exchanger, on the Na,K-ATPase, or ammoniagenesis; (3) formate-stimulated NaCl reabsorption, for which simple addition of a luminal membrane chloride/formate exchanger fails to represent experimental observation, and (4) balancing luminal entry and peritubular exit, in which ATP-dependent peritubular K+ channels have been implicated, but appear unable to account for the bulk of proximal tubule cell volume homeostasis.

Organizational Uses of Health Information Exchange to Change Cost and Utilization Outcomes: A Typology from a Multi-Site Qualitative Analysis.

PubMed

Vest, Joshua R; Abramson, Erika

2015-01-01

Health information exchange (HIE) systems facilitate access to patient information for a variety of health care organizations, end users, and clinical and organizational goals. While a complex intervention, organizations' usage of HIE is often conceptualized and measured narrowly. We sought to provide greater specificity to the concept of HIE as an intervention by formulating a typology of organizational HIE usage. We interviewed representatives of a regional health information organization and health care organizations actively using HIE information to change patient utilization and costs. The resultant typology includes three dimensions: user role, usage initiation, and patient set. This approach to categorizing how health care organizations are actually applying HIE information to clinical and business tasks provides greater clarity about HIE as an intervention and helps elucidate the conceptual linkage between HIE an organizational and patient outcomes.

"Let him speak:" a descriptive qualitative study of the roles and behaviors of family companions in primary care visits among older adults with cognitive impairment.

PubMed

Vick, Judith B; Amjad, Halima; Smith, Katherine C; Boyd, Cynthia M; Gitlin, Laura N; Roth, David L; Roter, Debra L; Wolff, Jennifer L

2018-01-01

Cognitive impairment poses communication challenges in primary care. Although family "companions" commonly attend primary care visits of older adults with cognitive impairment, little is known about how their involvement affects communication. Therefore, we sought to understand how companion involvement affects the quality of primary care visit communication for older adults with cognitive impairment. Cross-sectional, descriptive qualitative study participants were as follows: (1) English-speaking adults age 65 or older with mild, moderate, or severe cognitive impairment; (2) family members or other unpaid companions who accompany older adults to primary care visits; and (3) primary care clinicians. Twenty semi-structured and in-depth qualitative interviews of older adults and their companions (N = 20 dyads) and two focus groups (N = 10 primary care clinicians) were conducted. Interviews and focus groups were transcribed and analyzed thematically. Family companions commonly facilitate communication by advocating for patients, ensuring the accuracy of information exchange and understanding, and preserving rapport. Significant communication challenges were also identified, including patient and companion role ambiguity, competing visit agendas, and primary care clinician confusion regarding the most accurate source of information. Patients, companions, and clinicians each identified strategies to improve communication, chief among them being to identify, differentiate, and respect both patient and companion priorities and perspectives. Family companions actively participate in primary care visits of older adults with cognitive impairment in ways that promote and inhibit effective communication. Findings suggest the need for strategies that more effectively and purposefully involve family in the care of primary care patients with cognitive impairment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

"Why the hell do we need electronic health records?". EHR acceptance among physicians in private practice in Austria: a qualitative study.

PubMed

Hackl, W O; Hoerbst, A; Ammenwerth, E

2011-01-01

Progress in the medical sciences, together with related technologies, in the past has led to higher specialization and has created a strong need to exchange health information across institutional borders. The concept of electronic health records (EHR) was introduced to fulfill these needs. Remarkably, many EHR introduction projects ran into trouble, not least because they lacked the acceptance of EHR among physicians. Negative emotions, such as anxiety and fear due to a lack of information, may cause change barriers and hamper physicians' acceptance of such projects. The goal of this study was to gain deeper insight into the negative emotions related to the intended implementation of a mandatory national electronic health record system (called ELGA) in Austria among physicians in private practice. Qualitative, problem-centered interviews were conducted with eight physicians in private practice in the capital region of Tyrol. The methods of qualitative content analysis were used to analyze the data. Three hundred and twenty-eight passages in the interviews were selected, annotated, and paraphrased. These passages were assigned to 139 different primary categories. Finally, 18 main categories in the form of statements were derived. They were correlated and a theoretical model was formed to explain the genesis of the detected fears and anxiety related to the ELGA project. The results show that the physicians feel uninformed and snubbed. They fear unknown changes, increased costs, as well as workload and surveillance without obtaining any advantages from using electronic health records in their daily practice. Impartial information campaigns that are tailored to the physicians' needs and questions as along with a comprehensive cost-benefit analysis could benefit the physicians' opinion of EHRs.

The Association Between Law Enforcement Encounters and Syringe Sharing Among IDUs on Skid Row: A Mixed Methods Analysis

PubMed Central

Simon-Freeman, Rebecca; Bluthenthal, Ricky N.

2013-01-01

The legal environment is one factor that influences injection drug users' (IDUs) risk for HIV and other bloodborne pathogens such as hepatitis C virus (HCV). We examined the association between law enforcement encounters (i.e., arrests and citations) and receptive syringe sharing among IDUs in the context of an intensified policing effort. We conducted a mixed methods analysis of 30 qualitative and 187 quantitative interviews with IDUs accessing services at a Los Angeles, CA syringe exchange program from 2008 to 2009. Qualitative findings illustrate concerns related to visibility, drug withdrawal, and previous history of arrest/incarceration. In quantitative analysis, the number of citations received, current homelessness, and perceiving that being arrested would be a “big problem” were independently associated with recent syringe sharing. Findings illustrate some of the unintended public health consequences associated with intensified street-level policing, including risk for HIV and HCV transmission. PMID:23620243

Research and knowledge in Ontario tobacco control networks.

PubMed

Bickford, Julia J; Kothari, Anita R

2008-01-01

This study sought to better understand the role of research knowledge in Ontario tobacco control networks by asking: 1) How is research managed; 2) How is research evaluated; and 3) How is research utilized? This is a secondary analysis of a qualitative study based on individual semistructured interviews with 29 participants between January and May 2006. These participants were purposefully sampled from across four Ministries in the provincial government (n = 7), non-government (n = 15), and public health organizations (n = 7). Interviews were transcribed verbatim and coded and analyzed using QSR N7 qualitative software. This study received ethics approval from The University of Western Ontario Health Research Ethics Board. There exists a dissonance between the preference for peer-reviewed, unbiased, non-partisan knowledge to support claims and the need for fast, "real-time" information on which to base tobacco-related policy decisions. Second, there is a great deal of tacit knowledge held by experts within the Ontario tobacco control community. The networks among government, non-government, and public health organizations are the structures through which tacit knowledge is exchanged. These networks are dynamic, fluid and shifting. There exists a gap in the production and utilization of research knowledge for tobacco control policy. Tacit knowledge held by experts in Ontario tobacco control networks is an integral means of managing and evaluating research knowledge. Finally, this study builds on Weiss's concept of tactical model of evidence use by highlighting the utilization of research to enhance one's credibility.

[Professionalization of Legal Dental Experts in Germany: Results of Studies on Structured Focus Groups].

PubMed

Brauer, H U; Walther, W; Dick, M

2018-04-01

Legal expert opinions are a crucial instrument of professional self-control in medicine. To give impulses for further development, focus groups were initiated to reflect upon the perspective of legal dental experts. 5 focus group discussions on the topic "Professionalization of legal dental experts" were conducted. A total of 32 experienced legal dental experts participated in the discussions. The results were evaluated by qualitative content analysis. A catalogue of 68 ideas was generated for improvement and divided into 15 categories. Among these were periodic quality circles, interprofessional exchange, supervision of novices and periodic feedback for legal dental experts and dentists. Self-reflection can be included as an instrument for quality improvement of legal dental expert opinions. © Georg Thieme Verlag KG Stuttgart · New York.

Social networks of patients with chronic skin lesions: nursing care.

PubMed

Bandeira, Luciana Alves; Santos, Maxuel Cruz Dos; Duarte, Êrica Rosalba Mallmann; Bandeira, Andrea Gonçalves; Riquinho, Deise Lisboa; Vieira, Letícia Becker

2018-01-01

To describe the social networks of patients with chronic skin damages. A qualitative study conducted through semi-structured interviews with nine subjects with chronic skin lesions from June 2016 to March 2017; we used the theoretical-methodological framework of Lia Sanicola's Social Network. The analysis of the relational maps revealed that the primary network was formed mainly by relatives and neighbors; its characteristics, such as: reduced size, low density and few exchanges/relationships, configures fragility in these links. The secondary network was essentially described by health services, and the nurse was cited as a linker in the therapeutic process. Faced with the fragility of the links and social isolation, the primary health care professionals are fundamental foundations for the construction of networks of social support and care for patients with chronic skin lesions.

The Perceived Impact of 42 CFR Part 2 on Coordination and Integration of Care: A Qualitative Analysis.

PubMed

McCarty, Dennis; Rieckmann, Traci; Baker, Robin L; McConnell, K John

2017-03-01

Title 42 of the Code of Federal Regulations Part 2 (42 CFR Part 2) controls the release of patient information about treatment for substance use disorders. In 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a proposed rule to update the regulations, reduce provider burdens, and facilitate information exchange. Oregon's Medicaid program (Oregon Health Plan) altered the financing and structure of medical, dental, and behavioral care to promote greater integration and coordination. A qualitative analysis examined the perceived impact of 42 CFR Part 2 on care coordination and integration. Interviews with 76 stakeholders (114 interviews) conducted in 2012-2015 probed the processes of integrating behavioral health into primary care settings in Oregon and assessed issues associated with adherence to 42 CFR Part 2. Respondents expressed concerns that the regulations caused legal confusion, inhibited communication and information sharing, and required updating. Addiction treatment directors noted the challenges of obtaining patient consent to share information with primary care providers. The confidentiality regulations were perceived as a barrier to care coordination and integration. The Oregon Health Authority, therefore, requested regulatory changes. SAMHSA's proposed revisions permit a general consent to an entire health care team and allow inclusion of substance use disorder information within health information exchanges, but they mandate data segmentation of diagnostic and procedure codes related to substance use disorders and restrict access only to parties with authorized consent, possibly adding barriers to the coordination and integration of addiction treatment with primary care.

Nuclear quantum effects in water exchange around lithium and fluoride ions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilkins, David M.; Manolopoulos, David; Dang, Liem X.

2015-02-14

We employ classical and ring polymer molecular dynamics simulations to study the effect of nuclear quantum fluctuations on the structure and the water exchange dynamics of aqueous solutions of lithium and fluoride ions. While we obtain reasonably good agreement with experimental data for solutions of lithium by augmenting the Coulombic interactions between the ion and the water molecules with a standard Lennard-Jones ion-oxygen potential, the same is not true for solutions of fluoride, for which we find that a potential with a softer repulsive wall gives much better agreement. A small degree of destabilization of the first hydration shell ismore » found in quantum simulations of both ions when compared with classical simulations, with the shell becoming less sharply defined and the mean residence time of the water molecules in the shell decreasing. In line with these modest differences, we find that the mechanisms of the water exchange reactions are unaffected by quantization, so a classical description of these reactions gives qualitatively correct and quantitatively reasonable results. We also find that the quantum effects in solutions of lithium are larger than in solutions of fluoride. This is partly due to the stronger interaction of lithium with water molecules, partly due to the lighter mass of lithium, and partly due to competing quantum effects in the hydration of fluoride, which are absent in the hydration of lithium. LXD was supported by US Department of Energy, Office of Science, Office of Basic Energy Sciences, Division of Chemical Sciences, Geosciences, and Biosciences.« less

Fair relationships and policies to support family day care educators' mental health: a qualitative study.

PubMed

Corr, Lara; Davis, Elise; Cook, Kay; Waters, Elizabeth; LaMontagne, Anthony D

2014-11-25

High quality child care is a population health investment that relies on the capacity of providers. The mental health and wellbeing of child care educators is fundamental to care quality and turnover, yet sector views on the relationship between working conditions and mental health and wellbeing are scarce. This paper examines child care educators' and sector key informants' perspectives on how working in family day care influences educator's mental health and wellbeing. Semi-structured telephone interviews were conducted with Australian family day care educators (n = 16) and key informants (n = 18) comprised of representatives from family day care schemes, government and other relevant organisations regarding the relationship between working conditions and educator mental health. Thematic analysis referenced the assumptions and concepts of critical inquiry and used social exchange theory. Educators and key informants reported that educators' mental health was affected by the quality of their relationships with government, family day care schemes, and the parents and children using their services. These social relationships created and contributed to working conditions that were believed to promote or diminish educators' mental health. High quality relationships featured fair exchanges of educator work for key resources of social support and respect; adequate income; professional services; and information. Crucially, how exchanges influenced educator wellbeing was largely contingent on government policies that reflect the values and inequities present in society. Making policies and relationships between educators, government and family day care schemes fairer would contribute strongly to the protection and promotion of educator mental health and wellbeing, and in turn contribute to workforce stability and care quality.

The growth of a culture of evidence-based obstetrics in South Africa: a qualitative case study

PubMed Central

2011-01-01

Background While the past two decades have seen a shift towards evidence-based obstetrics and midwifery, the process through which a culture of evidence-based practice develops and is sustained within particular fields of clinical practice has not been well documented, particularly in LMICs (low- and middle-income countries). Forming part of a broader qualitative study of evidence-based policy making, this paper describes the development of a culture of evidence-based practice amongst maternal health policy makers and senior academic obstetricians in South Africa Methods A qualitative case-study approach was used. This included a literature review, a policy document review, a timeline of key events and the collection and analysis of 15 interviews with policy makers and academic clinicians involved in these policy processes and sampled using a purposive approach. The data was analysed thematically. Results The concept of evidence-based medicine became embedded in South African academic obstetrics at a very early stage in relation to the development of the concept internationally. The diffusion of this concept into local academic obstetrics was facilitated by contact and exchange between local academic obstetricians, opinion leaders in international research and structures promoting evidence-based practice. Furthermore the growing acceptance of the concept was stimulated locally through the use of existing professional networks and meetings to share ideas and the contribution of local researchers to building the evidence base for obstetrics both locally and internationally. As a testimony to the extent of the diffusion of evidence-based medicine, South Africa has strongly evidence-based policies for maternal health. Conclusion This case study shows that the combined efforts of local and international researchers can create a culture of evidence-based medicine within one country. It also shows that doing so required time and perseverance from international researchers combined with a readiness by local researchers to receive and actively promote the practice. PMID:21443794

Exploring the usefulness of comprehensive care plans for children with medical complexity (CMC): a qualitative study.

PubMed

Adams, Sherri; Cohen, Eyal; Mahant, Sanjay; Friedman, Jeremy N; Macculloch, Radha; Nicholas, David B

2013-01-19

The Medical Home model recommends that Children with Special Health Care Needs (CSHCN) receive a medical care plan, outlining the child's major medical issues and care needs to assist with care coordination. While care plans are a primary component of effective care coordination, the creation and maintenance of care plans is time, labor, and cost intensive, and the desired content of the care plan has not been studied. The purpose of this qualitative study was to understand the usefulness and desired content of comprehensive care plans by exploring the perceptions of parents and health care providers (HCPs) of children with medical complexity (CMC). This qualitative study utilized in-depth semi-structured interviews and focus groups. HCPs (n = 15) and parents (n = 15) of CMC who had all used a comprehensive care plan were recruited from a tertiary pediatric academic health sciences center. Themes were identified through grounded theory analysis of interview and focus group data. A multi-dimensional model of perceived care plan usefulness emerged. The model highlights three integral aspects of the care plan: care plan characteristics, activating factors and perceived outcomes of using a care plan. Care plans were perceived as a useful tool that centralized and focused the care of the child. Care plans were reported to flatten the hierarchical relationship between HCPs and parents, resulting in enhanced reciprocal information exchange and strengthened relationships. Participants expressed that a standardized template that is family-centered and includes content relevant to both the medical and social needs of the child is beneficial when integrated into overall care planning and delivery for CMC. Care plans are perceived to be a useful tool to both health care providers and parents of CMC. These findings inform the utility and development of a comprehensive care plan template as well as a model of how and when to best utilize care plans within family-centered models of care.

Diffusion of the property tax work-off program for senior homeowners in Massachusetts.

PubMed

Prakash, Archana; Caro, Francis G

2010-07-01

Property tax work-off programs (TWOPs) provide senior homeowners with relief from some of their property tax obligations in exchange for services provided to local governments. These programs are offered by some county and municipal governments at their own discretion in a number of states. Through a qualitative study comparing municipalities in Massachusetts that participate in the program with similar communities that do not participate, the authors sought to learn the reasons for both participation and nonparticipation. They interviewed local officials in eight participating and six nonparticipating communities. Mohr's theory for adoption and Roger's theory for diffusion are used for the conceptual framework of the study. Local leaderships' motivation, financial or political resources and obstacles, senior homeowners' awareness, communication between communities, and perceived benefits of the program were the major factors in adoption and diffusion of TWOPs in Massachusetts.

Cesium migration in Hanford sediment: a multisite cation exchange model based on laboratory transport experiments.

PubMed

Steefel, Carl I; Carroll, Susan; Zhao, Pihong; Roberts, Sarah

2003-12-01

Cs+ transport experiments carried out in columns packed with uncontaminated Hanford formation sediment from the SX tank farm provide strong support for the use of a multisite, multicomponent cation exchange model to describe Cs+ migration in the Hanford vadose zone. The experimental results indicate a strong dependence of the effective Cs+ Kd on the concentrations of other cations, including Na+ that is present at high to extremely high concentrations in fluids leaking from the Hanford SX tanks. A strong dependence of the Cs+ Kd on the aqueous Cs+ concentration is also apparent, with retardation of Cs+ increasing from a value of 41 at a Cs+ concentration of 10(-4) M in the feed solution to as much as 282 at a Cs+ concentration of 5x10(-7) M, all in a background of 1 M NaNO3. The total cation exchange capacity (CEC) of the Hanford sediment was determined using 22Na isotopic equilibrium exchange in a flow-through column experiment. The value for the CEC of 120 microeq/g determined with this method is compatible with a value of 121.9 microeq/g determined by multi-cation elution. While two distinct exchange sites were proposed by Zachara et al. [Geochim. Cosmochim. Acta 66 (2002) 193] based on binary batch exchange experiments, a third site is proposed in this study to improve the fit of the Cs+-Na+ and Cs+-Ca+ exchange data and to capture self-sharpened Cs+ breakthrough curves at low concentrations of Cs+. Two of the proposed exchange sites represent frayed edge sites (FES) on weathered micas and constitute 0.02% and 0.22% of the total CEC. Both of the FES show a very strong selectivity for Cs+ over Na+ (K(Na-Cs)=10(7.22) and 10(4.93), respectively). The third site, accounting for over 99% of the total CEC, is associated with planar sites on expansible clays and shows a smaller Na+-Cs+ selectivity coefficient of 10(1.99). Parameters derived from a fit of binary batch experiments alone tend to under predict Cs+ retardation in the column experiments. The transport experiments indicate 72-90% of the Cs+ sorbed in experiments targeting exchange on FES was desorbed over a 10- and 24-day period, respectively. At high Cs+ concentrations, where sorption is controlled primarily by exchange on planar sites, 95% of the Cs+ desorption was desorbed. Most of the difficulty in desorbing Cs+ from FES is a result of the extremely high selectivity of these sites for Cs+, although truly irreversible sorption as high as 23% was suggested in one experiment. The conclusion that Cs+ exchange is largely reversible in a thermodynamic sense is supported by the ability to match Cs+ desorption curves almost quantitatively with an equilibrium reactive transport simulation. The model for Cs+ retardation developed here qualitatively explains the behavior of Cs+ in the Hanford vadose zone underneath a variety of leaking tanks with differing salt concentrations. The high selectivity of FES for Cs+ implies that future desorption and migration is very unlikely to occur under natural recharge conditions.

"I want to know everything": a qualitative study of perspectives from patients with chronic diseases on sharing health information during hospitalization.

PubMed

Benham-Hutchins, Marge; Staggers, Nancy; Mackert, Michael; Johnson, Alisha H; deBronkart, Dave

2017-08-04

Patient-centered care promotes the inclusion of the most prominent and important member of the health care team, the patient, as an active participant in information exchange and decision making. Patient self-management of a chronic disease requires the patient to bridge the gap between multiple care settings and providers. Hospitalizations often disrupt established self-management routines. Access to medical information during hospitalization reflects patients' rights to partner in their own care and has the potential to improve self-management as well as promote informed decision making during and after hospitalization. The objectives of this study were to elicit the perspectives of patients with chronic disease about desired medical information content and access during hospitalization. This exploratory study incorporated a qualitative approach. The online survey included the research team created open and limited response survey, demographic and hospital characteristic questions, and the Patient Activation Measurement instrument (PAM®). Convenience and social media snowball sampling were used to recruit participants through patient support groups, email invitations, listservs, and blogs. The research team employed descriptive statistics and qualitative content analysis techniques. The study sample (n = 34) ranged in age from 20 to 76 (μ = 48; SD = 16.87), Caucasian (91%, n = 31), female (88%, n = 30) and very highly educated (64%, n = 22 were college graduates). The PAM® survey revealed a highly activated sample. Qualitative analysis of the open-ended question responses resulted in six themes: Caring for myself; I want to know everything; Include me during handoff and rounds; What I expect; You're not listening; and Tracking my health information. This study revealed that hospitalized patients want to be included in provider discussions, such as nursing bedside handoff and medical rounds. Only a few participants had smooth transitions from hospital to home. Participants expressed frustration with failures in communication among their providers during and after hospitalization and provider behaviors that interfered with patient provider communication processes. Patients also identified interest in maintaining their own health histories and information but most had to "cobble together" a myriad of methods to keep track of their evolving condition during hospitalization.

Access to healthcare insurance and healthcare services among syringe exchange program clients in Massachusetts: qualitative findings from health navigators with the iDU ("I do") Care Collaborative.

PubMed

Stopka, Thomas J; Hutcheson, Marguerite; Donahue, Ashley

2017-05-18

Little is known about access to health insurance among people who inject drugs (PWID) who attend syringe exchange programs (SEPs). The goal of the current study was to assess perceptions of SEP staff, including health navigators and program managers, on access to health insurance and healthcare access among SEP clients following implementation of state and federal policies to enhance universal healthcare access in Massachusetts. Between December 2014 and January 2015, we conducted in-depth interviews (n = 14) with SEP staff, including both program managers and health navigators, to assess knowledge, attitudes, and beliefs related to health insurance enrollment and access to enhanced referrals among SEP clients. We developed a preliminary coding scheme from the interview guide and used a grounded theory approach to guide inclusion of subsequent thematic codes that emanated from the data. We analyzed the coded data thematically in an iterative fashion using a consensus-based approach. We identified five primary themes that emerged from the qualitative interviews, including high levels of health insurance enrollment among SEP clients; barriers to enrolling in health insurance; highly needed referrals to services, including improved access to substance use disorder treatment and hepatitis C virus treatment; barriers to referring clients to these highly needed services; and recommendations for policy change. While barriers to enrollment and highly needed referrals remain, access to and enrollment in healthcare insurance plans among PWID at SEPs in Massachusetts are high. With the uncertain stability of the Affordable Care Act following the US presidential election of 2016, our findings summarize the opportunities and challenges that are connected to health insurance and healthcare access in Massachusetts. SEPs can play an important role in facilitating access to health insurance and enhancing access to preventive health and primary care.

Evaluation of exchange-correlation functionals for time-dependent density functional theory calculations on metal complexes.

PubMed

Holland, Jason P; Green, Jennifer C

2010-04-15

The electronic absorption spectra of a range of copper and zinc complexes have been simulated by using time-dependent density functional theory (TD-DFT) calculations implemented in Gaussian03. In total, 41 exchange-correlation (XC) functionals including first-, second-, and third-generation (meta-generalized gradient approximation) DFT methods were compared in their ability to predict the experimental electronic absorption spectra. Both pure and hybrid DFT methods were tested and differences between restricted and unrestricted calculations were also investigated by comparison of analogous neutral zinc(II) and copper(II) complexes. TD-DFT calculated spectra were optimized with respect to the experimental electronic absorption spectra by use of a Matlab script. Direct comparison of the performance of each XC functional was achieved both qualitatively and quantitatively by comparison of optimized half-band widths, root-mean-squared errors (RMSE), energy scaling factors (epsilon(SF)), and overall quality-of-fit (Q(F)) parameters. Hybrid DFT methods were found to outperform all pure DFT functionals with B1LYP, B97-2, B97-1, X3LYP, and B98 functionals providing the highest quantitative and qualitative accuracy in both restricted and unrestricted systems. Of the functionals tested, B1LYP gave the most accurate results with both average RMSE and overall Q(F) < 3.5% and epsilon(SF) values close to unity (>0.990) for the copper complexes. The XC functional performance in spin-restricted TD-DFT calculations on the zinc complexes was found to be slightly worse. PBE1PBE, mPW1PW91 and B1LYP gave the most accurate results with typical RMSE and Q(F) values between 5.3 and 7.3%, and epsilon(SF) around 0.930. These studies illustrate the power of modern TD-DFT calculations for exploring excited state transitions of metal complexes. 2009 Wiley Periodicals, Inc.

Ion transport in proximal colon of the rat. Sodium depletion stimulates neutral sodium chloride absorption.

PubMed Central

Foster, E S; Budinger, M E; Hayslett, J P; Binder, H J

1986-01-01

The model of sodium and chloride transport proposed for the colon is based on studies performed in the distal segment and tacitly assumes that ion transport is similar throughout the colon. In rat distal colon, neutral sodium-chloride absorption accounts for the major fraction of overall sodium absorption and aldosterone stimulates electrogenic, amiloride-sensitive sodium absorption. Since we have demonstrated qualitative differences in potassium transport in proximal and distal segments of rat colon, unidirectional 22Na and 36Cl fluxes were performed under short-circuit conditions across isolated proximal colon of control and sodium-depleted rats with secondary hyperaldosteronism. In the control group, net sodium absorption (JNanet) (7.4 +/- 0.5 mu eq/h . cm2) was greater than Isc (1.4 +/- 0.1 mu eq/h . cm2), and JClnet was 0 in Ringer solution. Residual flux (JR) was -5.2 +/- 0.5 mu eq/h . cm2 consistent with hydrogen ion secretion suggesting that neutral sodium absorption may represent sodium-hydrogen exchange. 1 mM mucosal amiloride, which inhibits sodium-hydrogen exchange in other epithelia, produced comparable decreases in JNanet and JR (4.1 +/- 0.6 and 3.2 +/- 0.6 mu eq/h . cm2, respectively) without a parallel fall in Isc. Sodium depletion stimulated JNanet, JClnet, and Isc by 7.0 +/- 1.4, 6.3 +/- 1.9, and 0.8 +/- 0.2 mu eq/h . cm2, respectively, and 1 mM amiloride markedly inhibited JNanet and JClnet by 6.0 +/- 1.1 and 4.0 +/- 1.6 mu eq/h . cm2, respectively, with only a minimal reduction in Isc. Conclusions: the predominant neutral sodium-absorptive mechanism in proximal colon is sodium-hydrogen exchange. Sodium depletion stimulates electroneutral chloride-dependent sodium absorption (most likely as a result of increasing sodium-hydrogen and chloride-bicarbonate exchanges), not electrogenic chloride-independent sodium transport. The model of ion transport in the proximal colon is distinct from that of the distal colon. PMID:2418060

Functional respiratory morphology in the newborn quokka wallaby (Setonix brachyurus)

PubMed Central

Makanya, A N; Tschanz, S A; Haenni, B; Burri, P H

2007-01-01

A morphological and morphometric study of the lung of the newborn quokka wallaby (Setonix brachyurus) was undertaken to assess its morphofunctional status at birth. Additionally, skin structure and morphometry were investigated to assess the possibility of cutaneous gas exchange. The lung was at canalicular stage and comprised a few conducting airways and a parenchyma of thick-walled tubules lined by stretches of cuboidal pneumocytes alternating with squamous epithelium, with occasional portions of thin blood–gas barrier. The tubules were separated by abundant intertubular mesenchyme, aggregations of developing capillaries and mesenchymal cells. Conversion of the cuboidal pneumocytes to type I cells occurred through cell broadening and lamellar body extrusion. Superfluous cuboidal cells were lost through apoptosis and subsequent clearance by alveolar macrophages. The establishment of the thin blood–gas barrier was established through apposition of the incipient capillaries to the formative thin squamous epithelium. The absolute volume of the lung was 0.02 ± 0.001 cm3 with an air space surface area of 4.85 ± 0.43 cm2. Differentiated type I pneumocytes covered 78% of the tubular surface, the rest 22% going to long stretches of type II cells, their precursors or low cuboidal transitory cells with sparse lamellar bodies. The body weight-related diffusion capacity was 2.52 ± 0.56 mL O2 min−1 kg−1. The epidermis was poorly developed, and measured 29.97 ± 4.88 µm in thickness, 13% of which was taken by a thin layer of stratum corneum, measuring 4.87 ± 0.98 µm thick. Superficial capillaries were closely associated with the epidermis, showing the possibility that the skin also participated in some gaseous exchange. Qualitatively, the neonate quokka lung had the basic constituents for gas exchange but was quantitatively inadequate, implying the significance of percutaneous gas exchange. PMID:17553103

Managing Everyday Life: A Qualitative Study of Patients’ Experiences of a Web-Based Ulcer Record for Home-Based Treatment

PubMed Central

Trondsen, Marianne V.

2014-01-01

Chronic skin ulcers are a significant challenge for patients and health service resources, and ulcer treatment often requires the competence of a specialist. Although e-health interventions are increasingly valued for ulcer care by giving access to specialists at a distance, there is limited research on patients’ use of e-health services for home-based ulcer treatment. This article reports an exploratory qualitative study of the first Norwegian web-based counselling service for home-based ulcer treatment, established in 2011 by the University Hospital of North Norway (UNN). Community nurses, general practitioners (GPs) and patients are offered access to a web-based record system to optimize ulcer care. The web-based ulcer record enables the exchange and storage of digital photos and clinical information, by the use of which, an ulcer team at UNN, consisting of specialized nurses and dermatologists, is accessible within 24 h. This article explores patients’ experiences of using the web-based record for their home-based ulcer treatment without assistance from community nurses. Semi-structured interviews were conducted with a total of four patients who had used the record. The main outcomes identified were: autonomy and flexibility; safety and trust; involvement and control; and motivation and hope. These aspects improved the patients’ everyday life during long-term ulcer care and can be understood as stimulating patient empowerment. PMID:27429289

Socioecological factors influencing women's HIV risk in the United States: qualitative findings from the women's HIV SeroIncidence study (HPTN 064).

PubMed

Frew, Paula M; Parker, Kimberly; Vo, Linda; Haley, Danielle; O'Leary, Ann; Diallo, Dazon Dixon; Golin, Carol E; Kuo, Irene; Soto-Torres, Lydia; Wang, Jing; Adimora, Adaora A; Randall, Laura A; Del Rio, Carlos; Hodder, Sally

2016-08-17

We sought to understand the multilevel syndemic factors that are concurrently contributing to the HIV epidemic among women living in the US. We specifically examined community, network, dyadic, and individual factors to explain HIV vulnerability within a socioecological framework. We gathered qualitative data (120 interviews and 31 focus groups) from a subset of women ages 18-44 years (N = 2,099) enrolled in the HPTN 064 HIV seroincidence estimation study across 10 US communities. We analyzed data from 4 diverse locations: Atlanta, New York City (the Bronx), Raleigh, and Washington, DC. Data were thematically coded using grounded theory methodology. Intercoder reliability was assessed to evaluate consistency of team-based coding practices. The following themes were identified at 4 levels including 1) exosystem (community): poverty prevalence, discrimination, gender imbalances, community violence, and housing challenges; 2) mesosystem (network): organizational social support and sexual concurrency; 3) microsystem (dyadic): sex exchange, interpersonal social support, intimate partner violence; and 4) individual: HIV/STI awareness, risk taking, and substance use. A strong theme emerged with over 80 % of responses linked to the fundamental role of financial insecurity underlying risk-taking behavioral pathways. Multilevel syndemic factors contribute to women's vulnerability to HIV in the US. Financial insecurity is a predominant theme, suggesting the need for tailored programming for women to reduce HIV risk. Clinicaltrials.gov, NCT00995176.

What do external consultants from private and not-for-profit companies offer healthcare commissioners? A qualitative study of knowledge exchange

PubMed Central

Wye, Lesley; Brangan, Emer; Cameron, Ailsa; Gabbay, John; Klein, Jonathan H; Anthwal, Rachel; Pope, Catherine

2015-01-01

Objectives The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. Setting NHS commissioning organisations and private and not-for-profit providers. Design Mixed methods case study of eight cases. Data collection 92 interviews with external consultants (n=36), their clients (n=47) and others (n=9). Observation of 25 training events and meetings. Documentation, for example, meeting minutes and reports. Analysis Constant comparison. Data were coded, summarised and analysed by the research team with a coding framework to facilitate cross-case comparison. Results In the four contracts presented here, external providers offered technical solutions (eg, software tools), outsourcing and expertise including project management, data interpretation and brokering relationships with experts. In assessing perceived impact on quality of commissioning, two contracts had limited value, one had short-term benefits and one provided short and longer term benefits. Contracts with commissioners actively learning, embedding and applying new skills were more valued. Other elements of success were: (1) addressing clearly agreed problems of relevance to managerial and operational staff (2) solutions co-produced at all organisational levels (3) external consultants working directly with clients to interpret data outputs to inform locally contextualised commissioning strategies. Without explicit knowledge exchange strategies, outsourcing commissioning to external providers resulted in the NHS clients becoming dependent. Conclusions NHS commissioning will be disadvantaged if commissioners both fail to learn in the short term from the knowledge of external providers and in the longer term lose local skills. Knowledge exchange mechanisms are a vital component of commissioning and should be embedded in external provider contracts. PMID:25716174

Two Studies on Twitter Networks and Tweet Content in Relation to Amyotrophic Lateral Sclerosis (ALS): Conversation, Information, and 'Diary of a Daily Life'.

PubMed

Hemsley, Bronwyn; Palmer, Stuart

2016-01-01

To date, there is no research examining how adults with Amyotrophic Lateral Sclerosis (ALS) or Motor Neurone Disease (MND) and severe communication disability use Twitter, nor the use of Twitter in relation to ALS/MND beyond its use for fundraising and raising awareness. In this paper we (a) outline a rationale for the use of Twitter as a method of communication and information exchange for adults with ALS/MND, (b) detail multiple qualitative and quantitative methods used to analyse Twitter networks and tweet content in the our studies, and (c) present the results of two studies designed to provide insights on the use of Twitter by an adult with ALS/MND and by #ALS and #MND hashtag communities in Twitter. We will also discuss findings across the studies, implications for health service providers in Twitter, and directions for future Twitter research in relation to ALS/MND.

A lanthanide complex with dual biosensing properties: CEST (chemical exchange saturation transfer) and BIRDS (biosensor imaging of redundant deviation in shifts) with europium DOTA-tetraglycinate.

PubMed

Coman, Daniel; Kiefer, Garry E; Rothman, Douglas L; Sherry, A Dean; Hyder, Fahmeed

2011-12-01

Responsive contrast agents (RCAs) composed of lanthanide(III) ion (Ln3R) complexes with a variety of1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetate (DOTA4S) derivatives have shown great potential as molecular imaging agents for MR. A variety of LnDOTA–tetraamide complexes have been demonstrated as RCAs for molecular imaging using chemical exchange saturation transfer (CEST). The CEST method detects proton exchange between bulk water and any exchangeable sites on the ligand itself or an inner sphere of bound water that is shifted by a paramagnetic Ln3R ion bound in the core of the macrocycle. It has also been shown that molecular imaging is possible when the RCA itself is observed (i.e. not its effect on bulk water) using a method called biosensor imaging of redundant deviation in shifts (BIRDS). The BIRDS method utilizes redundant information stored in the nonexchangeable proton resonances emanating from the paramagnetic RCA for ambient factors such as temperature and/or pH.Thus, CEST and BIRDS rely on exchangeable and nonexchangeable protons, respectively, for biosensing. We posited that it would be feasible to combine these two biosensing features into the same RCA (i.e. dual CEST and BIRDS properties). A complex between europium(III) ion (Eu3R) and DOTA–tetraglycinate [DOTA–(gly)S4] was used to demonstrate that its CEST characteristics are preserved, while its BIRDS properties are also detectable. The in vitro temperature sensitivity of EuDOTA–(gly)S4 was used to show that qualitative MR contrast with CEST can be calibrated using quantitative MR mapping with BIRDS, thereby enabling quantitative molecular imaging at high spatial resolution.

A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations.

PubMed

Jones, Christine D; Vu, Maihan B; O'Donnell, Christopher M; Anderson, Mary E; Patel, Snehal; Wald, Heidi L; Coleman, Eric A; DeWalt, Darren A

2015-04-01

Care coordination between adult hospitalists and primary care providers (PCPs) is a critical component of successful transitions of care from hospital to home, yet one that is not well understood. The purpose of this study was to understand the challenges in coordination of care, as well as potential solutions, from the perspective of hospitalists and PCPs in North Carolina. We conducted an exploratory qualitative study with 58 clinicians in four hospitalist focus groups (n = 32), three PCP focus groups (n = 19), and one hybrid group with both hospitalists and PCPs (n = 7). Interview guides included questions about care coordination, information exchange, follow-up care, accountability, and medication management. Focus group sessions were recorded, transcribed verbatim, and analyzed in ATLAS.ti. The constant comparative method was used to evaluate differences between hospitalists and PCPs. Hospitalists and PCPs were found to encounter similar care coordination challenges, including (1) lack of time, (2) difficulty reaching other clinicians, (3) lack of personal relationships with other clinicians, (4) lack of information feedback loops, (5) medication list discrepancies, and (6) lack of clarity regarding accountability for pending tests and home health. Hospitalists additionally noted difficulty obtaining timely follow-up appointments for after-hours or weekend discharges. PCPs additionally noted (1) not knowing when patients were hospitalized, (2) not having hospital records for post-hospitalization appointments, (3) difficulty locating important information in discharge summaries, and (4) feeling undervalued when hospitalists made medication changes without involving PCPs. Hospitalists and PCPs identified common themes of successful care coordination as (1) greater efforts to coordinate care for "high-risk" patients, (2) improved direct telephone access to each other, (3) improved information exchange through shared electronic medical records, (4) enhanced interpersonal relationships, and (5) clearly defined accountability. Hospitalists and PCPs encounter similar challenges in care coordination, yet have important experiential differences related to sending and receiving roles for hospital discharges. Efforts to improve coordination of care between hospitalists and PCPs should aim to understand perspectives of clinicians in each setting.

Measuring the impact of a health information exchange intervention on provider-based notifiable disease reporting using mixed methods: a study protocol.

PubMed

Dixon, Brian E; Grannis, Shaun J; Revere, Debra

2013-10-30

Health information exchange (HIE) is the electronic sharing of data and information between clinical care and public health entities. Previous research has shown that using HIE to electronically report laboratory results to public health can improve surveillance practice, yet there has been little utilization of HIE for improving provider-based disease reporting. This article describes a study protocol that uses mixed methods to evaluate an intervention to electronically pre-populate provider-based notifiable disease case reporting forms with clinical, laboratory and patient data available through an operational HIE. The evaluation seeks to: (1) identify barriers and facilitators to implementation, adoption and utilization of the intervention; (2) measure impacts on workflow, provider awareness, and end-user satisfaction; and (3) describe the contextual factors that impact the effectiveness of the intervention within heterogeneous clinical settings and the HIE. The intervention will be implemented over a staggered schedule in one of the largest and oldest HIE infrastructures in the U.S., the Indiana Network for Patient Care. Evaluation will be conducted utilizing a concurrent design mixed methods framework in which qualitative methods are embedded within the quantitative methods. Quantitative data will include reporting rates, timeliness and burden and report completeness and accuracy, analyzed using interrupted time-series and other pre-post comparisons. Qualitative data regarding pre-post provider perceptions of report completeness, accuracy, and timeliness, reporting burden, data quality, benefits, utility, adoption, utilization and impact on reporting workflow will be collected using semi-structured interviews and open-ended survey items. Data will be triangulated to find convergence or agreement by cross-validating results to produce a contextualized portrayal of the facilitators and barriers to implementation and use of the intervention. By applying mixed research methods and measuring context, facilitators and barriers, and individual, organizational and data quality factors that may impact adoption and utilization of the intervention, we will document whether and how the intervention streamlines provider-based manual reporting workflows, lowers barriers to reporting, increases data completeness, improves reporting timeliness and captures a greater portion of communicable disease burden in the community.

Implementing the Baby One Program: a qualitative evaluation of family-centred child health promotion in remote Australian Aboriginal communities.

PubMed

Campbell, Sandra; McCalman, Janya; Redman-MacLaren, Michelle; Canuto, Karla; Vine, Kristina; Sewter, Jenny; McDonald, Malcolm

2018-03-24

A healthy start predicts better health in later life. Many remote-living Aboriginal and Torres Strait Islander Australian families lack access to consistent, culturally-safe health services. This paper presents a study of implementation of the Baby One Program (BOP). The BOP was designed as a family-centred, Indigenous Healthworker-led, home-visiting model of care focused on promoting family health to give children the best start to life. It was developed by Aboriginal community-controlled Apunipima Cape York Health Council and delivered in Queensland Cape York remote communities. We aimed to determine how the BOP was implemented, enablers, strategies used and formative implementation outcomes. The qualitative approach utilised theoretical and purposive sampling to explore people's experiences of a program implementation process. Data were generated from semi-structured interviews with four family members enrolled in the BOP and 24 Apunipima staff members. In addition, twenty community members, including two program users, participated in a men's community focus group. The findings are presented according to themes arising from the data. The BOP was rolled out in nine remote Cape York communities between July 2014 and December 2015 and there was high uptake. Indigenous Healthworkers were supported by midwives and maternal and child health nurses to deliver health education to 161 eligible families. The key to effective implementation of family-centred care appeared to be the relationships formed between health practitioners, especially Indigenous Healthworkers, and families. The data revealed the following themes: challenging environments for new families and valuing cultural ways, resourcing program delivery, working towards a team approach, negotiating the cultural interface, engaging families, exchanging knowledge through 'yarning', strengthening the workforce, and seeing health changes in families. Healthworker education and training, and knowledge exchange between Healthworkers, midwives and nurses was critical to program effectiveness. The program continues to grow despite substantial logistic, financial and practical challenges. This study describes an evolving process and explores how health providers connect with families and how the program responds to family and cultural issues. Program development is ongoing; strengthened by more community-level involvement, embedded strategies for ongoing self-evaluation and continuous quality improvements that are responsive to family needs.

Foreign Exchange Value-at-Risk with Multiple Currency Exposure: A Multivariate and Copula Generalized Autoregressive Conditional Heteroskedasticity Approach

DTIC Science & Technology

2014-11-01

du taux de change, et les responsables de la gestion interne se voient donc pressés de trouver des ... mesurer les effets négatifs que peuvent avoir les fluctuations mo- nétaires sur le budget et la planification du MDN, il faut connaître le poids des ...qualités comparables et qu’ils permettent d’effectuer une meilleure évaluation du risque qu’avec la méthode courante. On obtient désormais des estimations de

Amino acid analysis

NASA Technical Reports Server (NTRS)

Winitz, M.; Graff, J. (Inventor)

1974-01-01

The process and apparatus for qualitative and quantitative analysis of the amino acid content of a biological sample are presented. The sample is deposited on a cation exchange resin and then is washed with suitable solvents. The amino acids and various cations and organic material with a basic function remain on the resin. The resin is eluted with an acid eluant, and the eluate containing the amino acids is transferred to a reaction vessel where the eluant is removed. Final analysis of the purified acylated amino acid esters is accomplished by gas-liquid chromatographic techniques.

Axelrod's model with surface tension

NASA Astrophysics Data System (ADS)

Pace, Bruno; Prado, Carmen P. C.

2014-06-01

In this work we propose a subtle change in Axelrod's model for the dissemination of culture. The mechanism consists of excluding from the set of potentially interacting neighbors those that would never possibly exchange. Although the alteration proposed does not alter the state space topologically, it yields significant qualitative changes, specifically the emergence of surface tension, driving the system in some cases to metastable states. The transient behavior is considerably richer, and cultural regions become stable leading to the formation of different spatiotemporal patterns. A metastable "glassy" phase emerges between the globalized phase and the disordered, multicultural phase.

Spin Mode Switching at the Edge of a Quantum Hall System.

PubMed

Khanna, Udit; Murthy, Ganpathy; Rao, Sumathi; Gefen, Yuval

2017-11-03

Quantum Hall states can be characterized by their chiral edge modes. Upon softening the edge potential, the edge has long been known to undergo spontaneous reconstruction driven by charging effects. In this Letter we demonstrate a qualitatively distinct phenomenon driven by exchange effects, in which the ordering of the edge modes at ν=3 switches abruptly as the edge potential is made softer, while the ordering in the bulk remains intact. We demonstrate that this phenomenon is robust, and has many verifiable experimental signatures in transport.

It takes two to tango: A dyadic approach to understanding the medication dialogue in patient-provider relationships.

PubMed

Schoenthaler, Antoinette; Basile, Melissa; West, Tessa V; Kalet, Adina

2018-08-01

To describe typologies of dyadic communication exchanges between primary care providers and their hypertensive patients about prescribed antihypertensive medications. Qualitative analysis of 94 audiotaped patient-provider encounters, using grounded theory methodology. Four types of dyadic exchanges were identified: Interactive (53% of interactions), divergent-traditional (24% of interactions), convergent-traditional (17% of interactions) and disconnected (6% of interactions). In the interactive and convergent-traditional types, providers adopted a patient-centered approach and used communication behaviors to engage patients in the relationship. Patients in these interactions adopted either an active role in the visit (interactive), or a passive role (convergent-traditional). The divergent-traditional type was characterized by provider verbal dominance, which inhibited patients' ability to ask questions, seek information, or check understanding of information. In the disconnected types, providers used mainly closed-ended questions and terse directives to gather and convey information, which was often disregarded by patients who instead diverted the conversation to psychosocial issues. This study identified interdependent patient-provider communication styles that can either facilitate or hinder discussions about prescribed medications. Examining the processes that underlie dyadic communication in patient-provider interactions is an essential first step to developing interventions that can improve the patient-provider relationship and patient health behaviors. Copyright © 2018 Elsevier B.V. All rights reserved.

Itinerant electrons in the Coulomb phase

NASA Astrophysics Data System (ADS)

Jaubert, L. D. C.; Piatecki, Swann; Haque, Masudul; Moessner, R.

2012-02-01

We study the interplay between magnetic frustration and itinerant electrons. For example, how does the coupling to mobile charges modify the properties of a spin liquid, and does the underlying frustration favor insulating or conducting states? Supported by Monte Carlo simulations, our goal is in particular to provide an analytical picture of the mechanisms involved. The models under consideration exhibit Coulomb phases in two and three dimensions, where the itinerant electrons are coupled to the localized spins via double exchange interactions. Because of the Hund coupling, magnetic loops naturally emerge from the Coulomb phase and serve as conducting channels for the mobile electrons, leading to doping-dependent rearrangements of the loop ensemble in order to minimize the electronic kinetic energy. At low electron density ρ, the double exchange coupling mainly tends to segment the very long loops winding around the system into smaller ones while it gradually lifts the extensive degeneracy of the Coulomb phase with increasing ρ. For higher doping, the results are strongly lattice dependent, displaying loop crystals with a given loop length for some specific values of ρ. By varying ρ, they can melt into different mixtures of these loop crystals, recovering extensive degeneracy in the process. Finally, we contrast this to the qualitatively different behavior of analogous models on kagome or triangular lattices.

Covalent bonds against magnetism in transition metal compounds

PubMed Central

Streltsov, Sergey V.; Khomskii, Daniel I.

2016-01-01

Magnetism in transition metal compounds is usually considered starting from a description of isolated ions, as exact as possible, and treating their (exchange) interaction at a later stage. We show that this standard approach may break down in many cases, especially in 4d and 5d compounds. We argue that there is an important intersite effect—an orbital-selective formation of covalent metal–metal bonds that leads to an “exclusion” of corresponding electrons from the magnetic subsystem, and thus strongly affects magnetic properties of the system. This effect is especially prominent for noninteger electron number, when it results in suppression of the famous double exchange, the main mechanism of ferromagnetism in transition metal compounds. We study this mechanism analytically and numerically and show that it explains magnetic properties of not only several 4d–5d materials, including Nb2O2F3 and Ba5AlIr2O11, but can also be operative in 3d transition metal oxides, e.g., in CrO2 under pressure. We also discuss the role of spin–orbit coupling on the competition between covalency and magnetism. Our results demonstrate that strong intersite coupling may invalidate the standard single-site starting point for considering magnetism, and can lead to a qualitatively new behavior. PMID:27601669

Insights into the distribution of water in a self-humidifying H2/O2 proton-exchange membrane fuel cell using 1H NMR microscopy.

PubMed

Feindel, Kirk W; Bergens, Steven H; Wasylishen, Roderick E

2006-11-01

Proton ((1)H) NMR microscopy is used to investigate in-situ the distribution of water throughout a self-humidifying proton-exchange membrane fuel cell, PEMFC, operating at ambient temperature and pressure on dry H(2)(g) and O(2)(g). The results provide the first experimental images of the in-plane distribution of water within the PEM of a membrane electrode assembly in an operating fuel cell. The effect of gas flow configuration on the distribution of water in the PEM and cathode flow field is investigated, revealing that the counter-flow configurations yield a more uniform distribution of water throughout the PEM. The maximum power output from the PEMFC, while operating under conditions of constant external load, occurs when H(2)O(l) is first visible in the (1)H NMR image of the cathode flow field, and subsequently declines as this H(2)O(l) continues to accumulate. The (1)H NMR microscopy experiments are in qualitative agreement with predictions from several theoretical modeling studies (e.g., Pasaogullari, U.; Wang, C. Y. J. Electrochem. Soc. 2005, 152, A380-A390), suggesting that combined theoretical and experimental approaches will constitute a powerful tool for PEMFC design, diagnosis, and optimization.

Excited configurations of hydrogen in the BaTiO3 -xHx perovskite lattice associated with hydrogen exchange and transport

NASA Astrophysics Data System (ADS)

Ito, T. U.; Koda, A.; Shimomura, K.; Higemoto, W.; Matsuzaki, T.; Kobayashi, Y.; Kageyama, H.

2017-01-01

Excited configurations of hydrogen in the oxyhydride BaTiO3 -xHx (x =0.1 -0.5 ), which are considered to be involved in its hydrogen transport and exchange processes, were investigated by positive muon spin relaxation spectroscopy using muonium (Mu) as a pseudoisotope of hydrogen. Muons implanted into the BaTiO3 -xHx perovskite lattice were mainly found in two qualitatively different metastable states. One was assigned to a highly mobile interstitial protonic state, which is commonly observed in perovskite oxides. The other was found to form an entangled two spin-1/2 system with the nuclear spin of an H- ion at the anion site. The structure of the (H,Mu) complex agrees well with that of a neutralized center containing two H- ions at a doubly charged oxygen vacancy, which was predicted to form in the SrTiO3 -δ perovskite lattice by a computational study [Y. Iwazaki et al., APL Mater. 2, 012103 (2014), 10.1063/1.4854355]. Above 100 K, interstitial Mu+ diffusion and retrapping to a deep defect were observed, which could be a rate-limiting step of macroscopic Mu/H transport in the BaTiO3 -xHx lattice.

Rapid spread of complex change: a case study in inpatient palliative care.

PubMed

Della Penna, Richard; Martel, Helene; Neuwirth, Esther B; Rice, Jennifer; Filipski, Marta I; Green, Jennifer; Bellows, Jim

2009-12-29

Based on positive findings from a randomized controlled trial, Kaiser Permanente's national executive leadership group set an expectation that all Kaiser Permanente and partner hospitals would implement a consultative model of interdisciplinary, inpatient-based palliative care (IPC). Within one year, the number of IPC consultations program-wide increased almost tenfold from baseline, and the number of teams nearly doubled. We report here results from a qualitative evaluation of the IPC initiative after a year of implementation; our purpose was to understand factors supporting or impeding the rapid and consistent spread of a complex program. Quality improvement study using a case study design and qualitative analysis of in-depth semi-structured interviews with 36 national, regional, and local leaders. Compelling evidence of impacts on patient satisfaction and quality of care generated 'pull' among adopters, expressed as a remarkably high degree of conviction about the value of the model. Broad leadership agreement gave rise to sponsorship and support that permeated the organization. A robust social network promoted knowledge exchange and built on an existing network with a strong interest in palliative care. Resource constraints, pre-existing programs of a different model, and ambiguous accountability for implementation impeded spread. A complex, hospital-based, interdisciplinary intervention in a large health care organization spread rapidly due to a synergy between organizational 'push' strategies and grassroots-level pull. The combination of push and pull may be especially important when the organizational context or the practice to be spread is complex.

Interdisciplinary collaboration experiences in creating an everyday rehabilitation model: a pilot study

PubMed Central

Moe, Aud; Brataas, Hildfrid V

2016-01-01

Background When functional impairment occurs, assistance to achieve self-help can lead to qualitatively more active everyday life for recipients and better use of community resources. Home-based everyday rehabilitation is a new interdisciplinary service for people living at home. Rehabilitation involves meeting the need for interprofessional services, interdisciplinary collaboration, and coordination of services. Everyday rehabilitation is a service that requires close interdisciplinary cooperation. The purpose of this study was to gain knowledge about employees’ experiences with establishing a new multidisciplinary team and developing a team-based work model. Method The study had a qualitative design using two focus group interviews with a newly established rehabilitation team. The sample consisted of an occupational therapist, two care workers with further education in rehabilitation, a nurse, a physiotherapist, and a project leader. Data were analyzed by thematic content analysis. Results The data highlight three phases: a planning phase (ten meetings over half a year), a startup phase of trials of interdisciplinary everyday rehabilitation in practice (2 months), and a third period specifying and implementing an everyday rehabilitation model (6 months). During these phases, three themes emerged: 1) team creation and design of the service, 2) targeted practical trials, and 3) equality of team members and combining interdisciplinary methods. Conclusion The team provided information about three processes: developing work routines and a revised team-based flow chart, developing team cooperation with integrated Trans- and interdisciplinary collaboration, and working with external exchange. There is more need for secure network solutions. PMID:27143911

[The study of establishment of the " Chinese provincial Blindness prevention technical guidance group performance evaluation system"].

PubMed

Lu, L N; He, X G; Zhu, J F; Xu, X; Zhang, R; Hu, X; Zou, H D

2016-11-11

Objective: To establish an assessment system, including indexes and scoring methods, that can be used for performance evaluation of the provincial blindness prevention technical guidance group properly and effectively . Methods: The indexes and scoring methods were set based on the core content of The " National Plan of Prevention and Treatment of Blindness (2012-2015)" , the specific requirement and target of the World Health Organization (WHO) "For the General Eye Health: Global plan of Action (2014-2019)" , and the current situation of the China's provinces and autonomous regions. These indexes should be of effectiveness, feasibility, comparability, guidance and advancing. Formed by a literature review of candidate indicators, the framework of the system is built by qualitative assessment. With the Delphi method, the system was further revised and improved. Empirical pilot study was then used to prove the feasibility, followed by the final qualitative analysis that establish the " Chinese provincial Blindness prevention technical guidance group performance evaluation system" . Results: Through the literature review and qualitative assessment, a six dimensional system framework was built, including 6 first-level indicators, 16 second-level indicators, and 29 third-level indicators through Delphi method evaluation. With the variation coefficient method, the coeffiences of the first-level index weight were calculated as: Organization and management 0.15, Development and implementation of blindness prevention plans 0.15, Implementation of blindness prevention projects 0.14, Training 0.17, Health education 0.18, and Cooperation and exchanges 0.21. The specific scoring method for this system is confirmed as: data and files check, field interview, and record interview, sampling investigation. Empirical pilot study was conducted in the Jilin, Guizhou and Gansu provinces, and the self-assessment results from local experts were consistent with the scores from the systems. Conclusion: This system established is appropriate at current time, and it can effectively evaluate the performance of the Chinese provincial Blindness prevention technical guidance group. (Chin J Ophthalmol, 2016, 52:814-824) .

Laying the Groundwork for an HIV Prevention Intervention: A Descriptive Profile of the Los Angeles House and Ball Communities

PubMed Central

Kipke, Michele D.; Kubicek, Katrina; Supan, Jocelyn; Weiss, George; Schrager, Sheree

2012-01-01

African American young men who have sex with men (AAYMSM) represent the largest proportion of new HIV infections among MSM. While evidence-based interventions are lacking, all too often HIV interventions are implemented in a community without thoroughly understanding its needs, risks and assets. AAYMSM are not homogenous; subgroups exist that may require different approaches to be effective. The House and Ball communities represent one such subgroup. A community-engaged, mixed-methods approach was used. Participant observations, qualitative interviews (N=26), and a survey at House/Ball events (N=252) were completed. Survey data broadly describe the community. For example: 69% of survey respondents identify as gay; 25% as bisexual; 13% reported recent use of ecstasy and 11% recently participated in sex exchange. The depth of qualitative data is key for intervention development. For example, while the survey provides broad descriptions of respondents’ involvement in the House and Ball communities, leaders provided in-depth descriptions of the structure of the House and Ball scene –something vital to the development of HIV prevention programs within these communities. This kind of rigorous study is recommended prior to implementing an intervention. Findings are discussed in relation to leveraging the communities’ supportive aspects to design culturally relevant HIV prevention programs. PMID:22699855

Indoor air condensate as a novel matrix for monitoring inhalable organic contaminants.

PubMed

Roll, Isaac B; Halden, Rolf U; Pycke, Benny F G

2015-05-15

With the population of developed nations spending nearly 90% of their time indoors, indoor air quality (IAQ) is a critical indicator of human health risks from inhalation of airborne contaminants. We present a novel approach for qualitative monitoring of IAQ through the collection and analysis of indoor air condensate discharged from heat exchangers of heating, ventilation, and air conditioning (HVAC) systems. Condensate samples were collected from six suburban homes and one business in Maricopa County, Arizona, concentrated via solid-phase extraction, analyzed for 10 endocrine disrupting chemicals (EDCs) by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and screened for additional organic compounds by gas chromatography-mass spectrometry (GC-MS). All 10 EDCs were detected in at least one of the sampled buildings. More than 100 additional compounds were detected by GC-MS, of which 40 were tentatively identified using spectral database searches. Twelve compounds listed as designated chemicals for biomonitoring by the California Environmental Contaminant Biomonitoring Program were detected. Microfiltration of condensate samples prior to extraction had no discernable effect on contaminant concentration, suggesting that contaminants were freely dissolved or associated with inhalable, submicron particles. This study is the first to document the utility of HVAC condensate for the qualitative assessment of indoor air for pollutants. Copyright © 2015 Elsevier B.V. All rights reserved.

In Pursuit of Theoretical Ground in Behavior Change Support Systems: Analysis of Peer-to-Peer Communication in a Health-Related Online Community.

PubMed

Myneni, Sahiti; Cobb, Nathan; Cohen, Trevor

2016-02-02

Research studies involving health-related online communities have focused on examining network structure to understand mechanisms underlying behavior change. Content analysis of the messages exchanged in these communities has been limited to the "social support" perspective. However, existing behavior change theories suggest that message content plays a prominent role reflecting several sociocognitive factors that affect an individual's efforts to make a lifestyle change. An understanding of these factors is imperative to identify and harness the mechanisms of behavior change in the Health 2.0 era. The objective of this work is two-fold: (1) to harness digital communication data to capture essential meaning of communication and factors affecting a desired behavior change, and (2) to understand the applicability of existing behavior change theories to characterize peer-to-peer communication in online platforms. In this paper, we describe grounded theory-based qualitative analysis of digital communication in QuitNet, an online community promoting smoking cessation. A database of 16,492 de-identified public messages from 1456 users from March 1-April 30, 2007, was used in our study. We analyzed 795 messages using grounded theory techniques to ensure thematic saturation. This analysis enabled identification of key concepts contained in the messages exchanged by QuitNet members, allowing us to understand the sociobehavioral intricacies underlying an individual's efforts to cease smoking in a group setting. We further ascertained the relevance of the identified themes to theoretical constructs in existing behavior change theories (eg, Health Belief Model) and theoretically linked techniques of behavior change taxonomy. We identified 43 different concepts, which were then grouped under 12 themes based on analysis of 795 messages. Examples of concepts include "sleepiness," "pledge," "patch," "spouse," and "slip." Examples of themes include "traditions," "social support," "obstacles," "relapse," and "cravings." Results indicate that themes consisting of member-generated strategies such as "virtual bonfires" and "pledges" were related to the highest number of theoretical constructs from the existing behavior change theories. In addition, results indicate that the member-generated communication content supports sociocognitive constructs from more than one behavior change model, unlike the majority of the existing theory-driven interventions. With the onset of mobile phones and ubiquitous Internet connectivity, online social network data reflect the intricacies of human health behavior as experienced by health consumers in real time. This study offers methodological insights for qualitative investigations that examine the various kinds of behavioral constructs prevalent in the messages exchanged among users of online communities. Theoretically, this study establishes the manifestation of existing behavior change theories in QuitNet-like online health communities. Pragmatically, it sets the stage for real-time, data-driven sociobehavioral interventions promoting healthy lifestyle modifications by allowing us to understand the emergent user needs to sustain a desired behavior change.

Compensation behaviors and magnetic properties in a cylindrical ferrimagnetic nanotube with core-shell structure: A Monte Carlo study

NASA Astrophysics Data System (ADS)

Wang, Wei; Liu, Ying; Gao, Zhong-yue; Zhao, Xue-ru; Yang, Yi; Yang, Sen

2018-07-01

Compensation temperature Tcomp and transition temperature TC have significant applications for the experimental realization of magnetic nanotube structure in the field of thermal magnetic recording. In this work, we use the Monte Carlo simulation to investigate the phase diagrams, magnetizations, susceptibilities, internal energies, specific heats and hysteresis behaviors of a cylindrical ferrimagnetic nanotube with core-shell structure. The effects of the single-ion anisotropies (DC, DS) and the exchange couplings (Jint, JS) on the magnetic and thermodynamic properties of the system are examined. A number of characteristic behaviors are discovered in the thermal variations, depending on different physical parameters. In particular, the triple hysteresis loops behavior has been found for appropriate physical parameters. These findings are qualitatively in good agreement with related experimental and the other theoretical results.

[Volatile metabolites and external CO2 exchange of wheat cenoses under optimal conditions and thermal stress].

PubMed

Gitel'zon, I I; Tikhomirov, A A; Parshina, O V; Ushakova, S A; Kalacheva, G S

2002-01-01

The effects of elevated temperature (35 and 45 degrees C) on photosynthesis, respiration, and both the qualitative and quantitative compositions of volatile emissions (VE) of wheat (Triticum aestuvum L. cultivar 232) cenoses at light intensities of 70, 150, or 240 W/m2 of photosynthetically available radiation (PAR) were studied. At a PAR of 240 W/m2, the thermal stabilities of photosynthesis and respiration increased at 35 degrees C and decreased at 45 degrees C. Elevated temperatures nonuniformly changed the rates and direction of VE syntheses. In this process, the highest increase in VE evolution was observed at 70 W/m2; the lowest, at 240 W/m2 and 35 degrees C. In addition, the concentrations and composition of VE during the repair period differed from the initial values.

How do biological systems discriminate among physically similar ions?

PubMed

Diamond, J M

1975-10-01

This paper reviews the history of understanding how biological systems can discriminate so strikingly among physically similar ions, especially alkali cations. Appreciation of qualitative regularities ("permitted sequences") and quantitative regularities ("selectivity isotherms") in ion selectivity grew first from studies of ion exchangers and glass electrodes, then of biological systems such as enzymes and cell membranes, and most recently of lipid bilayers doped with model pores and carriers. Discrimination of ions depends on both electrostatic and steric forces. "Black-box" studies on intact biological membranes have in some cases yielded molecular clues to the structure of the actual biological pores and carriers. Major current problems involve the extraction of these molecules; how to do it, what to do when it is achieved, and how (and if) it is relevant to the central problems of membrane function. Further advances are expected soon from studies of rate barriers within membranes, of voltage-dependent ("excitable") conducting channels, and of increasingly complex model systems and biological membranes.

Experimental study of three-wave interactions among capillary-gravity surface waves

NASA Astrophysics Data System (ADS)

Haudin, Florence; Cazaubiel, Annette; Deike, Luc; Jamin, Timothée; Falcon, Eric; Berhanu, Michael

2016-04-01

In propagating wave systems, three- or four-wave resonant interactions constitute a classical nonlinear mechanism exchanging energy between the different scales. Here we investigate three-wave interactions for gravity-capillary surface waves in a closed laboratory tank. We generate two crossing wave trains and we study their interaction. Using two optical methods, a local one (laser doppler vibrometry) and a spatiotemporal one (diffusive light photography), a third wave of smaller amplitude is detected, verifying the three-wave resonance conditions in frequency and in wave number. Furthermore, by focusing on the stationary regime and by taking into account viscous dissipation, we directly estimate the growth rate of the resonant mode. The latter is then compared to the predictions of the weakly nonlinear triadic resonance interaction theory. The obtained results confirm qualitatively and extend previous experimental results obtained only for collinear wave trains. Finally, we discuss the relevance of three-wave interaction mechanisms in recent experiments studying gravity-capillary turbulence.

Experimental study of three-wave interactions among capillary-gravity surface waves.

PubMed

Haudin, Florence; Cazaubiel, Annette; Deike, Luc; Jamin, Timothée; Falcon, Eric; Berhanu, Michael

2016-04-01

In propagating wave systems, three- or four-wave resonant interactions constitute a classical nonlinear mechanism exchanging energy between the different scales. Here we investigate three-wave interactions for gravity-capillary surface waves in a closed laboratory tank. We generate two crossing wave trains and we study their interaction. Using two optical methods, a local one (laser doppler vibrometry) and a spatiotemporal one (diffusive light photography), a third wave of smaller amplitude is detected, verifying the three-wave resonance conditions in frequency and in wave number. Furthermore, by focusing on the stationary regime and by taking into account viscous dissipation, we directly estimate the growth rate of the resonant mode. The latter is then compared to the predictions of the weakly nonlinear triadic resonance interaction theory. The obtained results confirm qualitatively and extend previous experimental results obtained only for collinear wave trains. Finally, we discuss the relevance of three-wave interaction mechanisms in recent experiments studying gravity-capillary turbulence.

Characterization of eco-hydraulic habitats for examining biogeochemical processes in rivers

NASA Astrophysics Data System (ADS)

McPhillips, L. E.; O'Connor, B. L.; Harvey, J. W.

2009-12-01

Spatial variability in biogeochemical reaction rates in streams is often attributed to sediment characteristics such as particle size, organic material content, and biota attached to or embedded within the sediments. Also important in controlling biogeochemical reaction rates are hydraulic conditions, which influence mass transfer of reactants from the stream to the bed, as well as hyporheic exchange within near-surface sediments. This combination of physical and ecological variables has the potential to create habitats that are unique not only in sediment texture but also in their biogeochemical processes and metabolism rates. In this study, we examine the two-dimensional (2D) variability of these habitats in an agricultural river in central Iowa. The streambed substratum was assessed using a grid-based survey identifying dominant particle size classes, as well as aerial coverage of green algae, benthic organic material, and coarse woody debris. Hydraulic conditions were quantified using a calibrated 2D model, and hyporheic exchange was assessed using a scaling relationship based on sediment and hydraulic characteristics. Point-metabolism rates were inferred from measured sediment dissolved oxygen profiles using an effective diffusion model and compared to traditional whole-stream measurements of metabolism. The 185 m study reach had contrasting geomorphologic and hydraulic characteristics in the upstream and downstream portions of an otherwise relatively straight run of a meandering river. The upstream portion contained a large central gravel bar (50 m in length) flanked by riffle-run segments and the downstream portion contained a deeper, fairly uniform channel cross-section. While relatively high flow velocities and gravel sediments were characteristic of the study river, the upstream island bar separated channels that differed with sandy gravels on one side and cobbley gravels on the other. Additionally, green algae was almost exclusively found in riffle portions of the cobbley gravel channel sediments while fine benthic organic material was concentrated at channel margins, regardless of the underlying sediments. A high degree of spatial variability in hyporheic exchange potential was the result of the complex 2D nature of topography and hydraulics. However, sediment texture classifications did a reasonable job in characterizing variability in hyporheic exchange potential because sediment texture mapping incorporates qualitative aspects of bed shear stress and hydraulic conductivity that control hyporheic exchange. Together these variables greatly influenced point-metabolism measurements in different sediment texture habitats separated by only 1 to 2 m. Results from this study suggest that spatial variability and complex interactions between geomorphology, hydraulics, and biological communities generate eco-hydraulic habitats that control variability in biogeochemical processes. The processes controlling variability are highly two-dimensional in nature and are not often accounted for in traditional one-dimensional analysis approaches of biogeochemical processes.

Family members' influence on family meal vegetable choices

PubMed Central

Wenrich, Tionni R.; Brown, J. Lynne; Miller-Day, Michelle; Kelley, Kevin J.; Lengerich, Eugene J.

2010-01-01

Objective Characterize the process of family vegetable selection (especially cruciferous, deep orange, and dark green leafy vegetables); demonstrate the usefulness of Exchange Theory (how family norms and past experiences interact with rewards and costs) for interpreting the data. Design Eight focus groups, two with each segment (men/women vegetable-likers/dislikers based on a screening form). Participants completed a vegetable intake form. Setting Rural Appalachian Pennsylvania. Participants 61 low-income, married/cohabiting men (n=28) and women (n=33). Analysis Thematic analysis within Exchange Theory framework for qualitative data. Descriptive analysis, t-tests and chi-square tests for quantitative data. Results Exchange Theory proved useful for understanding that regardless of sex or vegetable-liker/disliker status, meal preparers see more costs than rewards to serving vegetables. Past experience plus expectations of food preparer role and of deference to family member preferences supported a family norm of serving only vegetables acceptable to everyone. Emphasized vegetables are largely ignored due to unfamiliarity; family norms prevented experimentation and learning through exposure. Conclusions and Implications Interventions to increase vegetable consumption of this audience could 1) alter family norms about vegetables served, 2) change perceptions of past experiences, 3) reduce social and personal costs of serving vegetables and 4) increase tangible and social rewards of serving vegetables. PMID:20452288

Exchange of sex for resources: HIV risk and gender norms in Cabo Delgado, Mozambique.

PubMed

Bandali, Sarah

2011-05-01

A qualitative analysis was carried out of data from 16 group discussions and 29 in-depth interviews conducted in rural and matrilineal areas of Cabo Delgado, Mozambique, to examine how the exchange of sex for resources--primarily money but also food, transportation, housing and gifts--is enacted and perceived in relation to HIV-related risk, and how prevalent gender norms are reflected in this practice. Findings reveal how gender norms shape access to resources differently for men and women as well as how variations in access to opportunities and income earning potential contribute to the emergence of sexual exchange for purposes of survival, but also as a means to ensure sexual and economic agency. Within this practice, individuals are confronting gender norms and re-defining their HIV-related risk. Some men refuse to spend scarce resources on other women by protecting their family from both financial insecurity and HIV acquisition. Among some women who engage in sexual transactions to obtain resources quickly, the resulting agency and decision making power gained are a trade-off to potential HIV risk. Nuanced understandings of gender dynamics and its influence on sexual risk taking and risk-reduction efforts in different local contexts are required. © 2011 Taylor & Francis

SU-E-J-120: Comparing 4D CT Computed Ventilation to Lung Function Measured with Hyperpolarized Xenon-129 MRI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Neal, B; Chen, Q

2015-06-15

Purpose: To correlate ventilation parameters computed from 4D CT to ventilation, profusion, and gas exchange measured with hyperpolarized Xenon-129 MRI for a set of lung cancer patients. Methods: Hyperpolarized Xe-129 MRI lung scans were acquired for lung cancer patients, before and after radiation therapy, measuring ventilation, perfusion, and gas exchange. In the standard clinical workflow, these patients also received 4D CT scans before treatment. Ventilation was computed from 4D CT using deformable image registration (DIR). All phases of the 4D CT scan were registered using a B-spline deformable registration. Ventilation at the voxel level was then computed for each phasemore » based on a Jacobian volume expansion metric, yielding phase sorted ventilation images. Ventilation based upon 4D CT and Xe-129 MRI were co-registered, allowing qualitative visual comparison and qualitative comparison via the Pearson correlation coefficient. Results: Analysis shows a weak correlation between hyperpolarized Xe-129 MRI and 4D CT DIR ventilation, with a Pearson correlation coefficient of 0.17 to 0.22. Further work will refine the DIR parameters to optimize the correlation. The weak correlation could be due to the limitations of 4D CT, registration algorithms, or the Xe-129 MRI imaging. Continued development will refine parameters to optimize correlation. Conclusion: Current analysis yields a minimal correlation between 4D CT DIR and Xe-129 MRI ventilation. Funding provided by the 2014 George Amorino Pilot Grant in Radiation Oncology at the University of Virginia.« less

Modeling and properties of an ion-exchanged optical variable attenuator

NASA Astrophysics Data System (ADS)

Orignac, Xavier; Ingenhoff, Jan; Fabricius, Norbert

1999-03-01

The optical signal power needs to be regulated at some locations in transmission lines. That can be done with the help of optical variable attenuators (OVA), devices which allows for the control of their insertion loss. This work describes the design and properties of some OVAs fabricated by the ion-exchange technique. The OVA functionality relies on a Mach-Zehnder structure, where the output optical intensity is tuned via the change in optical path along one of the two interferometer arms. Here, the optical path is varied through thermo-optic effect (change of refractive index with temperature). Modelling is first addressed: a mostly qualitative theoretical investigation is used to clarify how the fabrication parameters (burial depth and Mach-Zehnder arm separation distance) can be related to the OVAs properties (attenuation dynamic, switching power, settling time, PDL). Properties of fabricated OVAs are presented in a second part. They are compared with other existing products. The relationship between fabrication parameters and properties is also re-examined in light of these results.

Complex magnetic order in the kagome ferromagnet Pr3Ru4Al12

NASA Astrophysics Data System (ADS)

Henriques, M. S.; Gorbunov, D. I.; Andreev, A. V.; Fabrèges, X.; Gukasov, A.; Uhlarz, M.; Petříček, V.; Ouladdiaf, B.; Wosnitza, J.

2018-01-01

In the hexagonal crystal structure of Pr3Ru4Al12 , the Pr atoms form a distorted kagome lattice, and their magnetic moments, are subject to competing exchange and anisotropy interactions. We performed magnetization, magnetic-susceptibility, specific-heat, electrical-resistivity, and neutron-scattering measurements. Pr3Ru4Al12 is a uniaxial ferromagnet with TC=39 K that displays a collinear magnetic structure (in the high-temperature range of the magnetically ordered state) for which the only crystallographic position of Pr is split into two sites carrying different magnetic moments. A spin-reorientation phase transition is found at 7 K. Below this temperature, part of the Pr moments rotate towards the basal plane, resulting in a noncollinear magnetic state with a lower magnetic symmetry. We argue that unequal RKKY exchange interactions competing with the crystal electric field lead to a moment instability and qualitatively explain the observed magnetic phases in Pr3Ru4Al12 .

Magnetization reversal in exchange biased Co/CoO probed with anisotropic magnetoresistance

NASA Astrophysics Data System (ADS)

Gredig, Thomas; Krivorotov, Ilya N.; Dahlberg, E. Dan

2002-05-01

The magnetization reversal in exchange coupled polycrystalline Co/CoO bilayers has been investigated as a function of CoO thickness using anisotropic magnetoresistance as a probe. The anisotropic magnetoresistance (AMR) was measured during the magnetization reversal and it was used to determine the orientation of the magnetization. For thin CoO layers large training effects were present; ergo the first hysteresis loop after field cooling was not the same as the second. The magnitude of the observed training was found to decrease with increasing CoO thickness. In the samples where substantial training was observed, the first magnetization reversal was dominated by nucleation of reversed domains. For the reversal from the antiparallel state back to the parallel direction, the AMR is consistent with a rotation process. In thicker CoO films where the training was less, the asymmetry was drastically reduced. A simple model that couples the antiferromagnetic grains to the ferromagnetic layer simulates qualitatively the observed magnetoresistance.

Ion-exchange chromatography for the characterization of biopharmaceuticals.

PubMed

Fekete, Szabolcs; Beck, Alain; Veuthey, Jean-Luc; Guillarme, Davy

2015-09-10

Ion-exchange chromatography (IEX) is a historical technique widely used for the detailed characterization of therapeutic proteins and can be considered as a reference and powerful technique for the qualitative and quantitative evaluation of charge heterogeneity. The goal of this review is to provide an overview of theoretical and practical aspects of modern IEX applied for the characterization of therapeutic proteins including monoclonal antibodies (Mabs) and antibody drug conjugates (ADCs). The section on method development describes how to select a suitable stationary phase chemistry and dimensions, the mobile phase conditions (pH, nature and concentration of salt), as well as the temperature and flow rate, considering proteins isoelectric point (pI). In addition, both salt-gradient and pH-gradient approaches were critically reviewed and benefits as well as limitations of these two strategies were provided. Finally, several applications, mostly from pharmaceutical industries, illustrate the potential of IEX for the characterization of charge variants of various types of biopharmaceutical products. Copyright © 2015 Elsevier B.V. All rights reserved.

On the use of rhodamine WT for the characterization of stream hydrodynamics and transient storage

USGS Publications Warehouse

Runkel, Robert L.

2015-01-01

Recent advances in fluorometry have led to increased use of rhodamine WT as a tracer in streams and rivers. In light of this increased use, a review of the dye's behavior in freshwater systems is presented. Studies in the groundwater literature indicate that rhodamine WT is transported nonconservatively, with sorption removing substantial amounts of tracer mass. Column studies document a two-step breakthrough curve in which two structural isomers are chromatographically separated. Although the potential for nonconservative transport is acknowledged in the surface water literature, many studies assume that sorptive losses will not affect the characterization of physical transport processes. A literature review and modeling analysis indicates that this assumption is valid for quantification of physical properties that are based on the bulk of the tracer mass (traveltime), and invalid for the characterization of processes represented by the tracer tail (transient storage attributable to hyporheic exchange). Rhodamine WT should be considered nonconservative in the hyporheic zone due to nonconservative behavior demonstrated for similar conditions in groundwater. As such, rhodamine WT should not be used as a quantitative tracer in hyporheic zone investigations, including the study of long flow paths and the development of models describing hyporheic zone processes. Rhodamine WT may be used to qualitatively characterize storage in large systems, where there are few practical alternatives. Qualitative investigations should rely on early portions of the tracer profile, making use of the temporal resolution afforded by in situ fluorometry, while discarding later parts of the tracer profile that are adversely affected by sorption.

Hyporheic network (Hyporheisches Netzwerk)

NASA Astrophysics Data System (ADS)

Lewandowski, J.; Fleckenstein, J.; Hoehn, E.; Nützmann, G.; Radke, M.; Saenger, N.; Schmidt, C.

2009-04-01

The transition zone between surface waters like streams and rivers and the adjacent aquifers is a zone of paramount ecological importance. Due to the complexity of exchange processes, their temporal variability, and the spatial heterogeneity of the ecotone, the understanding and ability to modell the hydrodynamic, hydrochemical, and (micro-)biological processes is still limited. Therefore, a network of scientists and practitioners involved in research and management of hyporheic zones in German-speaking countries (Germany, Switzerland, Austria) is propsed in analogy to the hyporheic network (www.hyporheic.net) in the UK. The initiators of the network anticipate that an intense scientific exchange of knowledge and methods will improve our understanding of hyporheic processes and in turn our ability to manage them. The network will facilitate the formation of research groups to identify and understand key processes and their interactions. Research will be focused at a few major study sites, to bring together different expertise to allow more detailed, interdisciplinary investigations. Those sites can serve as crystallisation points for new research projects. Exchange within the network will be organized via an internet platform (www.hyporheisches-netzwerk.de), regular workshops, and several working groups dealing with different topics. A fast knowledge transfer is a further aim of the collaboration in order to shorten the time-lag between scientific findings and their implementation into management practice. Water resources management authorities should also be involved in the network to address urgent problems and direct some capacities to answer those questions. For instance, changes in geomorphology, water and temperature regimes as well as other anthropogenic impacts might increase the need for cold water refugia and altered flow regimes to maintain biodiversity. Additional qualitative improvements are required by the EU water framework directive.

The impact of international placements on nurses' personal and professional lives: literature review.

PubMed

Button, Lori; Green, Barbara; Tengnah, Cassam; Johansson, Inez; Baker, Christine

2005-05-01

This paper presents a critical review of research literature on the impact of international placements on the lives and practice of nurses. Health care institutions are progressively more aware of the need to respond to diverse patient populations and cultivate leaders to enrich the nursing profession, both locally and globally. One response has been to establish international exchange programmes for nursing students to give them experience of different cultures and health care systems. A search of the literature from 1980 to 2003 using electronic databases was undertaken using the databases CINAHL, ERIC, British Nursing Index, Web of Science, the BIDS Social Science Citation Index and Medline. The keywords used were 'international exchange experience', 'international studies', 'international education', 'international placement(s)', 'exchange programme(s)', combined with 'nurses/nursing', combined with 'evaluation', 'practice', 'education' and/or 'policy'. The papers retrieved used both qualitative and quantitative approaches and were scrutinized for recurring themes. Nurses reported significant changes in their personal development, perspectives on nursing practice and critical appraisal of health care systems. They also indicated an increased appreciation and sensitivity towards cultural issues and cross-cultural care. Moreover, differences in placement programmes, such as duration, preparation and debriefing were found to have affected the reported overall international placement experience. However, the primary effects of international placements were identified as personal development and transcultural adaptation. Students should be exposed to a variety of nursing experiences within the host country. This would give them a broad spectrum for comparisons between cultures, nursing practice and health care delivery in those cultures. Therefore, educational institutions are strongly encouraged to provide opportunities for students to participate in nursing care and education in another country.

How could health information exchange better meet the needs of care practitioners?

PubMed

Kierkegaard, P; Kaushal, R; Vest, J R

2014-01-01

Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high. We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners. We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State. The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows. Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable.

Differing Strategies to Meet Information‐Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems’ Enterprise Health Information Exchanges

PubMed Central

KASH, BITA A.

2016-01-01

Policy Points: Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations.Noninteroperable electronic health records and vendors’ expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges.Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. Context The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. Methods We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. Findings Enterprise HIEs support health systems' strategic goals through the control of an information technology network consisting of desired trading partners. Community HIEs support obtaining patient information from the broadest set of providers, but with more dispersed benefits to all participants, the community, and patients. Although not an either/or decision, community and enterprise HIEs compete for finite organizational resources like time, skilled staff, and money. Both approaches face challenges due to vendor costs and less‐than‐interoperable technology. Conclusions Both community and enterprise HIEs support aggregating clinical data and following patients across settings. Although they can be complementary, community and enterprise HIEs nonetheless compete for providers’ attention and organizational resources. Health policymakers might try to encourage the type of widespread information exchange pursued by community HIEs, but the business case for enterprise HIEs clearly is stronger. The sustainability of a community HIE, potentially a public good, may necessitate ongoing public funding and supportive regulation. PMID:26994710

Differing Strategies to Meet Information-Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems' Enterprise Health Information Exchanges.

PubMed

Vest, Joshua R; Kash, Bita A

2016-03-01

Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations. Noninteroperable electronic health records and vendors' expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges. Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. Enterprise HIEs support health systems' strategic goals through the control of an information technology network consisting of desired trading partners. Community HIEs support obtaining patient information from the broadest set of providers, but with more dispersed benefits to all participants, the community, and patients. Although not an either/or decision, community and enterprise HIEs compete for finite organizational resources like time, skilled staff, and money. Both approaches face challenges due to vendor costs and less-than-interoperable technology. Both community and enterprise HIEs support aggregating clinical data and following patients across settings. Although they can be complementary, community and enterprise HIEs nonetheless compete for providers' attention and organizational resources. Health policymakers might try to encourage the type of widespread information exchange pursued by community HIEs, but the business case for enterprise HIEs clearly is stronger. The sustainability of a community HIE, potentially a public good, may necessitate ongoing public funding and supportive regulation. © 2016 Milbank Memorial Fund.

Modeling Inflation Using a Non-Equilibrium Equation of Exchange

NASA Technical Reports Server (NTRS)

Chamberlain, Robert G.

2013-01-01

Inflation is a change in the prices of goods that takes place without changes in the actual values of those goods. The Equation of Exchange, formulated clearly in a seminal paper by Irving Fisher in 1911, establishes an equilibrium relationship between the price index P (also known as "inflation"), the economy's aggregate output Q (also known as "the real gross domestic product"), the amount of money available for spending M (also known as "the money supply"), and the rate at which money is reused V (also known as "the velocity of circulation of money"). This paper offers first a qualitative discussion of what can cause these factors to change and how those causes might be controlled, then develops a quantitative model of inflation based on a non-equilibrium version of the Equation of Exchange. Causal relationships are different from equations in that the effects of changes in the causal variables take time to play out-often significant amounts of time. In the model described here, wages track prices, but only after a distributed lag. Prices change whenever the money supply, aggregate output, or the velocity of circulation of money change, but only after a distributed lag. Similarly, the money supply depends on the supplies of domestic and foreign money, which depend on the monetary base and a variety of foreign transactions, respectively. The spreading of delays mitigates the shocks of sudden changes to important inputs, but the most important aspect of this model is that delays, which often have dramatic consequences in dynamic systems, are explicitly incorporated.macroeconomics, inflation, equation of exchange, non-equilibrium, Athena Project

Qualitative "trial-sibling" studies and "unrelated" qualitative studies contributed to complex intervention reviews.

PubMed

Noyes, Jane; Hendry, Margaret; Lewin, Simon; Glenton, Claire; Chandler, Jackie; Rashidian, Arash

2016-06-01

To compare the contribution of "trial-sibling" and "unrelated" qualitative studies in complex intervention reviews. Researchers are using qualitative "trial-sibling" studies undertaken alongside trials to provide explanations to understand complex interventions. In the absence of qualitative "trial-sibling" studies, it is not known if qualitative studies "unrelated" to trials are helpful. Trials, "trial-sibling," and "unrelated" qualitative studies looking at three health system interventions were identified. We looked for similarities and differences between the two types of qualitative studies, such as participants, intervention delivery, context, study quality and reporting, and contribution to understanding trial results. Reporting was generally poor in both qualitative study types. We detected no substantial differences in participant characteristics. Interventions in qualitative "trial-sibling" studies were delivered using standardized protocols, whereas interventions in "unrelated" qualitative studies were delivered in routine care. Qualitative "trial-sibling" studies alone provided insufficient data to develop meaningful transferrable explanations beyond the trial context, and their limited focus on immediate implementation did not address all phenomena of interest. Together, "trial-sibling" and "unrelated" qualitative studies provided larger, richer data sets across contexts to better understand the phenomena of interest. Findings support inclusion of "trial-sibling" and "unrelated" qualitative studies to explore complexity in complex intervention reviews. Copyright © 2016 Elsevier Inc. All rights reserved.

First-principles study of SnS electronic properties using LDA, PBE and HSE06 functionals

NASA Astrophysics Data System (ADS)

Ibragimova, R.; Ganchenkova, M.; Karazhanov, S.; Marstein, E. S.

2018-03-01

Recently, tin sulphide (SnS) has emerged as a promising alternative to conventional CIGS and CZTC for use in solar cells, possessing such properties as non-toxicity, low cost and production stability. SnS has a high theoretically predicted efficiency above 20%, but the experimentally achieved efficiency so far is as low as 4.36%. The reason for the low achieved efficiency is unclear. One of the powerful tools to get deeper insights about the nature of the problem is first-principles calculation approaches. That is why SnS has become an attractive subject for first-principles calculations recently. Previously calculated data, however, show a widespread of such fundamental value as the bandgap varying from 0.26 to 1.26 eV. In order to understand a reason for that, in this work, we concentrate on a systematic study of calculation parameters effects on the resulting electronic structure, with the particular attention paid to the influence of the exchange-correlation functional chosen for calculations. Several exchange-correlation functionals (LDA, PBE and HSE06) were considered. The systematic analysis has shown that the bandgap variation can result from a tensile/compressive hydrostatic pressure introduced by non-equilibrium lattice parameters used for the calculations. The study of the applicability of three functionals has shown that HSE06 gives the best match to both experimentally obtained bandgap and the XPS valence band spectra. LDA underestimates the bandgap but qualitatively reproduces experimentally measured valence DOS similar to that of HSE06 in contrast to PBE. PBE underestimates the bandgap and does not match to the measured XPS spectra.

Something-for-something love: the motivations of young women in Uganda.

PubMed

Samara, Suesanne

2010-01-01

This paper aims to explore the motivations of young women in Busoga, Uganda, engaging in "Something-for-something" love (SFSL) relationships. Something-for-something love is defined as engaging in sex in exchange for money, favours, gifts and goods. This paper examines whether these relationships affect young women's ability to negotiate safe sex. Qualitative methods were used with a group of six young women including participatory video, drawing, stories and life histories. In addition, semi-structured interviews were conducted with each participant and two key informants. Data were analysed using an inductive thematic approach. Peer pressure, financial gain, school fees, basic needs and family pressure were key motivations for SFSL. Power dynamics embedded in Ugandan local culture were found to play a significant role in SFSL and family pressure is suggested to assume a greater role than previously perceived. Transaction was considered to be part of what was expected within a "natural romantic relationship". Condom use was less likely in relationships where a great amount of gifts were exchanged, as men were more likely to negotiate sex on their terms, and this often led to unprotected sex. The study contributes much-needed insight into motivations behind young women participating in SFSL. Young women involved in such relationships are portrayed along a spectrum ranging from vulnerable to empowered. The study emphasises the role parents and other kin play in influencing their children's sexual and reproductive health choices. The study highlights to policy makers that interventions aimed at improving parent-child communication are needed; as well as a more informed approach to HIV prevention, taking onboard the complexities of SFSL.

Separation techniques: Chromatography

PubMed Central

Coskun, Ozlem

2016-01-01

Chromatography is an important biophysical technique that enables the separation, identification, and purification of the components of a mixture for qualitative and quantitative analysis. Proteins can be purified based on characteristics such as size and shape, total charge, hydrophobic groups present on the surface, and binding capacity with the stationary phase. Four separation techniques based on molecular characteristics and interaction type use mechanisms of ion exchange, surface adsorption, partition, and size exclusion. Other chromatography techniques are based on the stationary bed, including column, thin layer, and paper chromatography. Column chromatography is one of the most common methods of protein purification. PMID:28058406

Feasibility of a patient decision aid regarding disclosure of personal health information: qualitative evaluation of the Health Care Information Directive

PubMed Central

Tracy, C Shawn; Dantas, Guilherme Coelho; Upshur, Ross EG

2004-01-01

Background Concerns regarding the privacy of health information are escalating owing both to the growing use of information technology to store and exchange data and to the increasing demand on the part of patients to control the use of their medical records. The objective of this study was to evaluate the Health Care Information Directive (HCID), a recently-developed patient decision aid that aims to delineate the level of health information an individual is willing to share. Methods We convened a series of four focus group meetings with several communities in a large Canadian city. A total of 28 men and women participated, representing health care consumer advocates, urban professionals, senior citizens, and immigrants who speak English as a second language. Data were analysed using qualitative methods. Results Participants lacked substantial knowledge regarding the fate and uses of personal health information. They expressed mistrust concerning how their information will be used and protected. Several suggestions were made towards customizing the use of data according to specific needs rather than broad and full access to their charts. Furthermore, despite concern regarding the implementation of a tool like the HCID, participants were hopeful that a refined instrument could contribute to the improved regulation of health information. Conclusion This study indicated poor knowledge concerning the uses of personal health information, distrust concerning security provisions, and cautious support for a patient decision aid such as the HCID to improve control over health data. PMID:15361257

Feasibility of a patient decision aid regarding disclosure of personal health information: qualitative evaluation of the Health Care Information Directive.

PubMed

Tracy, C Shawn; Dantas, Guilherme Coelho; Upshur, Ross E G

2004-09-10

Concerns regarding the privacy of health information are escalating owing both to the growing use of information technology to store and exchange data and to the increasing demand on the part of patients to control the use of their medical records. The objective of this study was to evaluate the Health Care Information Directive (HCID), a recently-developed patient decision aid that aims to delineate the level of health information an individual is willing to share. We convened a series of four focus group meetings with several communities in a large Canadian city. A total of 28 men and women participated, representing health care consumer advocates, urban professionals, senior citizens, and immigrants who speak English as a second language. Data were analysed using qualitative methods. Participants lacked substantial knowledge regarding the fate and uses of personal health information. They expressed mistrust concerning how their information will be used and protected. Several suggestions were made towards customizing the use of data according to specific needs rather than broad and full access to their charts. Furthermore, despite concern regarding the implementation of a tool like the HCID, participants were hopeful that a refined instrument could contribute to the improved regulation of health information. This study indicated poor knowledge concerning the uses of personal health information, distrust concerning security provisions, and cautious support for a patient decision aid such as the HCID to improve control over health data.

How do the EMA and FDA decide which anticancer drugs make it to the market? A comparative qualitative study on decision makers' views.

PubMed

Tafuri, G; Stolk, P; Trotta, F; Putzeist, M; Leufkens, H G; Laing, R O; De Allegri, M

2014-01-01

The process leading to a regulatory outcome is guided by factors both related and unrelated to the data package, defined in this analysis as 'formal and informal factors', respectively. The aim of this qualitative study was to analyse which formal and informal factors drive the decision-making process of the European Medicines Agency (EMA) and Food and Drug Administration (FDA) regulators with regard to anticancer drugs, using in-depth semi-structured interviews with regulators of the two agencies. In line with the theory and practice of qualitative research, no set sample size was defined a priori. Respondent enrolment continued until saturation and redundancy were reached. Data were collected through means of in-depth semi-structured interviews conducted either in a face-to-face setting or via Skype(®) with each regulator. The interviews were audio-recorded and verbatim transcribed. The analysis was manually carried out on the transcribed text. Data were independently coded and categorized by two researchers. Interpretation of the findings emerged through a process of triangulation between the two. Seven EMA and six FDA regulators, who had extensive experience with making decisions about anticancer medicines, were interviewed between April and June 2012. There is an open dialogue between the FDA and EMA, with the two moving closer and exchanging information, not opinions. Differences in decision-making between the agencies may be due to a different evaluation of end points. Different interaction modalities with industry and patients represent an additional source of divergence with a potential impact on decision-making. The key message of our respondents was that the agencies manage uncertainty in a different way: unlike the EMA, the FDA has a prevailing attitude to take risks in order to guarantee quicker access to new treatments. Although formal factors are the main drivers for regulatory decisions, the influence of informal factors plays an important role in the drug evaluation process.

Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions

PubMed Central

McMurray, Robert; Cheater, Francine M; Weighall, Anna; Nelson, Carolyn; Schweiger, Martin; Mukherjee, Suzanne

2004-01-01

Background: Controversy over the measles, mumps, and rubella (MMR) vaccine has reduced uptake, raising concerns of a future disease epidemic. Aims: To explore parents' accounts of decision making relating to the MMR vaccine controversy, identifying uptake determinants and education needs. Design of study: Qualitative interviews analysed using the ‘framework’ approach. Setting: Five general practices in the Leeds area, 2002–2003. Method: Sixty-nine interviews conducted with parents of children aged between 4 and 5 years, and 12 interviews with primary care practitioners, managers and immunisation coordinators serving participating sites. Participants were interviewed one-to-one in a place of their choice. Results: The vaccination decision is primarily a function of parental assessments of the relative acceptability and likelihood of possible outcomes. For most parents the evidence of science and medicine plays little role in the decision. Although local general practitioners and health visitors are trusted information sources, the influence of primary care providers on the vaccination decision is limited by concerns over consultation legitimacy, discussion opportunity, and perceptions of financial and political partiality. Parents and practitioners identify a need for new approaches to support decisions and learning when faced with this and similar healthcare controversies. These include new collaborative approaches to information exchange designed to transform rather than supplant existing parent knowledge as part of an ongoing learning process. Conclusion: The study identified new ways in which parents and practitioners need to be supported in order to increase understanding of medical science and secure more informed decisions in the face of health controversy. PMID:15239914

Street furniture concept in Pasar Buah and Bukit Gundaling Based on place identity

NASA Astrophysics Data System (ADS)

Ginting, Nurlisa; Vinky Rahman, N.; Delianur Nasution, Achmad; Nawawiy Loebis, M.; Sinaga, Fitri A.

2018-03-01

Tourism is one of the largest sources of the foreign exchange for a country, that encourage many developers to develop it. Karo District located in the province of North Sumatera, Indonesia, which has many tourist destinations with natural and cultural resources, including Pasar Buah and Bukit Gundaling. To develop Tourism, one of way is with increasing place identity in tourist destinations. Unfortunately, place identity in Pasar Buah and Bukit Gundaling are still lacking, so it needs improvement, one of that is the Street furniture in Pasar Buah and Bukit Gundaling. This study aims to design the concept of the Street furniture planning in Pasar Buah and Bukit Gundaling. The method used is a qualitative method, that is design street furniture using five groups elements of street furniture: decorative element, service furniture, trade furniture, signaling furniture, and advertisement furniture. The result of this study is the concept of the design street furniture of Pasar Buah and Bukit Gundaling, which can use to improve place identity in tourism of Karo District.

Determination of prohibited, small peptides in urine for sports drug testing by means of nano-liquid chromatography/benchtop quadrupole orbitrap tandem-mass spectrometry.

PubMed

Thomas, Andreas; Walpurgis, Katja; Krug, Oliver; Schänzer, Wilhelm; Thevis, Mario

2012-10-12

In the present study, a screening assay was developed comprising 11 prohibited peptides (<1.5 kDa) that are sufficiently purified from urine using weak cation exchange with subsequent determination of all substances by means of nanoUHPLC separation coupled to high resolution tandem mass spectrometry. These peptides included Gonadorelin (LH-RH), Desmopressin and 9 growth hormone releasing peptides (GHRP-1, -2, -4, -5, -6, Hexarelin, Alexamorelin, Ipamorelin and a GHRP-2 metabolite); however, the procedure is expandable to further target analytes or metabolites. The method was validated with a main focus on qualitative result interpretation considering the parameters specificity, linearity (0-500 pg/mL), recovery (45-95%), precision (<20% at 100 pg/mL), limits of detection (2-10 pg/mL), robustnesss and ion suppression. The proof-of-principle was shown by analysing excretion study urine samples for LHRH, Desmopressin and GHRP-2. Copyright © 2012 Elsevier B.V. All rights reserved.

US and Dutch nurse experiences with fall prevention technology within nursing home environment and workflow: A qualitative study.

PubMed

Vandenberg, Ann E; van Beijnum, Bert-Jan; Overdevest, Vera G P; Capezuti, Elizabeth; Johnson, Theodore M

Falls remain a major geriatric problem, and the search for new solutions continues. We investigated how existing fall prevention technology was experienced within nursing home nurses' environment and workflow. Our NIH-funded study in an American nursing home was followed by a cultural learning exchange with a Dutch nursing home. We constructed two case reports from interview and observational data and compared the magnitude of falls, safety cultures, and technology characteristics and effectiveness. Falls were a high-magnitude problem at the US site, with a collectively vigilant safety culture attending to non-directional audible alarms; falls were a low-magnitude problem at the NL site which employed customizable, infrared sensors that directed text alerts to assigned staff members' mobile devices in patient-centered care culture. Across cases, 1) a coordinated communication system was essential in facilitating effective fall prevention alert response, and 2) nursing home safety culture is tightly associated with the chosen technological system. Copyright © 2016 Elsevier Inc. All rights reserved.

[Compensated sex: a practice at the heart of young Mexican women's vulnerabilities (STI/HIV/AIDS)].

PubMed

Théodore, Florence Lise; Gutiérrez, Juan Pablo; Torres, Pilar; Luna, Gabriela

2004-01-01

To discuss the risks for Mexican young women who engage in sexual relations in exchange for social or economic benefits, also known as compensated sex (CS), with the objective of exploring its possible public health implications. This is a qualitative study conducted in youths 15 to 25 years of age in Cuernavaca, Morelos, Mexico, between September 2001 and December 2002. The theoretical framework included sociology of knowledge, post-structuralism, and gender studies. Research methods consisted of six focal groups and eight interviews with young subjects identified or self-declared as having practiced CS. To conceal their CS practices as a way to obtain social or economic benefits, young girls disguise it as "courtship" and subject themselves to rules and behaviors that restrain them in terms of condom use and expose them to sexually transmitted infections (STI). Although CS itself may not necessarily constitute a risky practice, the courtship context in which young women tend to develop these practices exposes them to a greater risk of STIs.

Internet-based remote consultations - general practitioner experience and attitudes in Norway and Germany.

PubMed

Kampik, Timotheus; Larsen, Frank; Bellika, Johan Gustav

2015-01-01

The objective of the study was to identify experiences and attitudes of German and Norwegian general practitioners (GPs) towards Internet-based remote consultation solutions supporting communication between GPs and patients in the context of the German and Norwegian healthcare systems. Interviews with four German and five Norwegian GPs were conducted. The results were qualitatively analyzed. All interviewed GPs stated they would like to make use of Internet-based remote consultations in the future. Current experiences with remote consultations are existent to a limited degree. No GP reported to use a comprehensive remote consultation solution. The main features GPs would like to see in a remote consultation solution include asynchronous exchange of text messages, video conferencing with text chat, scheduling of remote consultation appointments, secure login and data transfer and the integration of the remote consultation solution into the GP's EHR system.

Ua neeb khu: a Hmong American healing ceremony.

PubMed

Capps, Lisa L

2011-06-01

Ua neeb khu (pronounced "oo-ah neng kue") is a ceremonial healing practice engaged in by Hmong Americans for the treatment of various health problems involving spiritually focused concerns that only a shaman practitioner is qualified to treat. A qualitative ethnographic case study method with participant observation was used to analyze a spiritual healing ceremony performed by a shaman healer (txiv neeb) for an elderly Hmong American male residing in a midwestern city in the United States. The healing ritual was filmed and reviewed with the shaman healer to identify symbolic meanings and processes. Through ritual exchange and reciprocal transaction between the spirit and living world, the shaman facilitated the resolution of the spiritual problem and promoted the patient's healing and sense of well-being. Awareness of the symbolic aspects of ritual in ua neeb khu and the relationship to the patient's world view is useful to health practitioners for a holistic understanding of Hmong American healing practices.

Magnetic resonance imaging (MRI) of PEM dehydration and gas manifold flooding during continuous fuel cell operation

NASA Astrophysics Data System (ADS)

Minard, Kevin R.; Viswanathan, Vilayanur V.; Majors, Paul D.; Wang, Li-Qiong; Rieke, Peter C.

Magnetic resonance imaging (MRI) was employed for visualizing water inside a proton exchange membrane (PEM) fuel cell during 11.4 h of continuous operation with a constant load. Two-dimensional images acquired every 128 s revealed the formation of a dehydration front that propagated slowly over the surface of the fuel cell membrane-starting from gas inlets and progressing toward gas outlets. After traversing the entire PEM surface, channels in the gas manifold began to flood on the cathode side. To establish a qualitative understanding of these observations, acquired images were correlated to the current output and the operating characteristics of the fuel cell. Results demonstrate the power of MRI for visualizing changing water distributions during PEM fuel cell operation, and highlight its potential utility for studying the causes of cell failure and/or strategies of water management.

[Yellow fever: nurse counseling on travelers' health at basic health clinics].

PubMed

Mallet, Anna Paula; Dall'Agnol, Clarice Maria; Souza, Dirciara Barañano

2010-06-01

The objective of this qualitative, exploratory and descriptive study is to investigate the nursing practices related to travelers' health counseling. Data were collected from nursing professionals who work in the immunization sector of three Basic Health Units in Porto Alegre, Rio Grande do Sul, Brazil, using the technique of semi-structured interview. Five categories emerged from content analysis: care profile, health orientation, referrals to exchange the National Immunization Card for the International Certificate of Vaccination, information source and information material. The results signal the beginning of an organization of nursing practices focused on travelers' health, going beyond the focus on yellow fever. Failures in guidelines for acquisition of International Certificate of Vaccination still occur and information materials are missing. It points out to the need of broadening the discussion on travelers' health for a review of strategies for care organization and referrals for the construction of a specific policy.

Disorder Problem In Diluted Magnetic Semiconductors

NASA Astrophysics Data System (ADS)

Nelson, Ryky; Ekuma, Chinedu; Terletska, Hanna; Sudhindra, Vidhyadhiraja; Moreno, Juana; Jarrell, Mark

2015-03-01

Motivated by experimental studies addressing the role of impurity disorder in diluted magnetic semiconductors (DMS), we investigate the effects of disorder using a simple tight-binding Hamiltonian with random impurity potential and spin-fermion exchange which is self-consistently solved using the typical medium theory. Adopting the typical density of states (TDoS) as the order parameter, we find that the TDoS vanishes below a critical concentration of the impurity, which indicates an Anderson localization transition in the system. Our results qualitatively explain why at concentrations lower than a critical value DMS are insulating and paramagnetic, while at larger concentrations are ferromagnetic. We also compare several simple models to explore the interplay between ferromagnetic order and disorder induced insulating behavior, and the role of the spin-orbit interaction on this competition. We apply our findings to (Ga,Mn)As and (Ga,Mn)N to compare and contrast their phase diagrams.

Organisational learning and self-adaptation in dynamic disaster environments.

PubMed

Corbacioglu, Sitki; Kapucu, Naim

2006-06-01

This paper examines the problems associated with inter-organisational learning and adaptation in the dynamic environments that characterise disasters. The research uses both qualitative and quantitative methods to investigate whether organisational learning took place during and in the time in between five disaster response operations in Turkey. The availability of information and its exchange and distribution within and among organisational actors determine whether self-adaptation happens in the course of a disaster response operation. Organisational flexibility supported by an appropriate information infrastructure creates conditions conducive to essential interaction and permits the flow of information. The study found that no significant organisational learning occurred within Turkish disaster management following the earthquakes in Erzincan (1992), Dinar (1995) and Ceyhan (1998). By contrast, the 'symmetry-breaking' Marmara earthquake of 1999 initiated a 'double loop' learning process that led to change in the organisational, technical and cultural aspects of Turkish disaster management, as revealed by the Duzce earthquake response operations.

Drug use and HIV risk in Trinidad and Tobago: qualitative study.

PubMed

Djumalieva, D; Imamshah, W; Wagner, U; Razum, O

2002-09-01

Crack use is an important risk factor for HIV infection because of its association with unsafe sexual practices. We investigated factors promoting the initiation of crack cocaine use; the sexual behaviour of crack users; and their rehabilitation care seeking behaviour in Trinidad and Tobago. We conducted 40 in-depth interviews with drug users. Respondents frequently reported a history of parental desertion, alcohol abuse, and physical abuse within the family. They perceived peer pressure and drug use in the family as important factors promoting first drug use. Exchanging sex for drugs was common, and practising oral sex was considered safe. Female drug users rarely seek rehabilitative care because of stigmatization and lack of care for their children. In Trinidad, attitudes towards drugs in society and families need to be changed. Campaigns promoting safer sex should emphasize the risk of oral sex. Rehabilitation facilities caring for female drug users should offer child care.

A graphical method to evaluate predominant geochemical processes occurring in groundwater systems for radiocarbon dating

USGS Publications Warehouse

Han, Liang-Feng; Plummer, Niel; Aggarwal, Pradeep

2012-01-01

A graphical method is described for identifying geochemical reactions needed in the interpretation of radiocarbon age in groundwater systems. Graphs are constructed by plotting the measured 14C, δ13C, and concentration of dissolved inorganic carbon and are interpreted according to specific criteria to recognize water samples that are consistent with a wide range of processes, including geochemical reactions, carbon isotopic exchange, 14C decay, and mixing of waters. The graphs are used to provide a qualitative estimate of radiocarbon age, to deduce the hydrochemical complexity of a groundwater system, and to compare samples from different groundwater systems. Graphs of chemical and isotopic data from a series of previously-published groundwater studies are used to demonstrate the utility of the approach. Ultimately, the information derived from the graphs is used to improve geochemical models for adjustment of radiocarbon ages in groundwater systems.

Using social media to promote international student partnerships.

PubMed

Garrett, Bernard M; Cutting, Roger

2012-11-01

This paper describes a project to establish and evaluate online study partnerships, using social networking applications, between final year Canadian nursing students at the University of British Columbia (UBC) and second year undergraduate science education students at the University of Plymouth (UoP) in the UK. The project took place between 2009 and 2010 and evaluated the use of social networking applications with international interdisciplinary partnerships between Canadian and UK students. A multi-method evaluation strategy incorporating questionnaires, online focus groups and web analytics was used to explore the value of social media to promote the exchange of ideas and discussion of scientific philosophy in different contexts, between students working in disciplines with differing philosophical perspectives principally modern/post-modern, quantitative/qualitative, empirical/theoretical. This project resulted in a very successful collaborative partnership between UK and Canadian students. Copyright © 2012 Elsevier Ltd. All rights reserved.

Oceanic Fluxes of Mass, Heat and Freshwater: A Global Estimate and Perspective

NASA Technical Reports Server (NTRS)

MacDonald, Alison Marguerite

1995-01-01

Data from fifteen globally distributed, modern, high resolution, hydrographic oceanic transects are combined in an inverse calculation using large scale box models. The models provide estimates of the global meridional heat and freshwater budgets and are used to examine the sensitivity of the global circulation, both inter and intra-basin exchange rates, to a variety of external constraints provided by estimates of Ekman, boundary current and throughflow transports. A solution is found which is consistent with both the model physics and the global data set, despite a twenty five year time span and a lack of seasonal consistency among the data. The overall pattern of the global circulation suggested by the models is similar to that proposed in previously published local studies and regional reviews. However, significant qualitative and quantitative differences exist. These differences are due both to the model definition and to the global nature of the data set.

Multi-tracer investigation of river and groundwater interactions: a case study in Nalenggele River basin, northwest China

NASA Astrophysics Data System (ADS)

Xu, Wei; Su, Xiaosi; Dai, Zhenxue; Yang, Fengtian; Zhu, Pucheng; Huang, Yong

2017-11-01

Environmental tracers (such as major ions, stable and radiogenic isotopes, and heat) monitored in natural waters provide valuable information for understanding the processes of river-groundwater interactions in arid areas. An integrated framework is presented for interpreting multi-tracer data (major ions, stable isotopes (2H, 18O), the radioactive isotope 222Rn, and heat) for delineating the river-groundwater interactions in Nalenggele River basin, northwest China. Qualitative and quantitative analyses were undertaken to estimate the bidirectional water exchange associated with small-scale interactions between groundwater and surface water. Along the river stretch, groundwater and river water exchange readily. From the high mountain zone to the alluvial fan, groundwater discharge to the river is detected by tracer methods and end-member mixing models, but the river has also been identified as a losing river using discharge measurements, i.e. discharge is bidirectional. On the delta-front of the alluvial fan and in the alluvial plain, in the downstream area, the characteristics of total dissolved solids values, 222Rn concentrations and δ18O values in the surface water, and patterns derived from a heat-tracing method, indicate that groundwater discharges into the river. With the environmental tracers, the processes of river-groundwater interaction have been identified in detail for better understanding of overall hydrogeological processes and of the impacts on water allocation policies.

A hybrid probabilistic/spectral model of scalar mixing

NASA Astrophysics Data System (ADS)

Vaithianathan, T.; Collins, Lance

2002-11-01

In the probability density function (PDF) description of a turbulent reacting flow, the local temperature and species concentration are replaced by a high-dimensional joint probability that describes the distribution of states in the fluid. The PDF has the great advantage of rendering the chemical reaction source terms closed, independent of their complexity. However, molecular mixing, which involves two-point information, must be modeled. Indeed, the qualitative shape of the PDF is sensitive to this modeling, hence the reliability of the model to predict even the closed chemical source terms rests heavily on the mixing model. We will present a new closure to the mixing based on a spectral representation of the scalar field. The model is implemented as an ensemble of stochastic particles, each carrying scalar concentrations at different wavenumbers. Scalar exchanges within a given particle represent ``transfer'' while scalar exchanges between particles represent ``mixing.'' The equations governing the scalar concentrations at each wavenumber are derived from the eddy damped quasi-normal Markovian (or EDQNM) theory. The model correctly predicts the evolution of an initial double delta function PDF into a Gaussian as seen in the numerical study by Eswaran & Pope (1988). Furthermore, the model predicts the scalar gradient distribution (which is available in this representation) approaches log normal at long times. Comparisons of the model with data derived from direct numerical simulations will be shown.

Evaluating Environmental Governance along Cross-Border Electricity Supply Chains with Policy-Informed Life Cycle Assessment: The California-Mexico Energy Exchange.

PubMed

Bolorinos, Jose; Ajami, Newsha K; Muñoz Meléndez, Gabriela; Jackson, Robert B

2018-05-01

This paper presents a "policy-informed" life cycle assessment of a cross-border electricity supply chain that links the impact of each unit process to its governing policy framework. An assessment method is developed and applied to the California-Mexico energy exchange as a unique case study. CO 2 -equivalent emissions impacts, water withdrawals, and air quality impacts associated with California's imports of electricity from Mexican combined-cycle facilities fueled by natural gas from the U.S. Southwest are estimated, and U.S. and Mexican state and federal environmental regulations are examined to assess well-to-wire consistency of energy policies. Results indicate most of the water withdrawn per kWh exported to California occurs in Baja California, most of the air quality impacts accrue in the U.S. Southwest, and emissions of CO 2 -equivalents are more evenly divided between the two regions. California energy policy design addresses generation-phase CO 2 emissions, but not upstream CO 2 -eq emissions of methane during the fuel cycle. Water and air quality impacts are not regulated consistently due to varying U.S. state policies and a lack of stringent federal regulation of unconventional gas development. Considering local impacts and the regulatory context where they occur provides essential qualitative information for functional-unit-based measures of life cycle impact and is necessary for a more complete environmental impact assessment.

A Data Model for Teleconsultation in Managing High-Risk Pregnancies: Design and Preliminary Evaluation

PubMed Central

Deldar, Kolsoum

2017-01-01

Background Teleconsultation is a guarantor for virtual supervision of clinical professors on clinical decisions made by medical residents in teaching hospitals. Type, format, volume, and quality of exchanged information have a great influence on the quality of remote clinical decisions or tele-decisions. Thus, it is necessary to develop a reliable and standard model for these clinical relationships. Objective The goal of this study was to design and evaluate a data model for teleconsultation in the management of high-risk pregnancies. Methods This study was implemented in three phases. In the first phase, a systematic review, a qualitative study, and a Delphi approach were done in selected teaching hospitals. Systematic extraction and localization of diagnostic items to develop the tele-decision clinical archetypes were performed as the second phase. Finally, the developed model was evaluated using predefined consultation scenarios. Results Our review study has shown that present medical consultations have no specific structure or template for patient information exchange. Furthermore, there are many challenges in the remote medical decision-making process, and some of them are related to the lack of the mentioned structure. The evaluation phase of our research has shown that data quality (P<.001), adequacy (P<.001), organization (P<.001), confidence (P<.001), and convenience (P<.001) had more scores in archetype-based consultation scenarios compared with routine-based ones. Conclusions Our archetype-based model could acquire better and higher scores in the data quality, adequacy, organization, confidence, and convenience dimensions than ones with routine scenarios. It is probable that the suggested archetype-based teleconsultation model may improve the quality of physician-physician remote medical consultations. PMID:29242181

Continuous Groundwater Monitoring Collocated at USGS Streamgages

NASA Astrophysics Data System (ADS)

Constantz, J. E.; Eddy-Miller, C.; Caldwell, R.; Wheeer, J.; Barlow, J.

2012-12-01

USGS Office of Groundwater funded a 2-year pilot study collocating groundwater wells for monitoring water level and temperature at several existing continuous streamgages in Montana and Wyoming, while U.S. Army Corps of Engineers funded enhancement to streamgages in Mississippi. To increase spatial relevance with in a given watershed, study sites were selected where near-stream groundwater was in connection with an appreciable aquifer, and where logistics and cost of well installations were considered representative. After each well installation and surveying, groundwater level and temperature were easily either radio-transmitted or hardwired to existing data acquisition system located in streamgaging shelter. Since USGS field personnel regularly visit streamgages during routine streamflow measurements and streamgage maintenance, the close proximity of observation wells resulted in minimum extra time to verify electronically transmitted measurements. After field protocol was tuned, stream and nearby groundwater information were concurrently acquired at streamgages and transmitted to satellite from seven pilot-study sites extending over nearly 2,000 miles (3,200 km) of the central US from October 2009 until October 2011, for evaluating the scientific and engineering add-on value of the enhanced streamgage design. Examination of the four-parameter transmission from the seven pilot study groundwater gaging stations reveals an internally consistent, dynamic data suite of continuous groundwater elevation and temperature in tandem with ongoing stream stage and temperature data. Qualitatively, the graphical information provides appreciation of seasonal trends in stream exchanges with shallow groundwater, as well as thermal issues of concern for topics ranging from ice hazards to suitability of fish refusia, while quantitatively this information provides a means for estimating flux exchanges through the streambed via heat-based inverse-type groundwater modeling. In June USGS Fact Sheet 2012-3054 was released online, summarizing the results of the pilot project.

Patients in transition--improving hospital-home care collaboration through electronic messaging: providers' perspectives.

PubMed

Melby, Line; Brattheim, Berit J; Hellesø, Ragnhild

2015-12-01

To explore how the use of electronic messages support hospital and community care nurses' collaboration and communication concerning patients' admittance to and discharges from hospitals. Nurses in hospitals and in community care play a crucial role in the transfer of patients between the home and the hospital. Several studies have shown that transition situations are challenging due to a lack of communication and information exchange. Information and communication technologies may support nurses' work in these transition situations. An electronic message system was introduced in Norway to support patient transitions across the health care sector. A descriptive, qualitative interview study was conducted. One hospital and three adjacent communities were included in the study. We conducted semi-structured interviews with hospital nurses and community care nurses. In total, 41 persons were included in the study. The analysis stemmed from three main topics related to the aims of e-messaging: efficiency, quality and safety. These were further divided into sub-themes. All informants agreed that electronic messaging is more efficient, i.e. less time-consuming than previous means of communication. The shift from predominantly oral communication to writing electronic messages has brought attention to the content of the information exchanged, thereby leading to more conscious communication. Electronic messaging enables improved information security, thereby enhancing patient safety, but this depends on nurses using the system as intended. Nurses consider electronic messaging to be a useful tool for communication and collaboration in patient transitions. Patient transitions are demanding situations both for patients and for the nurses who facilitate the transitions. The introduction of information and communication technologies can support nurses' work in the transition situations, and this is likely to benefit the patients. © 2015 John Wiley & Sons Ltd.

Biased thermohaline exchanges with the Arctic across the Iceland-Faroe Ridge in ocean climate models

NASA Astrophysics Data System (ADS)

Olsen, S. M.; Hansen, B.; Østerhus, S.; Quadfasel, D.; Valdimarsson, H.

2016-04-01

The northern limb of the Atlantic thermohaline circulation and its transport of heat and salt towards the Arctic strongly modulate the climate of the Northern Hemisphere. The presence of warm surface waters prevents ice formation in parts of the Arctic Mediterranean, and ocean heat is directly available for sea-ice melt, while salt transport may be critical for the stability of the exchanges. Through these mechanisms, ocean heat and salt transports play a disproportionally strong role in the climate system, and realistic simulation is a requisite for reliable climate projections. Across the Greenland-Scotland Ridge (GSR) this occurs in three well-defined branches where anomalies in the warm and saline Atlantic inflow across the shallow Iceland-Faroe Ridge (IFR) have been shown to be particularly difficult to simulate in global ocean models. This branch (IF-inflow) carries about 40 % of the total ocean heat transport into the Arctic Mediterranean and is well constrained by observation during the last 2 decades but associated with significant inter-annual fluctuations. The inconsistency between model results and observational data is here explained by the inability of coarse-resolution models to simulate the overflow across the IFR (IF-overflow), which feeds back onto the simulated IF-inflow. In effect, this is reduced in the model to reflect only the net exchange across the IFR. Observational evidence is presented for a substantial and persistent IF-overflow and mechanisms that qualitatively control its intensity. Through this, we explain the main discrepancies between observed and simulated exchange. Our findings rebuild confidence in modelled net exchange across the IFR, but reveal that compensation of model deficiencies here through other exchange branches is not effective. This implies that simulated ocean heat transport to the Arctic is biased low by more than 10 % and associated with a reduced level of variability, while the quality of the simulated salt transport becomes critically dependent on the link between IF-inflow and IF-overflow. These features likely affect sensitivity and stability of climate models to climate change and limit the predictive skill.

Structural analysis of health-relevant policy-making information exchange networks in Canada.

PubMed

Contandriopoulos, Damien; Benoît, François; Bryant-Lukosius, Denise; Carrier, Annie; Carter, Nancy; Deber, Raisa; Duhoux, Arnaud; Greenhalgh, Trisha; Larouche, Catherine; Leclerc, Bernard-Simon; Levy, Adrian; Martin-Misener, Ruth; Maximova, Katerina; McGrail, Kimberlyn; Nykiforuk, Candace; Roos, Noralou; Schwartz, Robert; Valente, Thomas W; Wong, Sabrina; Lindquist, Evert; Pullen, Carolyn; Lardeux, Anne; Perroux, Melanie

2017-09-20

Health systems worldwide struggle to identify, adopt, and implement in a timely and system-wide manner the best-evidence-informed-policy-level practices. Yet, there is still only limited evidence about individual and institutional best practices for fostering the use of scientific evidence in policy-making processes The present project is the first national-level attempt to (1) map and structurally analyze-quantitatively-health-relevant policy-making networks that connect evidence production, synthesis, interpretation, and use; (2) qualitatively investigate the interaction patterns of a subsample of actors with high centrality metrics within these networks to develop an in-depth understanding of evidence circulation processes; and (3) combine these findings in order to assess a policy network's "absorptive capacity" regarding scientific evidence and integrate them into a conceptually sound and empirically grounded framework. The project is divided into two research components. The first component is based on quantitative analysis of ties (relationships) that link nodes (participants) in a network. Network data will be collected through a multi-step snowball sampling strategy. Data will be analyzed structurally using social network mapping and analysis methods. The second component is based on qualitative interviews with a subsample of the Web survey participants having central, bridging, or atypical positions in the network. Interviews will focus on the process through which evidence circulates and enters practice. Results from both components will then be integrated through an assessment of the network's and subnetwork's effectiveness in identifying, capturing, interpreting, sharing, reframing, and recodifying scientific evidence in policy-making processes. Knowledge developed from this project has the potential both to strengthen the scientific understanding of how policy-level knowledge transfer and exchange functions and to provide significantly improved advice on how to ensure evidence plays a more prominent role in public policies.

Invited Paper - Density functional theory: coverage of dynamic and non-dynamic electron correlation effects

NASA Astrophysics Data System (ADS)

Cremer, Dieter

The electron correlation effects covered by density functional theory (DFT) can be assessed qualitatively by comparing DFT densities ρ(r) with suitable reference densities obtained with wavefunction theory (WFT) methods that cover typical electron correlation effects. The analysis of difference densities ρ(DFT)-ρ(WFT) reveals that LDA and GGA exchange (X) functionals mimic non-dynamic correlation effects in an unspecified way. It is shown that these long range correlation effects are caused by the self-interaction error (SIE) of standard X functionals. Self-interaction corrected (SIC) DFT exchange gives, similar to exact exchange, for the bonding region a delocalized exchange hole, and does not cover any correlation effects. Hence, the exchange SIE is responsible for the fact that DFT densities often resemble MP4 or MP2 densities. The correlation functional changes X-only DFT densities in a manner observed when higher order coupling effects between lower order N-electron correlation effects are included. Hybrid functionals lead to changes in the density similar to those caused by SICDFT, which simply reflects the fact that hybrid functionals have been developed to cover part of the SIE and its long range correlation effects in a balanced manner. In the case of spin-unrestricted DFT (UDFT), non-dynamic electron correlation effects enter the calculation both via the X functional and via the wavefunction, which may cause a double-counting of correlation effects. The use of UDFT in the form of permuted orbital and broken-symmetry DFT (PO-UDFT, BS-UDFT) can lead to reasonable descriptions of multireference systems provided certain conditions are fulfilled. More reliable, however, is a combination of DFT and WFT methods, which makes the routine description of multireference systems possible. The development of such methods implies a separation of dynamic and non-dynamic correlation effects. Strategies for accomplishing this goal are discussed in general and tested in practice for CAS (complete active space)-DFT.

Exchange potential from the common energy denominator approximation for the Kohn-Sham Green's function: Application to (hyper)polarizabilities of molecular chains

NASA Astrophysics Data System (ADS)

Grüning, M.; Gritsenko, O. V.; Baerends, E. J.

2002-04-01

An approximate Kohn-Sham (KS) exchange potential vxσCEDA is developed, based on the common energy denominator approximation (CEDA) for the static orbital Green's function, which preserves the essential structure of the density response function. vxσCEDA is an explicit functional of the occupied KS orbitals, which has the Slater vSσ and response vrespσCEDA potentials as its components. The latter exhibits the characteristic step structure with "diagonal" contributions from the orbital densities |ψiσ|2, as well as "off-diagonal" ones from the occupied-occupied orbital products ψiσψj(≠1)σ*. Comparison of the results of atomic and molecular ground-state CEDA calculations with those of the Krieger-Li-Iafrate (KLI), exact exchange (EXX), and Hartree-Fock (HF) methods show, that both KLI and CEDA potentials can be considered as very good analytical "closure approximations" to the exact KS exchange potential. The total CEDA and KLI energies nearly coincide with the EXX ones and the corresponding orbital energies ɛiσ are rather close to each other for the light atoms and small molecules considered. The CEDA, KLI, EXX-ɛiσ values provide the qualitatively correct order of ionizations and they give an estimate of VIPs comparable to that of the HF Koopmans' theorem. However, the additional off-diagonal orbital structure of vxσCEDA appears to be essential for the calculated response properties of molecular chains. KLI already considerably improves the calculated (hyper)polarizabilities of the prototype hydrogen chains Hn over local density approximation (LDA) and standard generalized gradient approximations (GGAs), while the CEDA results are definitely an improvement over the KLI ones. The reasons of this success are the specific orbital structures of the CEDA and KLI response potentials, which produce in an external field an ultranonlocal field-counteracting exchange potential.

Structures and processes in spontaneous ADR reporting systems: a comparative study of Australia and Denmark.

PubMed

Aagaard, Lise; Stenver, Doris Irene; Hansen, Ebba Holme

2008-10-01

To explore the organisational structure and processes of the Danish and Australian spontaneous ADR reporting systems with a view to how information is generated about new ADRs. The Danish and Australian spontaneous ADR reporting systems. Qualitative analyses of documentary material, descriptive interviews with key informants, and observations were made. We analysed the organisational structure of the Danish and Australian ADR reporting systems with respect to structures and processes, including information flow and exchange of ADR data. The analysis was made based on Scott's adapted version of Leavitt's diamond model, with the components: goals/tasks, social structure, technology and participants, within a surrounding environment. The main differences between the systems were: (1) PARTICIPANTS: Outsourcing of ADR assessments to the pharmaceutical companies complicates maintenance of scientific skills within the Danish Medicines Agency (DKMA), as it leaves the handling of spontaneous ADR reports purely administrative within the DKMA, and the knowledge creation process remains with the pharmaceutical companies, while in Australia senior scientific staff work with evaluation of the ADR report; (2) Goals/tasks: In Denmark, resources are targeted at evaluating Periodic Safety Update Reports (PSUR) submitted by the companies, while the resources in Australia are focused on single case assessment resulting in faster and more proactive medicine surveillance; (3) Social structure: Discussions between scientific staff about ADRs take place in Australia, while the Danish system primarily focuses on entering and forwarding ADR data to the relevant pharmaceutical companies; (4) Technology: The Danish system exchanges ADR data electronically with pharmaceutical companies and the other EU countries, while Australia does not have a system for electronic exchange of ADR data; and (5) ENVIRONMENT: The Danish ADR system is embedded in the routines of cooperation within European pharmacovigilance network while the Australian system is acting alone, although they communicate with other systems. The two systems differ with regard to reporting requirements, report handling, resources being spent and information exchange with the environment. In Denmark, learning about ADRs primarily takes place in the safety divisions of the pharmaceutical companies and the authorities have no control over the knowledge creation process. In Australia, more learning and control of the knowledge is present than in Denmark.

Trust, confidentiality, and the acceptability of sharing HIV-related patient data: lessons learned from a mixed methods study about Health Information Exchanges.

PubMed

Maiorana, Andre; Steward, Wayne T; Koester, Kimberly A; Pearson, Charles; Shade, Starley B; Chakravarty, Deepalika; Myers, Janet J

2012-04-19

Concerns about the confidentiality of personal health information have been identified as a potential obstacle to implementation of Health Information Exchanges (HIEs). Considering the stigma and confidentiality issues historically associated with human immunodeficiency virus (HIV) disease, we examine how trust-in technology, processes, and people-influenced the acceptability of data sharing among stakeholders prior to implementation of six HIEs intended to improve HIV care in parts of the United States. Our analyses identify the kinds of concerns expressed by stakeholders about electronic data sharing and focus on the factors that ultimately facilitated acceptability of the new exchanges. We conducted 549 surveys with patients and 66 semi-structured interviews with providers and other stakeholders prior to implementation of the HIEs to assess concerns about confidentiality in the electronic sharing of patient data. The patient quantitative data were analyzed using SAS 9.2 to yield sample descriptive statistics. The analysis of the qualitative interviews with providers and other stakeholders followed an open-coding process, and convergent and divergent perspectives emerging from those data were examined within and across the HIEs. We found widespread acceptability for electronic sharing of HIV-related patient data through HIEs. This acceptability appeared to be driven by growing comfort with information technologies, confidence in the security protocols utilized to protect data, trust in the providers and institutions who use the technologies, belief in the benefits to the patients, and awareness that electronic exchange represents an enhancement of data sharing already taking place by other means. HIE acceptability depended both on preexisting trust among patients, providers, and institutions and on building consensus and trust in the HIEs as part of preparation for implementation. The process of HIE development also resulted in forging shared vision among institutions. Patients and providers are willing to accept the electronic sharing of HIV patient data to improve care for a disease historically seen as highly stigmatized. Acceptability depends on the effort expended to understand and address potential concerns related to data sharing and confidentiality, and on the trust established among stakeholders in terms of the nature of the systems and how they will be used.

A multi-centre qualitative study exploring the experiences of UK South Asian and white diabetic patients referred for renal care.

PubMed

Wilkinson, Emma; Randhawa, Gurch; Feehally, John; Farrington, Ken; Greenwood, Roger; Choi, Peter; Lightstone, Liz

2012-11-23

An exploration of renal complications of diabetes from the patient perspective is important for developing quality care through the diabetic renal disease care pathway. Newly referred South Asian and White diabetic renal patients over 16 years were recruited from nephrology outpatient clinics in three UK centres--Luton, West London and Leicester--and their experiences of the diabetes and renal care recorded.A semi-structured qualitative interview was conducted with 48 patients. Interview transcripts were analysed thematically and comparisons made between the White and South Asian groups. 23 South Asian patients and 25 White patients were interviewed. Patient experience of diabetes ranged from a few months to 35 years with a mean time since diagnosis of 12.1 years and 17.1 years for the South Asian and White patients respectively. Confusion emerged as a response to referral shared by both groups. This sense of confusion was associated with reported lack of information at the time of referral, but also before referral. Language barriers exacerbated confusion for South Asian patients. The diabetic renal patients who have been referred for specialist renal care and found the referral process confusing have poor of awareness of kidney complications of diabetes. Healthcare providers should be more aware of the ongoing information needs of long term diabetics as well as the context of any information exchange including language barriers.

Exchange Studies as Actor-Networks: Following Korean Exchange Students in Swedish Higher Education

ERIC Educational Resources Information Center

Ahn, Song-ee

2011-01-01

This article explores how Korean exchange students organized their studies during exchange programs in Swedish higher education. For most students, the programs became a disordered period in relation to their education. The value of exchange studies seems mainly to be extra-curricular. Drawing upon actor network theory, the article argues that the…

What do external consultants from private and not-for-profit companies offer healthcare commissioners? A qualitative study of knowledge exchange.

PubMed

Wye, Lesley; Brangan, Emer; Cameron, Ailsa; Gabbay, John; Klein, Jonathan H; Anthwal, Rachel; Pope, Catherine

2015-02-25

The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. NHS commissioning organisations and private and not-for-profit providers. Mixed methods case study of eight cases. 92 interviews with external consultants (n=36), their clients (n=47) and others (n=9). Observation of 25 training events and meetings. Documentation, for example, meeting minutes and reports. Constant comparison. Data were coded, summarised and analysed by the research team with a coding framework to facilitate cross-case comparison. In the four contracts presented here, external providers offered technical solutions (eg, software tools), outsourcing and expertise including project management, data interpretation and brokering relationships with experts. In assessing perceived impact on quality of commissioning, two contracts had limited value, one had short-term benefits and one provided short and longer term benefits. Contracts with commissioners actively learning, embedding and applying new skills were more valued. Other elements of success were: (1) addressing clearly agreed problems of relevance to managerial and operational staff (2) solutions co-produced at all organisational levels (3) external consultants working directly with clients to interpret data outputs to inform locally contextualised commissioning strategies. Without explicit knowledge exchange strategies, outsourcing commissioning to external providers resulted in the NHS clients becoming dependent. NHS commissioning will be disadvantaged if commissioners both fail to learn in the short term from the knowledge of external providers and in the longer term lose local skills. Knowledge exchange mechanisms are a vital component of commissioning and should be embedded in external provider contracts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

How do stakeholders from multiple hierarchical levels of a large provincial health system define engagement? A qualitative study.

PubMed

Norris, Jill M; White, Deborah E; Nowell, Lorelli; Mrklas, Kelly; Stelfox, Henry T

2017-08-01

Engaging stakeholders from varied organizational levels is essential to successful healthcare quality improvement. However, engagement has been hard to achieve and to measure across diverse stakeholders. Further, current implementation science models provide little clarity about what engagement means, despite its importance. The aim of this study was to understand how stakeholders of healthcare improvement initiatives defined engagement. Participants (n = 86) in this qualitative thematic study were purposively sampled for individual interviews. Participants included leaders, core members, frontline clinicians, support personnel, and other stakeholders of Strategic Clinical Networks in Alberta Health Services, a Canadian provincial health system with over 108,000 employees. We used an iterative thematic approach to analyze participants' responses to the question, "How do you define engagement?" Regardless of their organizational role, participants defined engagement through three interrelated themes. First, engagement was active participation from willing and committed stakeholders, with levels that ranged from information sharing to full decision-making. Second, engagement centered on a shared decision-making process about meaningful change for everyone "around the table," those who are most impacted. Third, engagement was two-way interactions that began early in the change process, where exchanges were respectful and all stakeholders felt heard and understood. This study highlights the commonalities of how stakeholders in a large healthcare system defined engagement-a shared understanding and terminology-to guide and improve stakeholder engagement. Overall, engagement was an active and committed decision-making about a meaningful problem through respectful interactions and dialog where everyone's voice is considered. Our results may be used in conjunction with current implementation models to provide clarity about what engagement means and how to engage various stakeholders.

In Pursuit of Theoretical Ground in Behavior Change Support Systems: Analysis of Peer-to-Peer Communication in a Health-Related Online Community

PubMed Central

Cobb, Nathan; Cohen, Trevor

2016-01-01

Background Research studies involving health-related online communities have focused on examining network structure to understand mechanisms underlying behavior change. Content analysis of the messages exchanged in these communities has been limited to the “social support” perspective. However, existing behavior change theories suggest that message content plays a prominent role reflecting several sociocognitive factors that affect an individual’s efforts to make a lifestyle change. An understanding of these factors is imperative to identify and harness the mechanisms of behavior change in the Health 2.0 era. Objective The objective of this work is two-fold: (1) to harness digital communication data to capture essential meaning of communication and factors affecting a desired behavior change, and (2) to understand the applicability of existing behavior change theories to characterize peer-to-peer communication in online platforms. Methods In this paper, we describe grounded theory–based qualitative analysis of digital communication in QuitNet, an online community promoting smoking cessation. A database of 16,492 de-identified public messages from 1456 users from March 1-April 30, 2007, was used in our study. We analyzed 795 messages using grounded theory techniques to ensure thematic saturation. This analysis enabled identification of key concepts contained in the messages exchanged by QuitNet members, allowing us to understand the sociobehavioral intricacies underlying an individual’s efforts to cease smoking in a group setting. We further ascertained the relevance of the identified themes to theoretical constructs in existing behavior change theories (eg, Health Belief Model) and theoretically linked techniques of behavior change taxonomy. Results We identified 43 different concepts, which were then grouped under 12 themes based on analysis of 795 messages. Examples of concepts include “sleepiness,” “pledge,” “patch,” “spouse,” and “slip.” Examples of themes include “traditions,” “social support,” “obstacles,” “relapse,” and “cravings.” Results indicate that themes consisting of member-generated strategies such as “virtual bonfires” and “pledges” were related to the highest number of theoretical constructs from the existing behavior change theories. In addition, results indicate that the member-generated communication content supports sociocognitive constructs from more than one behavior change model, unlike the majority of the existing theory-driven interventions. Conclusions With the onset of mobile phones and ubiquitous Internet connectivity, online social network data reflect the intricacies of human health behavior as experienced by health consumers in real time. This study offers methodological insights for qualitative investigations that examine the various kinds of behavioral constructs prevalent in the messages exchanged among users of online communities. Theoretically, this study establishes the manifestation of existing behavior change theories in QuitNet-like online health communities. Pragmatically, it sets the stage for real-time, data-driven sociobehavioral interventions promoting healthy lifestyle modifications by allowing us to understand the emergent user needs to sustain a desired behavior change. PMID:26839162

Knowledge exchange throughout the dementia care journey by Canadian rural community-based health care practitioners, persons with dementia, and their care partners: an interpretive descriptive study.

PubMed

Forbes, Dorothy A; Finkelstein, Sara; Blake, Catherine M; Gibson, Maggie; Morgan, Debra G; Markle-Reid, Maureen; Culum, Ivan; Thiessen, Emily

2012-10-01

Accessing, assessing, exchanging, and applying dementia care information can be challenging in rural communities for healthcare practitioners (HCPs), persons with dementia (PWD), and their care partners. The overall purpose of this research was to enable HCPs, care partners, and PWD to use dementia care information more effectively by examining their information needs, how these change over time, and how they access, assess, and apply the knowledge. A qualitative interpretive descriptive approach was used. A convenience sample was initially recruited through study collaborators in Southwestern Ontario, followed by purposive sampling. Nine rural dementia care networks consisting of PWD (n = 5), care partners (n = 14), and HCPs (n = 14) were recruited and 80 interviews were conducted at three time points. Transcripts were coded using Lubrosky's thematic analysis. Six stages of the dementia care journey were identified: (1) recognizing the symptoms; (2) receiving a diagnosis; (3) loss of independence; (4) initiating and using home care and respite services; (5) long-term care (LTC) placement; and (6) decisions related to end-of-life care. Rural care partners identified the need for different types of knowledge during each of these critical decision points of the dementia care journey. They accessed information from family members, friends, local organizations, and dementia internet sites. Persons with dementia tended not to identify the need for dementia care information. The HCPs accessed dementia care information from their own organization, other organizations, and internet sites. Care partners and HCPs assessed the trustworthiness of the information based on whether the source was a well-known agency or their own organization. Barriers to knowledge exchange included: lack of rural community-based services for dementia care; care partners reluctant to seek help and had limited energy; and lack of integration of dementia-related services and supports. Facilitators of knowledge exchange included: rural care partners with healthcare experience who were actively seeking information; development of trusting relationships between HCPs, care partners, and PWD; and formal mechanisms for exchanging information within and across rural community-based organizations. This research illustrates the stages of the dementia care journey, and the types of information typically needed, accessed, assessed, and applied at each stage. Healthcare practitioners can use these findings to support rural care partners in navigating their dementia care journey. Support is needed as care partners often do not have the time, energy, skills, or knowledge to seek out dementia care information independently. In addition, PWD typically do not recognize the need for this knowledge, leaving care partners potentially isolated in this journey. Developing formal linkages within and across rural organizations will facilitate knowledge exchange and the delivery of cost-effective, quality dementia care. However, additional rural community-based resources are urgently needed to implement these recommendations. This may require a redistribution of resources from acute care to rural community care.

Multicomponent density functional theory embedding formulation.

PubMed

Culpitt, Tanner; Brorsen, Kurt R; Pak, Michael V; Hammes-Schiffer, Sharon

2016-07-28

Multicomponent density functional theory (DFT) methods have been developed to treat two types of particles, such as electrons and nuclei, quantum mechanically at the same level. In the nuclear-electronic orbital (NEO) approach, all electrons and select nuclei, typically key protons, are treated quantum mechanically. For multicomponent DFT methods developed within the NEO framework, electron-proton correlation functionals based on explicitly correlated wavefunctions have been designed and used in conjunction with well-established electronic exchange-correlation functionals. Herein a general theory for multicomponent embedded DFT is developed to enable the accurate treatment of larger systems. In the general theory, the total electronic density is separated into two subsystem densities, denoted as regular and special, and different electron-proton correlation functionals are used for these two electronic densities. In the specific implementation, the special electron density is defined in terms of spatially localized Kohn-Sham electronic orbitals, and electron-proton correlation is included only for the special electron density. The electron-proton correlation functional depends on only the special electron density and the proton density, whereas the electronic exchange-correlation functional depends on the total electronic density. This scheme includes the essential electron-proton correlation, which is a relatively local effect, as well as the electronic exchange-correlation for the entire system. This multicomponent DFT-in-DFT embedding theory is applied to the HCN and FHF(-) molecules in conjunction with two different electron-proton correlation functionals and three different electronic exchange-correlation functionals. The results illustrate that this approach provides qualitatively accurate nuclear densities in a computationally tractable manner. The general theory is also easily extended to other types of partitioning schemes for multicomponent systems.

Multicomponent density functional theory embedding formulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Culpitt, Tanner; Brorsen, Kurt R.; Pak, Michael V.

Multicomponent density functional theory (DFT) methods have been developed to treat two types of particles, such as electrons and nuclei, quantum mechanically at the same level. In the nuclear-electronic orbital (NEO) approach, all electrons and select nuclei, typically key protons, are treated quantum mechanically. For multicomponent DFT methods developed within the NEO framework, electron-proton correlation functionals based on explicitly correlated wavefunctions have been designed and used in conjunction with well-established electronic exchange-correlation functionals. Herein a general theory for multicomponent embedded DFT is developed to enable the accurate treatment of larger systems. In the general theory, the total electronic density ismore » separated into two subsystem densities, denoted as regular and special, and different electron-proton correlation functionals are used for these two electronic densities. In the specific implementation, the special electron density is defined in terms of spatially localized Kohn-Sham electronic orbitals, and electron-proton correlation is included only for the special electron density. The electron-proton correlation functional depends on only the special electron density and the proton density, whereas the electronic exchange-correlation functional depends on the total electronic density. This scheme includes the essential electron-proton correlation, which is a relatively local effect, as well as the electronic exchange-correlation for the entire system. This multicomponent DFT-in-DFT embedding theory is applied to the HCN and FHF{sup −} molecules in conjunction with two different electron-proton correlation functionals and three different electronic exchange-correlation functionals. The results illustrate that this approach provides qualitatively accurate nuclear densities in a computationally tractable manner. The general theory is also easily extended to other types of partitioning schemes for multicomponent systems.« less

Super-exchange in transition-metal oxides

NASA Astrophysics Data System (ADS)

Harrison, Walter

2007-03-01

Using contemporary tight-binding theory and parameters[1]. Anderson's perturbation approach [2] gives a qualitatively correct energy difference (a factor 2.3 too high) between ferromagnetic and antiferromagnetic configurations for MnO, It corresponds to a Heisenberg model with J2/J1= 11/7. Perturbation theory fails as the energy denominator gets smaller for FeO and CoO, and changes sign for NiO. Use of the special- points method to treat exchange-split bands gives smaller values not well characterized by a J1 and J2. Carrying it out self-consistently reorders the NiO levels and leads to still smaller energy differences near experiment for all four oxides, as estimated from the experimental N'eel temperature TN , The theory predicts a variation with pressure corresponding to (d/ TN)TN/d = -12.2 for MnO , near experiment, dropping to -9.1 for NiO. The theory is applicable also to the paramagnetic susceptibility. [1] Walter A. Harrison, Elementary Electronic Structure, World Scientific (Singapore, 1999), revised edition (2004). [2] P. W. Anderson, Phys. Rev. 115, 2 (1959).

[The relationship of the saturation density of multilayer cell cultures to their mass exchange with the medium].

PubMed

Akatov, V S; Lavrovskaia, V P

1991-01-01

Chinese hamster fibroblasts (CHF) and NIH 3T3 cells were cultured on a glass substrate at different distances from the porous membrane separating the cells from the perfusing medium. It is shown that with perfusion of medium above the membrane there is no movement of the medium near the cells. In both the types of culture, the cells grow in multilayers, however the multilayer character of growth in CHF is more pronounced than in NIH 3T3 cells. The saturation density of the cultures depends on the cell-membrane separation, and at separations of no more than 0.2 mm exceeds the saturation density in the monolayer by 8-10 fold. The dependences of the saturation density on separation are different for CHE and NIH 3T3 cells, indicating qualitative differences in the inhibition of cell growth in monolayers between these cultures. The results obtained indicate that the inhibition of cell growth in monolayer is due to mass exchange limitations, rather than to intercellular contact interactions.

Barriers and Potential Improvements for Needle and Syringe Exchange Programs (NSPs) in China: A Qualitative Study from Perspectives of Both Health and Public Security Sectors

PubMed Central

Chow, Eric P. F.; Jing, Jun; Zheng, Jun; Zhao, Junshi; Zhang, Lei

2015-01-01

This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs) and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1) participants’ attitudes towards NSPs, (2) participants’ opinions on the effectiveness and barriers of NSPs, and (3) suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division). Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34) regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24) questioned the legitimacy of NSPs and concerned about the poor management of drug users’ risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users’ addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation. PMID:26114556

Overcoming Barriers to Experience Benefits: A Qualitative Analysis of Electronic Health Records and Health Information Exchange Implementation in Local Health Departments

PubMed Central

Williams, Karmen S.; Shah, Gulzar H.; Leider, JP; Gupta, Akarti

2017-01-01

Introduction: Electronic Health Records (EHRs) and Health Information Exchanges (HIEs) are changing surveillance and analytic operations within local health departments (LHDs) across the United States. The objective of this study was to analyze the status, benefits, barriers, and ways of overcoming challenges in the implementation of EHRs and HIEs in LHDs. Methods: This study employed a mixed methods approach, first using the 2013 National Profile of LHDs survey to ascertain the status of EHR and HIE implementation across the US, as well as to aid in selection of respondents for the second, interview-based part of project. Next, forty-nine key-informant interviews of local health department staff were conducted. Data were coded thematically and independently by two researchers. Coding was compared and re-coded using the consensus definitions. Results: Twenty-three percent of LHDs nationwide are using EHRs and 14 percent are using HIEs. The most frequently mentioned benefits for implementation were identified as care coordination, retrieval or managing information, and the ability to track outcomes of care. A few mentioned barriers included financial resources, resistance to change, and IT related issues during implementation. Discussion: Despite financial, technical capacity, and operational constraints, leaders interviewed as part of this project were optimistic about the future of EHRs in local health departments. Recent policy changes and accreditation have implications of improving processes to affect populations served. Conclusions: Overcoming the challenges in implementing EHRs can result in increased efficiencies in surveillance and higher quality patient care and tracking. However, significant opportunity cost does exist. PMID:29881738

How could Health Information Exchange Better Meet the Needs of Care Practitioners?

PubMed Central

Kaushal, R.; Vest, J.R.

2014-01-01

Summary Background Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high. Objectives We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners. Methods We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State. Results The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows. Conclusions Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable. PMID:25589903

Relationship-Building Skills of Child-Rearing Mothers in Japanese Communities

PubMed Central

Matsuda, Nobuko; Hirano, Michiyo; Saeki, Kazuko

2016-01-01

This study elucidated the skills of mothers who used to build positive interpersonal relationships with people they met through child-rearing. The research method was qualitative descriptive study. The participants were 24 mothers who had children between ages of one and four years. These participants were recruited at child-rearing salons and childcare centers located in various municipalities in Japan. The survey period was from September 2013 to July 2014. The mothers' interpersonal relationship-building skills were described by six categories: “ability to strive for new encounters,” “ability to try to interact socially with others,” “ability to choose compatible people,” “ability to continuously maintain good relationships,” “ability to take action suitable to a situation,” and “ability to build positive relationships with parents-in-law.” Cognitive aspects of assessing and understanding the interactions that occur during exchanges and behavioral aspects guided by these cognitions were identified within these skills. This study contributed to providing a framework to understand mothers' interpersonal relationship-building skills for public health nurses involved in child-rearing support. PMID:27429804

Near-Surface Transport Pathways in the North Atlantic Ocean: Looking for Throughput from the Subtropical to the Subpolar Gyre

NASA Astrophysics Data System (ADS)

Rypina, I. I.; Pratt, L. J.; Lozier, M.

2011-12-01

Motivated by discrepancies between Eulerian transport estimates and the behavior of Lagrangian surface drifters, near-surface transport pathways and processes in the North Atlantic are studied using a combination of data, altimetric surface heights, statistical analysis of trajectories, and dynamical systems techniques. Particular attention is paid to the issue of the subtropical-to-subpolar intergyre fluid exchange. The velocity field used in this study is composed of a steady drifter-derived background flow, upon which a time-dependent altimeter-based perturbation is superimposed. This analysis suggests that most of the fluid entering the subpolar gyre from the subtropical gyre within two years comes from a narrow region lying inshore of the Gulf Stream core, whereas fluid on the offshore side of the Gulf Stream is largely prevented from doing so by the Gulf Stream core, which acts as a strong transport barrier, in agreement with past studies. The transport barrier near the Gulf Stream core is robust and persistent from 1992 until 2008. The qualitative behavior is found to be largely independent of the Ekman drift.

Synthesis and Ion-Exchange Properties of Graphene Th(IV) Phosphate Composite Cation Exchanger: Its Applications in the Selective Separation of Lead Metal Ions

PubMed Central

Rangreez, Tauseef Ahmad; Alhogbi, Basma G.; Naushad, Mu.

2017-01-01

In this study, graphene Th(IV) phosphate was prepared by sol–gel precipitation method. The ion-exchange behavior of this cation-exchanger was studied by investigating properties like ion-exchange capacity for various metal ions, the effect of eluent concentration, elution behavior, and thermal effect on ion-exchange capacity (IEC). Several physicochemical properties as Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD) study, thermal studies, scanning electron microscopy (SEM) and transmission electron microscopy (TEM) studies were also carried out. The material possessed an IEC of 1.56 meq·dry·g−1 of the exchanger and was found to be nano-composite. The selectivity studies showed that the material is selective towards Pb(II) ions. The selectivity of this cation-exchanger was demonstrated in the binary separation of Pb(II) ions from mixture with other metal ions. The recovery was found to be both quantitative and reproducible. PMID:28737717

Intershell correlations in Compton photon scattering by an atom

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hopersky, Alexey N.; Nadolinsky, Alexey M.; Novikov, Sergey A.

The role of the intershell correlation effect is theoretically investigated using the example of the Ne atom in nonresonance Compton high-energy x-ray photon scattering by a free atom. The calculation results qualitatively reproduce the same results in the formalism of the generalized oscillator strength and the random phase approximation with exchange for the Compton photon and electron scattering by an atom; when the incident photon energy is 11 keV and the scattering angle is 90 deg., they correspond well with the results of the synchrotron experiment presented in the work by Jung et al. [Phys. Rev. Lett. 81, 1596 (1998)].

The study of the mobile compressor unit heat losses recovery system waste heat exchanger thermal insulation types influence on the operational efficiency

NASA Astrophysics Data System (ADS)

Yusha, V. L.; Chernov, G. I.; Kalashnikov, A. M.

2017-08-01

The paper examines the mobile compressor unit (MCU) heat losses recovery system waste heat exchanger prototype external thermal insulation types influence on the operational efficiency. The study is conducted by means of the numerical method through the modellingof the heat exchange processes carried out in the waste heat exchanger in ANSUS. Thermaflex, mineral wool, penofol, water and air were applied as the heat exchanger external insulation. The study results showed the waste heat exchanger external thermal insulationexistence or absence to have a significant impact on the heat exchanger operational efficiency.

Physical and social availability of alcohol for young enlisted naval personnel in and around home port

PubMed Central

Moore, Roland S; Ames, Genevieve M; Cunradi, Carol B

2007-01-01

Background Heavy alcohol consumption rates are higher in the young adult military enlisted population than among civilians of the same age. The literature on alcohol availability, both generally and specifically with respect to work-related drinking, establishes clear links between ease of access, alcohol consumption rates and alcohol-related problems. Methods In this paper, a qualitative analysis of 50 semi-structured interviews with U.S. Navy personnel was combined with quantitative findings from a mail survey of 713 young enlisted men and women in order to shed light on alcohol availability and its correlates in the home port environments of young adult enlisted personnel. The interviews were analyzed by two anthropologists seeking recurring themes or topics related to alcohol availability. These qualitative data were contextualized by descriptive statistics of the survey responses regarding ease of obtaining alcohol on and around naval bases, and from friends in and out of the Navy. Results Findings associated with social and physical availability of alcohol include low prices in Navy Exchange base stores, frequent barracks parties, drink promotions in bars surrounding bases, and multiple opportunities for underage drinking despite age limits on alcohol purchases and official efforts to deglamorize alcohol use in the Navy. Both qualitative and qualitative findings suggest that respondents found alcohol and opportunities to drink overwhelmingly available in both on-base and off-base settings, and from friends both in and out of the Navy. Conclusion There is qualitative and quantitative evidence for extensive physical and social availability of alcohol in and around bases for young adults in the military. Policy implications include raising the presently tax-free alcohol prices in base stores and enforcing existing policies regarding underage drinking, particularly the provision of alcohol by people of legal drinking age, and by bars in and around bases. Cooperative preventive efforts with surrounding communities also offer promising ways for bases to reduce alcohol availability for young adult servicemembers. PMID:17603908

Physical and social availability of alcohol for young enlisted naval personnel in and around home port.

PubMed

Moore, Roland S; Ames, Genevieve M; Cunradi, Carol B

2007-06-30

Heavy alcohol consumption rates are higher in the young adult military enlisted population than among civilians of the same age. The literature on alcohol availability, both generally and specifically with respect to work-related drinking, establishes clear links between ease of access, alcohol consumption rates and alcohol-related problems. In this paper, a qualitative analysis of 50 semi-structured interviews with U.S. Navy personnel was combined with quantitative findings from a mail survey of 713 young enlisted men and women in order to shed light on alcohol availability and its correlates in the home port environments of young adult enlisted personnel. The interviews were analyzed by two anthropologists seeking recurring themes or topics related to alcohol availability. These qualitative data were contextualized by descriptive statistics of the survey responses regarding ease of obtaining alcohol on and around naval bases, and from friends in and out of the Navy. Findings associated with social and physical availability of alcohol include low prices in Navy Exchange base stores, frequent barracks parties, drink promotions in bars surrounding bases, and multiple opportunities for underage drinking despite age limits on alcohol purchases and official efforts to deglamorize alcohol use in the Navy. Both qualitative and qualitative findings suggest that respondents found alcohol and opportunities to drink overwhelmingly available in both on-base and off-base settings, and from friends both in and out of the Navy. There is qualitative and quantitative evidence for extensive physical and social availability of alcohol in and around bases for young adults in the military. Policy implications include raising the presently tax-free alcohol prices in base stores and enforcing existing policies regarding underage drinking, particularly the provision of alcohol by people of legal drinking age, and by bars in and around bases. Cooperative preventive efforts with surrounding communities also offer promising ways for bases to reduce alcohol availability for young adult servicemembers.

Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study.

PubMed

Jack, Susan M; Dobbins, Maureen; Sword, Wendy; Novotna, Gabriela; Brooks, Sandy; Lipman, Ellen L; Niccols, Alison

2011-11-07

Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. A descriptive qualitative study was conducted to explore: 1) the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2) how decision makers at different levels report using research evidence; and 3) factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence, knowledge brokering, and for partnering with universities. Resources are required to maintain web-based databases of searchable evidence to facilitate access to research evidence. A need exists to address the perception that there is a paucity of research evidence available to inform program decisions. Finally, there is a need to consider how experiential knowledge influences decision-making and what guidance research evidence has to offer regarding the implementation of different treatment approaches within the field of addictions.

Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study

PubMed Central

2011-01-01

Background Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. Methods A descriptive qualitative study was conducted to explore: 1) the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2) how decision makers at different levels report using research evidence; and 3) factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Results Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. Conclusions There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence, knowledge brokering, and for partnering with universities. Resources are required to maintain web-based databases of searchable evidence to facilitate access to research evidence. A need exists to address the perception that there is a paucity of research evidence available to inform program decisions. Finally, there is a need to consider how experiential knowledge influences decision-making and what guidance research evidence has to offer regarding the implementation of different treatment approaches within the field of addictions. PMID:22059528

Identifying Home Care Clinicians’ Information Needs for Managing Fall Risks

PubMed Central

Alhuwail, Dari

2016-01-01

Summary Objectives To help manage the risk of falls in home care, this study aimed to (i) identify home care clinicians’ information needs and how they manage missing or inaccurate data, (ii) identify problems that impact effectiveness and efficiency associated with retaining, exchanging, or processing information about fall risks in existing workflows and currently adopted health information technology (IT) solutions, and (iii) offer informatics-based recommendations to improve fall risk management interventions. Methods A case study was carried out in a single not-for-profit suburban Medicare-certified home health agency with three branches. Qualitative data were collected over a six month period through observations, semi-structured interviews, and focus groups. The Framework method was used for analysis. Maximum variation sampling was adopted to recruit a diverse sample of clinicians. Results Overall, the information needs for fall risk management were categorized into physiological, care delivery, educational, social, environmental, and administrative domains. Examples include a brief fall-related patient history, weight-bearing status, medications that affect balance, availability of caregivers at home, and the influence of patients’ cultures on fall management interventions. The unavailability and inaccuracy of critical information related to fall risks can delay necessary therapeutic services aimed at reducing patients’ risk for falling and thereby jeopardizing their safety. Currently adopted IT solutions did not adequately accommodate data related to fall risk management. Conclusion The results highlight the essential information for fall risk management in home care. Home care workflows and health IT solutions must effectively and efficiently retain, exchange, and process information necessary for fall risk management. Interoperability and integration of the various health IT solutions to make data sharing accessible to all clinicians is critical for fall risk management. Findings from this study can help home health agencies better understand their information needs to manage fall risks. PMID:27437035

[Socianalytical device: intervention instrument and data collection in qualitative research in nursing].

PubMed

Spagnol, Carla Aparecida; L'Abbate, Solange; Monceau, Gilles; Jovic, Ljiljana

2016-03-01

The aims of this paper is to describe and to analyze the use of a socioanalytical device as a data collection too as well as a space of professional practice and work relations analysis, with nurses from a School Hospital of the Minas Gerais Federal University, Brazil. The qualitative approach was chosen to develop an intervention research with Institutional Analysis as theoretical and methodological framework. In the first stage of data collection, an exploratory research was carried out through a questionnaire and, in the second phase, a socianalytical device was built in 5 meetings that took place during two months. For the nurses, the analysis device has enabled personal and professional growth; to review positions; to exchange experience and to reflect on their own problems through the experience of other colleagues. We conclude that the socioanalytical device was a space for discussion, for analysis of professional practice and was the methodological strategy for data collection in this research. It has allowed the creation and recreation of forms of intervention, the production of knowledge and has improved quality of health work.

Promoting Hmong refugees' well-being through mutual learning: valuing knowledge, culture, and experience.

PubMed

Goodkind, Jessica R

2006-03-01

Refugees who resettle in a new country face numerous struggles, including overcoming past traumas and coping with post-migration stressors, such as lack of meaningful social roles, poverty, discrimination, lack of environmental mastery, and social isolation. Thus, in addition to needing to learn concrete language skills and gain access to resources and employment, it is important for refugees to become a part of settings where their experiences, knowledge, and identity are valued and validated. The Refugee Well-Being Project (RWBP) was developed to promote the well-being of Hmong refugees by creating settings for mutual learning to occur between Hmong adults and undergraduate students. The RWBP had two major components: (1) Learning Circles, which involved cultural exchange and one-on-one learning opportunities, and (2) an advocacy component, which involved undergraduates advocating for and transferring advocacy skills to Hmong families to increase their access to resources in their communities. The project was evaluated using a mixed quantitative and qualitative approach. This article discusses data from qualitative interviews with participants, during which the importance of reciprocal helping relationships and mutual learning emerged as significant themes.

Improving the interface between informal carers and formal health and social services: a qualitative study.

PubMed

McPherson, K M; Kayes, N K; Moloczij, N; Cummins, C

2014-03-01

Reports about the impact of caring vary widely, but a consistent finding is that the role is influenced (for better or worse) by how formal services respond to, and work with informal carers and of course the cared for person. We aimed to explore the connection between informal and formal cares and identify how a positive connection or interface might be developed and maintained. We undertook a qualitative descriptive study with focus groups and individual interviews with informal carers, formal care service providers and representatives from carer advocacy groups. Content analysis was used to identify key factors impacting on the interface between informal and formal carers and propose specific recommendations for service development. Community setting including urban and rural areas of New Zealand. Seventy participants (the majority informal carers) took part in 13 focus groups and 22 individual interviews. Four key themes were derived: Quality of care for the care recipient; Knowledge exchange (valuing carer perspectives); One size does not fit all (creating flexible services); and A constant struggle (reducing the burden services add). An optimum interface to address these key areas was proposed. In addition to ensuring quality care for the care recipient, specific structures and processes to support a more positive interface appear warranted if informal carers and services are to work well together. An approach recognising the caring context and carer expertise may decrease the additional burden services contribute, and reduce conflicting information and resultant confusion and/or frustration many carers experience. Copyright © 2013 Elsevier Ltd. All rights reserved.

How do Dutch primary care providers overcome barriers to advance care planning with older people? A qualitative study.

PubMed

Glaudemans, Jolien J; de Jong, Anja E; Onwuteaka Philipsen, Bregje D; Wind, Jan; Willems, Dick L

2018-06-11

Few older people benefit from advance care planning (ACP), due to several barriers related to primary care professionals, such as insufficient knowledge, negative beliefs and a lack of time. Information on overcoming these barriers is limited. We assumed primary care professionals experienced in ACP with older patients are likely to have learned how to overcome these barriers. To investigate how Dutch primary care professionals experienced in ACP with older patients overcome these barriers. A qualitative study, based on semi-structured interviews, among a purposive sample of 14 Dutch primary care professionals experienced in ACP with older people. Transcripts were thematically analysed. We interviewed eight general practitioners (GPs), three nurses and three elderly care physicians, experienced in ACP with older people. Respondents overcame their own insufficient knowledge and skills, as well as their negative attitudes and beliefs by gaining experience through practicing ACP in their daily practices, exchanging and reflecting on those experiences with peers, pursuing continuing education, teaching and participating in research. To overcome patients' and families' lack of initiative and openness to ACP, respondents prepared them for further steps in ACP. To overcome a lack of time, respondents used tools and information communication technology, delegated parts of ACP to other primary care professionals, acquired financing and systematized documentation of ACP. Primary care professionals can overcome barriers to ACP with older patients by practicing, reflecting on experiences and pursuing continuing education, by preparing patients and involving family and by investing in support to approach ACP more efficiently.

[Disagreements between GP trainees and their seniors. Management and impacts on the hidden curriculum. Qualitative study of 37 situations in Paris].

PubMed

Galam, Éric; Multon, Romain

2016-03-01

Disagreements and conflicts have a negative impact on the satisfaction and the performances of working team members. Young doctors in training are part of the health care team. The management of the disagreements with which they are confronted is a part of their professionalization process. To clarify and analyze the disagreements between GP trainees and their seniors in patients care and their consequences in doctor curriculum. Qualitative descriptive study. Five focus groups including a total of 25 Parisian trainees were performed to explore situations of disagreements with their seniors about patients care. Phenomenical analysis was performed by two researchers. Thirty-seven situations were reported. A number of potential sources of conflicts were highlighted. Factors that can transform a disagreement into an insoluble conflict were identified. The consequences of these disagreements on the quality of care and their impact on the empowerment of trainees were analysed. Number of disagreements related patients facing end of life. Specificities of emergency contexts and ambulatory practice were underlined. The role of the hierarchical link in the genesis and the development of the conflicts was confirmed. The personality of the trainee, his conception of responsibility, the exchange of knowledge, the "commercial" aspects of doctors practice can be at the origin of conflicts. The disagreements can play a positive role in trainees empowerment. A training in the management of anticipated or known conflicts can usefully clarify and optimize the hidden curriculum of the medical students towards professionalism. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Comparative metabolism and genotoxicity of the structurally similar nitrophenylenediamine dyes, HC Blue 1 and HC Blue 2, in mouse hepatocytes.

PubMed

Kari, F W; Driscoll, S M; Abu-Shakra, A; Strom, S C; Jenkins, W L; Volosin, J S; Rudo, K M; Langenbach, R

1990-04-01

Previous studies indicated that HC Blue 1 induced heptocellular carcinomas in B6C3F1 mice whereas the structurally similar nitroaromatic amine HC Blue 2 did not. In an attempt to elucidate the biochemical mechanisms responsible for their different carcinogenic potencies, comparative metabolism and genetic toxicity studies were undertaken. Eighteen-hour urinary recovery of administered radioactivity was equivalent for both compounds following oral gavage (100 mg/kg) in female B6C3F1 mice. By HPLC analysis, HC Blue 1 yielded 3 major polar metabolite peaks, one of which was susceptible to glucuronidase. In vivo metabolism of HC Blue 2 yielded a single major metabolite peak which was not hydrolyzed by glucuronidase. Metabolism by B6C3F1 mouse hepatocytes yielded metabolite profiles which were qualitatively similar to the profiles observed after in vivo metabolism. HC Blue 1 was metabolized by hepatocytes at approximately twice the rate of HC Blue 2. Cytogenetic evaluations of mouse hepatocytes after in vitro treatment indicated HC Blue 1 was more potent than HC Blue 2 in inducing chromosomal aberrations while both chemicals showed weak activity for inducing sister-chromatid exchanges. Furthermore, in the V79 cell metabolic cooperation assay, HC Blue 1, but not HC Blue 2, inhibited cell-to-cell communication suggesting a non-genotoxic activity may be present for HC Blue 1. It is concluded that qualitative and quantitative differences exist in the metabolism of these compounds and that genotoxic as well as nongenotoxic effects may contribute to their different carcinogenic potencies.

The involvement of cancer patients in the four stages of decision-making preceding continuous sedation until death: A qualitative study.

PubMed

Robijn, Lenzo; Seymour, Jane; Deliens, Luc; Korfage, Ida; Brown, Jayne; Pype, Peter; Van Der Heide, Agnes; Chambaere, Kenneth; Rietjens, Judith

2018-04-01

Involving patients in decision-making is considered to be particularly appropriate towards the end of life. Professional guidelines emphasize that the decision to initiate continuous sedation should be made in accordance with the wishes of the dying person and be preceded by their consent. To describe the decision-making process preceding continuous sedation until death with particular attention to the involvement of the person who is dying. Qualitative case studies using interviews. Interviews with 26 physicians, 30 nurses and 24 relatives caring for 24 patients with cancer who received continuous sedation until death in Belgium, the United Kingdom and the Netherlands. We distinguished four stages of decision-making: initiation, information exchange, deliberation and the decision to start continuous sedation until death. There was wide variation in the role the patient had in the decision-making process. At one end of the spectrum (mostly in the United Kingdom), the physician discussed the possible use of sedation with the patient, but took the decision themselves. At the other end (mostly in Belgium and the Netherlands), the patient initiated the conversation and the physician's role was largely limited to evaluating if and when the medical criteria were met. Decision-making about continuous sedation until death goes through four stages and the involvement of the patient in the decision-making varies. Acknowledging the potential sensitivity of raising the issue of end-of-life sedation, we recommend building into clinical practice regular opportunities to discuss the goals and preferences of the person who is dying for their future medical treatment and care.

What are the barriers of quality survivorship care for haematology cancer patients? Qualitative insights from cancer nurses.

PubMed

Langbecker, Danette; Ekberg, Stuart; Yates, Patsy; Chan, Alexandre; Chan, Raymond Javan

2016-02-01

Many haematological cancer survivors report long-term physiological and psychosocial effects beyond treatment completion. These survivors continue to experience impaired quality of life (QoL) as a result of their disease and aggressive treatment. As key members of the multidisciplinary team, the purpose of this study is to examine the insights of cancer nurses to inform future developments in survivorship care provision. Open text qualitative responses from two prospective Australian cross-sectional surveys of nurses (n = 136) caring for patients with haematological cancer. Data were analysed thematically, using an inductive approach to identify themes. This study has identified a number of issues that nurses perceive as barriers to quality survivorship care provision. Two main themes were identified: the first relating to the challenges nurses face in providing care ('care challenges') and the second relating to the challenges of providing survivorship care within contemporary health care systems ('system challenges'). Cancer nurses perceive the nature of haematological cancer and its treatment and of the health care system itself, as barriers to the provision of quality survivorship care. Care challenges such as the lack of a standard treatment path and the relapsing or remitting nature of haematological cancers may be somewhat intractable, but system challenges relating to clearly defining and delineating professional responsibilities and exchanging information with other clinicians are not. Addressing the issues identified will facilitate cancer nurses' provision of survivorship care and help address haematological survivors' needs with regard to the physical and psychosocial consequences of their cancer and treatment.

The patient, the doctor, and the patient’s loyalty: a qualitative study in French general practice

PubMed Central

Gérard, Laura; François, Mathilde; de Chefdebien, Marine; Saint-Lary, Oliver; Jami, Alain

2016-01-01

Background The term loyalty can be defined as the attachment that characterises someone who consistent in their feelings, affections, or habits. By introducing the Declaration of General Practitioner (or preferred doctor declaration) in 2004, France adopted a formal incentive for patients to be faithful to their doctor since it entailed optimal coverage of medical care by their national health insurance There has been no research evaluating the impact of this measure and to determine the components of doctor–patient loyalty. Aim To explore what builds and maintains patients’ loyalty to their GP. Design and setting Qualitative study based on semi-structured interviews close to Paris (the département of Yvelines’), France. Method Twenty-eight patients were interviewed in five surgeries of self-employed GPs with different demographics. Interviews were transcribed and a thematic analysis conducted to categorise the data. Phenomenological analysis was used to analyse the transcripts. Results Patient loyalty is based mainly on trust. Trust can be reinforced by certain comforting factors such as the ability to listen, a sense of carefulness, and the quality of care. Loyalty is both a dynamic construct and a relational exchange subject to various influences. Patients find advantages in being loyal. The model of the ‘family doctor’ has always been the archetype of loyalty for several generations within one family. A GP’s inability to meet all of the patient’s requirements is not necessarily a determining factor in breaking the patient’s loyalty. Conclusion Loyalty is more complex than commonly assumed and involves dimensions of trust, listening, quality of care, availability, and familiarity. The observations drawn out from this study warrant a larger scale investigation. PMID:27789510

Determinants of concurrent sexual partnerships within stable relationships: a qualitative study in Tanzania

PubMed Central

Cox, Carie Muntifering; Babalola, Stella; Kennedy, Caitlin E; Mbwambo, Jessie; Likindikoki, Samuel; Kerrigan, Deanna

2014-01-01

Objective Concurrent sexual partnerships (CP) have been identified as a potential driver in the HIV epidemic in southern Africa, making it essential to understand motivating factors for engagement in CP. We aimed to assess community attitudes and beliefs about relationship factors that influence men and women in stable relationships to engage in CP in Tanzania. Social exchange theory was used for interpreting the data. Design Qualitative study with focus group discussions (FGDs). Setting Semiurban/rural communities in four regions across Tanzania (Dar es Salaam, Shinyanga, Iringa and Mbeya). Participants 120 women aged 17–45 years and 111 men aged 18–49 years from four study areas participated in 32 FGDs. Outcome measures FGD participants were asked the following questions about CP: definitions and types, motivations and justifications for engaging or not engaging, cultural factors, gender and socialisation, and local resources and efforts available for addressing CP. Our analysis focused specifically on beliefs about how relationship factors influence engagement in CP. Results Dissatisfaction with a stable relationship was believed to be a contributing factor for engagement in CP for both men and women. Participants more commonly reported financial dissatisfaction as a contributing factor for women engaging in CP within stable relationships, whereas emotional and sexual dissatisfaction were reported as contributing factors for men and women. Furthermore, participants described how potential outside partners are often evaluated based on what they are able to offer compared with stable partners. Conclusions Efforts to reach men and women in stable relationships with HIV prevention messages must consider the various dimensions of motivation for engaging in CP, including relationship dynamics. PMID:24508848

The patient, the doctor, and the patient's loyalty: a qualitative study in French general practice.

PubMed

Gérard, Laura; François, Mathilde; de Chefdebien, Marine; Saint-Lary, Oliver; Jami, Alain

2016-11-01

The term loyalty can be defined as the attachment that characterises someone who consistent in their feelings, affections, or habits. By introducing the Declaration of General Practitioner (or preferred doctor declaration) in 2004, France adopted a formal incentive for patients to be faithful to their doctor since it entailed optimal coverage of medical care by their national health insurance There has been no research evaluating the impact of this measure and to determine the components of doctor-patient loyalty. To explore what builds and maintains patients' loyalty to their GP. Qualitative study based on semi-structured interviews close to Paris (the département of Yvelines'), France. Twenty-eight patients were interviewed in five surgeries of self-employed GPs with different demographics. Interviews were transcribed and a thematic analysis conducted to categorise the data. Phenomenological analysis was used to analyse the transcripts. Patient loyalty is based mainly on trust. Trust can be reinforced by certain comforting factors such as the ability to listen, a sense of carefulness, and the quality of care. Loyalty is both a dynamic construct and a relational exchange subject to various influences. Patients find advantages in being loyal. The model of the 'family doctor' has always been the archetype of loyalty for several generations within one family. A GP's inability to meet all of the patient's requirements is not necessarily a determining factor in breaking the patient's loyalty. Loyalty is more complex than commonly assumed and involves dimensions of trust, listening, quality of care, availability, and familiarity. The observations drawn out from this study warrant a larger scale investigation. © British Journal of General Practice 2016.

A Pilot Study of the Noninvasive Assessment of the Lung Microbiota as a Potential Tool for the Early Diagnosis of Ventilator-Associated Pneumonia

PubMed Central

Brady, Jacob S.; Romano-Keeler, Joann; Drake, Wonder P.; Norris, Patrick R.; Jenkins, Judith M.; Isaacs, Richard J.; Boczko, Erik M.

2015-01-01

BACKGROUND: Ventilator-associated pneumonia (VAP) remains a common complication in critically ill surgical patients, and its diagnosis remains problematic. Exhaled breath contains aerosolized droplets that reflect the lung microbiota. We hypothesized that exhaled breath condensate fluid (EBCF) in hygroscopic condenser humidifier/heat and moisture exchanger (HCH/HME) filters would contain bacterial DNA that qualitatively and quantitatively correlate with pathogens isolated from quantitative BAL samples obtained for clinical suspicion of pneumonia. METHODS: Forty-eight adult patients who were mechanically ventilated and undergoing quantitative BAL (n = 51) for suspected pneumonia in the surgical ICU were enrolled. Per protocol, patients fulfilling VAP clinical criteria undergo quantitative BAL bacterial culture. Immediately prior to BAL, time-matched HCH/HME filters were collected for study of EBCF by real-time polymerase chain reaction. Additionally, convenience samples of serially collected filters in patients with BAL-diagnosed VAP were analyzed. RESULTS: Forty-nine of 51 time-matched EBCF/BAL fluid samples were fully concordant (concordance > 95% by κ statistic) relative to identified pathogens and strongly correlated with clinical cultures. Regression analysis of quantitative bacterial DNA in paired samples revealed a statistically significant positive correlation (r = 0.85). In a convenience sample, qualitative and quantitative polymerase chain reaction analysis of serial HCH/HME samples for bacterial DNA demonstrated an increase in load that preceded the suspicion of pneumonia. CONCLUSIONS: Bacterial DNA within EBCF demonstrates a high correlation with BAL fluid and clinical cultures. Bacterial DNA within EBCF increases prior to the suspicion of pneumonia. Further study of this novel approach may allow development of a noninvasive tool for the early diagnosis of VAP. PMID:25474571

Underlying risk factors for prescribing errors in long-term aged care: a qualitative study.

PubMed

Tariq, Amina; Georgiou, Andrew; Raban, Magdalena; Baysari, Melissa Therese; Westbrook, Johanna

2016-09-01

To identify system-related risk factors perceived to contribute to prescribing errors in Australian long-term care settings, that is, residential aged care facilities (RACFs). The study used qualitative methods to explore factors that contribute to unsafe prescribing in RACFs. Data were collected at three RACFs in metropolitan Sydney, Australia between May and November 2011. Participants included RACF managers, doctors, pharmacists and RACF staff actively involved in prescribing-related processes. Methods included non-participant observations (74 h), in-depth semistructured interviews (n=25) and artefact analysis. Detailed process activity models were developed for observed prescribing episodes supplemented by triangulated analysis using content analysis methods. System-related factors perceived to increase the risk of prescribing errors in RACFs were classified into three overarching themes: communication systems, team coordination and staff management. Factors associated with communication systems included limited point-of-care access to information, inadequate handovers, information storage across different media (paper, electronic and memory), poor legibility of charts, information double handling, multiple faxing of medication charts and reliance on manual chart reviews. Team factors included lack of established lines of responsibility, inadequate team communication and limited participation of doctors in multidisciplinary initiatives like medication advisory committee meetings. Factors related to staff management and workload included doctors' time constraints and their accessibility, lack of trained RACF staff and high RACF staff turnover. The study highlights several system-related factors including laborious methods for exchanging medication information, which often act together to contribute to prescribing errors. Multiple interventions (eg, technology systems, team communication protocols) are required to support the collaborative nature of RACF prescribing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Locating qualitative studies in dementia on MEDLINE, EMBASE, CINAHL, and PsycINFO: A comparison of search strategies.

PubMed

Rogers, Morwenna; Bethel, Alison; Abbott, Rebecca

2017-10-28

Qualitative research in dementia improves understanding of the experience of people affected by dementia. Searching databases for qualitative studies is problematic. Qualitative-specific search strategies might help with locating studies. To examine the effectiveness (sensitivity and precision) of 5 qualitative strategies on locating qualitative research studies in dementia in 4 major databases (MEDLINE, EMBASE, PsycINFO, and CINAHL). Qualitative dementia studies were checked for inclusion on MEDLINE, EMBASE, PsycINFO, and CINAHL. Five qualitative search strategies (subject headings, simple free-text terms, complex free-text terms, and 2 broad-based strategies) were tested for study retrieval. Specificity, precision and number needed to read were calculated. Two hundred fourteen qualitative studies in dementia were included. PsycINFO and CINAHL held the most qualitative studies out the 4 databases studied (N = 171 and 166, respectively) and both held unique records (N = 14 and 7, respectively). The controlled vocabulary strategy in CINAHL returned 96% (N = 192) of studies held; by contrast, controlled vocabulary in PsycINFO returned 7% (N = 13) of studies held. The broad-based strategies returned more studies (93-99%) than the other free-text strategies (22-82%). Precision ranged from 0.061 to 0.004 resulting in a number needed to read to obtain 1 relevant study ranging from 16 (simple free-text search in CINAHL) to 239 (broad-based search in EMBASE). Qualitative search strategies using 3 broad terms were more sensitive than long complex searches. The controlled vocabulary for qualitative research in CINAHL was particularly effective. Furthermore, results indicate that MEDLINE and EMBASE offer little benefit for locating qualitative dementia research if CINAHL and PSYCINFO are also searched. Copyright © 2017 John Wiley & Sons, Ltd.

Swiss Armed Forces Organizational Level Leader Development: A Qualitative Case Study

DTIC Science & Technology

2017-06-09

chapter, divided in five distinct parts, describes the chosen research methodology , explain why the qualitative case study is appropriate to conduct...research study uses a qualitative methodology by performing a qualitative case study on the organizational level leader’s development process within...develop an in-depth understsanding of the phenomen.”82 Summary This research study uses a qualitative methodology by performing a case study on the

Qualitative Descriptive Methods in Health Science Research.

PubMed

Colorafi, Karen Jiggins; Evans, Bronwynne

2016-07-01

The purpose of this methodology paper is to describe an approach to qualitative design known as qualitative descriptive that is well suited to junior health sciences researchers because it can be used with a variety of theoretical approaches, sampling techniques, and data collection strategies. It is often difficult for junior qualitative researchers to pull together the tools and resources they need to embark on a high-quality qualitative research study and to manage the volumes of data they collect during qualitative studies. This paper seeks to pull together much needed resources and provide an overview of methods. A step-by-step guide to planning a qualitative descriptive study and analyzing the data is provided, utilizing exemplars from the authors' research. This paper presents steps to conducting a qualitative descriptive study under the following headings: describing the qualitative descriptive approach, designing a qualitative descriptive study, steps to data analysis, and ensuring rigor of findings. The qualitative descriptive approach results in a summary in everyday, factual language that facilitates understanding of a selected phenomenon across disciplines of health science researchers. © The Author(s) 2016.

Establishing the credibility of qualitative research findings: the plot thickens.

PubMed

Cutcliffe, J R; McKenna, H P

1999-08-01

Qualitative research is increasingly recognized and valued and its unique place in nursing research is highlighted by many. Despite this, some nurse researchers continue to raise epistemological issues about the problems of objectivity and the validity of qualitative research findings. This paper explores the issues relating to the representativeness or credibility of qualitative research findings. It therefore critiques the existing distinct philosophical and methodological positions concerning the trustworthiness of qualitative research findings, which are described as follows: quantitative studies should be judged using the same criteria and terminology as quantitative studies; it is impossible, in a meaningful way, for any criteria to be used to judge qualitative studies; qualitative studies should be judged using criteria that are developed for and fit the qualitative paradigm; and the credibility of qualitative research findings could be established by testing out the emerging theory by means of conducting a deductive quantitative study. The authors conclude by providing some guidelines for establishing the credibility of qualitative research findings.

Physical and Theoretical Models of Heat Pollution Applied to Cramped Conditions Welding Taking into Account the Different Types of Heat

NASA Astrophysics Data System (ADS)

Bulygin, Y. I.; Koronchik, D. A.; Legkonogikh, A. N.; Zharkova, M. G.; Azimova, N. N.

2017-05-01

The standard k-epsilon turbulence model, adapted for welding workshops, equipped with fixed workstations with sources of pollution took into account only the convective component of heat transfer, which is quite reasonable for large-volume rooms (with low density distribution of sources of pollution) especially the results of model calculations taking into account only the convective component correlated well with experimental data. For the purposes of this study, when we are dealing with a small confined space where necessary to take account of the body heated to a high temperature (for welding), located next to each other as additional sources of heat, it can no longer be neglected radiative heat exchange. In the task - to experimentally investigate the various types of heat transfer in a limited closed space for welding and behavior of a mathematical model, describing the contribution of the various components of the heat exchange, including radiation, influencing the formation of fields of concentration, temperature, air movement and thermal stress in the test environment. Conducted field experiments to model cubic body, allowing you to configure and debug the model of heat and mass transfer processes with the help of the developed approaches, comparing the measurement results of air flow velocity and temperature with the calculated data showed qualitative and quantitative agreement between process parameters, that is an indicator of the adequacy of heat and mass transfer model.

Does cemented or cementless single-stage exchange arthroplasty of chronic periprosthetic hip infections provide similar infection rates to a two-stage? A systematic review.

PubMed

George, D A; Logoluso, N; Castellini, G; Gianola, S; Scarponi, S; Haddad, F S; Drago, L; Romano, C L

2016-10-10

The best surgical modality for treating chronic periprosthetic hip infections remains controversial, with a lack of randomised controlled studies. The aim of this systematic review is to compare the infection recurrence rate after a single-stage versus a two-stage exchange arthroplasty, and the rate of cemented versus cementless single-stage exchange arthroplasty for chronic periprosthetic hip infections. We searched for eligible studies published up to December 2015. Full text or abstract in English were reviewed. We included studies reporting the infection recurrence rate as the outcome of interest following single- or two-stage exchange arthroplasty, or both, with a minimum follow-up of 12 months. Two reviewers independently abstracted data and appraised quality assessment. After study selection, 90 observational studies were included. The majority of studies were focused on a two-stage hip exchange arthroplasty (65 %), 18 % on a single-stage exchange, and only a 17 % were comparative studies. There was no statistically significant difference between a single-stage versus a two-stage exchange in terms of recurrence of infection in controlled studies (pooled odds ratio of 1.37 [95 % CI = 0.68-2.74, I 2  = 45.5 %]). Similarly, the recurrence infection rate in cementless versus cemented single-stage hip exchanges failed to demonstrate a significant difference, due to the substantial heterogeneity among the studies. Despite the methodological limitations and the heterogeneity between single cohorts studies, if we considered only the available controlled studies no superiority was demonstrated between a single- and two-stage exchange at a minimum of 12 months follow-up. The overalapping of confidence intervals related to single-stage cementless and cemented hip exchanges, showed no superiority of either technique.

Halogenation effects on electron collisions with CF3Cl, CF2Cl2, and CFCl3

NASA Astrophysics Data System (ADS)

Freitas, T. C.; Lopes, A. R.; Azeredo, A. D.; Bettega, M. H. F.

2016-04-01

We report differential and integral elastic cross sections for low-energy electron collisions with CF3Cl, CF2Cl2, and CFCl3 molecules for energies ranging from 0.1 eV to 30 eV. The calculations were performed using the Schwinger multichannel method with pseudopotentials in the static-exchange and static-exchange plus polarization approximations. The influence of the permanent electric dipole moment on the cross sections was included using the Born closure scheme. A very good agreement between our calculations and the experimental results of Jones [J. Chem. Phys. 84, 813 (1986)], Mann and Linder [J. Phys. B 25, 1621 (1992); 25, 1633 (1992)] and Hoshino et al. [J. Chem. Phys. 138, 214305 (2013)] was found. We also compare our results with the calculations of Beyer et al. [Chem. Phys. 255, 1 (2000)] using the R-matrix method, where we find good agreement with respect to the location of the resonances, and with the calculations of Hoshino et al. using the independent atom method with screening corrected additivity rule, where we find qualitative agreement at energies above 20 eV. Additional electronic structure calculations were carried out in order to help in the interpretation of the scattering results. The stabilization the lowest σ∗ resonance due to the exchange of fluorine by chlorine atoms (halogenation effect) follows a simple linear relation with the energy of the lowest unoccupied molecular orbitals and can be considered as a signature of the halogenation effect.

Biosorption of Pb (II) from aqueous solution by extracellular polymeric substances extracted from Klebsiella sp. J1: Adsorption behavior and mechanism assessment

NASA Astrophysics Data System (ADS)

Wei, Wei; Wang, Qilin; Li, Ang; Yang, Jixian; Ma, Fang; Pi, Shanshan; Wu, Dan

2016-08-01

The adsorption performance and mechanism of extracellular polymeric substances (EPS) extracted from Klebsiella sp. J1 for soluble Pb (II) were investigated. The maximum biosorption capacity of EPS for Pb (II) was found to be 99.5 mg g-1 at pH 6.0 and EPS concentration of 0.2 g/L. The data for adsorption process satisfactorily fitted to both Langmuir isotherm and pseudo-second order kinetic model. The mean free energy E and activation energy Ea were determined at 8.22- 8.98 kJ mol-1 and 42.46 kJ mol-1, respectively. The liquid-film diffusion step might be the rate-limiting step. The thermodynamic parameters (ΔGo, ΔHo and ΔSo) revealed that the adsorption process was spontaneous and exothermic under natural conditions. The interactions between EPS system and Pb (II) ions were investigated by qualitative analysis methods (i.e Zeta potential, FT-IR and EDAX). Based on the strong experimental evidence from the mass balance of the related elements participating in the sorption process, an ion exchange process was identified quantitatively as the major mechanism responsible for Pb (II) adsorption by EPS. Molar equivalents of both K+ and Mg2+ could be exchanged with Pb2+ molar equivalents in the process and the contribution rate of ion exchange to adsorption accounted for 85.72% (Δmequiv = -0.000541).

Biosorption of Pb (II) from aqueous solution by extracellular polymeric substances extracted from Klebsiella sp. J1: Adsorption behavior and mechanism assessment

PubMed Central

Wei, Wei; Wang, Qilin; Li, Ang; Yang, Jixian; Ma, Fang; Pi, Shanshan; Wu, Dan

2016-01-01

The adsorption performance and mechanism of extracellular polymeric substances (EPS) extracted from Klebsiella sp. J1 for soluble Pb (II) were investigated. The maximum biosorption capacity of EPS for Pb (II) was found to be 99.5 mg g−1 at pH 6.0 and EPS concentration of 0.2 g/L. The data for adsorption process satisfactorily fitted to both Langmuir isotherm and pseudo-second order kinetic model. The mean free energy E and activation energy Ea were determined at 8.22– 8.98 kJ mol−1 and 42.46 kJ mol−1, respectively. The liquid-film diffusion step might be the rate-limiting step. The thermodynamic parameters (ΔGo, ΔHo and ΔSo) revealed that the adsorption process was spontaneous and exothermic under natural conditions. The interactions between EPS system and Pb (II) ions were investigated by qualitative analysis methods (i.e Zeta potential, FT-IR and EDAX). Based on the strong experimental evidence from the mass balance of the related elements participating in the sorption process, an ion exchange process was identified quantitatively as the major mechanism responsible for Pb (II) adsorption by EPS. Molar equivalents of both K+ and Mg2+ could be exchanged with Pb2+ molar equivalents in the process and the contribution rate of ion exchange to adsorption accounted for 85.72% (Δmequiv = −0.000541). PMID:27514493

“Because he has bought for her, he wants to sleep with her”: Alcohol as a currency for sexual exchange in South African drinking venues

PubMed Central

Watt, Melissa H.; Aunon, Frances M.; Skinner, Donald; Sikkema, Kathleen J.; Kalichman, Seth C.; Pieterse, Desiree

2012-01-01

Previous research has documented the practice of transactional sex in sub-Saharan Africa and its association with gender-based violence, gender inequalities and HIV risk. At the same time, it has been suggested that women may use transactional sex to obtain a greater sense of control over their lives and their sexualities, and to garner access to resources. The aim of this study was to better understand the practice of exchanging alcohol for sex in alcohol-serving venues in a township in Cape Town, South Africa. Data were collected between June 2009 and October 2010. Six venues were included and observations were conducted in each for four one-week periods over the course of a year. In-depth qualitative interviews included 31 women and 13 men whom interviewers had observed as regular venue customers. Follow-up interviews were conducted with 24 respondents to explore emerging themes. Interviews were recorded and transcribed. Using a grounded theory approach, Atlas.ti was used to code transcripts, field notes, and analytical memos written about each document. Results revealed that alcohol was commonly used as a currency of sexual exchange in this setting, and both women and men understood that accepting alcohol from a man implied consent for sexual favors. Women reported a sense of agency in participating in the transactional sex dynamic, especially when they were able to manipulate it to meet their own ends without fulfilling the men’s sexual expectations. At the same time, data revealed that the norm of transactional sex reinforced the undervaluing and commoditization of women. As identified elsewhere, transactional sex put both women and men at greater risk of HIV through multiple partners and inconsistent use of condoms, and the possibility of rape. Interventions are needed to address sexual risk behaviors and substance use within this context to prevent new HIV infections. PMID:22326304

Cation-exchanged SAPO-34 for adsorption-based hydrocarbon separations: predictions from dispersion-corrected DFT calculations.

PubMed

Fischer, Michael; Bell, Robert G

2014-10-21

The influence of the nature of the cation on the interaction of the silicoaluminophosphate SAPO-34 with small hydrocarbons (ethane, ethylene, acetylene, propane, propylene) is investigated using periodic density-functional theory calculations including a semi-empirical dispersion correction (DFT-D). Initial calculations are used to evaluate which of the guest-accessible cation sites in the chabazite-type structure is energetically preferred for a set of ten cations, which comprises four alkali metals (Li(+), Na(+), K(+), Rb(+)), three alkaline earth metals (Mg(2+), Ca(2+), Sr(2+)), and three transition metals (Cu(+), Ag(+), Fe(2+)). All eight cations that are likely to be found at the SII site (centre of a six-ring) are then included in the following investigation, which studies the interaction with the hydrocarbon guest molecules. In addition to the interaction energies, some trends and peculiarities regarding the adsorption geometries are analysed, and electron density difference plots obtained from the calculations are used to gain insights into the dominant interaction types. In addition to dispersion interactions, electrostatic and polarisation effects dominate for the main group cations, whereas significant orbital interactions are observed for unsaturated hydrocarbons interacting with transition metal (TM) cations. The differences between the interaction energies obtained for pairs of hydrocarbons of interest (such as ethylene-ethane and propylene-propane) deliver some qualitative insights: if this energy difference is large, it can be expected that the material will exhibit a high selectivity in the adsorption-based separation of alkene-alkane mixtures, which constitutes a problem of considerable industrial relevance. While the calculations show that TM-exchanged SAPO-34 materials are likely to exhibit a very high preference for alkenes over alkanes, the strong interaction may render an application in industrial processes impractical due to the large amount of energy required for regeneration. In this respect, SAPOs exchanged with alkaline earth cations could provide a better balance between selectivity and energy cost of regeneration.

Uncovering Hospitalists' Information Needs from Outside Healthcare Facilities in the Context of Health Information Exchange Using Association Rule Learning.

PubMed

Martinez, D A; Mora, E; Gemmani, M; Zayas-Castro, J

2015-01-01

Important barriers to health information exchange (HIE) adoption are clinical workflow disruptions and troubles with the system interface. Prior research suggests that HIE interfaces providing faster access to useful information may stimulate use and reduce barriers for adoption; however, little is known about informational needs of hospitalists. To study the association between patient health problems and the type of information requested from outside healthcare providers by hospitalists of a tertiary care hospital. We searched operational data associated with fax-based exchange of patient information (previous HIE implementation) between hospitalists of an internal medicine department in a large urban tertiary care hospital in Florida, and any other affiliated and unaffiliated healthcare provider. All hospitalizations from October 2011 to March 2014 were included in the search. Strong association rules between health problems and types of information requested during each hospitalization were discovered using Apriori algorithm, which were then validated by a team of hospitalists of the same department. Only 13.7% (2 089 out of 15 230) of the hospitalizations generated at least one request of patient information to other providers. The transactional data showed 20 strong association rules between specific health problems and types of information exist. Among the 20 rules, for example, abdominal pain, chest pain, and anaemia patients are highly likely to have medical records and outside imaging results requested. Other health conditions, prone to have records requested, were lower urinary tract infection and back pain patients. The presented list of strong co-occurrence of health problems and types of information requested by hospitalists from outside healthcare providers not only informs the implementation and design of HIE, but also helps to target future research on the impact of having access to outside information for specific patient cohorts. Our data-driven approach helps to reduce the typical biases of qualitative research.

Synthesis and Characterization of Perfluoro Quaternary Ammonium Anion Exchange Membranes

DTIC Science & Technology

2012-01-01

study, new alkaline exchange membranes were prepared from the perfluorinated 3M ionomer with various quaternary ammonium cations attached with...ammonium anion exchange membranes Report Title ABSTRACT In this study, new alkaline exchange membranes were prepared from the perfluorinated 3M ionomer...exchange membranes were prepared from the perfluorinated 3M ionomer with vari- ous quaternary ammonium cations attached with sulfonamide linkage. The

Appraising Qualitative Research in Health Education: Guidelines for Public Health Educators

PubMed Central

Jeanfreau, Scharalda G.; Jack, Leonard

2010-01-01

Research studies, including qualitative studies, form the basis for evidence-based practice among health professionals. However, many practicing health educators do not feel fully confident in their ability to critically appraise qualitative research studies. This publication presents an overview of qualitative research approaches, defines key terminology used in qualitative research, and provides guidelines for appraising the strengths and weaknesses of published qualitative research. On reading, health educators will be better equipped to evaluate the quality of the evidence through critical appraisals of qualitative research publications. PMID:20817630

A quantitative analysis of qualitative studies in clinical journals for the 2000 publishing year

PubMed Central

McKibbon, Kathleen Ann; Gadd, Cynthia S

2004-01-01

Background Quantitative studies are becoming more recognized as important to understanding health care with all of its richness and complexities. The purpose of this descriptive survey was to provide a quantitative evaluation of the qualitative studies published in 170 core clinical journals for 2000. Methods All identified studies that used qualitative methods were reviewed to ascertain which clinical journals publish qualitative studies and to extract research methods, content (persons and health care issues studied), and whether mixed methods (quantitative and qualitative methods) were used. Results 60 330 articles were reviewed. 355 reports of original qualitative studies and 12 systematic review articles were identified in 48 journals. Most of the journals were in the discipline of nursing. Only 4 of the most highly cited health care journals, based on ISI Science Citation Index (SCI) Impact Factors, published qualitative studies. 37 of the 355 original reports used both qualitative and quantitative (mixed) methods. Patients and non-health care settings were the most common groups of people studied. Diseases and conditions were cancer, mental health, pregnancy and childbirth, and cerebrovascular disease with many other diseases and conditions represented. Phenomenology and grounded theory were commonly used; substantial ethnography was also present. No substantial differences were noted for content or methods when articles published in all disciplines were compared with articles published in nursing titles or when studies with mixed methods were compared with studies that included only qualitative methods. Conclusions The clinical literature includes many qualitative studies although they are often published in nursing journals or journals with low SCI Impact Factor journals. Many qualitative studies incorporate both qualitative and quantitative methods. PMID:15271221

Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study

PubMed Central

Glenton, Claire; Oxman, Andrew D

2009-01-01

Objective To examine the use of qualitative approaches alongside randomised trials of complex healthcare interventions. Design Review of randomised controlled trials of interventions to change professional practice or the organisation of care. Data sources Systematic sample of 100 trials published in English from the register of the Cochrane Effective Practice and Organisation of Care Review Group. Methods Published and unpublished qualitative studies linked to the randomised controlled trials were identified through database searches and contact with authors. Data were extracted from each study by two reviewers using a standard form. We extracted data describing the randomised controlled trials and qualitative studies, the quality of these studies, and how, if at all, the qualitative and quantitative findings were combined. A narrative synthesis of the findings was done. Results 30 of the 100 trials had associated qualitative work and 19 of these were published studies. 14 qualitative studies were done before the trial, nine during the trial, and four after the trial. 13 studies reported an explicit theoretical basis and 11 specified their methodological approach. Approaches to sampling and data analysis were poorly described. For most cases (n=20) we found no indication of integration of qualitative and quantitative findings at the level of either analysis or interpretation. The quality of the qualitative studies was highly variable. Conclusions Qualitative studies alongside randomised controlled trials remain uncommon, even where relatively complex interventions are being evaluated. Most of the qualitative studies were carried out before or during the trials with few studies used to explain trial results. The findings of the qualitative studies seemed to be poorly integrated with those of the trials and often had major methodological shortcomings. PMID:19744976

The use of theory in qualitative approaches to research: application in end-of-life studies.

PubMed

Wu, Hung-Lan; Volker, Deborah L

2009-12-01

This paper is a report of an analysis of the use of theory in qualitative approaches to research as exemplified in qualitative end-of-life studies. Nurses researchers turn to theory to conceptualize research problems and guide investigations. However, researchers using qualitative approaches do not consistently articulate how theory has been applied, and no clear consensus exists regarding the appropriate application of theory in qualitative studies. A review of qualitative, end-of-life studies is used to illustrate application of theory to study design and findings. A review of theoretical literature was carried out, focusing on definitions and use of theory in qualitative end-of-life studies published in English between 1990 and 2008. The term 'theory' continues to be used in a variety of ways by theorists and researchers. Within the reviewed end-of-life studies, the use of theory included theory creation or provision of a comparative framework for data analysis and interpretation. Implications for nursing. Nurses who conduct qualitative studies should examine the philosophical and theoretical bases of their selected methodological approach, articulate a theoretical framework that fits the phenomenon being studied, and adopt a critical, flexible and creative attitude when applying theory to a study. Theory can be put to several uses in qualitative inquiry and should guide nurse researchers as they develop and implement their studies. Nurse educators who teach qualitative approaches to research should emphasize a variety of ways to incorporate theory in qualitative designs.

Qualitative-Based Methodology to Teaching Qualitative Methodology in Higher Education

ERIC Educational Resources Information Center

Katz, Sara

2015-01-01

There is no defined theory for teaching Qualitative Inquiry, and very few studies have focused on the topic. This study is a qualitative case study focused on the Qualitative Methods course that I teach at a college of education in Israel. The aim of the study is to explore and describe the course, to provide a true picture of my pedagogy, and to…

A Case Study of the Degree of Collaboration Between Various Levels in the Reparable Chain in the United States Air Force

DTIC Science & Technology

2005-03-01

qualitative research methods , a case study approach was selected to conduct this research . “A case study can be defined as an empirical study ... qualitative in nature, and also described the qualitative research method chosen as a case study . From 49 there, data collection was focused upon... qualitative nature of the research , a qualitative design was used to conduct the

Mass exchange in an experimental new-generation life support system model based on biological regeneration of environment.

PubMed

Tikhomirov, A A; Ushakova, S A; Manukovsky, N S; Lisovsky, G M; Kudenko, Yu A; Kovalev, V S; Gubanov, V G; Barkhatov, Yu V; Gribovskaya, I V; Zolotukhin, I G; Gros, J B; Lasseur, Ch

2003-01-01

An experimental model of a biological life support system was used to evaluate qualitative and quantitative parameters of the internal mass exchange. The photosynthesizing unit included the higher plant component (wheat and radish), and the heterotrophic unit consisted of a soil-like substrate, California worms, mushrooms and microbial microflora. The gas mass exchange involved evolution of oxygen by the photosynthesizing component and its uptake by the heterotroph component along with the formation and maintaining of the SLS structure, growth of mushrooms and California worms, human respiration, and some other processes. Human presence in the system in the form of "virtual human" that at regular intervals took part in the respirative gas exchange during the experiment. Experimental data demonstrated good oxygen/carbon dioxide balance, and the closure of the cycles of these gases was almost complete. The water cycle was nearly 100% closed. The main components in the water mass exchange were transpiration water and the watering solution with mineral elements. Human consumption of the edible plant biomass (grains and roots) was simulated by processing these products by a unique physicochemical method of oxidizing them to inorganic mineral compounds, which were then returned into the system and fully assimilated by the plants. The oxidation was achieved by "wet combustion" of organic biomass, using hydrogen peroxide following a special procedure, which does not require high temperature and pressure. Hydrogen peroxide is produced from the water inside the system. The closure of the cycle was estimated for individual elements and compounds. Stoichiometric proportions are given for the main components included in the experimental model of the system. Approaches to the mathematical modeling of the cycling processes are discussed, using the data of the experimental model. Nitrogen, as a representative of biogenic elements, shows an almost 100% closure of the cycle inside the system. The proposed experimental model of a biological system is discussed as a candidate for potential application in the investigations aimed at creating ecosystems with largely closed cycles of the internal mass exchange. The formation and maintenance of sustainable cycling of vitally important chemical elements and compounds in biological life support systems (BLSS) is an extremely pressing problem. To attain the stable functioning of biological life support systems (BLSS) and to maintain a high degree of closure of material cycles in than, it is essential to understand the character of mass exchange processes and stoichiometnc proportions of the initial and synthesized components of the system. c2003 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

Interprofessional communication between community pharmacists and general practitioners: a qualitative study.

PubMed

Weissenborn, Marina; Haefeli, Walter E; Peters-Klimm, Frank; Seidling, Hanna M

2017-06-01

Background While collaboration between community pharmacists (CPs) and general practitioners (GPs) is essential to provide comprehensive patient care, their communication often is scarce and hampered by multiple barriers. Objective We aimed to assess both professions' perceptions of interprofessional communication with regard to content and methods of communication as a basis to subsequently develop best-practice recommendations for information exchange. Setting Ambulatory care setting in Germany. Method CPs and GPs shared their experience in focus groups and in-depth interviews which were conducted using a semi-structured interview guideline. Transcribed recordings were assessed using qualitative content analysis according to Mayring. Main outcome measure Specification of existing barriers, CPs'/GPs' general perceptions of interprofessional communication and similarities and differences regarding prioritization of specific information items and how to best communicate with each other. Results Four focus groups and fourteen interviews were conducted. Seven internal (e.g. professions were not personally known to one another) and nine external barriers (e.g. mutual accessibility) were identified. Ten organizational, eight medication-related, and four patient-related information items were identified requiring interprofessional communication. Their relevance varied between the professions, e.g. CPs rated organizational issues higher than GPs. Both professions indicated communication via phone to be the most frequently used method of communication. Conclusion CPs and GPs opinions often differ. However, communication between CPs and GPs is perceived as crucial suggesting that a future concept has to offer standardized recommendations, while leaving CPs and GPs room to adjust it to their individual needs.

A qualitative study of epistemologies and pedagogies of environmental practitioners in Maui, Hawai'i

NASA Astrophysics Data System (ADS)

Buczynski, Sandra C.

This dissertation presents a discussion of the knowledge systems and teaching styles of five environmental practitioners in Maui, Hawaii. The voices of the informants illustrate the beliefs, values, and priorities relevant to local environmental knowledge production and exchange, and are also used to provide a framework for models of epistemological and pedagogical practices. In this qualitative research, several models of local environmental knowledge emerged. The models include local environmental knowledge as a semiotic system, knowledge given and received from narrative sources, experiential based knowledge, and place and plant priorities in seeking and dispensing environmental information. The notion of what constitutes environmental knowledge was expanded through careful interpretation of the informant's voice. Several broad conclusions concerning local environmental knowledge emerged from this research. First, local environmental knowledge is formed through a long-term relationship between the practitioner, the land, and natural resources. Secondly, each of the environmental practitioner's local environmental knowledge is dynamic, plural and hybrid. And finally, transmission of the environmental practitioner's local environmental knowledge is integral to the life of the community as well as a component of their personal identities. Through these local environmental practitioners, endemic knowledge is shared, indigenous species are spared, traditional practices are passed down, customary ways are preserved, and unique ways of knowing and teaching are appreciated. 'A'ohe papu ka 'ike i ka halau ho'okahi. All knowledge is not taught in the same school. One can learn from many sources (Pukui, 1983: 24).

A multi-centre qualitative study exploring the experiences of UK South Asian and White Diabetic Patients referred for renal care

PubMed Central

2012-01-01

Background An exploration of renal complications of diabetes from the patient perspective is important for developing quality care through the diabetic renal disease care pathway. Methods Newly referred South Asian and White diabetic renal patients over 16 years were recruited from nephrology outpatient clinics in three UK centres - Luton, West London and Leicester – and their experiences of the diabetes and renal care recorded. A semi-structured qualitative interview was conducted with 48 patients. Interview transcripts were analysed thematically and comparisons made between the White and South Asian groups. Results 23 South Asian patients and 25 White patients were interviewed. Patient experience of diabetes ranged from a few months to 35 years with a mean time since diagnosis of 12.1 years and 17.1 years for the South Asian and White patients respectively. Confusion emerged as a response to referral shared by both groups. This sense of confusion was associated with reported lack of information at the time of referral, but also before referral. Language barriers exacerbated confusion for South Asian patients. Conclusions The diabetic renal patients who have been referred for specialist renal care and found the referral process confusing have poor of awareness of kidney complications of diabetes. Healthcare providers should be more aware of the ongoing information needs of long term diabetics as well as the context of any information exchange including language barriers. PMID:23176053

The relevance of context in understanding health literacy skills: Findings from a qualitative study.

PubMed

McKenna, Verna B; Sixsmith, Jane; Barry, Margaret M

2017-10-01

Conceptualizing health literacy as a relational concept, which involves how individuals interact with complex health and social systems, requires a greater understanding of the context of people's health experiences. To describe individuals' experiences of accessing, understanding, appraising and applying health information; explore the barriers and facilitators to using these skills; and to describe the experience of information exchange in health consultations. A longitudinal qualitative methodology with thematic analysis of interviews was used. Health literacy levels were assessed using the HLS-EU-47-Item Questionnaire. Findings are presented from the first round of data collection. Twenty-six participants purposefully selected from a CVD risk reduction programme at three separate time points. Four key themes identified: using health literacy capacities for managing health; psychological and structural factors that impact on these capacities; and the relationship quality with the health-care provider (HCP). Although limited health literacy was prevalent across the sample (65%), all individuals were very proactive in attempting to utilize health literacy skills. Findings emphasize the importance of contextual factors such as the quality of communication with the health-care provider, perceptions of control, attitudes to family medical history, navigating structural barriers and being supported in managing treatment and medication side-effects. Findings are relevant for health-care providers in order to enhance the patient-provider relationship and to ensure optimum health outcomes for all individuals regardless of health literacy levels. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Patients' quality of life after stopping plasma exchange: a pilot study.

PubMed

Dahlan, Randah; McCormick, Brendan B; Alkhattabi, Maan; Gallo, Kerri; Clark, William F; Rock, Gail

2014-10-01

Plasma exchange is being widely used to treat various serious medical conditions. There has been very little follow-up data to describe the quality of life (QOL) of plasma exchange-recipients after active plasma exchange has stopped. To assess the QOL of plasma exchange recipients after stopping plasma exchange. A pilot study, based on responses to a postal questionnaire and clinical data obtained from the patients' charts, was carried out. The scores were computed from questionnaire responses and analyzed. The response rate was 59% with 58 patients completing a questionnaire three months after their final plasma exchange therapy. We identified significant heterogeneity in the quality of life of plasma exchange recipients after stopping plasma exchange therapy. This could be driven by different patient co-morbidities. We recommend that during follow up visits, a multi-disciplinary approach including consultation with a social worker might be considered for patients who may continue to have some limitations in their psychosocial activities post-discontinuation of plasma exchange. The high response rate to the questionnaire indicates that PLEX patients are interested in being involved in QOL studies, which suggests potential support for a prospective study of QOL with pre and post questionnaires and more detailed tracking of baseline co-morbidities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Orbital-Dependent-Functionals within Density Functional Theory: Methodology and Applications

NASA Astrophysics Data System (ADS)

Makmal, Adi

I have designed and implemented a new numerical scheme for solving Kohn-Sham (KS) equations for diatomic systems, together with a full solution of the OEP equation. The equations are solved on a real-space prolate spheroidal coordinate grid, such that all the system's electrons are taken into account. The OEP equation is solved via the S-iteration scheme. This newly developed software package is called DARSEC (DiAtomic Real-Space Electronic structure Calculations). It involves no approximation except for the one inherent in the XC functional. Thus it is especially suitable for examining new functionals of any kind, and ODFs in particular. It is also an ideal tool for assessing the validity of commonly used approximations, for the same reasons. One case for which this uniqueness of DARSEC was exploited in this thesis is the examination of the validity of the pseudopotential approximation for KS gaps that are calculated with EXX OEP (xOEP). Before this study, use of the pseudopotential approximation in such calculations was called into question. I have shown that KS gaps obtained with pseudopotentials that have been constructed in a manner consistent with the exact-exchange functional agree with the all-electron results (i.e. without the pseudopotential approximation), for the cases studied. This confirmed the reliability of the pseudopotential approximation for ODFs such as EXX. Explicit density-dependent XC functionals traditionally fail to obtain atomization-energy as well as charge-dissociation curves that are, at least qualitatively, correct for diatomic systems. On the other hand, Hartree-Fock (HF) theory encounters no such problem. Hence, an additional goal of this research was to study the performances of the EXX functional (being the DFT counterpart of HF) in describing binding energies and charge dissociations for stretched diatomic molecules. Moreover, I wanted to investigate the special features of the resulting single and local EXX KS potential, as opposed to the non-local orbital specific HF potentials. I asked the following questions: Is it at all possible to obtain correct binding energy curves and charge dissociation curves with the local exact-exchange KS potential? What are the main features of such a local KS potential? And how are they related to the spatial shapes of the KS orbitals? To answer these questions, I calculated the electronic structures of highly stretched H2, HF and LiF molecules with EXX, using the Krieger, Li, and Iafrate (KLI) scheme. All calculations were done with DARSEC, whose coordinate system is highly suitable for calculating such stretched diatomic molecules. By examining several electronic configurations in a systematic manner, low energy ones were identified, and qualitatively correct binding-energy curves were obtained. For the LiF molecule a qualitatively correct charge separation curve was also achieved. Once the local EXX KLI potential was obtained for highly stretched diatomic systems, I could study its properties. Specifically, I have identified and demonstrated the following features: (a) The location and size of a constant shift in the potential and its relation to orbital spatial shapes; (b) The dependence of the shift's position on the inter-atomic separation length; (c) The existence of multiple constant shifts of the same kind; (d) The relation between the eigenvalues of the highly stretched diatomic system and the corresponding eigenvalues of the separated atoms - and how this relation is correlated with the asymptotic shift of the local potential. Understanding this unique combination of features sheds light on the mechanism with which the EXX potential enforces the correct charge dissociation. Last, a study on a novel ODF was initiated. The new ODF, suggested by Stephan Kummel, has a local function that mixes a fraction of EXX with a complementary fraction of exchange of the homogenous electronic gas (LDA), where a different fraction is assigned for each point in space. To derive the corresponding potential, the functional derivative of the new energy expression with respect to the KS orbitals was analytically derived. The new energy and potential expressions were implemented into DARSEC, and preliminary examinations were carried out. (Abstract shortened by UMI.)

Behavioral Consequences of Embeddedness: Effects of the Underlying Forms of Exchange

ERIC Educational Resources Information Center

Molm, Linda D.; Melamed, David; Whitham, Monica M.

2013-01-01

Network structures have strong effects on the frequency and terms of negotiated exchanges, shaping who exchanges with whom and who fares better or worse. In this study we ask how exchange patterns of commitment and inequality are affected when negotiated exchanges are combined with reciprocal exchanges in more complex relationships of…

Getting added value from using qualitative research with randomized controlled trials: a qualitative interview study

PubMed Central

2014-01-01

Background Qualitative research is undertaken with randomized controlled trials of health interventions. Our aim was to explore the perceptions of researchers with experience of this endeavour to understand the added value of qualitative research to the trial in practice. Methods A telephone semi-structured interview study with 18 researchers with experience of undertaking the trial and/or the qualitative research. Results Interviewees described the added value of qualitative research for the trial, explaining how it solved problems at the pretrial stage, explained findings, and helped to increase the utility of the evidence generated by the trial. From the interviews, we identified three models of relationship of the qualitative research to the trial. In ‘the peripheral’ model, the trial was an opportunity to undertake qualitative research, with no intention that it would add value to the trial. In ‘the add-on’ model, the qualitative researcher understood the potential value of the qualitative research but it was viewed as a separate and complementary endeavour by the trial lead investigator and wider team. Interviewees described how this could limit the value of the qualitative research to the trial. Finally ‘the integral’ model played out in two ways. In ‘integral-in-theory’ studies, the lead investigator viewed the qualitative research as essential to the trial. However, in practice the qualitative research was under-resourced relative to the trial, potentially limiting its ability to add value to the trial. In ‘integral-in-practice’ studies, interviewees described how the qualitative research was planned from the beginning of the study, senior qualitative expertise was on the team from beginning to end, and staff and time were dedicated to the qualitative research. In these studies interviewees described the qualitative research adding value to the trial although this value was not necessarily visible beyond the original research team due to the challenges of publishing this research. Conclusions Health researchers combining qualitative research and trials viewed this practice as strengthening evaluative research. Teams viewing the qualitative research as essential to the trial, and resourcing it in practice, may have a better chance of delivering its added value to the trial. PMID:24913438

Getting added value from using qualitative research with randomized controlled trials: a qualitative interview study.

PubMed

O'Cathain, Alicia; Goode, Jackie; Drabble, Sarah J; Thomas, Kate J; Rudolph, Anne; Hewison, Jenny

2014-06-09

Qualitative research is undertaken with randomized controlled trials of health interventions. Our aim was to explore the perceptions of researchers with experience of this endeavour to understand the added value of qualitative research to the trial in practice. A telephone semi-structured interview study with 18 researchers with experience of undertaking the trial and/or the qualitative research. Interviewees described the added value of qualitative research for the trial, explaining how it solved problems at the pretrial stage, explained findings, and helped to increase the utility of the evidence generated by the trial. From the interviews, we identified three models of relationship of the qualitative research to the trial. In 'the peripheral' model, the trial was an opportunity to undertake qualitative research, with no intention that it would add value to the trial. In 'the add-on' model, the qualitative researcher understood the potential value of the qualitative research but it was viewed as a separate and complementary endeavour by the trial lead investigator and wider team. Interviewees described how this could limit the value of the qualitative research to the trial. Finally 'the integral' model played out in two ways. In 'integral-in-theory' studies, the lead investigator viewed the qualitative research as essential to the trial. However, in practice the qualitative research was under-resourced relative to the trial, potentially limiting its ability to add value to the trial. In 'integral-in-practice' studies, interviewees described how the qualitative research was planned from the beginning of the study, senior qualitative expertise was on the team from beginning to end, and staff and time were dedicated to the qualitative research. In these studies interviewees described the qualitative research adding value to the trial although this value was not necessarily visible beyond the original research team due to the challenges of publishing this research. Health researchers combining qualitative research and trials viewed this practice as strengthening evaluative research. Teams viewing the qualitative research as essential to the trial, and resourcing it in practice, may have a better chance of delivering its added value to the trial.

Exploring the process of capacity-building among community-based health promotion workers in Alberta, Canada.

PubMed

Montemurro, Genevieve R; Raine, Kim D; Nykiforuk, Candace I J; Mayan, Maria

2014-09-01

Community capacity-building is a central element to health promotion. While capacity-building features, domains and relationships to program sustainability have been well examined, information on the process of capacity-building as experienced by practitioners is needed. This study examined this process as experienced by coordinators working within a community-based chronic disease prevention project implemented in four communities in Alberta (Canada) from 2005-2010 using a case study approach with a mixed-method design. Data collection involved semi-structured interviews, a focus group and program documents tracking coordinator activity. Qualitative analysis followed the constant comparative method using open, axial and selective coding. Quantitative data were analyzed for frequency of major activity distribution. Capacity-building process involves distinct stages of networking, information exchange, partnering, prioritizing, planning/implementing and supporting/ sustaining. Stages are incremental though not always linear. Contextual factors exert a great influence on the process. Implications for research, practice and policy are discussed. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Review on investigations of antisense oligonucleotides with the use of mass spectrometry.

PubMed

Studzińska, Sylwia

2018-01-01

Antisense oligonucleotides have been investigated as potential drugs for years. They inhibit target gene or protein expression. The present review summarizes their modifications, modes of action, and applications of liquid chromatography coupled with mass spectrometry for qualitative and quantitative analysis of these compounds. The most recent reports on a given topic were given prominence, while some early studies were reviewed in order to provide a theoretical background. The present review covers the issues of using ion-exchange chromatography, ion-pair reversed-phase high performance liquid chromatography and hydrophilic interaction chromatography for the separation of antisense oligonucleotides. The application of mass spectrometry was described with regard to the ionization type used for the determination of these potential therapeutics. Moreover, the current approaches and applications of mass spectrometry for quantitative analysis of antisense oligonucleotides and their metabolites as well as their impurities during in vitro and in vivo studies were discussed. Finally, certain conclusions and perspectives on the determination of therapeutic oligonucleotides in various samples were briefly described. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk factors and precautions of inpatient suicide from the perspective of nurses: A qualitative study.

PubMed

Hu, De-ying; Huang, Di; Xiong, Yu; Lu, Cai-hong; Han, Yan-hong; Ding, Xiao-ping; Wang, Shu-jie; Liu, Yi-lan

2015-04-01

The risk factors and precautions of inpatient suicide were explored. Thirty suicide victims were drawn from the adverse event reports of suicidal act during hospitalization in a general hospital from 2008 to 2014. Data were gathered from the focus group interviews of twelve nurses who had experienced inpatient suicide. The data were analyzed by using analytical technique based on grounded theory, and software QSR NVIVO8 was used to aid the collation of data. Three main themes of risk factors about inpatient suicide emerged from the analysis: individual value, social factors and environmental factors. The individual value was categorized into different groups such as sense of guilt, hopelessness and low self-esteem. Social factors included two aspects of negative life events and social support. Three themes of precautions about inpatient suicide appeared in this study: evaluation, nursing and information exchange. Evaluation was elaborated from both physical and psychological assessments. This finding extends existing work of risk factors and precautions about inpatient suicide and brings new knowledge about the reasons why inpatients commit suicide.

Curie temperature study of {Y(Fe_{1-\\it x} {Co_{\\it x})_2}} and {Zr(Fe_{1-\\it x} {Co_{\\it x})_2}} systems using mean field theory and Monte Carlo method

NASA Astrophysics Data System (ADS)

Wasilewski, Bartosz; Marciniak, Wojciech; Werwiński, Mirosław

2018-05-01

Cubic Laves phases including , , , and are considered as promising candidates for application in hydrogen storage and magnetic refrigeration. While and are ferromagnets, alloying with Co decreases magnetic moments and Curie temperatures (T C) of pseudobinary and systems, leading to the paramagnetic states of and . The following study focuses on the investigation of Curie temperature of the and system from first principles. To do it, Monte Carlo (MC) simulations and the mean field theory (MFT) based on the disordered local moments (DLM) calculations are used. The DLM-MFT results agree qualitatively with the experimental data from the literature and preserve the characteristic features of dependencies for both and . However, we have encountered complications in the Co-rich regions due to failure of the local density approximation (LDA) in describing the Co magnetic moment in the DLM state. The analysis of Fe–Fe exchange couplings for and phases indicates that the nearest-neighbor interactions play the main role in the formation of .

Cyber-support: an analysis of online self-help forums (online self-help forums in bipolar disorder).

PubMed

Bauer, Rita; Bauer, Michael; Spiessl, Hermann; Kagerbauer, Tanja

2013-06-01

The Internet is becoming increasingly important in psychiatry and psychotherapy. The objective of this study was to evaluate if and how online self-help forums are used by patients with bipolar disorders, their relatives and treating professionals. A total of 2400 postings in two online forums were analysed qualitatively and quantitatively. "Disclosure", "friendship" and "online-group cohesion" were the main self-help mechanisms. The topics most discussed were "social network", "symptoms of the illness" and "medication". Factor analyses revealed three factors concerning self-help mechanisms: "group cohesion", "emotional support" and "exchange of information", as well as three factors concerning fields of interest: "illness-related aspects", "social aspects" and "financial and legal issues". We infer that the main interest in participating in online forums for patients with bipolar disorders and their relatives is to share emotions and to discuss their daily struggles with the illness. Our study also reveals that social networking is very important for patients coping with bipolar disorders. Psycho-educative programmes should focus on those aspects.

Let's be professional about this: ideology and the psychological contracts of registered nurses.

PubMed

O'Donohue, Wayne; Nelson, Lindsay

2007-07-01

This study explores whether there is evidence of an ideological component in the psychological contracts of professional employees, as well as evidence of credible supporting commitments by their employer. Fundamental changes in the employment context have prompted many individuals to seek a closer alignment between themselves and their work, as well as with the organizational and broader societal contexts. For many professional employees identification with their professional ideology is a significant factor in producing such an alignment. The study uses an exploratory qualitative approach to analyse interview data collected from a sample of registered nurses employed in an Australian public hospital. The analysis identifies psychological contract terms best understood by reference to an ideological currency. It also suggests that the organization is perceived as obligated to provide credible support for that professional contribution, and the perceived lack of such support has significant impacts. The findings raise doubts about the utility of the concept of a psychological contract that recognizes only economic and socio-emotional exchanges for understanding the psychological contracts of professional employees.

A spin exchange model for singlet fission

NASA Astrophysics Data System (ADS)

Yago, Tomoaki; Wakasa, Masanobu

2018-03-01

Singlet fission has been analyzed with the Dexter model in which electron exchange occurs between chromophores, conserving the spin for each electron. In the present study, we propose a spin exchange model for singlet fission. In the spin exchange model, spins are exchanged by the exchange interaction between two electrons. Our analysis with simple spin functions demonstrates that singlet fission is possible by spin exchange. A necessary condition for spin exchange is a variation in exchange interactions. We also adapt the spin exchange model to triplet fusion and triplet energy transfer, which often occur after singlet fission in organic solids.

Characteristics of qualitative studies in influential journals of general medicine: a critical review.

PubMed

Yamazaki, Hiroshi; Slingsby, Brian Taylor; Takahashi, Miyako; Hayashi, Yoko; Sugimori, Hiroki; Nakayama, Takeo

2009-12-01

Although qualitative studies have increased since the 1990s, some reports note that relatively few influential journals published them up until 2000. This study critically reviewed the characteristics of qualitative studies published in top tier medical journals since 2000. We assessed full texts of qualitative studies published between 2000 and 2004 in the Annals of Internal Medicine, BMJ, JAMA, Lancet, and New England Journal of Medicine. We found 80 qualitative studies, of which 73 (91%) were published in BMJ. Only 10 studies (13%) combined qualitative and quantitative methods. Sixty-two studies (78%) used only one method of data collection. Interviews dominated the choice of data collection. The median sample size was 36 (range: 9-383). Thirty-three studies (41%) did not specify the type of analysis used but rather described the analytic process in detail. The rest indicated the mode of data analysis, in which the most prevalent methods were the constant comparative method (23%) and the grounded theory approach (22%). Qualitative data analysis software was used by 33 studies (41%). Among influential journals of general medicine, only BMJ consistently published an average of 15 qualitative study reports between 2000 and 2004. These findings lend insight into what qualities and characteristics make a qualitative study worthy of consideration to be published in an influential journal, primarily BMJ.

Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis.

PubMed

McNeil, Ryan; Guirguis-Younger, Manal; Dilley, Laura B; Aubry, Tim D; Turnbull, Jeffrey; Hwang, Stephen W

2012-05-17

Homeless and marginally housed persons who use alcohol and/or illicit drugs often have end-of-life care needs that go unmet due to barriers that they face to accessing end-of-life care services. Many homeless and marginally housed persons who use these substances must therefore rely upon alternate sources of end-of-life care and support. This article explores the role of harm reduction services in end-of-life care services delivery to homeless and marginally housed persons who use alcohol and/or illicit drugs. A qualitative case study design was used to explore end-of-life care services delivery to homeless and marginally housed persons in six Canadian cities. A key objective was to explore the role of harm reduction services. 54 health and social services professionals participated in semi-structured qualitative interviews. All participants reported that they provided care and support to this population at end-of-life. Harm reduction services (e.g., syringe exchange programs, managed alcohol programs, etc.) were identified as a critical point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs. Where possible, harm reduction services facilitated referrals to end-of-life care services for this population. Harm reduction services also provided end-of-life care and support when members of this population were unable or unwilling to access end-of-life care services, thereby improving quality-of-life and increasing self-determination regarding place-of-death. While partnerships between harm reduction programs and end-of-life care services are identified as one way to improve access, it is noted that more comprehensive harm reduction services might be needed in end-of-life care settings if they are to engage this underserved population.

On-line capacity-building program on "analysis of data" for medical educators in the South Asia region: a qualitative exploration of our experience.

PubMed

Dongre, A R; Chacko, T V; Banu, S; Bhandary, S; Sahasrabudhe, R A; Philip, S; Deshmukh, P R

2010-11-01

In medical education, using the World Wide Web is a new approach for building the capacity of faculty. However, there is little information available on medical education researchers' needs and their collective learning outcomes in such on-line environments. Hence, the present study attempted: 1)to identify needs for capacity-building of fellows in a faculty development program on the topic of data analysis; and 2) to describe, analyze and understand the collective learning outcomes of the fellows during this need-based on-line session. The present research is based on quantitative (on-line survey for needs assessment) and qualitative (contents of e-mails exchanged in listserv discussion) data which were generated during the October 2009 Mentoring and Learning (M-L) Web discussion on the topic of data analysis. The data sources were shared e-mail responses during the process of planning and executing the M-L Web discussion. Content analysis was undertaken and the categories of discussion were presented as a simple non-hierarchical typology which represents the collective learning of the project fellows. We identified the types of learning needs on the topic 'Analysis of Data' to be addressed for faculty development in the field of education research. This need-based M-L Web discussion could then facilitate collective learning on such topics as 'basic concepts in statistics', tests of significance, Likert scale analysis, bivariate correlation, and simple regression analysis and content analysis of qualitative data. Steps like identifying the learning needs for an on-line M-L Web discussion, addressing the immediate needs of learners and creating a flexible reflective learning environment on the M-L Web facilitated the collective learning of the fellows on the topic of data analysis. Our outcomes can be useful in the design of on-line pedagogical strategies for supporting research in medical education.

Noninteractive macroscopic reliability model for whisker-reinforced ceramic composites

NASA Technical Reports Server (NTRS)

Duffy, Stephen F.; Arnold, Steven M.

1990-01-01

Considerable research is underway in the field of material science focusing on incorporating silicon carbide whiskers into silicon nitride and alumina matrices. These composites show the requisite thermal stability and thermal shock resistance necessary for use as components in advanced gas turbines and heat exchangers. This paper presents a macroscopic noninteractive reliability model for whisker-reinforced ceramic composites. The theory is multiaxial and is applicable to composites that can be characterized as transversely isotropic. Enough processing data exists to suggest this idealization encompasses a significantly large class of fabricated components. A qualitative assessment of the model is made by presenting reliability surfaces in several different stress spaces and for different values of model parameters.

Strong Electron Correlation in Photoionization of Spin-Orbit Doublets

NASA Astrophysics Data System (ADS)

Amusia, M. Ya.; Chernsheva, L. V.; Mnason, S. T.; Msezane, A. Z.; Radojevic, V.

2002-05-01

A new and explicitly many-body aspect of the "leveraging" of the spin-orbit interaction is demonstrated, spin-orbit activated interchannel coupling, which can significantly alter the photoionization cross section of a spin-orbit doublet. As an example, using a modified version of the Spin-Polarized Random-Phase-Approximation with Exchange methodology, a recently observed structure in the photoionization of Xe 3d(A. Kivimaki et al, Phys. Rev. A 63), 012716 (2000) has been explained both qualitatively and quantitatively. The structure is entirely due to this new spin-orbit activated interchannel coupling effect, which should be a general feature of inner-shell photoionization. This work was supported by NSF, NASA, DOE and ISTC.

Analysis of organic acids and acylglycines for the diagnosis of related inborn errors of metabolism by GC- and HPLC-MS.

PubMed

la Marca, Giancarlo; Rizzo, Cristiano

2011-01-01

The analysis of organic acids in urine is commonly included in routine procedures for detecting many inborn errors of metabolism. Many analytical methods allow for both qualitative and quantitative determination of organic acids, mainly in urine but also in plasma, serum, whole blood, amniotic fluid, and cerebrospinal fluid. Liquid-liquid extraction and solid-phase extraction using anion exchange or silica columns are commonly employed approaches for sample treatment. Before analysis can be carried out using gas chromatography-mass spectrometry, organic acids must be converted into more thermally stable, volatile, and chemically inert forms, mainly trimethylsilyl ethers, esters, or methyl esters.

Does the physics of (Ga,Mn)N differ from (GaMn)As qualitatively or quantitatively? Is valance of Mn impurity 2+ or 3+?

NASA Astrophysics Data System (ADS)

Nelson, Ryky; Berlijn, Tom; Ku, Wei; Moreno, Juana; Jarrell, Mark

2013-03-01

(Ga,Mn)N is a promising material for spintronics due to its potential high currie temperature (Tc). However, unlike for (Ga,Mn)As, some of the experiments on (Ga,Mn)N are still controversial on the intrinsic nature of the magnetism. Furthermore, under debate are the spin and charge state of the disordered Mn impurities in (Ga,Mn)N and whether its local moments interact via the same exchange mechanism as in (Ga,Mn)As. To address these issues we will present ab-initio-based analyses of disorder and correlation via the recently developed Wannier function based methods.

Translating the Birmingham Neighborhood Leaders Survey into Innovative Action through the Community Health Innovation Awards.

PubMed

Allen, Shauntice; Pineda, Alaina; Hood, Anthony C; Wakelee, Jessica F

2017-01-01

The Carnegie Foundation for the Advancement of Teaching describes community engagement as the collaboration between higher education institutions and their larger communities (local, regional/state, national, global) for the mutually beneficial exchange of knowledge and resources in a context of partnership. This article describes the development, implementation and outcomes of a community-engaged grant-making program, the Community Health Innovation Awards (CHIA). The CHIA program was the by-product of a qualitative study jointly led by researchers at the University of Alabama at Birmingham and neighborhood leaders from the surrounding communities in Birmingham, AL. The competitive program provided funding to area organizations that proposed creative solutions to on-the-ground health challenges. Since its inception, CHIA has awarded $356,500 to 26 innovative projects between 2012 and 2017. These awards have supported novel programs that have connected academic and community partners in addressing health disparities and improving overall community well-being in the greater Birmingham area.

Cultural aspects within caregiver interactions of ultra-orthodox Jewish women and their family members with mental illness.

PubMed

Weiss, Penina; Shor, Ron; Hadas-Lidor, Naomi

2013-10-01

The role of cultural dynamics and norms within families of persons with mental illness has been an underexplored subject, although the familial context has been recognized as influential. This subject was studied with 24 ultra-Orthodox Jewish mothers of persons with mental illness who live in a relatively closed religious community. While participating in the Keshet educational program designed for family caregivers in mental health, they wrote Meaningful Interactional Life Episodes that involved a dialogue exchange in their lives. Qualitative analysis of 50 episodes illuminates the significant role that religious and cultural norms have in the perceptions of what are considered stressors and the dynamics in these families surrounding these stressors. The necessity and value of incorporating cultural competence into family educational programs and interventions is emphasized, as this may contribute to the potential use and success of mental health service models within a population that essentially underutilizes these services. © 2013 American Orthopsychiatric Association.

Effect of bioparticle size on dispersion and retention in monolithic and perfusive beds

PubMed Central

Trilisky, Egor I.; Lenhoff, Abraham M.

2010-01-01

Single-component pulse response studies were used to compare the retention and transport behavior of small molecules, proteins, and a virus on commercially available monolithic and perfusive ion-exchangers. Temporal distortion and extra-column effects were corrected for using a simple algorithm based on the method of moments. It was found that temporal distortion is inversely related to the number of theoretical plates. With increasing bioparticle size, retention increased and the transition from a non-eluting to a non-adsorbing state with increasing ionic strength became more abrupt. Both of these observations are qualitatively explained by calculations of particle-surface electrostatic attractive energy. Calculations also show that, for sufficiently large bioparticles, such as viruses or cells, hydrodynamic drag can promote elution. Under non-adsorbing conditions, plate height increased only weakly with flow rate and the skew remained unchanged. With increasing retention, plate height increased dramatically for proteins. Plate height was scaled by permeability rather than bead diameter to enable comparison among different stationary phases. PMID:20951383

Theoretical study of room temperature ferromagnetism and band gap energy of pure and ion doped In2O3 nanoparticles

NASA Astrophysics Data System (ADS)

Apostolov, A. T.; Apostolova, I. N.; Wesselinowa, J. M.

2018-06-01

Using the s-d microscopic model including the electron-phonon interaction and the Green's function theory we have considered the origin of room temperature ferromagnetism (RTFM) in pure and ion doped In2O3 nanoparticles (NPs). The magnetization M increases with decreasing particle size. M of Fe, Tb and Mn doped In2O3 NPs is investigated, which increases, decreases and has a maximum, respectively, with increasing doping concentration. The RTFM is due to surface oxygen vacancies and different ionic radius of the dopants compared to that of the host ions. This differences lead to different strains which changes the exchange interaction constants. We have calculated the dependence of the band gap energy on the particle size in In2O3 NPs and the Fe concentration of Fe doped In2O3 NPs. The results are in good qualitative agreement with the experimental data.

'Western Union daddies' and their quest for authenticity: an ethnographic study of the Dominican gay sex tourism industry.

PubMed

Padilla, Mark B

2007-01-01

This article draws on ethnographic research among two categories of male sex workers in the Dominican Republic in order to describe the relationships between gay male tourists and the Dominican men they hire on their trips to the Caribbean. Drawing on both qualitative interview data and quantitative surveys, the discussion examines the usefulness of theories of 'authenticity,' as they have been applied in the analysis of tourist practices more generally, in accounting for the behaviors and practices of male sex workers and their foreign gay clients. While the flow of international remittances from 'Western Union daddies' to their Dominican 'boys' creates a continuous reminder of the utilitarian nature of the exchange, both sex workers and clients are motivated to camouflage this instrumentality in their construction of a more 'authentic,' fulfilling relationship. The article examines the consequences of this ambivalent negotiation for the emotional and economic organization of gay male sex tourism in the Caribbean.

Spatio-temporal coordination among functional residues in protein

NASA Astrophysics Data System (ADS)

Dutta, Sutapa; Ghosh, Mahua; Chakrabarti, J.

2017-01-01

The microscopic basis of communication among the functional sites in bio-macromolecules is a fundamental challenge in uncovering their functions. We study the communication through temporal cross-correlation among the binding sites. We illustrate via Molecular Dynamics simulations the properties of the temporal cross-correlation between the dihedrals of a small protein, ubiquitin which participates in protein degradation in eukaryotes. We show that the dihedral angles of the residues possess non-trivial temporal cross-correlations with asymmetry with respect to exchange of the dihedrals, having peaks at low frequencies with time scales in nano-seconds and an algebraic tail with a universal exponent for large frequencies. We show the existence of path for temporally correlated degrees of freedom among the functional residues. We explain the qualitative features of the cross-correlations through a general mathematical model. The generality of our analysis suggests that temporal cross-correlation functions may provide convenient theoretical framework to understand bio-molecular functions on microscopic basis.

Stand by Me: Qualitative Insights into the Ease of Use of Adjustable Workstations

PubMed Central

Leavy, Justine; Jancey, Jonine

2016-01-01

Background Office workers sit for more than 80% of the work day making them an important target for work site health promotion interventions to break up prolonged sitting time. Adjustable workstations are one strategy used to reduce prolonged sitting time. This study provides both an employees' and employers' perspective into the advantages, disadvantages, practicality and convenience of adjustable workstations and how movement in the office can be further supported by organisations. Methods This qualitative study was part of the Uprising pilot study. Employees were from the intervention arm of a two group (intervention n = 18 and control n = 18) study. Employers were the immediate line-manager of the employee. Data were collected via employee focus groups (n = 17) and employer individual interviews (n = 12). The majority of participants were female (n = 18), had healthy weight, and had a post-graduate qualification. All focus group discussions and interviews were recorded, transcribed verbatim and the data coded according to the content. Qualitative content analysis was conducted. Results Employee data identified four concepts: enhanced general wellbeing; workability and practicality; disadvantages of the retro-fit; and triggers to stand. Most employees (n = 12) reported enhanced general well-being, workability and practicality included less email exchange and positive interaction (n = 5), while the instability of the keyboard a commonly cited disadvantage. Triggers to stand included time and task based prompts. Employer data concepts included: general health and wellbeing; work engagement; flexibility; employee morale; and injury prevention. Over half of the employers (n = 7) emphasised back care and occupational health considerations as important, as well as increased level of staff engagement and strategies to break up prolonged periods of sitting. Discussion The focus groups highlight the perceived general health benefits from this short intervention, including opportunity to sit less and interact in the workplace, creating an ‘energised’ work environment. The retro-fit workstation and keyboard platform provided challenges for some participants. Supervisors emphasised injury prevention and employee morale as two important by products of the adjustable workstation. These were not mentioned by employees. They called for champions to advocate for strategies to break up prolonged sitting. Implications The findings of this novel research from both the employee and employer perspective may support installation of adjustable workstations as one component of a comprehensive approach to improve the long term health of employees. PMID:29546187

Stand by Me: Qualitative Insights into the Ease of Use of Adjustable Workstations.

PubMed

Leavy, Justine; Jancey, Jonine

2016-01-01

Office workers sit for more than 80% of the work day making them an important target for work site health promotion interventions to break up prolonged sitting time. Adjustable workstations are one strategy used to reduce prolonged sitting time. This study provides both an employees' and employers' perspective into the advantages, disadvantages, practicality and convenience of adjustable workstations and how movement in the office can be further supported by organisations. This qualitative study was part of the Uprising pilot study. Employees were from the intervention arm of a two group (intervention n = 18 and control n = 18) study. Employers were the immediate line-manager of the employee. Data were collected via employee focus groups (n = 17) and employer individual interviews (n = 12). The majority of participants were female (n = 18), had healthy weight, and had a post-graduate qualification. All focus group discussions and interviews were recorded, transcribed verbatim and the data coded according to the content. Qualitative content analysis was conducted. Employee data identified four concepts: enhanced general wellbeing; workability and practicality; disadvantages of the retro-fit; and triggers to stand. Most employees (n = 12) reported enhanced general well-being, workability and practicality included less email exchange and positive interaction (n = 5), while the instability of the keyboard a commonly cited disadvantage. Triggers to stand included time and task based prompts. Employer data concepts included: general health and wellbeing; work engagement; flexibility; employee morale; and injury prevention. Over half of the employers (n = 7) emphasised back care and occupational health considerations as important, as well as increased level of staff engagement and strategies to break up prolonged periods of sitting. The focus groups highlight the perceived general health benefits from this short intervention, including opportunity to sit less and interact in the workplace, creating an 'energised' work environment. The retro-fit workstation and keyboard platform provided challenges for some participants. Supervisors emphasised injury prevention and employee morale as two important by products of the adjustable workstation. These were not mentioned by employees. They called for champions to advocate for strategies to break up prolonged sitting. The findings of this novel research from both the employee and employer perspective may support installation of adjustable workstations as one component of a comprehensive approach to improve the long term health of employees.

Expectations, effect and experiences of an easily accessible self-management intervention for people with chronic pain: study protocol for a randomised controlled trial with embedded qualitative study.

PubMed

Nøst, Torunn Hatlen; Steinsbekk, Aslak; Bratås, Ola; Grønning, Kjersti

2016-07-18

People struggling with chronic pain may benefit from different types of non-pharmacological interventions such as self-management courses. Self-management courses aim to increase participants' skills and knowledge in managing chronic conditions. Community health-care services in Norway have increasingly established Healthy Life Centres (HLCs) to offer easily accessible interventions to people in need of support to better handle a life with chronic illness. The aim of this trial is to investigate the expectations, effect and experience of an easily accessible, group-based self-management course delivered at a HLC for people with chronic pain. This is an open pragmatic two-armed randomised controlled trial with an embedded qualitative study. The intervention is a self-management course comprising education, discussions, exchange of experiences between the participants, and physical movement exercises. The control group is offered a drop-in outdoor physical activity. The intervention period is 6 weeks. The primary outcome is patient activation measured by the patient activation measure (PAM). The secondary outcomes include measures of self-efficacy, pain and quality of life. Data will be collected at baseline, and after 3, 6 and 12 months. Using a mixed linear model, the number needed in each arm to achieve a power of 80 % becomes 55. To allow for dropout, the aim is to include 120 participants. Analysis will be done using mixed linear models. In the embedded qualitative study, we will perform semi-structured face-to-face interviews with a sample from both trial arms before randomisation and after 3 and 12 months. The topics elaborated will be motivation for participation and experiences with the activity related to possible changes in managing and coping with chronic pain. There is need for more knowledge on interventions delivering self-care support in an easily accessible way that aim to reach those in need of this kind of health service. This trial will produce important knowledge on the effect and the experiences of participants in such an easily accessible self-management course delivered in Norwegian public primary care. ClinicalTrials.gov: NCT02531282 . Registered on 21 August 2015.

Examining the reaction of monetary policy to exchange rate changes: A nonlinear ARDL approach

NASA Astrophysics Data System (ADS)

Manogaran, Lavaneesvari; Sek, Siok Kun

2017-04-01

Previous studies showed the exchange rate changes can have significant impacts on macroeconomic performance. Over fluctuation of exchange rate may lead to economic instability. Hence, monetary policy rule tends to react to exchange rate changes. Especially, in emerging economies where the policy-maker tends to limit the exchange rate movement through interventions. In this study, we seek to investigate how the monetary policy rule reacts to exchange rate changes. The nonlinear autoregressive distributed lag (NARDL) model is applied to capture the asymmetric effect of exchange rate changes on monetary policy reaction function (interest rate). We focus the study in ASEAN5 countries (Indonesia, Malaysia, Philippines, Thailand and Singapore). The results indicated the existence of asymmetric effect of exchange rates changes on the monetary reaction function for all ASEAN5 countries in the long-run. Where, in majority of the cases the monetary policy is reacting to the appreciation and depreciation of exchange rate by raising the policy rate. This affirms the intervention of policymakers with the `fear of floating' behavior.

Environment-Dependent Guest Exchange in Supramolecular Hosts

PubMed Central

2015-01-01

Dynamic exchange of guest molecules, encapsulated in host assemblies, is a phenomenon in supramolecular chemistry that has important implications in several applications. While the mechanism of exchange in micellar assemblies has been previously investigated, the effect of host and guest environment upon the guest-exchange dynamics has received little attention, if any. In this paper, we study the guest-exchange mechanism in pH-sensitive nanogels along with pH-insensitive nanogels as a control. By systematically comparing the behavior of these nanogels, we show that size, concentration, and hydrophobicity can all play a critical role in guest-exchange dynamics. More importantly, these studies reveal that the dominant mechanism of guest exchange can intimately depend on environmental factors. PMID:25244305

Agricultural science in the wild: a social network analysis of farmer knowledge exchange.

PubMed

Wood, Brennon A; Blair, Hugh T; Gray, David I; Kemp, Peter D; Kenyon, Paul R; Morris, Steve T; Sewell, Alison M

2014-01-01

Responding to demands for transformed farming practices requires new forms of knowledge. Given their scale and complexity, agricultural problems can no longer be solved by linear transfers in which technology developed by specialists passes to farmers by way of extension intermediaries. Recent research on alternative approaches has focused on the innovation systems formed by interactions between heterogeneous actors. Rather than linear transfer, systems theory highlights network facilitation as a specialized function. This paper contributes to our understanding of such facilitation by investigating the networks in which farmers discuss science. We report findings based on the study of a pastoral farming experiment collaboratively undertaken by a group of 17 farmers and five scientists. Analysis of prior contact and alter sharing between the group's members indicates strongly tied and decentralized networks. Farmer knowledge exchanges about the experiment have been investigated using a mix of quantitative and qualitative methods. Network surveys identified who the farmers contacted for knowledge before the study began and who they had talked to about the experiment by 18 months later. Open-ended interviews collected farmer statements about their most valuable contacts and these statements have been thematically analysed. The network analysis shows that farmers talked about the experiment with 192 people, most of whom were fellow farmers. Farmers with densely tied and occupationally homogeneous contacts grew their networks more than did farmers with contacts that are loosely tied and diverse. Thematic analysis reveals three general principles: farmers value knowledge delivered by persons rather than roles, privilege farming experience, and develop knowledge with empiricist rather than rationalist techniques. Taken together, these findings suggest that farmers deliberate about science in intensive and durable networks that have significant implications for theorizing agricultural innovation. The paper thus concludes by considering the findings' significance for current efforts to rethink agricultural extension.

On the ability of a global atmospheric inversion to constrain variations of CO2 fluxes over Amazonia

NASA Astrophysics Data System (ADS)

Molina, L.; Broquet, G.; Imbach, P.; Chevallier, F.; Poulter, B.; Bonal, D.; Burban, B.; Ramonet, M.; Gatti, L. V.; Wofsy, S. C.; Munger, J. W.; Dlugokencky, E.; Ciais, P.

2015-07-01

The exchanges of carbon, water and energy between the atmosphere and the Amazon basin have global implications for the current and future climate. Here, the global atmospheric inversion system of the Monitoring of Atmospheric Composition and Climate (MACC) service is used to study the seasonal and interannual variations of biogenic CO2 fluxes in Amazonia during the period 2002-2010. The system assimilated surface measurements of atmospheric CO2 mole fractions made at more than 100 sites over the globe into an atmospheric transport model. The present study adds measurements from four surface stations located in tropical South America, a region poorly covered by CO2 observations. The estimates of net ecosystem exchange (NEE) optimized by the inversion are compared to an independent estimate of NEE upscaled from eddy-covariance flux measurements in Amazonia. They are also qualitatively evaluated against reports on the seasonal and interannual variations of the land sink in South America from the scientific literature. We attempt at assessing the impact on NEE of the strong droughts in 2005 and 2010 (due to severe and longer-than-usual dry seasons) and the extreme rainfall conditions registered in 2009. The spatial variations of the seasonal and interannual variability of optimized NEE are also investigated. While the inversion supports the assumption of strong spatial heterogeneity of these variations, the results reveal critical limitations of the coarse-resolution transport model, the surface observation network in South America during the recent years and the present knowledge of modelling uncertainties in South America that prevent our inversion from capturing the seasonal patterns of fluxes across Amazonia. However, some patterns from the inversion seem consistent with the anomaly of moisture conditions in 2009.

HPLC separation post-column reaction, UV-visible and fluorescence detection of trace UO/sub 2//sup 2 +//U/sup 4 +/ species in aqueous solutions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Karimi, A.R.

In this study a method for the measurement of uranium in natural waters at sub-ppB concentration levels by the separation and determination of U/sup 4 +/ and UO/sub 2//sup 2 +/ species is proposed. Reversed phase high performance liquid chromatography, followed by a post-column reaction and a sensitive UV-visible detection system was the method of choice to determine qualitatively and quantitatively the two uranium species. Also a cation-exchange and fluorescence detection system was studied for separation and determination of UO/sub 2//sup 2 +/ ions. Uranyl ion was selectively complexed with L-phenylalanine moetie in the sample solution containing U/sup 4 +/more » ions. Uranium (IV)/U(VI)-ligand was separated on a C/sub 18/ column with acetate buffer. Hexanesulfonate was found to be the choice for ion-pair reagent. The separation was best done with the acetate buffer at .01 M concentration and pH of 3.5. Absorption of the two species were measured after a post-column reaction with Arsenazo-III. Chromatographic parameters were calculated and a calibration curves were constructed. The detection limit for the procedure was 0.7 ..mu..g/mo and 1.2..mu..g/ml for U(IV) and U(VI) respectively. When U(VI) was separated on the cation-exchange column the limit of detection was calculated to be 1 ..mu..g/ml. The direct fluorometric method for U(VI) measurement results in a detection limit of 2 ppB and upper concentration limit of 2 ppM. The effect of interfering ions in the direct method of determination could be eliminated by dilution of sample solution.« less

Trust, confidentiality, and the acceptability of sharing HIV-related patient data: lessons learned from a mixed methods study about Health Information Exchanges

PubMed Central

2012-01-01

Background Concerns about the confidentiality of personal health information have been identified as a potential obstacle to implementation of Health Information Exchanges (HIEs). Considering the stigma and confidentiality issues historically associated with human immunodeficiency virus (HIV) disease, we examine how trust—in technology, processes, and people—influenced the acceptability of data sharing among stakeholders prior to implementation of six HIEs intended to improve HIV care in parts of the United States. Our analyses identify the kinds of concerns expressed by stakeholders about electronic data sharing and focus on the factors that ultimately facilitated acceptability of the new exchanges. Methods We conducted 549 surveys with patients and 66 semi-structured interviews with providers and other stakeholders prior to implementation of the HIEs to assess concerns about confidentiality in the electronic sharing of patient data. The patient quantitative data were analyzed using SAS 9.2 to yield sample descriptive statistics. The analysis of the qualitative interviews with providers and other stakeholders followed an open-coding process, and convergent and divergent perspectives emerging from those data were examined within and across the HIEs. Results We found widespread acceptability for electronic sharing of HIV-related patient data through HIEs. This acceptability appeared to be driven by growing comfort with information technologies, confidence in the security protocols utilized to protect data, trust in the providers and institutions who use the technologies, belief in the benefits to the patients, and awareness that electronic exchange represents an enhancement of data sharing already taking place by other means. HIE acceptability depended both on preexisting trust among patients, providers, and institutions and on building consensus and trust in the HIEs as part of preparation for implementation. The process of HIE development also resulted in forging shared vision among institutions. Conclusions Patients and providers are willing to accept the electronic sharing of HIV patient data to improve care for a disease historically seen as highly stigmatized. Acceptability depends on the effort expended to understand and address potential concerns related to data sharing and confidentiality, and on the trust established among stakeholders in terms of the nature of the systems and how they will be used. PMID:22515736

Rethinking exchange market models as optimization algorithms

NASA Astrophysics Data System (ADS)

Luquini, Evandro; Omar, Nizam

2018-02-01

The exchange market model has mainly been used to study the inequality problem. Although the human society inequality problem is very important, the exchange market models dynamics until stationary state and its capability of ranking individuals is interesting in itself. This study considers the hypothesis that the exchange market model could be understood as an optimization procedure. We present herein the implications for algorithmic optimization and also the possibility of a new family of exchange market models

Instructional Practices: A Qualitative Study on the Response to Common Core Standardized Testing

ERIC Educational Resources Information Center

Hightower, Gabrielle

2017-01-01

The purpose of this qualitative study was to examine the instructional practices implemented by Tennessee elementary teachers in response to Common Core Standardized Testing. This research study utilized a basic qualitative method that included a purposive and convenient sampling. This qualitative study focused on face-to-face interviews, phone…

Temporal Dynamics of Social Exchange and the Development of Solidarity: "Testing the Waters" versus "Taking a Leap of Faith"

ERIC Educational Resources Information Center

Kuwabara, Ko; Sheldon, Oliver

2012-01-01

In their concerted efforts to unpack the microprocesses that transform repeated exchanges into an exchange relation, exchange theorists have paid little attention to how actors perceive changes and dynamics in exchanges over time. We help fill this gap by studying how temporal patterns of exchange affect the development of cohesion. Some exchange…

Dynamics of neural cryptography

NASA Astrophysics Data System (ADS)

Ruttor, Andreas; Kinzel, Wolfgang; Kanter, Ido

2007-05-01

Synchronization of neural networks has been used for public channel protocols in cryptography. In the case of tree parity machines the dynamics of both bidirectional synchronization and unidirectional learning is driven by attractive and repulsive stochastic forces. Thus it can be described well by a random walk model for the overlap between participating neural networks. For that purpose transition probabilities and scaling laws for the step sizes are derived analytically. Both these calculations as well as numerical simulations show that bidirectional interaction leads to full synchronization on average. In contrast, successful learning is only possible by means of fluctuations. Consequently, synchronization is much faster than learning, which is essential for the security of the neural key-exchange protocol. However, this qualitative difference between bidirectional and unidirectional interaction vanishes if tree parity machines with more than three hidden units are used, so that those neural networks are not suitable for neural cryptography. In addition, the effective number of keys which can be generated by the neural key-exchange protocol is calculated using the entropy of the weight distribution. As this quantity increases exponentially with the system size, brute-force attacks on neural cryptography can easily be made unfeasible.

Macroscopic and microscopic components of exchange-correlation interactions

NASA Astrophysics Data System (ADS)

Sottile, F.; Karlsson, K.; Reining, L.; Aryasetiawan, F.

2003-11-01

We consider two commonly used approaches for the ab initio calculation of optical-absorption spectra, namely, many-body perturbation theory based on Green’s functions and time-dependent density-functional theory (TDDFT). The former leads to the two-particle Bethe-Salpeter equation that contains a screened electron-hole interaction. We approximate this interaction in various ways, and discuss in particular the results obtained for a local contact potential. This, in fact, allows us to straightforwardly make the link to the TDDFT approach, and to discuss the exchange-correlation kernel fxc that corresponds to the contact exciton. Our main results, illustrated in the examples of bulk silicon, GaAs, argon, and LiF, are the following. (i) The simple contact exciton model, used on top of an ab initio calculated band structure, yields reasonable absorption spectra. (ii) Qualitatively extremely different fxc can be derived approximatively from the same Bethe-Salpeter equation. These kernels can however yield very similar spectra. (iii) A static fxc, both with or without a long-range component, can create transitions in the quasiparticle gap. To the best of our knowledge, this is the first time that TDDFT has been shown to be able to reproduce bound excitons.

Dynamics of neural cryptography.

PubMed

Ruttor, Andreas; Kinzel, Wolfgang; Kanter, Ido

2007-05-01

Synchronization of neural networks has been used for public channel protocols in cryptography. In the case of tree parity machines the dynamics of both bidirectional synchronization and unidirectional learning is driven by attractive and repulsive stochastic forces. Thus it can be described well by a random walk model for the overlap between participating neural networks. For that purpose transition probabilities and scaling laws for the step sizes are derived analytically. Both these calculations as well as numerical simulations show that bidirectional interaction leads to full synchronization on average. In contrast, successful learning is only possible by means of fluctuations. Consequently, synchronization is much faster than learning, which is essential for the security of the neural key-exchange protocol. However, this qualitative difference between bidirectional and unidirectional interaction vanishes if tree parity machines with more than three hidden units are used, so that those neural networks are not suitable for neural cryptography. In addition, the effective number of keys which can be generated by the neural key-exchange protocol is calculated using the entropy of the weight distribution. As this quantity increases exponentially with the system size, brute-force attacks on neural cryptography can easily be made unfeasible.

A 43-year-old woman with unexplained elevation of hCG.

PubMed

Johnson, Lisa M; Gniadek, Thomas J; Cohn, Claudia S; Bachowski, Gary; Karger, Amy B

2018-05-01

This case report investigates an unusual hCG result in a woman who is not pregnant. A 43-year-old woman was admitted for recurrence of thrombotic thrombocytopenic purpura (TTP) and therapeutic plasma exchange (TPE) was initiated. Prior to transitioning the patient from TPE to immunosuppressive therapy, a serum qualitative hCG test was performed and was positive. Several etiologies for elevated hCG were considered and investigated, including heterophile antibody interference, endogenous hCG from pituitary or malignancy, and exogenous hCG. Retrospective measurement of hCG levels in remnant samples, including a sample obtained prior to TPE initiation, demonstrated that the hCG elevation occurred with plasma administration for TPE. Further investigation with the American Red Cross confirmed that a plasma donor was unknowingly pregnant and in the latter half of the first trimester at the time of donation, when hCG levels peak. In plasma recipients with unexplained hCG elevation, passive transfer of hCG from plasma should be considered in the differential diagnosis. Retrospective measurement of hCG in remnant samples obtained prior to plasma exchange can assist in confirming the source. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Accessing the reproducibility and specificity of pepsin and other aspartic proteases.

PubMed

Ahn, Joomi; Cao, Min-Jie; Yu, Ying Qing; Engen, John R

2013-06-01

The aspartic protease pepsin is less specific than other endoproteinases. Because aspartic proteases like pepsin are active at low pH, they are utilized in hydrogen deuterium exchange mass spectrometry (HDX MS) experiments for digestion under hydrogen exchange quench conditions. We investigated the reproducibility, both qualitatively and quantitatively, of online and offline pepsin digestion to understand the compliment of reproducible pepsin fragments that can be expected during a typical pepsin digestion. The collection of reproducible peptides was identified from >30 replicate digestions of the same protein and it was found that the number of reproducible peptides produced during pepsin digestion becomes constant above 5-6 replicate digestions. We also investigated a new aspartic protease from the stomach of the rice field eel (Monopterus albus Zuiew) and compared digestion efficiency and specificity to porcine pepsin and aspergillopepsin. Unique cleavage specificity was found for rice field eel pepsin at arginine, asparagine, and glycine. Different peptides produced by the various proteases can enhance protein sequence coverage and improve the spatial resolution of HDX MS data. This article is part of a Special Issue entitled: Mass spectrometry in structural biology. Copyright © 2012 Elsevier B.V. All rights reserved.

Predictive equation of state method for heavy materials based on the Dirac equation and density functional theory

NASA Astrophysics Data System (ADS)

Wills, John M.; Mattsson, Ann E.

2012-02-01

Density functional theory (DFT) provides a formally predictive base for equation of state properties. Available approximations to the exchange/correlation functional provide accurate predictions for many materials in the periodic table. For heavy materials however, DFT calculations, using available functionals, fail to provide quantitative predictions, and often fail to be even qualitative. This deficiency is due both to the lack of the appropriate confinement physics in the exchange/correlation functional and to approximations used to evaluate the underlying equations. In order to assess and develop accurate functionals, it is essential to eliminate all other sources of error. In this talk we describe an efficient first-principles electronic structure method based on the Dirac equation and compare the results obtained with this method with other methods generally used. Implications for high-pressure equation of state of relativistic materials are demonstrated in application to Ce and the light actinides. Sandia National Laboratories is a multi-program laboratory managed andoperated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

Bias correction in the realized stochastic volatility model for daily volatility on the Tokyo Stock Exchange

NASA Astrophysics Data System (ADS)

Takaishi, Tetsuya

2018-06-01

The realized stochastic volatility model has been introduced to estimate more accurate volatility by using both daily returns and realized volatility. The main advantage of the model is that no special bias-correction factor for the realized volatility is required a priori. Instead, the model introduces a bias-correction parameter responsible for the bias hidden in realized volatility. We empirically investigate the bias-correction parameter for realized volatilities calculated at various sampling frequencies for six stocks on the Tokyo Stock Exchange, and then show that the dynamic behavior of the bias-correction parameter as a function of sampling frequency is qualitatively similar to that of the Hansen-Lunde bias-correction factor although their values are substantially different. Under the stochastic diffusion assumption of the return dynamics, we investigate the accuracy of estimated volatilities by examining the standardized returns. We find that while the moments of the standardized returns from low-frequency realized volatilities are consistent with the expectation from the Gaussian variables, the deviation from the expectation becomes considerably large at high frequencies. This indicates that the realized stochastic volatility model itself cannot completely remove bias at high frequencies.

Managing 'difficult emotions' and family life: exploring insights and social support within online self-management training.

PubMed

Sanders, C; Rogers, A; Gardner, C; Kennedy, A

2011-06-01

Previous research has demonstrated how the Internet can foster emotional support and provide a 'private' space for discussing sensitive issues. Whilst the family has been located as a primary source of support, empirical research on the dynamics of close personal relationships in chronic illness experience remains a challenge. To explore the role of family relationships in supporting self-care and the nature of social support exchanged within an online self-management training course. Qualitative thematic and narrative analysis of online discussion boards. Postings for 218 participants, divided between 11 groups were included for a course section that focused on 'difficult emotions'. Participants exchanged a high degree of emotional support and revealed much about their 'real life' relationships. The latter highlighted the complexities of managing illness within family contexts alongside additional pressures of daily life such as caring commitments and work roles. The private interactive space created within the course allowed insights into the dynamics of family life associated with illness management that are challenging to research. Simultaneously, collective support was developed amongst this group of predominantly working women. The article points to the implications for such interventions and associated evaluative research beyond this selective group.

A Large Deviations Analysis of Certain Qualitative Properties of Parallel Tempering and Infinite Swapping Algorithms

DOE PAGES

Doll, J.; Dupuis, P.; Nyquist, P.

2017-02-08

Parallel tempering, or replica exchange, is a popular method for simulating complex systems. The idea is to run parallel simulations at different temperatures, and at a given swap rate exchange configurations between the parallel simulations. From the perspective of large deviations it is optimal to let the swap rate tend to infinity and it is possible to construct a corresponding simulation scheme, known as infinite swapping. In this paper we propose a novel use of large deviations for empirical measures for a more detailed analysis of the infinite swapping limit in the setting of continuous time jump Markov processes. Usingmore » the large deviations rate function and associated stochastic control problems we consider a diagnostic based on temperature assignments, which can be easily computed during a simulation. We show that the convergence of this diagnostic to its a priori known limit is a necessary condition for the convergence of infinite swapping. The rate function is also used to investigate the impact of asymmetries in the underlying potential landscape, and where in the state space poor sampling is most likely to occur.« less

Dynamics of neural cryptography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ruttor, Andreas; Kinzel, Wolfgang; Kanter, Ido

2007-05-15

Synchronization of neural networks has been used for public channel protocols in cryptography. In the case of tree parity machines the dynamics of both bidirectional synchronization and unidirectional learning is driven by attractive and repulsive stochastic forces. Thus it can be described well by a random walk model for the overlap between participating neural networks. For that purpose transition probabilities and scaling laws for the step sizes are derived analytically. Both these calculations as well as numerical simulations show that bidirectional interaction leads to full synchronization on average. In contrast, successful learning is only possible by means of fluctuations. Consequently,more » synchronization is much faster than learning, which is essential for the security of the neural key-exchange protocol. However, this qualitative difference between bidirectional and unidirectional interaction vanishes if tree parity machines with more than three hidden units are used, so that those neural networks are not suitable for neural cryptography. In addition, the effective number of keys which can be generated by the neural key-exchange protocol is calculated using the entropy of the weight distribution. As this quantity increases exponentially with the system size, brute-force attacks on neural cryptography can easily be made unfeasible.« less

Ion cyclotron instability at Io: Hybrid simulation results compared to in situ observations

NASA Astrophysics Data System (ADS)

Šebek, Ondřej; Trávníček, Pavel M.; Walker, Raymond J.; Hellinger, Petr

2016-08-01

We present analysis of global three-dimensional hybrid simulations of Io's interaction with Jovian magnetospheric plasma. We apply a single-species model with simplified neutral-plasma chemistry and downscale Io in order to resolve the ion kinetic scales. We consider charge exchange, electron impact ionization, and photoionization by using variable rates of these processes to investigate their impact. Our results are in a good qualitative agreement with the in situ magnetic field measurements for five Galileo flybys around Io. The hybrid model describes ion kinetics self-consistently. This allows us to assess the distribution of temperature anisotropies around Io and thereby determine the possible triggering mechanism for waves observed near Io. We compare simulated dynamic spectra of magnetic fluctuations with in situ observations made by Galileo. Our results are consistent with both the spatial distribution and local amplitude of magnetic fluctuations found in the observations. Cyclotron waves, triggered probably by the growth of ion cyclotron instability, are observed mainly downstream of Io and on the flanks in regions farther from Io where the ion pickup rate is relatively low. Growth of the ion cyclotron instability is governed mainly by the charge exchange rate.

History of Sex Exchange in Women with a History of Incarceration

PubMed Central

Noska, Amanda J.; Roberts, Mary B.; Sufrin, Carolyn; Stein, L.A.R.; Beckwith, Curt G.; Rich, Josiah D.; Dauria, Emily F.; Clarke, Jennifer G.

2016-01-01

Sex exchange among incarcerated women is not well-described in the literature. Sex exchange can lead to numerous adverse health outcomes, especially when combined with individual factors (e.g., depression and homelessness) and larger systemic inequalities. The purpose of this study was to explore factors associated with having a history of sex exchange among a sample of incarcerated women. Of 257 women surveyed in this study, 68 women (26.5%) reported a history of sex exchange. In multivariate logistic regression analysis, physical abuse history (p=.05, OR 2.20), history of two or more sexually transmitted infections (p=.01, OR 2.90), injection drug use (p=.04, OR 2.46) and crack-cocaine use (p<.01, OR 3.42) were associated with prior sex exchange. This is one of only two studies to examine factors associated with prior sex exchange among incarcerated women. Our study has important implications for corrections providers to provide more comprehensive care, directly addressing the unique needs of this population. PMID:27133516

Experimental studies on coherent synchrotron radiation at an emittance exchange beam line

NASA Astrophysics Data System (ADS)

Thangaraj, J. C. T.; Thurman-Keup, R.; Ruan, J.; Johnson, A. S.; Lumpkin, A. H.; Santucci, J.

2012-11-01

One of the goals of the Fermilab A0 photoinjector is to investigate experimentally the transverse to longitudinal emittance exchange (EEX) principle. Coherent synchrotron radiation in the emittance exchange line could limit the performance of the emittance exchanger at short bunch lengths. In this paper, we present experimental and simulation studies of the coherent synchrotron radiation (CSR) in the emittance exchange line at the A0 photoinjector. We report on time-resolved CSR studies using a skew-quadrupole technique. We also demonstrate the advantages of running the EEX with an energy-chirped beam.

Diffusion-Welded Microchannel Heat Exchanger for Industrial Processes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Piyush Sabharwall; Denis E. Clark; Michael V. Glazoff

The goal of next generation reactors is to increase energy ef?ciency in the production of electricity and provide high-temperature heat for industrial processes. The ef?cient transfer of energy for industrial applications depends on the ability to incorporate effective heat exchangers between the nuclear heat transport system and the industrial process. The need for ef?ciency, compactness, and safety challenge the boundaries of existing heat exchanger technology. Various studies have been performed in attempts to update the secondary heat exchanger that is downstream of the primary heat exchanger, mostly because its performance is strongly tied to the ability to employ more ef?cientmore » industrial processes. Modern compact heat exchangers can provide high compactness, a measure of the ratio of surface area-to-volume of a heat exchange. The microchannel heat exchanger studied here is a plate-type, robust heat exchanger that combines compactness, low pressure drop, high effectiveness, and the ability to operate with a very large pressure differential between hot and cold sides. The plates are etched and thereafter joined by diffusion welding, resulting in extremely strong all-metal heat exchanger cores. After bonding, any number of core blocks can be welded together to provide the required ?ow capacity. This study explores the microchannel heat exchanger and draws conclusions about diffusion welding/bonding for joining heat exchanger plates, with both experimental and computational modeling, along with existing challenges and gaps. Also, presented is a thermal design method for determining overall design speci?cations for a microchannel printed circuit heat exchanger for both supercritical (24 MPa) and subcritical (17 MPa) Rankine power cycles.« less

The Use of Journal Clubs in Science Teacher Education

NASA Astrophysics Data System (ADS)

Tallman, Karen A.; Feldman, Allan

2016-04-01

This qualitative study explored how in a 7-month-long journal club pre- and inservice science teachers engaged with education research literature relevant to their practice to reduce the theory-practice gap. In the journal club they had the opportunity to critique and analyze peer-reviewed science education articles in the context of their classroom practice. Data sources included audio recordings of the meetings; semi-structured pre- and post-interviews of the teachers; focus groups; and artifacts (e.g., journal articles, reflective paper, email exchanges, and researcher's field notes). Data were analyzed using the techniques of grounded theory (Corbin & Strauss in Basics of qualitative research, 3rd ed. Sage, Thousand Oaks, 2008). In addition we used some preconceived categories that we created from existing literature on journal clubs and communities of practice (Newswander & Borrego in European Journal of Engineering Education 34(6): 561-571, 2009; Wenger in Communities of practice: learning, meaning, and identity. Cambridge University Press, Cambridge, 1998) and from our previous research (Tallman & Feldman, 2012). We found that the journal club incorporated the three characteristics of a community of practice (Wenger in Communities of practice: learning, meaning, and identity. Cambridge University Press, Cambridge, 1998) into its functioning (mutual engagement, joint enterprise, and shared repertoire). The teachers mutually engaged around the joint enterprise of reading, critiquing, and understanding the research studies with the goal of improving practice. The teachers also asked each other analytical questions, which became a shared repertoire of the journal club. They reflected on their practice by presenting, reading, and discussing the articles, which helped them to determine whether and how the findings from the articles could be incorporated into their teaching practice. In doing so, they learned the skills needed to critique the research literature in relation to their practice as classroom teachers.

‘Safer Environment Interventions’: A qualitative synthesis of the experiences and perceptions of people who inject drugs

PubMed Central

McNeil, Ryan; Small, Will

2014-01-01

There is growing acknowledgment that social, structural, and environmental forces produce vulnerability to health harms among people who inject drugs (PWID), and safer environment interventions (SEI) have been identified as critical to mitigating the impacts of these contextual forces on drug-related harm. To date, however, SEIs have been under-theorized in the literature, and how they minimize drug-related risks across intervention types and settings has not been adequately examined. This article presents findings from a systematic review and meta-synthesis of qualitative studies reporting PWID’s experiences with three types of SEIs (syringe exchange programmes, supervised injection facilities and peer-based harm reduction interventions) published between 1997 and 2012. This meta-synthesis seeks to develop a comprehensive understanding of SEIs informed by the experiences of PWID. Twenty-nine papers representing twenty-one unique studies that included an aggregate of more than 800 PWID were included in this meta-synthesis. This meta- synthesis found that SEIs fostered social and physical environments that mitigated drug-related harms and increased access to social and material resources. Specifically, SEIs: (1) provided refuge from street-based drug scenes; (2) enabled safer injecting by reshaping the social and environmental contexts of injection drug use; (3) mediated access to resources and health care services; and, (4) were constrained by drug prohibition and law enforcement activities. These findings indicate that it is critical to situate SEIs in relation to the lived experiences of PWID, and in particular provide broader environmental support to PWID. Given that existing drug laws limit the effectiveness of interventions, drug policy reforms are needed to enable public health, and specifically SEIs, to occupy a more prominent role in the response to injection drug use. PMID:24561777

Exploring the components of physician volunteer engagement: a qualitative investigation of a national Canadian simulation-based training programme

PubMed Central

Sarti, Aimee J; Sutherland, Stephanie; Landriault, Angele; DesRosier, Kirk; Brien, Susan; Cardinal, Pierre

2017-01-01

Objectives Conceptual clarity on physician volunteer engagement is lacking in the medical literature. The aim of this study was to present a conceptual framework to describe the elements which influence physician volunteer engagement and to explore volunteer engagement within a national educational programme. Setting The context for this study was the Acute Critical Events Simulation (ACES) programme in Canada, which has successfully evolved into a national educational programme, driven by physician volunteers. From 2010 to 2014, the programme recruited 73 volunteer healthcare professionals who contributed to the creation of educational materials and/or served as instructors. Method A conceptual framework was constructed based on an extensive literature review and expert consultation. Secondary qualitative analysis was undertaken on 15 semistructured interviews conducted from 2012 to 2013 with programme directors and healthcare professionals across Canada. An additional 15 interviews were conducted in 2015 with physician volunteers to achieve thematic saturation. Data were analysed iteratively and inductive coding techniques applied. Results From the physician volunteer data, 11 themes emerged. The most prominent themes included volunteer recruitment, retention, exchange, recognition, educator network and quasi-volunteerism. Captured within these interrelated themes were the framework elements, including the synergistic effects of emotional, cognitive and reciprocal engagement. Behavioural engagement was driven by these factors along with a cue to action, which led to contributions to the ACES programme. Conclusion This investigation provides a preliminary framework and supportive evidence towards understanding the complex construct of physician volunteer engagement. The need for this research is particularly important in present day, where growing fiscal constraints create challenges for medical education to do more with less. PMID:28645956