Implementation of a health data-sharing infrastructure across diverse primary care organizations.

PubMed

Cole, Allison M; Stephens, Kari A; Keppel, Gina A; Lin, Ching-Ping; Baldwin, Laura-Mae

2014-01-01

Practice-based research networks bring together academic researchers and primary care clinicians to conduct research that improves health outcomes in real-world settings. The Washington, Wyoming, Alaska, Montana, and Idaho region Practice and Research Network implemented a health data-sharing infrastructure across 9 clinics in 3 primary care organizations. Following implementation, we identified challenges and solutions. Challenges included working with diverse primary care organizations, adoption of health information data-sharing technology in a rapidly changing local and national landscape, and limited resources for implementation. Overarching solutions included working with a multidisciplinary academic implementation team, maintaining flexibility, and starting with an established network for primary care organizations. Approaches outlined may generalize to similar initiatives and facilitate adoption of health data sharing in other practice-based research networks.

Implementation of a Health Data-Sharing Infrastructure Across Diverse Primary Care Organizations

PubMed Central

Cole, Allison M.; Stephens, Kari A.; Keppel, Gina A.; Lin, Ching-Ping; Baldwin, Laura-Mae

2014-01-01

Practice-based research networks bring together academic researchers and primary care clinicians to conduct research that improves health outcomes in real-world settings. The Washington, Wyoming, Alaska, Montana, and Idaho region Practice and Research Network implemented a health data-sharing infrastructure across 9 clinics in 3 primary care organizations. Following implementation, we identified challenges and solutions. Challenges included working with diverse primary care organizations, adoption of health information data-sharing technology in a rapidly changing local and national landscape, and limited resources for implementation. Overarching solutions included working with a multidisciplinary academic implementation team, maintaining flexibility, and starting with an established network for primary care organizations. Approaches outlined may generalize to similar initiatives and facilitate adoption of health data sharing in other practice-based research networks. PMID:24594564

Case Presentations Demonstrating Periodontal Treatment Variation: PEARL Network.

PubMed

Curro, Frederick A; Grill, Ashley C; Matthews, Abigail G; Martin, John; Kalenderian, Elisabeth; Craig, Ronald G; Naftolin, Frederick; Thompson, Van P

2015-06-01

Variation in periodontal terminology can affect the diagnosis and treatment plan as assessed by practicing general dentists in the Practitioners Engaged in Applied Research and Learning (PEARL) Network. General dentists participating in the PEARL Network are highly screened, credentialed, and qualified and may not be representative of the general population of dentists. Ten randomized case presentations ranging from periodontal health to gingivitis, to mild, moderate, and severe periodontitis were randomly presented to respondents. Descriptive comparisons were made between these diagnosis groups in terms of the treatment recommendations following diagnosis. PEARL practitioners assessing periodontal clinical scenarios were found to either over- or under-diagnose the case presentations, which affected treatment planning, while the remaining responses concurred with respect to the diagnosis. The predominant diagnosis was compared with that assigned by two practicing periodontists. There was variation in treatment based on the diagnosis for gingivitis and the lesser forms of periodontitis. Data suggests that a lack of clarity of periodontal terminology affects both diagnosis and treatment planning, and terminology may be improved by having diagnosis codes, which could be used to assess treatment outcomes. This article provides data to support best practice for the use of diagnosis coding and integration of dentistry with medicine using ICD-10 terminology.

An architectural approach to create self organizing control systems for practical autonomous robots

NASA Technical Reports Server (NTRS)

Greiner, Helen

1991-01-01

For practical industrial applications, the development of trainable robots is an important and immediate objective. Therefore, the developing of flexible intelligence directly applicable to training is emphasized. It is generally agreed upon by the AI community that the fusion of expert systems, neural networks, and conventionally programmed modules (e.g., a trajectory generator) is promising in the quest for autonomous robotic intelligence. Autonomous robot development is hindered by integration and architectural problems. Some obstacles towards the construction of more general robot control systems are as follows: (1) Growth problem; (2) Software generation; (3) Interaction with environment; (4) Reliability; and (5) Resource limitation. Neural networks can be successfully applied to some of these problems. However, current implementations of neural networks are hampered by the resource limitation problem and must be trained extensively to produce computationally accurate output. A generalization of conventional neural nets is proposed, and an architecture is offered in an attempt to address the above problems.

On the sample complexity of learning for networks of spiking neurons with nonlinear synaptic interactions.

PubMed

Schmitt, Michael

2004-09-01

We study networks of spiking neurons that use the timing of pulses to encode information. Nonlinear interactions model the spatial groupings of synapses on the neural dendrites and describe the computations performed at local branches. Within a theoretical framework of learning we analyze the question of how many training examples these networks must receive to be able to generalize well. Bounds for this sample complexity of learning can be obtained in terms of a combinatorial parameter known as the pseudodimension. This dimension characterizes the computational richness of a neural network and is given in terms of the number of network parameters. Two types of feedforward architectures are considered: constant-depth networks and networks of unconstrained depth. We derive asymptotically tight bounds for each of these network types. Constant depth networks are shown to have an almost linear pseudodimension, whereas the pseudodimension of general networks is quadratic. Networks of spiking neurons that use temporal coding are becoming increasingly more important in practical tasks such as computer vision, speech recognition, and motor control. The question of how well these networks generalize from a given set of training examples is a central issue for their successful application as adaptive systems. The results show that, although coding and computation in these networks is quite different and in many cases more powerful, their generalization capabilities are at least as good as those of traditional neural network models.

Family networks and health among Métis aged 45 or older.

PubMed

Ramage-Morin, Pamela L; Bougie, Evelyne

2017-12-20

Social networks are important for promoting and maintaining health and well-being. Social networks, including family and friendship ties, are sources of emotional, practical and other support that enhance social participation and help combat isolation and loneliness. Aboriginal seniors have been identified as a population at risk of social isolation. The data are from the 2012 Aboriginal Peoples Survey, a national survey of First Nations people living off reserve, Métis, and Inuit. Frequencies, cross-tabulations, and logistic regression models were used to look at family networks and self-perceived general and mental health among Métis aged 45 or older. An estimated 48% of Métis men and 60% of Métis women aged 45 or older had strong family networks. Older age, lower education, and non-participation in the labour force were associated with strong networks. Métis men and women with strong family networks had higher odds than did those with weak networks of reporting positive mental health, even when potential confounders were taken into account. Among Métis men, a relationship between strong family networks and positive general health was also observed. Strong family networks are associated with positive self-perceived general and mental health among Métis adults. In addition to individual behaviours, family well-being is important for general health promotion.

Prescribing Data in General Practice Demonstration (PDGPD) project--a cluster randomised controlled trial of a quality improvement intervention to achieve better prescribing for chronic heart failure and hypertension.

PubMed

Williamson, Margaret; Cardona-Morrell, Magnolia; Elliott, Jeffrey D; Reeve, James F; Stocks, Nigel P; Emery, Jon; Mackson, Judith M; Gunn, Jane M

2012-08-23

Research literature consistently documents that scientifically based therapeutic recommendations are not always followed in the hospital or in the primary care setting. Currently, there is evidence that some general practitioners in Australia are not prescribing appropriately for patients diagnosed with 1) hypertension (HT) and 2) chronic heart failure (CHF). The objectives of this study were to improve general practitioner's drug treatment management of these patients through feedback on their own prescribing and small group discussions with peers and a trained group facilitator. The impact evaluation includes quantitative assessment of prescribing changes at 6, 9, 12 and 18 months after the intervention. A pragmatic multi site cluster RCT began recruiting practices in October 2009 to evaluate the effects of a multi-faceted quality improvement (QI) intervention on prescribing practice among Australian general practitioners (GP) in relation to patients with CHF and HT. General practices were recruited nationally through General Practice Networks across Australia. Participating practices were randomly allocated to one of three groups: two groups received the QI intervention (the prescribing indicator feedback reports and small group discussion) with each group undertaking the clinical topics (CHF and HT) in reverse order to the other. The third group was waitlisted to receive the intervention 6 months later and acted as a "control" for the other two groups.De-identified data on practice, doctor and patient characteristics and their treatment for CHF and HT are extracted at six-monthly intervals before and after the intervention. Post-test comparisons will be conducted between the intervention and control arms using intention to treat analysis and models that account for clustering of practices in a Network and clustering of patients within practices and GPs. This paper describes the study protocol for a project that will contribute to the development of acceptable and sustainable methods to promote QI activities within routine general practice, enhance prescribing practices and improve patient outcomes in the context of CHF and HT. Australian New Zealand Clinical Trials Registry (ANZCTR), Trial # 320870.

Prescribing Data in General Practice Demonstration (PDGPD) project - a cluster randomised controlled trial of a quality improvement intervention to achieve better prescribing for chronic heart failure and hypertension

PubMed Central

2012-01-01

Background Research literature consistently documents that scientifically based therapeutic recommendations are not always followed in the hospital or in the primary care setting. Currently, there is evidence that some general practitioners in Australia are not prescribing appropriately for patients diagnosed with 1) hypertension (HT) and 2) chronic heart failure (CHF). The objectives of this study were to improve general practitioner’s drug treatment management of these patients through feedback on their own prescribing and small group discussions with peers and a trained group facilitator. The impact evaluation includes quantitative assessment of prescribing changes at 6, 9, 12 and 18 months after the intervention. Methods A pragmatic multi site cluster RCT began recruiting practices in October 2009 to evaluate the effects of a multi-faceted quality improvement (QI) intervention on prescribing practice among Australian general practitioners (GP) in relation to patients with CHF and HT. General practices were recruited nationally through General Practice Networks across Australia. Participating practices were randomly allocated to one of three groups: two groups received the QI intervention (the prescribing indicator feedback reports and small group discussion) with each group undertaking the clinical topics (CHF and HT) in reverse order to the other. The third group was waitlisted to receive the intervention 6 months later and acted as a “control” for the other two groups. De-identified data on practice, doctor and patient characteristics and their treatment for CHF and HT are extracted at six-monthly intervals before and after the intervention. Post-test comparisons will be conducted between the intervention and control arms using intention to treat analysis and models that account for clustering of practices in a Network and clustering of patients within practices and GPs. Discussion This paper describes the study protocol for a project that will contribute to the development of acceptable and sustainable methods to promote QI activities within routine general practice, enhance prescribing practices and improve patient outcomes in the context of CHF and HT. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), Trial # 320870. PMID:22913571

Network representations of angular regions for electromagnetic scattering

PubMed Central

2017-01-01

Network modeling in electromagnetics is an effective technique in treating scattering problems by canonical and complex structures. Geometries constituted of angular regions (wedges) together with planar layers can now be approached with the Generalized Wiener-Hopf Technique supported by network representation in spectral domain. Even if the network representations in spectral planes are of great importance by themselves, the aim of this paper is to present a theoretical base and a general procedure for the formulation of complex scattering problems using network representation for the Generalized Wiener Hopf Technique starting basically from the wave equation. In particular while the spectral network representations are relatively well known for planar layers, the network modelling for an angular region requires a new theory that will be developed in this paper. With this theory we complete the formulation of a network methodology whose effectiveness is demonstrated by the application to a complex scattering problem with practical solutions given in terms of GTD/UTD diffraction coefficients and total far fields for engineering applications. The methodology can be applied to other physics fields. PMID:28817573

Egg production forecasting: Determining efficient modeling approaches.

PubMed

Ahmad, H A

2011-12-01

Several mathematical or statistical and artificial intelligence models were developed to compare egg production forecasts in commercial layers. Initial data for these models were collected from a comparative layer trial on commercial strains conducted at the Poultry Research Farms, Auburn University. Simulated data were produced to represent new scenarios by using means and SD of egg production of the 22 commercial strains. From the simulated data, random examples were generated for neural network training and testing for the weekly egg production prediction from wk 22 to 36. Three neural network architectures-back-propagation-3, Ward-5, and the general regression neural network-were compared for their efficiency to forecast egg production, along with other traditional models. The general regression neural network gave the best-fitting line, which almost overlapped with the commercial egg production data, with an R(2) of 0.71. The general regression neural network-predicted curve was compared with original egg production data, the average curves of white-shelled and brown-shelled strains, linear regression predictions, and the Gompertz nonlinear model. The general regression neural network was superior in all these comparisons and may be the model of choice if the initial overprediction is managed efficiently. In general, neural network models are efficient, are easy to use, require fewer data, and are practical under farm management conditions to forecast egg production.

Identifiability of large-scale non-linear dynamic network models applied to the ADM1-case study.

PubMed

Nimmegeers, Philippe; Lauwers, Joost; Telen, Dries; Logist, Filip; Impe, Jan Van

2017-06-01

In this work, both the structural and practical identifiability of the Anaerobic Digestion Model no. 1 (ADM1) is investigated, which serves as a relevant case study of large non-linear dynamic network models. The structural identifiability is investigated using the probabilistic algorithm, adapted to deal with the specifics of the case study (i.e., a large-scale non-linear dynamic system of differential and algebraic equations). The practical identifiability is analyzed using a Monte Carlo parameter estimation procedure for a 'non-informative' and 'informative' experiment, which are heuristically designed. The model structure of ADM1 has been modified by replacing parameters by parameter combinations, to provide a generally locally structurally identifiable version of ADM1. This means that in an idealized theoretical situation, the parameters can be estimated accurately. Furthermore, the generally positive structural identifiability results can be explained from the large number of interconnections between the states in the network structure. This interconnectivity, however, is also observed in the parameter estimates, making uncorrelated parameter estimations in practice difficult. Copyright © 2017. Published by Elsevier Inc.

Cluster and propensity based approximation of a network

PubMed Central

2013-01-01

Background The models in this article generalize current models for both correlation networks and multigraph networks. Correlation networks are widely applied in genomics research. In contrast to general networks, it is straightforward to test the statistical significance of an edge in a correlation network. It is also easy to decompose the underlying correlation matrix and generate informative network statistics such as the module eigenvector. However, correlation networks only capture the connections between numeric variables. An open question is whether one can find suitable decompositions of the similarity measures employed in constructing general networks. Multigraph networks are attractive because they support likelihood based inference. Unfortunately, it is unclear how to adjust current statistical methods to detect the clusters inherent in many data sets. Results Here we present an intuitive and parsimonious parametrization of a general similarity measure such as a network adjacency matrix. The cluster and propensity based approximation (CPBA) of a network not only generalizes correlation network methods but also multigraph methods. In particular, it gives rise to a novel and more realistic multigraph model that accounts for clustering and provides likelihood based tests for assessing the significance of an edge after controlling for clustering. We present a novel Majorization-Minimization (MM) algorithm for estimating the parameters of the CPBA. To illustrate the practical utility of the CPBA of a network, we apply it to gene expression data and to a bi-partite network model for diseases and disease genes from the Online Mendelian Inheritance in Man (OMIM). Conclusions The CPBA of a network is theoretically appealing since a) it generalizes correlation and multigraph network methods, b) it improves likelihood based significance tests for edge counts, c) it directly models higher-order relationships between clusters, and d) it suggests novel clustering algorithms. The CPBA of a network is implemented in Fortran 95 and bundled in the freely available R package PropClust. PMID:23497424

MRI correlates of general intelligence in neurotypical adults.

PubMed

Malpas, Charles B; Genc, Sila; Saling, Michael M; Velakoulis, Dennis; Desmond, Patricia M; O'Brien, Terence J

2016-02-01

There is growing interest in the neurobiological substrate of general intelligence. Psychometric estimates of general intelligence are reduced in a range of neurological disorders, leading to practical application as sensitive, but non-specific, markers of cerebral disorder. This study examined estimates of general intelligence in neurotypical adults using diffusion tensor imaging and resting-state functional connectivity analysis. General intelligence was related to white matter organisation across multiple brain regions, confirming previous work in older healthy adults. We also found that variation in general intelligence was related to a large functional sub-network involving all cortical lobes of the brain. These findings confirm that individual variance in general intelligence is related to diffusely represented brain networks. Copyright © 2015 Elsevier Ltd. All rights reserved.

Rubber dam use during root canal treatment: findings from The Dental Practice-Based Research Network

PubMed Central

Anabtawi, Mona F.; Gilbert, Gregg H.; Bauer, Michael R.; Reams, Gregg; Makhija, Sonia K.; Benjamin, Paul L.; Williams, O. Dale

2012-01-01

Background The Dental Practice-Based Research Network (DPBRN) provides a venue to investigate whether certain procedures are performed routinely. Study objectives were to: (1) quantify rubber dam use during root canal treatment (RCT) among general dentists; (2) test the hypothesis that certain dentist or practice characteristics are associated with its use. Methods DPBRN practitioner-investigators participated in a questionnaire that included items about rubber dam use and other forms of isolation during root RCT. DPBRN Enrollment Questionnaire data provided certain practitioner and practice characteristics. Results A total of 729 practitioners responded (74%); 524 were general dentists and indicated they do RCT and the percentage of RCT in which they use a rubber dam. Of these 524, 44% use rubber dam for all RCTs; 24% use it for 51%–99% of RCTs; 17% use it for 1%–50%; 15% never use it during RCT. Usage varied significantly by geographic region and practice type. Cotton rolls and other forms of isolation were also reported. Conclusions Similar to other reports in the literature, not all DPBRN general dentists use a rubber dam during RCT. Clinical implications Because the current clinical standard of care is to use a rubber dam during RCT, increasing its use may be important. PMID:23372134

Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece

PubMed Central

2011-01-01

Background Research has indicated that general practitioners (GPs) have good clinical judgment in regards to diagnosing and managing herpes zoster (HZ) within clinical practice in a country with limited resources for primary care and general practice. The objective of the current study was to assess the burden of HZ and post herpetic neuralgia (PHN) within rural general practices in Crete, Greece. Methods The current study took place within a rural setting in Crete, Greece during the period of November 2007 to November 2009 within the catchment area in which the Cretan Rural Practice-based Research Network is operating. In total 19 GP's from 14 health care units in rural Crete were invited to participate, covering a total turnover patient population of approximately 25, 000 subjects. For the purpose of this study an electronic record database was constructed and used as the main tool for monitoring HZ and PHN incidence. Stress related data was also collected with the use of the Short Anxiety Screening Test (SAST). Results The crude incidence rate of HZ was 1.4/1000 patients/year throughout the entire network of health centers and satellite practices, while among satellite practices alone it was calculated at 1.3/1000 patients/year. Additionally, the standardised incidence density within satellite practices was calculated at 1.6/1000 patients/year. In regards to the stress associated with HZ and PHN, the latter were found to have lower levels of anxiety, as assessed through the SAST score (17.4 ± 3.9 vs. 21.1 ± 5.7; p = 0.029). Conclusions The implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete. PMID:22145678

General Motors' R&D: Managing Innovation Globally

NASA Astrophysics Data System (ADS)

Taub, Alan

2006-03-01

The rapid pace of technology development and the globalization of the automobile industry are major forces driving General Motors to devise new ways to innovate faster and more efficiently. In response, GM has developed a global R&D network that has transformed GM's research and development organization from a U.S.-based enterprise to one that is over 30 percent leveraged with collaboration in 16 countries. This talk will focus on the challenges faced as well as the lessons learned and best practices developed in building this network.

Online social networking for radiology.

PubMed

Auffermann, William F; Chetlen, Alison L; Colucci, Andrew T; DeQuesada, Ivan M; Grajo, Joseph R; Heller, Matthew T; Nowitzki, Kristina M; Sherry, Steven J; Tillack, Allison A

2015-01-01

Online social networking services have changed the way we interact as a society and offer many opportunities to improve the way we practice radiology and medicine in general. This article begins with an introduction to social networking. Next, the latest advances in online social networking are reviewed, and areas where radiologists and clinicians may benefit from these new tools are discussed. This article concludes with several steps that the interested reader can take to become more involved in online social networking. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

General practitioners' use of caries-preventive agents in adult patients versus pediatric patients: findings from the dental practice-based research network.

PubMed

Riley, Joseph L; Gordan, Valeria V; Rindal, D Brad; Fellows, Jeffrey L; Williams, O Dale; Ritchie, Lloyd K; Gilbert, Gregg H

2010-06-01

In this study, the authors tested the frequency of dentists' recommendations for and use of caries-preventive agents for children as compared with adults. The authors surveyed 467 general dentists in the Dental Practice-Based Research Network who practice within the United States and treat both pediatric and adult patients. They asked dentists to identify the percentage of their patients for whom they had administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse and xylitol gum. Dentists were less likely to provide adult patients than pediatric patients with in-office caries-preventive agents. However, the rate at which they recommended at-home preventive regimens for the two groups of patients was similar. Dentists with a conservative approach to caries treatment were the most likely to use and recommend the use of caries-preventive agents at similar rates in adults as in children. In addition, dentists in practices with a greater number of patients who had dental insurance were significantly more likely to provide in-office fluoride or sealants to adult patients than to pediatric patients. General dentists use in-office caries-preventive agents more commonly with their pediatric patients than with their adult patients. General dentists should consider providing additional in-office caries-preventive agents for their adult patients who are at increased risk of experiencing dental caries.

Themes and methods of research presented at European General Practice Research Network conferences.

PubMed

Kruschinski, Carsten; Lange, Maaike; Lionis, Christos; van Weel, Chris; Hummers-Pradier, Eva

2010-08-01

The World Organization of Family Doctors (Wonca) defined core characteristics of general practice and general practitioners' competencies. It is unclear to which extent research has addressed these issues so far. To determine themes and research methods of general practice research as reflected by presentations at the European General Practice Research Network (EGPRN) meetings. Descriptive and retrospective study. All abstracts presented at each of the 14 EGPRN conferences between June 2001 and October 2007 were analysed for content and study design/methodology. Categories for content were developed inductively; a predefined hierarchical scheme was used for study designs. A total of N=614 abstracts were classified. The main research topics were related to GP/health service issues (n=232), clinical (n=148) and patient-related themes (n=118). Original data (n=558) were mainly derived from cross-sectional designs (38.7%). Intervention studies (11.0%), longitudinal designs including case-control and cohort studies (13.3%) as well as instrumental research (2.2%) were less common. More than one-fourth of all original studies were qualitative studies (27.6%). Stratified analysis revealed that cross-sectional designs were less frequent in the second half of conferences. Analysis by country showed that, in contrast to different quantitative designs, the proportion of qualitative studies was comparable. To test effectiveness of diagnostic and therapeutic interventions under primary care conditions, a higher proportion of experimental studies would be preferable. This could increase the acceptance of general practitioners' specific approaches and provide clear guidance on approaches and procedures, especially in health care systems not predominantly based on primary care.

Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from The National Dental PBRN

PubMed Central

Fellows, Jeffrey L; Gordan, Valeria V.; Gilbert, Gregg H.; Rindal, D. Brad; Qvist, Vibeke; Litaker, Mark S.; Benjamin, Paul; Flink, Håkan; Pihlstrom, Daniel J.; Johnson, Neil

2014-01-01

Purpose Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. We used actual clinical data to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Methods We combined data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists. Analysis of variance and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Results Network dentists from 5 regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (p<0.05) by patient age and race/ethnicity, dentist use of caries risk assessment, network region, and practice type. Enamel proximal restorations varied significantly (p<0.05) by dentist race/ethnicity, network region, and practice type. CLINICAL SIGNIFICANCE Identifying patient, dentist, and practice characteristics associated with enamel caries restorations can guide strategies to improve provider adherence to evidence-based clinical recommendations. PMID:25000667

Variation in formulary adherence in general practice over time (2003-2007).

PubMed

van Dijk, Liset; de Jong, Judith D; Westert, Gert P; de Bakker, Dinny H

2011-12-01

To study trends and variation in adherence to the main national formulary for the 20 most prevalent health problems in Dutch general practice over a 5-year period (2003-07). Routine electronic medical records from a pool of 115 representative general practices were linked to the main national formulary. Analyses included over 2 million prescriptions for 246 391 patients. The outcome variable was whether or not the prescribed medication was congruent with recommendations in the national formulary. Trends and variation were analysed using three-level multilevel logistic regression analyses (general practice, patient, and prescription). The percentage of formulary adherent prescriptions for the 20 most prevalent health problems was 73-76% between 2003 and 2007. The percentage varied considerably between guidelines. Lowest adherence rates were found for acute bronchitis and acute upper respiratory infection. Interpractice variation was constant over time. General practice information networks are useful for monitoring general patterns of formulary on a year-to-year basis. Formulary adherence is stable over time but varies across diagnoses, patients and general practices. In the past decade, efforts have been made to increase the level of formulary adherent prescribing. These general efforts managed to stabilize (variation in) adherence in a field where many other initiatives (e.g. by pharmaceutical companies) are undertaken to influence prescribing behaviour.

Moving into the 'patient-centred medical home': reforming Australian general practice.

PubMed

Hayes, Paul; Lynch, Anthony; Stiffe, Jenni

2016-09-01

The Australian healthcare system is a complex network of services and providers funded and administered by federal, state and territory governments, supplemented by private health insurance and patient contributions. The broad geographical range, complexity and increasing demand within the Australian healthcare sector mean health expenditure is high. Aspects of current funding for the healthcare system have attracted criticism from medical practitioners, patients, representative organisations and independent statutory agencies. In response to the problems in primary care funding in Australia, The Royal Australian College of General Practitioners developed the Vision for general practice and a sustainable healthcare system (the Vision). The Vision presents a plan to improve healthcare delivery in Australia through greater quality, access and efficiency by reorienting how general practice services are funded based on the 'patient-centred medical home' model.

SSA Sensor Calibration Best Practices

NASA Astrophysics Data System (ADS)

Johnson, T.

Best practices for calibrating orbit determination sensors in general and space situational awareness (SSA) sensors in particular are presented. These practices were developed over the last ten years within AGI and most recently applied to over 70 sensors in AGI's Commercial Space Operations Center (ComSpOC) and the US Air Force Space Command (AFSPC) Space Surveillance Network (SSN) to evaluate and configure new sensors and perform on-going system calibration. They are generally applicable to any SSA sensor and leverage some unique capabilities of an SSA estimation approach using an optimal sequential filter and smoother. Real world results are presented and analyzed.

Cognition through a Social Network: The Propagation of Induced Forgetting and Practice Effects

ERIC Educational Resources Information Center

Coman, Alin; Hirst, William

2012-01-01

Although a burgeoning literature has shown that practice effects and socially shared retrieval-induced forgetting can reshape the memories of speakers and listeners involved in a conversation, it has generally failed to examine whether such effects can propagate through a sequence of conversational interactions. This lacuna is unfortunate, since…

Teledermatology via a social networking web site: a pilot study between a general hospital and a rural clinic.

PubMed

Garcia-Romero, Maria Teresa; Prado, Fernanda; Dominguez-Cherit, Judith; Hojyo-Tomomka, Maria Teresa; Arenas, Roberto

2011-10-01

Teledermatology via a free public social networking Web site is a practical tool to provide attention to patients who do not have access to dermatologic care. In this pilot study, a general practitioner sent consults to a dermatology department at a general hospital via Facebook(®). Forty-four patients were seen and treatment was installed. We identified both simple-to-treat, common skin diseases and rare congenital diseases that require genetic counseling and more complex treatment. The majority of patients (75%) benefited with the diagnoses and treatments offered, thus avoiding unnecessary expenses or transportation to urban areas.

Improving outcomes for patients with type 2 diabetes using general practice networks: a quality improvement project in east London.

PubMed

Hull, Sally; Chowdhury, Tahseen A; Mathur, Rohini; Robson, John

2014-02-01

Structured diabetes care can improve outcomes and reduce risk of complications, but improving care in a deprived, ethnically diverse area can prove challenging. This report evaluates a system change to enhance diabetes care delivery in a primary care setting. All 35 practices in one inner London Primary Care Trust were geographically grouped into eight networks of four to five practices, each supported by a network manager, clerical staff and an educational budget. A multidisciplinary team developed a 'care package' for type 2 diabetes management, with financial incentives based on network achievement of targets. Monthly electronic performance dashboards enabled networks to track and improve performance. Network multidisciplinary team meetings including the diabetic specialist team supported case management and education. Key measures for improvement included the number of diabetes care plans completed, proportion of patients attending for digital retinal screen and proportions of patients achieving a number of biomedical indices (blood pressure, cholesterol, glycated haemoglobin). Between 2009 and 2012, completed care plans rose from 10% to 88%. The proportion of patients attending for digital retinal screen rose from 72% to 82.8%. The proportion of patients achieving a combination of blood pressure ≤ 140/80 mm Hg and cholesterol ≤ 4 mmol/L rose from 35.3% to 46.1%. Mean glycated haemoglobin dropped from 7.80% to 7.66% (62-60 mmol/mol). Investment of financial, organisational and education resources into primary care practice networks can achieve clinically important improvements in diabetes care in deprived, ethnically diverse communities. This success is predicated on collaborative working between practices, purposively designed high-quality information on network performance and engagement between primary and secondary care clinicians.

Understanding Health Professionals' Informal Learning in Online Social Networks: A Cross-Sectional Survey.

PubMed

Li, Xin; Verspoor, Karin; Gray, Kathleen; Barnett, Stephen

2017-01-01

Online social networks (OSNs) enable health professionals to learn informally, for example by sharing medical knowledge, or discussing practice management challenges and clinical issues. Understanding how learning occurs in OSNs is necessary to better support this type of learning. Through a cross-sectional survey, this study found that learning interaction in OSNs is low in general, with a small number of active users. Some health professionals actively used OSNs to support their practice, including sharing practical and experiential knowledge, benchmarking themselves, and to keep up-to-date on policy, advanced information and news in the field. These health professionals had an overall positive learning experience in OSNs.

A French network of bipolar expert centres: a model to close the gap between evidence-based medicine and routine practice.

PubMed

Henry, Chantal; Etain, Bruno; Mathieu, Flavie; Raust, Aurélie; Vibert, Jean-Francois; Scott, Jan; Leboyer, Marion

2011-06-01

Bipolar disorders are a major public health concern. Efforts to provide optimal care by general practitioners and psychiatrists are undermined by the complexity of the disorder and difficulties in applying clinical practice guidelines and new research findings to the spectrum of cases seen in day to day practice. A national network of bipolar expert centres was established. Each centre has established strong links to local health services and provides support to clinicians in delivering personalized care plans derived from systematic case assessments undertaken at the centre. A common set of diagnostic and clinical assessment tools has been adopted at eight centres. Evaluations are undertaken by trained assessors and cross-centre reliability is monitored. A web application, e-bipolar© is used to record data in a common computerized medical file. Anonymized data is entered into a shared national database for use in multi-centre audit and research. Instead of offering treatment advice based on clinical practice guidelines recommendations for selected sub-populations of patients (a 'top-down' approach), the French bipolar network offers systematic, comprehensive, longitudinal, and multi-dimensional assessments of cases representative of general bipolar populations. This 'bottom-up' strategy may offer a more efficient and effective way to transfer knowledge and share expertise as the referrer can appreciate the rationale underpinning suggested treatment protocols and more readily apply such principles and approaches to other cases. The network also builds an infrastructure for clinical cohort and comparative-effectiveness research on more representative patient populations. Copyright © 2010 Elsevier B.V. All rights reserved.

Key factors of clinical research network capacity building.

PubMed

Li, Guowei; Wu, Qianyu; Jin, Yanling; Vanniyasingam, Thuva; Thabane, Lehana

2018-01-01

In general, clinical research network capacity building refers to programs aimed at enhancing networks of researchers to conduct clinical research. Although in the literature there is a large body of research on how to develop and build capacity in clinical research networks, the conceptualizations and implementations remain controversial and challenging. Moreover, the experiences learnt from the past accomplishments and failures can assist in the future capacity building efforts to be more practical, effective and efficient. In this paper, we aim to provide an overview of capacity building in clinical research network by (1) identifying the key barriers to clinical research network capacity building, (2) providing insights into how to overcome those obstacles, and (3) sharing our experiences in collaborating with national and international partners to build capacity in clinical research networks. In conclusion, we have provided some insight into how to address the key factors of clinical research network capacity building and shared some empirical experiences. A successful capacity building practice requires a joint endeavor to procure sufficient resources and support from the relevant stakeholders, to ensure its efficiency, cost-effectiveness, and sustainability.

Discrete-time BAM neural networks with variable delays

NASA Astrophysics Data System (ADS)

Liu, Xin-Ge; Tang, Mei-Lan; Martin, Ralph; Liu, Xin-Bi

2007-07-01

This Letter deals with the global exponential stability of discrete-time bidirectional associative memory (BAM) neural networks with variable delays. Using a Lyapunov functional, and linear matrix inequality techniques (LMI), we derive a new delay-dependent exponential stability criterion for BAM neural networks with variable delays. As this criterion has no extra constraints on the variable delay functions, it can be applied to quite general BAM neural networks with a broad range of time delay functions. It is also easy to use in practice. An example is provided to illustrate the theoretical development.

Development of programmable artificial neural networks

NASA Technical Reports Server (NTRS)

Meade, Andrew J.

1993-01-01

Conventionally programmed digital computers can process numbers with great speed and precision, but do not easily recognize patterns or imprecise or contradictory data. Instead of being programmed in the conventional sense, artificial neural networks are capable of self-learning through exposure to repeated examples. However, the training of an ANN can be a time consuming and unpredictable process. A general method is being developed to mate the adaptability of the ANN with the speed and precision of the digital computer. This method was successful in building feedforward networks that can approximate functions and their partial derivatives from examples in a single iteration. The general method also allows the formation of feedforward networks that can approximate the solution to nonlinear ordinary and partial differential equations to desired accuracy without the need of examples. It is believed that continued research will produce artificial neural networks that can be used with confidence in practical scientific computing and engineering applications.

Going for gold: the health promoting general practice.

PubMed

Watson, Michael

2008-01-01

The World Health Organization's Ottawa Charter for Health Promotion has been influential in guiding the development of 'settings' based health promotion. Over the past decade, settings such as schools have flourished and there has been a considerable amount of academic literature produced, including theoretical papers, descriptive studies and evaluations. However, despite its central importance, the health-promoting general practice has received little attention. This paper discusses: the significance of this setting for health promotion; how a health promoting general practice can be created; effective health promotion approaches; the nursing contribution; and some challenges that need to be resolved. In order to become a health promoting general practice, the staff must undertake a commitment to fulfil the following conditions: create a healthy working environment; integrate health promotion into practice activities; and establish alliances with other relevant institutions and groups within the community. The health promoting general practice is the gold standard for health promotion. Settings that have developed have had the support of local, national and European networks. Similar assistance and advocacy will be needed in general practice. This paper recommends that a series of rigorously evaluated, high-quality pilot sites need to be established to identify and address potential difficulties, and to ensure that this innovative approach yields tangible health benefits for local communities. It also suggests that government support is critical to the future development of health promoting general practices. This will be needed both directly and in relation to the capacity and resourcing of public health in general.

Primary health care service delivery networks for the prevention and management of type 2 diabetes: using social network methods to describe interorganisational collaboration in a rural setting.

PubMed

McDonald, Julie; Jayasuriya, Rohan; Harris, Mark Fort

2011-01-01

Adults with type 2 diabetes or with behavioural risk factors require comprehensive and well coordinated responses from a range of health care providers who often work in different organisational settings. This study examines three types of collaborative links between organisations involved in a rural setting. Social network methods were employed using survey data on three types of links, and data was collected from a purposive sample of 17 organisations representing the major provider types. The analysis included a mix of unconfirmed and confirmed links, and network measures. General practices were the most influential provider group in initiating referrals, and they referred to the broadest range of organisations in the network. Team care arrangements formed a small part of the general practice referral network. They were used more for access to private sector allied health care providers and less for sharing care with public sector health services. Involvement in joint programs/activities was limited to public and non-government sector services, with no participation from the private sector. The patterns of interactions suggest that informal referral networks provide access to services and coordination of care for individual patients with diabetes. Two population subgroups would benefit from more proactive approaches to ensure equitable access to services and coordination of care across organisational boundaries: people with more complex health care needs and people at risk of developing diabetes.

The ground truth about metadata and community detection in networks.

PubMed

Peel, Leto; Larremore, Daniel B; Clauset, Aaron

2017-05-01

Across many scientific domains, there is a common need to automatically extract a simplified view or coarse-graining of how a complex system's components interact. This general task is called community detection in networks and is analogous to searching for clusters in independent vector data. It is common to evaluate the performance of community detection algorithms by their ability to find so-called ground truth communities. This works well in synthetic networks with planted communities because these networks' links are formed explicitly based on those known communities. However, there are no planted communities in real-world networks. Instead, it is standard practice to treat some observed discrete-valued node attributes, or metadata, as ground truth. We show that metadata are not the same as ground truth and that treating them as such induces severe theoretical and practical problems. We prove that no algorithm can uniquely solve community detection, and we prove a general No Free Lunch theorem for community detection, which implies that there can be no algorithm that is optimal for all possible community detection tasks. However, community detection remains a powerful tool and node metadata still have value, so a careful exploration of their relationship with network structure can yield insights of genuine worth. We illustrate this point by introducing two statistical techniques that can quantify the relationship between metadata and community structure for a broad class of models. We demonstrate these techniques using both synthetic and real-world networks, and for multiple types of metadata and community structures.

Social Networking in Schools: Benefits and Risks; Review of the Research; Policy Considerations; and Current Practices. Information Capsule. Volume 1109

ERIC Educational Resources Information Center

Blazer, Christie

2012-01-01

The role that social media should play in education is being hotly debated in school districts across the country. The adoption of social networking for educational purposes lags behind the public's general usage because educators fear that students will be exposed to inappropriate online content, unwanted adult interactions, and bullying from…

Cooperation dynamics of generalized reciprocity in state-based social dilemmas

NASA Astrophysics Data System (ADS)

Stojkoski, Viktor; Utkovski, Zoran; Basnarkov, Lasko; Kocarev, Ljupco

2018-05-01

We introduce a framework for studying social dilemmas in networked societies where individuals follow a simple state-based behavioral mechanism based on generalized reciprocity, which is rooted in the principle "help anyone if helped by someone." Within this general framework, which applies to a wide range of social dilemmas including, among others, public goods, donation, and snowdrift games, we study the cooperation dynamics on a variety of complex network examples. By interpreting the studied model through the lenses of nonlinear dynamical systems, we show that cooperation through generalized reciprocity always emerges as the unique attractor in which the overall level of cooperation is maximized, while simultaneously exploitation of the participating individuals is prevented. The analysis elucidates the role of the network structure, here captured by a local centrality measure which uniquely quantifies the propensity of the network structure to cooperation by dictating the degree of cooperation displayed both at the microscopic and macroscopic level. We demonstrate the applicability of the analysis on a practical example by considering an interaction structure that couples a donation process with a public goods game.

Improving general practice based epidemiologic surveillance using desktop clients: the French Sentinel Network experience.

PubMed

Turbelin, Clément; Boëlle, Pierre-Yves

2010-01-01

Web-based applications are a choice tool for general practice based epidemiological surveillance; however their use may disrupt the general practitioners (GPs) work process. In this article, we propose an alternative approach based on a desktop client application. This was developed for use in the French General Practitioners Sentinel Network. We developed a java application running as a client on the local GP computer. It allows reporting cases to a central server and provides feedback to the participating GPs. XML was used to describe surveillance protocols and questionnaires as well as instances of case descriptions. An evaluation of the users' feelings was carried out and the impact on the timeliness and completeness of surveillance data was measured. Better integration in the work process was reported, especially when the software was used at the time of consultation. Reports were received more frequently with less missing data. This study highlights the potential of allowing multiple ways of interaction with the surveillance system to increase participation of GPs and the quality of surveillance.

A community of practice: librarians in a biomedical research network.

PubMed

De Jager-Loftus, Danielle P; Midyette, J David; Harvey, Barbara

2014-01-01

Providing library and reference services within a biomedical research community presents special challenges for librarians, especially those in historically lower-funded states. These challenges can include understanding needs, defining and communicating the library's role, building relationships, and developing and maintaining general and subject specific knowledge. This article describes a biomedical research network and the work of health sciences librarians at the lead intensive research institution with librarians from primarily undergraduate institutions and tribal colleges. Applying the concept of a community of practice to a collaborative effort suggests how librarians can work together to provide effective reference services to researchers in biomedicine.

An Authentic Journey: Teachers' Emergent Understandings about Authentic Assessment and Practice.

ERIC Educational Resources Information Center

Einbender, Lynne; Wood, Diane

As a challenge to traditional assessment, this paper describes how the work of a network of teachers to improve schooling through authentic assessment and practice may lead to a general reform of nearly all aspects of the educational enterprise. The paper springs from observation of participant teachers in the Four Seasons Project which is…

Students' Framing of Language Learning Practices in Social Networking Sites

ERIC Educational Resources Information Center

Lantz-Andersson, Annika; Vigmo, Sylvi; Bowen, Rhonwen

2012-01-01

The amount of time that people, especially young people, spend on communicative activities in social media is rapidly increasing. We are facing new arenas with great potential for learning in general and for language learning in particular, but their impact on learning is not yet acknowledged as such in educational practice (e.g., Conole, 2010;…

Periodic bidirectional associative memory neural networks with distributed delays

NASA Astrophysics Data System (ADS)

Chen, Anping; Huang, Lihong; Liu, Zhigang; Cao, Jinde

2006-05-01

Some sufficient conditions are obtained for the existence and global exponential stability of a periodic solution to the general bidirectional associative memory (BAM) neural networks with distributed delays by using the continuation theorem of Mawhin's coincidence degree theory and the Lyapunov functional method and the Young's inequality technique. These results are helpful for designing a globally exponentially stable and periodic oscillatory BAM neural network, and the conditions can be easily verified and be applied in practice. An example is also given to illustrate our results.

Developmental implications of children's brain networks and learning.

PubMed

Chan, John S Y; Wang, Yifeng; Yan, Jin H; Chen, Huafu

2016-10-01

The human brain works as a synergistic system where information exchanges between functional neuronal networks. Rudimentary networks are observed in the brain during infancy. In recent years, the question of how functional networks develop and mature in children has been a hotly discussed topic. In this review, we examined the developmental characteristics of functional networks and the impacts of skill training on children's brains. We first focused on the general rules of brain network development and on the typical and atypical development of children's brain networks. After that, we highlighted the essentials of neural plasticity and the effects of learning on brain network development. We also discussed two important theoretical and practical concerns in brain network training. Finally, we concluded by presenting the significance of network training in typically and atypically developed brains.

Extension of analog network coding in wireless information exchange

NASA Astrophysics Data System (ADS)

Chen, Cheng; Huang, Jiaqing

2012-01-01

Ever since the concept of analog network coding(ANC) was put forward by S.Katti, much attention has been focused on how to utilize analog network coding to take advantage of wireless interference, which used to be considered generally harmful, to improve throughput performance. Previously, only the case of two nodes that need to exchange information has been fully discussed while the issue of extending analog network coding to more than three nodes remains undeveloped. In this paper, we propose a practical transmission scheme to extend analog network coding to more than two nodes that need to exchange information among themselves. We start with the case of three nodes that need to exchange information and demonstrate that through utilizing our algorithm, the throughput can achieve 33% and 20% increase compared with that of traditional transmission scheduling and digital network coding, respectively. Then, we generalize the algorithm so that it can fit for occasions with any number of nodes. We also discuss some technical issues and throughput analysis as well as the bit error rate.

A general stochastic model for studying time evolution of transition networks

NASA Astrophysics Data System (ADS)

Zhan, Choujun; Tse, Chi K.; Small, Michael

2016-12-01

We consider a class of complex networks whose nodes assume one of several possible states at any time and may change their states from time to time. Such networks represent practical networks of rumor spreading, disease spreading, language evolution, and so on. Here, we derive a model describing the dynamics of this kind of network and a simulation algorithm for studying the network evolutionary behavior. This model, derived at a microscopic level, can reveal the transition dynamics of every node. A numerical simulation is taken as an ;experiment; or ;realization; of the model. We use this model to study the disease propagation dynamics in four different prototypical networks, namely, the regular nearest-neighbor (RN) network, the classical Erdös-Renyí (ER) random graph, the Watts-Strogátz small-world (SW) network, and the Barabási-Albert (BA) scalefree network. We find that the disease propagation dynamics in these four networks generally have different properties but they do share some common features. Furthermore, we utilize the transition network model to predict user growth in the Facebook network. Simulation shows that our model agrees with the historical data. The study can provide a useful tool for a more thorough understanding of the dynamics networks.

The Pediatric Emergency Care Applied Research Network: a history of multicenter collaboration in the United States.

PubMed

Tzimenatos, Leah; Kim, Emily; Kuppermann, Nathan

2014-12-01

In this article, we review the history and progress of a large multicenter research network pertaining to emergency medical services for children. We describe the history, organization, infrastructure, and research agenda of the Pediatric Emergency Care Applied Research Network (PECARN), and highlight some of the important accomplishments since its inception. We also describe the network's strategy to grow its research portfolio, train new investigators, and study how to translate new evidence into practice. This strategy ensures not only the sustainability of the network in the future, but the growth of research in emergency medical services for children in general.

Towards Device-Independent Information Processing on General Quantum Networks

NASA Astrophysics Data System (ADS)

Lee, Ciarán M.; Hoban, Matty J.

2018-01-01

The violation of certain Bell inequalities allows for device-independent information processing secure against nonsignaling eavesdroppers. However, this only holds for the Bell network, in which two or more agents perform local measurements on a single shared source of entanglement. To overcome the practical constraints that entangled systems can only be transmitted over relatively short distances, large-scale multisource networks have been employed. Do there exist analogs of Bell inequalities for such networks, whose violation is a resource for device independence? In this Letter, the violation of recently derived polynomial Bell inequalities will be shown to allow for device independence on multisource networks, secure against nonsignaling eavesdroppers.

The Pediatric Emergency Care Applied Research Network: a history of multicenter collaboration in the United States.

PubMed

Tzimenatos, Leah; Kim, Emily; Kuppermann, Nathan

2015-01-01

In this article, we review the history and progress of a large multicenter research network pertaining to emergency medical services for children. We describe the history, organization, infrastructure, and research agenda of the Pediatric Emergency Care Applied Research Network and highlight some of the important accomplishments since its inception. We also describe the network's strategy to grow its research portfolio, train new investigators, and study how to translate new evidence into practice. This strategy ensures not only the sustainability of the network in the future but the growth of research in emergency medical services for children in general.

Towards Device-Independent Information Processing on General Quantum Networks.

PubMed

Lee, Ciarán M; Hoban, Matty J

2018-01-12

The violation of certain Bell inequalities allows for device-independent information processing secure against nonsignaling eavesdroppers. However, this only holds for the Bell network, in which two or more agents perform local measurements on a single shared source of entanglement. To overcome the practical constraints that entangled systems can only be transmitted over relatively short distances, large-scale multisource networks have been employed. Do there exist analogs of Bell inequalities for such networks, whose violation is a resource for device independence? In this Letter, the violation of recently derived polynomial Bell inequalities will be shown to allow for device independence on multisource networks, secure against nonsignaling eavesdroppers.

MANEMO Routing in Practice: Protocol Selection, Expected Performance, and Experimental Evaluation

NASA Astrophysics Data System (ADS)

Tazaki, Hajime; van Meter, Rodney; Wakikawa, Ryuji; Wongsaardsakul, Thirapon; Kanchanasut, Kanchana; Dias de Amorim, Marcelo; Murai, Jun

Motivated by the deployment of post-disaster MANEMO (MANET for NEMO) composed of mobile routers and stations, we evaluate two candidate routing protocols through network simulation, theoretical performance analysis, and field experiments. The first protocol is the widely adopted Optimized Link State Routing protocol (OLSR) and the second is the combination of the Tree Discovery Protocol (TDP) with Network In Node Advertisement (NINA). To the best of our knowledge, this is the first time that these two protocols are compared in both theoretical and practical terms. We focus on the control overhead generated when mobile routers perform a handover. Our results confirm the correctness and operational robustness of both protocols. More interestingly, although in the general case OLSR leads to better results, TDP/NINA outperforms OLSR both in the case of sparse networks and in highly mobile networks, which correspond to the operation point of a large set of post-disaster scenarios.

Computer-aided design of biological circuits using TinkerCell

PubMed Central

Bergmann, Frank T; Sauro, Herbert M

2010-01-01

Synthetic biology is an engineering discipline that builds on modeling practices from systems biology and wet-lab techniques from genetic engineering. As synthetic biology advances, efficient procedures will be developed that will allow a synthetic biologist to design, analyze and build biological networks. In this idealized pipeline, computer-aided design (CAD) is a necessary component. The role of a CAD application would be to allow efficient transition from a general design to a final product. TinkerCell is a design tool for serving this purpose in synthetic biology. In TinkerCell, users build biological networks using biological parts and modules. The network can be analyzed using one of several functions provided by TinkerCell or custom programs from third-party sources. Since best practices for modeling and constructing synthetic biology networks have not yet been established, TinkerCell is designed as a flexible and extensible application that can adjust itself to changes in the field. PMID:21327060

Synchronization of generalized reaction-diffusion neural networks with time-varying delays based on general integral inequalities and sampled-data control approach.

PubMed

Dharani, S; Rakkiyappan, R; Cao, Jinde; Alsaedi, Ahmed

2017-08-01

This paper explores the problem of synchronization of a class of generalized reaction-diffusion neural networks with mixed time-varying delays. The mixed time-varying delays under consideration comprise of both discrete and distributed delays. Due to the development and merits of digital controllers, sampled-data control is a natural choice to establish synchronization in continuous-time systems. Using a newly introduced integral inequality, less conservative synchronization criteria that assure the global asymptotic synchronization of the considered generalized reaction-diffusion neural network and mixed delays are established in terms of linear matrix inequalities (LMIs). The obtained easy-to-test LMI-based synchronization criteria depends on the delay bounds in addition to the reaction-diffusion terms, which is more practicable. Upon solving these LMIs by using Matlab LMI control toolbox, a desired sampled-data controller gain can be acuqired without any difficulty. Finally, numerical examples are exploited to express the validity of the derived LMI-based synchronization criteria.

Developing an Industry-Education Community: The United Auto Workers/General Motors Quality Educator Program.

ERIC Educational Resources Information Center

Jacobson, Stephen L.; Walline, James

1995-01-01

Reviews the evolution of the Quality Educator Program (QEP), sponsored by the United Auto Workers at General Motors (GM), which employs teachers, school administrators, and college faculty each summer at GM assembly plants. Participation in QEP allows educators and those in industry to interact and demonstrates quality networks in practice. (SLD)

A practical introduction to tensor networks: Matrix product states and projected entangled pair states

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

Orús, Román, E-mail: roman.orus@uni-mainz.de

This is a partly non-technical introduction to selected topics on tensor network methods, based on several lectures and introductory seminars given on the subject. It should be a good place for newcomers to get familiarized with some of the key ideas in the field, specially regarding the numerics. After a very general introduction we motivate the concept of tensor network and provide several examples. We then move on to explain some basics about Matrix Product States (MPS) and Projected Entangled Pair States (PEPS). Selected details on some of the associated numerical methods for 1d and 2d quantum lattice systems aremore » also discussed. - Highlights: • A practical introduction to selected aspects of tensor network methods is presented. • We provide analytical examples of MPS and 2d PEPS. • We provide basic aspects on several numerical methods for MPS and 2d PEPS. • We discuss a number of applications of tensor network methods from a broad perspective.« less

The conduct of practice-based research in community clinics compared to private practices: similarities, differences, and challenges

PubMed Central

Gillette, Jane; Cunha-Cruz, Joana; Gilbert, Ann; Speed-McIntyre, Pollene; Zhou, Lingmei; DeRouen, Timothy

2013-01-01

Practice-based research should be performed in all practice settings if the results are to be applied to all settings. However, some practice settings, such as community clinics, have unique features that may make the conduct of such research more challenging. The purpose of this article is to describe and compare the similarities and unique challenges related to conducting research in community clinics compared to private practices within the Northwest Practice-Based REsearch Collaborative in Evidence-Based DENTistry (PRECEDENT) network. Information was obtained from meetings with general dentists, a survey of general dentists (N = 253), and a clinical examination and record review of a systemic random sample of patients visiting community clinics and private practices. (N = 1903)—all part of a dental practice-based research network. The processes of conducting research, the dentist and patient sociodemographic characteristics, the prevalence of oral diseases, and the dental treatments received in community clinics and private practices were compared. Both community clinics and private practices have the clinical treatment of the patients as their priority and have time constraints on research. The processes of research training, obtaining informed consent, and collecting, transmitting, and securely maintaining research data are also similar. The patient populations and treatment needs differ substantially between community clinics and private practices, with a higher prevalence of dental caries and higher restorative treatment needs in the community clinic patients. The process of study participant selection and follow-up for research and the dentist and staff work arrangements also vary between the two practice settings. Although community clinic patients and their dental healthcare providers have different research needs and challenges than their counterparts in private practice, practice-based research can be successfully PMID:25429251

Primary prevention of cardiovascular diseases: a cost study in family practices.

PubMed

de Bekker-Grob, Esther W; van Dulmen, Sandra; van den Berg, Matthijs; Verheij, Robert A; Slobbe, Laurentius C J

2011-07-06

Considering the scarcity of health care resources and the high costs associated with cardiovascular diseases, we investigated the spending on cardiovascular primary preventive activities and the prescribing behaviour of primary preventive cardiovascular medication (PPCM) in Dutch family practices (FPs). A mixed methods design was used, which consisted of a questionnaire (n = 80 FPs), video recordings of hypertension- or cholesterol-related general practitioner visits (n = 56), and the database of Netherlands Information Network of General Practice (n = 45 FPs; n = 157,137 patients). The questionnaire and video recordings were used to determine the average frequency and time spent on cardiovascular primary preventive activities per FP respectively. Taking into account the annual income and full time equivalents of general practitioners, health care assistants, and practice nurses as well as the practice costs, the total spending on cardiovascular primary preventive activities in Dutch FPs was calculated. The database of Netherlands Information Network of General Practice was used to determine the prescribing behaviour in Dutch FPs by conducting multilevel regression models and adjusting for patient and practice characteristics. Total expenditure on cardiovascular primary preventive activities in FPs in 2009 was €38.8 million (€2.35 per capita), of which 47% was spent on blood pressure measurements, 26% on cardiovascular risk profiling, and 11% on lifestyle counselling. Fifteen percent (€11 per capita) of all cardiovascular medication prescribed in FPs was a PPCM. FPs differed greatly on prescription of PPCM (odds ratio of 3.1). Total costs of cardiovascular primary preventive activities in FPs such as blood pressure measurements and lifestyle counselling are relatively low compared to the costs of PPCM. There is considerable heterogeneity in prescribing behaviour of PPCM between FPs. Further research is needed to determine whether such large differences in prescription rates are justified. Striving for an optimal use of cardiovascular primary preventive activities might lead to similar health outcomes, but may achieve important cost savings.

Enhancing social networks: a qualitative study of health and social care practice in UK mental health services.

PubMed

Webber, Martin; Reidy, Hannah; Ansari, David; Stevens, Martin; Morris, David

2015-03-01

People with severe mental health problems such as psychosis have access to less social capital, defined as resources within social networks, than members of the general population. However, a lack of theoretically and empirically informed models hampers the development of social interventions which seek to enhance an individual's social networks. This paper reports the findings of a qualitative study, which used ethnographic field methods in six sites in England to investigate how workers helped people recovering from psychosis to enhance their social networks. This study drew upon practice wisdom and lived experience to provide data for intervention modelling. Data were collected from 73 practitioners and 51 people who used their services in two phases. Data were selected and coded using a grounded theory approach to depict the key themes that appeared to underpin the generation of social capital within networks. Findings are presented in four over-arching themes - worker skills, attitudes and roles; connecting people processes; role of the agency; and barriers to network development. The sub-themes which were identified included worker attitudes; person-centred approach; equality of worker-individual relationship; goal setting; creating new networks and relationships; engagement through activities; practical support; existing relationships; the individual taking responsibility; identifying and overcoming barriers; and moving on. Themes were consistent with recovery models used within mental health services and will provide the basis for the development of an intervention model to enhance individuals' access to social capital within networks. © 2014 John Wiley & Sons Ltd.

Provision of specific dental procedures by general dentists in the National Dental Practice-Based Research Network: questionnaire findings.

PubMed

Gilbert, Gregg H; Gordan, Valeria V; Korelitz, James J; Fellows, Jeffrey L; Meyerowitz, Cyril; Oates, Thomas W; Rindal, D Brad; Gregory, Randall J

2015-01-22

Objectives were to: (1) determine whether and how often general dentists (GDs) provide specific dental procedures; and (2) test the hypothesis that provision is associated with key dentist, practice, and patient characteristics. GDs (n = 2,367) in the United States National Dental Practice-Based Research Network completed an Enrollment Questionnaire that included: (1) dentist; (2) practice; and (3) patient characteristics, and how commonly they provide each of 10 dental procedures. We determined how commonly procedures were provided and tested the hypothesis that provision was substantively related to the three sets of characteristics. Two procedure categories were classified as "uncommon" (orthodontics, periodontal surgery), three were "common" (molar endodontics; implants; non-surgical periodontics), and five were "very common" (restorative; esthetic procedures; extractions; removable prosthetics; non-molar endodontics). Dentist, practice, and patient characteristics were substantively related to procedure provision; several characteristics seemed to have pervasive effects, such as dentist gender, training after dental school, full-time/part-time status, private practice vs. institutional practice, presence of a specialist in the same practice, and insurance status of patients. As a group, GDs provide a comprehensive range of procedures. However, provision by individual dentists is substantively related to certain dentist, practice, and patient characteristics. A large number and broad range of factors seem to influence which procedures GDs provide. This may have implications for how GDs respond to the ever-changing landscape of dental care utilization, patient population demography, scope of practice, delivery models and GDs' evolving role in primary care.

An evaluation of general practice websites in the UK.

PubMed

Howitt, Alistair; Clement, Sarah; de Lusignan, Simon; Thiru, Krish; Goodwin, Daryl; Wells, Sally

2002-10-01

General practice websites are an emerging phenomenon, but there have been few critical evaluations of their content. Previously developed rating instruments to assess medical websites have been criticized for failing to report their reliability and validity. The purpose of this study was to develop a rating instrument for assessing UK general practice websites, and then to evaluate them critically. The STaRNet Website Assessment Tool (SWAT) was developed listing criteria that general practice websites may meet, which was then used to evaluate a random sample of websites drawn from an electronic database. A second assessor rated a subsample of the sites to assess the tool's inter-rater reliability. The setting was an information technology group of a general practice research network using a random sample of 108 websites identified from the database. The main outcome measures were identification of rating criteria and frequency counts from the website rating instrument. Ninety (93.3%) sites were accessible, of which 84 were UK general practice websites. Criteria most frequently met were those describing the scope of the website and their functionality. Apart from e-mail to practices, criteria related to electronic communication were rarely met. Criteria relating to the quality of information were least often met. Inter-rater reliability kappa values for the items in the tool ranged from -0.06 to 1.0 (mean 0.59). Values were >0.6 for 15 out of 25 criteria assessed in 40 sites which were rated by two assessors. General practice websites offer a wide range of information. They are technically satisfactory, but do not exploit fully the potential for electronic doctor-patient communication. The quality of information they provide is poor. The instrument may be developed as a template for general practices producing or revising their own websites.

Outcomes of implants and restorations placed in general dental practices: a retrospective study by the Practitioners Engaged in Applied Research and Learning (PEARL) Network.

PubMed

Da Silva, John D; Kazimiroff, Julie; Papas, Athena; Curro, Frederick A; Thompson, Van P; Vena, Donald A; Wu, Hongyu; Collie, Damon; Craig, Ronald G

2014-07-01

The authors conducted a study to determine the types, outcomes, risk factors and esthetic assessment of implants and their restorations placed in the general practices of a practice-based research network. All patients who visited network practices three to five years previously and underwent placement of an implant and restoration within the practice were invited to enroll. Practitioner-investigators (P-Is) recorded the status of the implant and restoration, characteristics of the implant site and restoration, presence of peri-implant pathology and an esthetic assessment by the P-I and patient. The P-Is classified implants as failures if the original implant was missing or had been replaced, the implant was mobile or elicited pain on percussion, there was overt clinical or radiographic evidence of pathology or excessive bone loss (> 0.2 millimeter per year after an initial bone loss of 2 mm). They classified restorations as failures if they had been replaced or if there was abutment or restoration fracture. The authors enrolled 922 implants and patients from 87 practices, with a mean (standard deviation) follow-up of 4.2 (0.6) years. Of the 920 implants for which complete data records were available, 64 (7.0 percent) were classified as failures when excessive bone loss was excluded from the analysis. When excessive bone loss was included, 172 implants (18.7 percent) were classified as failures. According to the results of univariate analysis, a history of severe periodontitis, sites with preexisting inflammation or type IV bone, cases of immediate implant placement and placement in the incisor or canine region were associated with implant failure. According to the results of multivariate analysis, sites with preexisting inflammation (odds ratio [OR] = 2.17; 95 percent confidence interval [CI], 1.41-3.34]) or type IV bone (OR = 1.99; 95 percent CI, 1.12-3.55) were associated with a greater risk of implant failure. Of the 908 surviving implants, 20 (2.2 percent) had restorations replaced or judged as needing to be replaced. The majority of P-Is and patients were satisfied with the esthetic outcomes for both the implant and restoration. These results suggest that implant survival and success rates in general dental practices may be lower than those reported in studies conducted in academic or specialty settings. The results of this study, generated in the private general practice setting, add to the evidence base to facilitate implant treatment planning.

Flavor network and the principles of food pairing

NASA Astrophysics Data System (ADS)

Ahn, Yong-Yeol; Ahnert, Sebastian E.; Bagrow, James P.; Barabási, Albert-László

2011-12-01

The cultural diversity of culinary practice, as illustrated by the variety of regional cuisines, raises the question of whether there are any general patterns that determine the ingredient combinations used in food today or principles that transcend individual tastes and recipes. We introduce a flavor network that captures the flavor compounds shared by culinary ingredients. Western cuisines show a tendency to use ingredient pairs that share many flavor compounds, supporting the so-called food pairing hypothesis. By contrast, East Asian cuisines tend to avoid compound sharing ingredients. Given the increasing availability of information on food preparation, our data-driven investigation opens new avenues towards a systematic understanding of culinary practice.

Numerical solution of differential equations by artificial neural networks

NASA Technical Reports Server (NTRS)

Meade, Andrew J., Jr.

1995-01-01

Conventionally programmed digital computers can process numbers with great speed and precision, but do not easily recognize patterns or imprecise or contradictory data. Instead of being programmed in the conventional sense, artificial neural networks (ANN's) are capable of self-learning through exposure to repeated examples. However, the training of an ANN can be a time consuming and unpredictable process. A general method is being developed by the author to mate the adaptability of the ANN with the speed and precision of the digital computer. This method has been successful in building feedforward networks that can approximate functions and their partial derivatives from examples in a single iteration. The general method also allows the formation of feedforward networks that can approximate the solution to nonlinear ordinary and partial differential equations to desired accuracy without the need of examples. It is believed that continued research will produce artificial neural networks that can be used with confidence in practical scientific computing and engineering applications.

Learning Search Control Knowledge for Deep Space Network Scheduling

NASA Technical Reports Server (NTRS)

Gratch, Jonathan; Chien, Steve; DeJong, Gerald

1993-01-01

While the general class of most scheduling problems is NP-hard in worst-case complexity, in practice, for specific distributions of problems and constraints, domain-specific solutions have been shown to perform in much better than exponential time.

47 CFR 8.3 - Transparency.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.3 Transparency. A person engaged in the provision of broadband Internet access service shall publicly disclose accurate information regarding the network management practices, performance, and commercial terms of its broadband Internet...

47 CFR 8.3 - Transparency.

Code of Federal Regulations, 2014 CFR

2014-10-01

... FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.3 Transparency. A person engaged in the provision of broadband Internet access service shall publicly disclose accurate information regarding the network management practices, performance, and commercial terms of its broadband Internet...

47 CFR 8.3 - Transparency.

Code of Federal Regulations, 2012 CFR

2012-10-01

... FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.3 Transparency. A person engaged in the provision of broadband Internet access service shall publicly disclose accurate information regarding the network management practices, performance, and commercial terms of its broadband Internet...

47 CFR 8.3 - Transparency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.3 Transparency. A person engaged in the provision of broadband Internet access service shall publicly disclose accurate information regarding the network management practices, performance, and commercial terms of its broadband Internet...

Current trends in lifestyle-related disease management by general practitioners: a report from the "Heart Care Network" groups.

PubMed

2009-01-01

In Japan, it is believed that guidelines for lifestyle-related disease are used in routine clinical practice, however, there are few reports on the actual rate of healthcare conducted in accordance with these guidelines by general practitioners and on their usefulness in preventing cardiovascular events. Therefore, the Heart Care Network (HCN) groups were organized mainly by general practitioners treating lifestyle diseases in 62 areas of Japan. The HCN has collected data on lifestyle diseases in high-risk patients in routine practices and investigated management conditions, guideline target achievement rates and medication. Additionally, the incidence of cardiovascular events was assessed. We analyzed 14,064 cases. The lipid profile, blood pressure, glycemic control were significantly improved over the 3 years. The incidence of cardiovascular events were significantly reduced by the achievement of target LDL cholesterol, systolic blood pressure and hemoglobin A1c and even after adjustment for age, gender, history of myocardial infarction, the reduction of these lifestyle-related parameters remains significant. These results revealed the current trends in the healthcare activities of general practitioners, the management conditions for lifestyle diseases in CHD high-risk patients and their effects on reducing cardiovascular events.

Leadership of healthcare commissioning networks in England: a mixed-methods study on clinical commissioning groups

PubMed Central

Zachariadis, Markos; Oborn, Eivor; Barrett, Michael; Zollinger-Read, Paul

2013-01-01

Objective To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation. Design Mixed-method, multisite and case study research. Setting Six clinical commissioning groups and local clusters in the East of England area, covering in total 208 GPs and 1 662 000 population. Methods Semistructured interviews with 56 lead GPs, practice managers and staff from the local health authorities (primary care trusts, PCT) as well as various healthcare professionals; 21 observations of clinical commissioning group (CCG) board and executive meetings; electronic survey of 58 CCG board members (these included GPs, practice managers, PCT employees, nurses and patient representatives) and subsequent social network analysis. Main outcome measures Collaborative relationships between CCG board members and stakeholders from their healthcare network; clarifying the role of GPs as network leaders; strengths and areas for development of CCGs. Results Drawing upon innovation network theory provides unique insights of the CCG leaders’ activities in establishing best practices and introducing new clinical pathways. In this context we identified three network leadership roles: managing knowledge flows, managing network coherence and managing network stability. Knowledge sharing and effective collaboration among GPs enable network stability and the alignment of CCG objectives with those of the wider health system (network coherence). Even though activities varied between commissioning groups, collaborative initiatives were common. However, there was significant variation among CCGs around the level of engagement with providers, patients and local authorities. Locality (sub) groups played an important role because they linked commissioning decisions with patient needs and brought the leaders closer to frontline stakeholders. Conclusions With the new commissioning arrangements, the leaders should seek to move away from dyadic and transactional relationships to a network structure, thereby emphasising on the emerging relational focus of their roles. Managing knowledge mobility, healthcare network coherence and network stability are the three clinical leadership processes that CCG leaders need to consider in coordinating their network and facilitating the development of good clinical commissioning decisions, best practices and innovative services. To successfully manage these processes, CCG leaders need to leverage the relational capabilities of their network as well as their clinical expertise to establish appropriate collaborations that may improve the healthcare services in England. Lack of local GP engagement adds uncertainty to the system and increases the risk of commissioning decisions being irrelevant and inefficient from patient and provider perspectives. PMID:23430596

Influence of network dynamics on the spread of sexually transmitted diseases.

PubMed

Risau-Gusman, Sebastián

2012-06-07

Network epidemiology often assumes that the relationships defining the social network of a population are static. The dynamics of relationships is only taken indirectly into account by assuming that the relevant information to study epidemic spread is encoded in the network obtained, by considering numbers of partners accumulated over periods of time roughly proportional to the infectious period of the disease. On the other hand, models explicitly including social dynamics are often too schematic to provide a reasonable representation of a real population, or so detailed that no general conclusions can be drawn from them. Here, we present a model of social dynamics that is general enough so its parameters can be obtained by fitting data from surveys about sexual behaviour, but that can still be studied analytically, using mean-field techniques. This allows us to obtain some general results about epidemic spreading. We show that using accumulated network data to estimate the static epidemic threshold lead to a significant underestimation of that threshold. We also show that, for a dynamic network, the relative epidemic threshold is an increasing function of the infectious period of the disease, implying that the static value is a lower bound to the real threshold. A practical example is given of how to apply the model to the study of a real population.

Influence of network dynamics on the spread of sexually transmitted diseases

PubMed Central

Risau-Gusman, Sebastián

2012-01-01

Network epidemiology often assumes that the relationships defining the social network of a population are static. The dynamics of relationships is only taken indirectly into account by assuming that the relevant information to study epidemic spread is encoded in the network obtained, by considering numbers of partners accumulated over periods of time roughly proportional to the infectious period of the disease. On the other hand, models explicitly including social dynamics are often too schematic to provide a reasonable representation of a real population, or so detailed that no general conclusions can be drawn from them. Here, we present a model of social dynamics that is general enough so its parameters can be obtained by fitting data from surveys about sexual behaviour, but that can still be studied analytically, using mean-field techniques. This allows us to obtain some general results about epidemic spreading. We show that using accumulated network data to estimate the static epidemic threshold lead to a significant underestimation of that threshold. We also show that, for a dynamic network, the relative epidemic threshold is an increasing function of the infectious period of the disease, implying that the static value is a lower bound to the real threshold. A practical example is given of how to apply the model to the study of a real population. PMID:22112655

[Vitamin D supplementation in the elderly: guidelines and practice].

PubMed

Chel, V G M; Elders, P J M; Tuijp, M L M; van den Berg, H H; van Drongelen, K I; Siedenburg, R C; Ooms, M E; Lips, P T A

2013-01-01

In 2008, the Health Council of the Netherlands published an advice on vitamin D supplementation for the elderly. Nevertheless, suspicion arose at the Ministry of Health, Welfare and Sport and the Netherlands Nutrition Centre that vitamin D supplementation in the elderly is still insufficient. We aimed to determine the extent to which general practitioners and elderly care physicians actually followed the advice of the Health Council. Questionnaire study. Brief questionnaires were sent to all elderly care physicians in the Netherlands. Some questions were also posed to general practitioners at a network meeting of the Academic Network of GP Practices of the VU University Medical Center in Amsterdam. More than two-thirds of the respondents, both elderly care physicians and general practitioners, are familiar with the guidelines of the Health Council of the Netherlands on vitamin D supplementation in the elderly, but about half do not prescribe vitamin D when the guideline advises to do so. When supplementation is prescribed, about half of the elderly care physicians and a fifth of the general practitioners uses an insufficient dose. The guidelines of the Health Council of the Netherlands on vitamin D supplementation in the elderly are not sufficiently followed by elderly care physicians and general practitioners. Awareness of and support for the vitamin D supplementation guidelines among health care providers is still limited.

Development of a general method for obtaining the geometry of microfluidic networks

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

Razavi, Mohammad Sayed, E-mail: m.sayedrazavi@gmail.com; Salimpour, M. R.; Shirani, Ebrahim

2014-01-15

In the present study, a general method for geometry of fluidic networks is developed with emphasis on pressure-driven flows in the microfluidic applications. The design method is based on general features of network's geometry such as cross-sectional area and length of channels. Also, the method is applicable to various cross-sectional shapes such as circular, rectangular, triangular, and trapezoidal cross sections. Using constructal theory, the flow resistance, energy loss and performance of the network are optimized. Also, by this method, practical design strategies for the fabrication of microfluidic networks can be improved. The design method enables rapid prediction of fluid flowmore » in the complex network of channels and is very useful for improving proper miniaturization and integration of microfluidic networks. Minimization of flow resistance of the network of channels leads to universal constants for consecutive cross-sectional areas and lengths. For a Y-shaped network, the optimal ratios of consecutive cross-section areas (A{sub i+1}/A{sub i}) and lengths (L{sub i+1}/L{sub i}) are obtained as A{sub i+1}/A{sub i} = 2{sup −2/3} and L{sub i+1}/L{sub i} = 2{sup −1/3}, respectively. It is shown that energy loss in the network is proportional to the volume of network. It is also seen when the number of channels is increased both the hydraulic resistance and the volume occupied by the network are increased in a similar manner. Furthermore, the method offers that fabrication of multi-depth and multi-width microchannels should be considered as an integral part of designing procedures. Finally, numerical simulations for the fluid flow in the network have been performed and results show very good agreement with analytic results.« less

Patient and professional attitudes towards research in general practice: the RepR qualitative study.

PubMed

Cadwallader, Jean-Sébastien; Lebeau, Jean-Pierre; Lasserre, Evelyne; Letrilliart, Laurent

2014-07-21

Since the 1990s, professional institutions worldwide have emphasised the need to develop research in general practice to improve the health of the population. The recent creation of professorships in general practice in French Universities should foster research in this field. Our aim was to explore the views of patients and relevant professionals on research in general practice. Qualitative study, using the grounded theory approach according to Strauss and Corbin, conducted in 2010 in three French regions. Nine focus groups were run to data saturation, and included 57 participants in four different categories: patients, non-academic GPs, academic GPs, academics in other disciplines. Most of the participants in the four categories described research in general practice as specific to the population managed and relevant for health care. They considered that its grounding in day-to-day practice enabled pragmatic approaches. The influence of the pharmaceutical industry, rivalries between university disciplines and a possible gap between research and practice were considered as pitfalls. The barriers identified were representations of the medical researcher as a "laboratory worker", the lack of awareness of any research in the discipline, and lack of time and training. While the views of patients and non-academic GPs are mostly focused on professional issues and the views of academics other than GPs on technical issues, academic GPs are in a position to play a role of interface between the universities and general practices. Although the role of GPs in research is perceived differently by the various protagonists, research in general practice has an undisputed legitimacy in France. Solutions for overcoming the identified barriers include research networks with appropriate resources and training and scientifically sound collaborative research projects, as already implemented in leading countries.

Practical training framework for fitting a function and its derivatives.

PubMed

Pukrittayakamee, Arjpolson; Hagan, Martin; Raff, Lionel; Bukkapatnam, Satish T S; Komanduri, Ranga

2011-06-01

This paper describes a practical framework for using multilayer feedforward neural networks to simultaneously fit both a function and its first derivatives. This framework involves two steps. The first step is to train the network to optimize a performance index, which includes both the error in fitting the function and the error in fitting the derivatives. The second step is to prune the network by removing neurons that cause overfitting and then to retrain it. This paper describes two novel types of overfitting that are only observed when simultaneously fitting both a function and its first derivatives. A new pruning algorithm is proposed to eliminate these types of overfitting. Experimental results show that the pruning algorithm successfully eliminates the overfitting and produces the smoothest responses and the best generalization among all the training algorithms that we have tested.

A framework for developing rural academic general practices: a qualitative case study in rural Victoria.

PubMed

Brown, J B; Morrison, Tracy; Bryant, Melanie; Kassell, Lisa; Nestel, Debra

2015-01-01

There is increasing pressure for Australian rural general practices to engage in educational delivery as a means of addressing workforce issues and accommodating substantial increases in learners. For practices that have now developed a strong focus on education, there is the challenge to complement this by engaging in research activity. This study develops a rural academic general practice framework to assist rural practices in developing both comprehensive educational activity and a strong research focus thus moving towards functioning as mature academic units. A case study research design was used with the unit of analysis at the level of the rural general practice. Purposively sampled practices were recruited and individual interviews conducted with staff (supervisors, practice managers, nurses), learners (medical students, interns and registrars) and patients. Three practices hosted 'multi-level learners', two practices hosted one learner group and one had no learners. Forty-four individual interviews were conducted with staff, learners and patients. Audio recordings were transcribed for thematic analysis. After initial inductive coding, deductive analysis was undertaken with reference to recent literature and the expertise of the research team resulting in the rural academic general practice framework. Three key themes emerged with embedded subthemes. For the first theme, organisational considerations, subthemes were values/vision/culture, patient population and clinical services, staffing, physical infrastructure/equipment, funding streams and governance. For the second theme, educational considerations, subthemes were processes, clinical supervision, educational networks and learner presence. Third, for research considerations, there were the subthemes of attitude to research and research activity. The framework maps the development of a rural academic practice across these themes in four progressive stages: beginning, emerging, consolidating and established. The data enabled a framework to be constructed to map rural general practice activity with respect to activity characteristic of an academic general practice. The framework offers guidance to practices seeking to transition towards becoming a mature academic practice. The framework also offers guidance to educational institutions and funding bodies to support the development of academic activity in rural general practices. The strengths and limitations of the study design are outlined.

Action Research Monographs. Complete Set. Pennsylvania Action Research Network, 1998-99. A Section 353 Project of the Pennsylvania Department of Education, Bureau of Adult Basic and Literacy Education. A Learning from Practice Project.

ERIC Educational Resources Information Center

Pennsylvania State Univ., McKeesport.

This publication consists of the complete set of 23 monographs developed by the Pennsylvania Action Research Network to supplement the 67 monographs produced over the past 3 years. The specific audience are literacy, General Educational Development (GED), and English-as-a Second Language (ESL) practitioners. The titles are: "Use of…

The ground truth about metadata and community detection in networks

PubMed Central

Peel, Leto; Larremore, Daniel B.; Clauset, Aaron

2017-01-01

Across many scientific domains, there is a common need to automatically extract a simplified view or coarse-graining of how a complex system’s components interact. This general task is called community detection in networks and is analogous to searching for clusters in independent vector data. It is common to evaluate the performance of community detection algorithms by their ability to find so-called ground truth communities. This works well in synthetic networks with planted communities because these networks’ links are formed explicitly based on those known communities. However, there are no planted communities in real-world networks. Instead, it is standard practice to treat some observed discrete-valued node attributes, or metadata, as ground truth. We show that metadata are not the same as ground truth and that treating them as such induces severe theoretical and practical problems. We prove that no algorithm can uniquely solve community detection, and we prove a general No Free Lunch theorem for community detection, which implies that there can be no algorithm that is optimal for all possible community detection tasks. However, community detection remains a powerful tool and node metadata still have value, so a careful exploration of their relationship with network structure can yield insights of genuine worth. We illustrate this point by introducing two statistical techniques that can quantify the relationship between metadata and community structure for a broad class of models. We demonstrate these techniques using both synthetic and real-world networks, and for multiple types of metadata and community structures. PMID:28508065

Questions of trust in health research on social capital: what aspects of personal network social capital do they measure?

PubMed

Carpiano, Richard M; Fitterer, Lisa M

2014-09-01

Health research on personal social capital has often utilized measures of respondents' perceived trust of others as either a proxy for one's social capital in the absence of more focused measures or as a subjective component of social capital. Little empirical work has evaluated the validity of such practices. We test the construct validity of two trust measures used commonly in health research on social capital-generalized trust and trust of neighbors-with respect to measures of people's general network-, organization-, family-, friend-, and neighborhood-based social capital and the extent to which these two trust measures are associated with self-rated general health and mental health when social capital measures are included in the same models. Analyses of 2008 Canadian General Social Survey data (response rate 57.3%) indicate that generalized trust and trust of neighbors are both positively-yet modestly-associated with measures of several domains of network-based social capital. Both trust measures are positively associated with general and mental health, but these associations remain robust after adjusting for social capital measures. Our findings suggest that (a) trust is conceptually distinct from social capital, (b) trust measures are inadequate proxies for actual personal social networks, and (c) trust measures may only be capturing psychological aspects relevant to-but not indicative of-social capital. Though links between perceived trust and health deserve study, health research on social capital needs to utilize measures of respondents' actual social networks and their inherent resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

Theoretical Basis for Dynamic Label Propagation in Stationary Metabolic Networks under Step and Periodic Inputs

PubMed Central

Sokol, Serguei; Portais, Jean-Charles

2015-01-01

The dynamics of label propagation in a stationary metabolic network during an isotope labeling experiment can provide highly valuable information on the network topology, metabolic fluxes, and on the size of metabolite pools. However, major issues, both in the experimental set-up and in the accompanying numerical methods currently limit the application of this approach. Here, we propose a method to apply novel types of label inputs, sinusoidal or more generally periodic label inputs, to address both the practical and numerical challenges of dynamic labeling experiments. By considering a simple metabolic system, i.e. a linear, non-reversible pathway of arbitrary length, we develop mathematical descriptions of label propagation for both classical and novel label inputs. Theoretical developments and computer simulations show that the application of rectangular periodic pulses has both numerical and practical advantages over other approaches. We applied the strategy to estimate fluxes in a simulated experiment performed on a complex metabolic network (the central carbon metabolism of Escherichia coli), to further demonstrate its value in conditions which are close to those in real experiments. This study provides a theoretical basis for the rational interpretation of label propagation curves in real experiments, and will help identify the strengths, pitfalls and limitations of such experiments. The cases described here can also be used as test cases for more general numerical methods aimed at identifying network topology, analyzing metabolic fluxes or measuring concentrations of metabolites. PMID:26641860

Simple Algorithms for Distributed Leader Election in Anonymous Synchronous Rings and Complete Networks Inspired by Neural Development in Fruit Flies.

PubMed

Xu, Lei; Jeavons, Peter

2015-11-01

Leader election in anonymous rings and complete networks is a very practical problem in distributed computing. Previous algorithms for this problem are generally designed for a classical message passing model where complex messages are exchanged. However, the need to send and receive complex messages makes such algorithms less practical for some real applications. We present some simple synchronous algorithms for distributed leader election in anonymous rings and complete networks that are inspired by the development of the neural system of the fruit fly. Our leader election algorithms all assume that only one-bit messages are broadcast by nodes in the network and processors are only able to distinguish between silence and the arrival of one or more messages. These restrictions allow implementations to use a simpler message-passing architecture. Even with these harsh restrictions our algorithms are shown to achieve good time and message complexity both analytically and experimentally.

Computer-aided design of biological circuits using TinkerCell.

PubMed

Chandran, Deepak; Bergmann, Frank T; Sauro, Herbert M

2010-01-01

Synthetic biology is an engineering discipline that builds on modeling practices from systems biology and wet-lab techniques from genetic engineering. As synthetic biology advances, efficient procedures will be developed that will allow a synthetic biologist to design, analyze, and build biological networks. In this idealized pipeline, computer-aided design (CAD) is a necessary component. The role of a CAD application would be to allow efficient transition from a general design to a final product. TinkerCell is a design tool for serving this purpose in synthetic biology. In TinkerCell, users build biological networks using biological parts and modules. The network can be analyzed using one of several functions provided by TinkerCell or custom programs from third-party sources. Since best practices for modeling and constructing synthetic biology networks have not yet been established, TinkerCell is designed as a flexible and extensible application that can adjust itself to changes in the field. © 2010 Landes Bioscience

Parameter estimation in spiking neural networks: a reverse-engineering approach.

PubMed

Rostro-Gonzalez, H; Cessac, B; Vieville, T

2012-04-01

This paper presents a reverse engineering approach for parameter estimation in spiking neural networks (SNNs). We consider the deterministic evolution of a time-discretized network with spiking neurons, where synaptic transmission has delays, modeled as a neural network of the generalized integrate and fire type. Our approach aims at by-passing the fact that the parameter estimation in SNN results in a non-deterministic polynomial-time hard problem when delays are to be considered. Here, this assumption has been reformulated as a linear programming (LP) problem in order to perform the solution in a polynomial time. Besides, the LP problem formulation makes the fact that the reverse engineering of a neural network can be performed from the observation of the spike times explicit. Furthermore, we point out how the LP adjustment mechanism is local to each neuron and has the same structure as a 'Hebbian' rule. Finally, we present a generalization of this approach to the design of input-output (I/O) transformations as a practical method to 'program' a spiking network, i.e. find a set of parameters allowing us to exactly reproduce the network output, given an input. Numerical verifications and illustrations are provided.

Flavor network and the principles of food pairing

PubMed Central

Ahn, Yong-Yeol; Ahnert, Sebastian E.; Bagrow, James P.; Barabási, Albert-László

2011-01-01

The cultural diversity of culinary practice, as illustrated by the variety of regional cuisines, raises the question of whether there are any general patterns that determine the ingredient combinations used in food today or principles that transcend individual tastes and recipes. We introduce a flavor network that captures the flavor compounds shared by culinary ingredients. Western cuisines show a tendency to use ingredient pairs that share many flavor compounds, supporting the so-called food pairing hypothesis. By contrast, East Asian cuisines tend to avoid compound sharing ingredients. Given the increasing availability of information on food preparation, our data-driven investigation opens new avenues towards a systematic understanding of culinary practice. PMID:22355711

Networks In ACA Marketplaces Are Narrower For Mental Health Care Than For Primary Care.

PubMed

Zhu, Jane M; Zhang, Yuehan; Polsky, Daniel

2017-09-01

There is increasing concern about the extent to which narrow-network plans, generally defined as those including fewer than 25 percent of providers in a given health insurance market, affect consumers' choice of and access to specialty providers-particularly in mental health care. Using data for 2016 from 531 unique provider networks in the Affordable Care Act Marketplaces, we evaluated how network size and the percentage of providers who participate in any network differ between mental health care providers and a control group of primary care providers. Compared to primary care networks, participation in mental health networks was low, with only 42.7 percent of psychiatrists and 19.3 percent of nonphysician mental health care providers participating in any network. On average, plan networks included 24.3 percent of all primary care providers and 11.3 percent of all mental health care providers practicing in a given state-level market. These findings raise important questions about provider-side barriers to meeting the goal of mental health parity regulations: that insurers cover mental health services on a par with general medical and surgical services. Concerted efforts to increase network participation by mental health care providers, along with greater regulatory attention to network size and composition, could improve consumer choice and complement efforts to achieve mental health parity. Project HOPE—The People-to-People Health Foundation, Inc.

Law and psychiatry. Doing forensic work, II: fees, billing, and collections.

PubMed

Reid, William H

2012-05-01

Forensic practice fees, billing, and collection procedures are quite different from those in general psychiatry. Most forensic practices have far fewer "clients," and individual bills are usually larger. Collections are usually better (and less frequently discounted) in forensic practice, and resolving billing disputes is far more straightforward. Medicare, Medicaid, other insurance coverage, provider networks and agreements, procedure codes, and diagnosis-related groups (DRGs) are all largely irrelevant in forensic work (although sometimes important to direct clinical services in correctional psychiatry or forensic treatment clinics). An understanding of the practicalities and ethics of charging and billing for forensic services greatly simplifies practice management.

Sources of influence on medical practice

PubMed Central

Fernandez, L. A.; Martin, J. M.; del Castillo, J. d. D. L.; Gaspar, O. S.; Millan, J. I.; Lozano, M. J.; Keenoy, E. D.

2000-01-01

OBJECTIVES—To explore the opinion of general practitioners on the importance and legitimacy of sources of influence on medical practice.
METHODS—General practitioners (n=723) assigned to Primary Care Teams (PCTs) in two Spanish regions were randomly selected to participate in this study. A self administered questionnaire was sent by mail and collected by hand. The dependent variable collected the opinion on different sources that exert influence on medical practice. Importance was measured with a 9 item scale while legitimacy was evaluated with 16 items measured with a 1 to 7 point Likert scale.
RESULTS—The most important and legitimate sources of influence according to general practitioners were: training courses and scientific articles, designing self developed protocols and discussing with colleagues. The worst evaluated were: financial incentives and the role played by the pharmaceutical industry.
CONCLUSIONS—The development of medical practice is determined by many factors, grouped around three big areas: organisational setting, professional system and social setting. The medical professional system is the one considered as being the most important and legitimate by general practitioners. Other strategies of influence, considered to be very important by the predominant management culture (financial incentives), are not considered to be so by general practitioners. These results, however, are not completely reliable as regards the real network of influences existing in medical practice, which reflect instead different "value systems".


Keywords: primary health care; physicians' practice patterns; medical practice management; physicians' incentive plans PMID:10890875

Promising Practices in CTS.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

This document contains 85 articles taken from previously published issues of the "CTS Communication Network Update," a publication about the career and technology studies (CTS) program of career education designed for Alberta, Canada, high school juniors and seniors. Following an introductory section and a section on general CTS, the…

Outcomes of endodontic therapy in general practice: a study by the Practitioners Engaged in Applied Research and Learning Network.

PubMed

Bernstein, Susan D; Horowitz, Allan J; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A; Collie, Damon; Matthews, Abigail G; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

2012-05-01

The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical periodontitis.

How do general practice residents use social networking sites in asynchronous distance learning?

PubMed

Maisonneuve, Hubert; Chambe, Juliette; Lorenzo, Mathieu; Pelaccia, Thierry

2015-09-21

Blended learning environments - involving both face-to-face and remote interactions - make it easier to adapt learning programs to constraints such as residents' location and low teacher-student ratio. Social networking sites (SNS) such as Facebook®, while not originally intended to be used as learning environments, may be adapted for the distance-learning part of training programs. The purpose of our study was to explore the use of SNS for asynchronous distance learning in a blended learning environment as well as its influence on learners' face-to-face interactions. We conducted a qualitative study and carried out semi-structured interviews. We performed purposeful sampling for maximal variation to include eight general practice residents in 2(nd) and 3(rd) year training. A thematic analysis was performed. The social integration of SNS facilitates the engagement of users in their learning tasks. This may also stimulate students' interactions and group cohesion when members meet up in person. Most of the general practice residents who work in the blended learning environment we studied had a positive appraisal on their use of SNS. In particular, we report a positive impact on their engagement in learning and their participation in discussions during face-to-face instruction. Further studies are needed in order to evaluate the effectiveness of SNS in blended learning environments and the appropriation of SNS by teachers.

Changing hearts and minds: examining student nurses' experiences and perceptions of a general practice placement through a 'community of practice' lens.

PubMed

Lewis, Robin; Kelly, Shona

2018-04-05

The recent UK Government paper 'Five year forward view' describes the need to move much patient management from secondary to primary care, and this will require a significant increase in the numbers of General Practice Nurses (GPNs). Until recently, there has been no clear recruitment strategy to address this. There have however been a number of proposed solutions to address the impending GPN recruitment crisis and to increase the numbers of new GPNs in post. General Practitioners (GPs) working in the Advanced Training Practice Scheme (ATPS) have been commissioned by Health Education England to provide placements for student nurses. This paper reports upon the findings of a study evaluating the South Yorkshire ATPS network in relation to nursing students' perceptions of general practice as a placement and a potential career option post-graduation. Data were collected using semi-structured interviews with 18 nursing students. Qualitative data analysis used a framework approach and themes were cross-checked within the team. The research had ethical approval and anonymity and confidentiality were maintained throughout. Using the Communities of Practice (CoP) framework as a theoretical lens, two main themes emerged from the data: 'Myths and misunderstandings' outlined some of the misconceptions that abounded in the absence of an established CoP in general practice. These included perceptions of what constitutes a 'good' placement, an apparent lack of relevant content in the curriculum, and the widespread use of social media by students as a means of information gathering. 'Changing hearts and minds' referred to the need to positively influence the culture within general practice by addressing some of the longstanding myths. Through the fledgling CoP, the students' perceptions of the GPN role in particular were positively revised, as was the prospect of a career in general practice upon graduation. The CoP that is emerging through the ATPS placements appear to be gradually changing the socio-cultural landscape within general practice by enabling student nurses to experience the reality of life in general practice nursing, and to view the GPN role as a viable career option upon graduation.

Virtual reality or real virtuality: the space of flows and nursing practice.

PubMed

Barnes, Lynne; Rudge, Trudy

2005-12-01

The use of virtual environments for the provision of health-care is on the increase, and with each new development brings debates about their impact on care, nursing and nursing practice. Such environments offer opportunities for extending care and improvements in communication. Others believe these developments threaten aspects of nursing they hold sacrosanct. This paper explores the development of an assemblage of computer networks, databases, information systems, software programs and management systems that together work to manage health-care in Australia, namely casemix. We contend that spatial theories on network society show how this assemblage co-ordinates and operates to manage care. We discuss how this assemblage affects care and suggest that changes in organisation may be a part of the shift in how bodily organisation occurs more generally, but more specifically in health-care. We also suggest how nurses are enrolled in and by such networks, leading to transformation in nurses' practices. Finally, we argue that using spatial forms of analysis allows an interpretation of such assemblages that may account for their strengths and their shortcomings.

Palliative sedation in Dutch general practice from 2005 to 2011: a dynamic cohort study of trends and reasons

PubMed Central

Donker, Gé A; Slotman, Frank G; Spreeuwenberg, Peter; Francke, Anneke L

2013-01-01

Background Little is known about the quantity and reasons for use of palliative sedation in general practice. Aim To gain more insight into the trends of and reasons for palliative sedation in Dutch general practice. Design and setting Dynamic cohort study using registrations and questionnaire data of Dutch GPs. Method Data collected in the years from 2005 until 2011 in the Dutch Sentinel General Practice Network were analysed. Trends and reasons for use of palliative sedation were analysed using multilevel analyses to control for clustering of observations within general practices. Results From 2005–2011, 183 cases were reported from 56 general practices. The incidence of palliative sedation fluctuated between 33.7 per 100 000 patients in 2006 and 15.2 in 2011. No rise or decline during the period was observed. Palliative sedation was applied in 5.7% of all deaths and most frequently used in younger patients with cancer. The mean number of refractory symptoms was 2.6 (SD 1.2); pain (69.4%), dyspnoea (53.0%), and fear (39.3%). Patient involvement in decision making before the start of palliative sedation (87.4%) was less frequently present in patients suffering from cardiovascular or chronic obstructive pulmonary disease and in older patients compared to patients with cancer (P<0.05). Pending euthanasia requests were present in 20.8% of cases; the choice for palliative sedation in these cases was clearly motivated. Conclusion Palliative sedation is performed in a small proportion of dying patients in Dutch general practice, without a rise or decline observed from 2005 to 2011. Patients with non-cancer diseases are less frequently involved in decision making than patients with cancer, possibly related to sudden deterioration. PMID:24152481

Palliative sedation in Dutch general practice from 2005 to 2011: a dynamic cohort study of trends and reasons.

PubMed

Donker, Gé A; Slotman, Frank G; Spreeuwenberg, Peter; Francke, Anneke L

2013-10-01

Little is known about the quantity and reasons for use of palliative sedation in general practice. To gain more insight into the trends of and reasons for palliative sedation in Dutch general practice. Dynamic cohort study using registrations and questionnaire data of Dutch GPs. Method Data collected in the years from 2005 until 2011 in the Dutch Sentinel General Practice Network were analysed. Trends and reasons for use of palliative sedation were analysed using multilevel analyses to control for clustering of observations within general practices. From 2005-2011, 183 cases were reported from 56 general practices. The incidence of palliative sedation fluctuated between 33.7 per 100 000 patients in 2006 and 15.2 in 2011. No rise or decline during the period was observed. Palliative sedation was applied in 5.7% of all deaths and most frequently used in younger patients with cancer. The mean number of refractory symptoms was 2.6 (SD 1.2); pain (69.4%), dyspnoea (53.0%), and fear (39.3%). Patient involvement in decision making before the start of palliative sedation (87.4%) was less frequently present in patients suffering from cardiovascular or chronic obstructive pulmonary disease and in older patients compared to patients with cancer (P<0.05). Pending euthanasia requests were present in 20.8% of cases; the choice for palliative sedation in these cases was clearly motivated. Palliative sedation is performed in a small proportion of dying patients in Dutch general practice, without a rise or decline observed from 2005 to 2011. Patients with non-cancer diseases are less frequently involved in decision making than patients with cancer, possibly related to sudden deterioration.

A frequency-domain approach to improve ANNs generalization quality via proper initialization.

PubMed

Chaari, Majdi; Fekih, Afef; Seibi, Abdennour C; Hmida, Jalel Ben

2018-08-01

The ability to train a network without memorizing the input/output data, thereby allowing a good predictive performance when applied to unseen data, is paramount in ANN applications. In this paper, we propose a frequency-domain approach to evaluate the network initialization in terms of quality of training, i.e., generalization capabilities. As an alternative to the conventional time-domain methods, the proposed approach eliminates the approximate nature of network validation using an excess of unseen data. The benefits of the proposed approach are demonstrated using two numerical examples, where two trained networks performed similarly on the training and the validation data sets, yet they revealed a significant difference in prediction accuracy when tested using a different data set. This observation is of utmost importance in modeling applications requiring a high degree of accuracy. The efficiency of the proposed approach is further demonstrated on a real-world problem, where unlike other initialization methods, a more conclusive assessment of generalization is achieved. On the practical front, subtle methodological and implementational facets are addressed to ensure reproducibility and pinpoint the limitations of the proposed approach. Copyright © 2018 Elsevier Ltd. All rights reserved.

Design of a universal two-layered neural network derived from the PLI theory

NASA Astrophysics Data System (ADS)

Hu, Chia-Lun J.

2004-05-01

The if-and-only-if (IFF) condition that a set of M analog-to-digital vector-mapping relations can be learned by a one-layered-feed-forward neural network (OLNN) is that all the input analog vectors dichotomized by the i-th output bit must be positively, linearly independent, or PLI. If they are not PLI, then the OLNN just cannot learn no matter what learning rules is employed because the solution of the connection matrix does not exist mathematically. However, in this case, one can still design a parallel-cascaded, two-layered, perceptron (PCTLP) to acheive this general mapping goal. The design principle of this "universal" neural network is derived from the major mathematical properties of the PLI theory - changing the output bits of the dependent relations existing among the dichotomized input vectors to make the PLD relations PLI. Then with a vector concatenation technique, the required mapping can still be learned by this PCTLP system with very high efficiency. This paper will report in detail the mathematical derivation of the general design principle and the design procedures of the PCTLP neural network system. It then will be verified in general by a practical numerical example.

Entropy of spatial network ensembles

NASA Astrophysics Data System (ADS)

Coon, Justin P.; Dettmann, Carl P.; Georgiou, Orestis

2018-04-01

We analyze complexity in spatial network ensembles through the lens of graph entropy. Mathematically, we model a spatial network as a soft random geometric graph, i.e., a graph with two sources of randomness, namely nodes located randomly in space and links formed independently between pairs of nodes with probability given by a specified function (the "pair connection function") of their mutual distance. We consider the general case where randomness arises in node positions as well as pairwise connections (i.e., for a given pair distance, the corresponding edge state is a random variable). Classical random geometric graph and exponential graph models can be recovered in certain limits. We derive a simple bound for the entropy of a spatial network ensemble and calculate the conditional entropy of an ensemble given the node location distribution for hard and soft (probabilistic) pair connection functions. Under this formalism, we derive the connection function that yields maximum entropy under general constraints. Finally, we apply our analytical framework to study two practical examples: ad hoc wireless networks and the US flight network. Through the study of these examples, we illustrate that both exhibit properties that are indicative of nearly maximally entropic ensembles.

New paths in post-graduate medical training in general practice - 8 years of experience with the pilot project Verbundweiterbildungplus Baden-Württemberg.

PubMed

Schwill, Simon; Magez, Julia; Joos, Stefanie; Steinhäuser, Jost; Ledig, Thomas; Rubik, Aline; Niebling, Wilhelm; Szecsenyi, Joachim; Flum, Elisabeth

2017-01-01

Background: In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program "Verbundweiterbildung plus Baden-Württemberg" (VWB plus BW) was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice. Project description: The Competence Center for General Practice in Baden-Wuerttemberg supports the organization of regional networks dedicated to post-graduate medical education. First core element of the VWB plus BW program is a special seminar series for physicians pursuing post-graduate training. This seminar program is aligned with the German competency-based curriculum in general medicine and is meant to promote medical expertise and other related competencies, such as business and medical practice management and communication skills. Mentoring and advising the physicians regarding professional and personal planning form the second core element. The third core element is seen in the train-the-trainer seminars that address the competencies of the trainers. In order to focus the program's content closely on the needs of the target groups, scientifically based evaluations and research are carried out. Results: Since starting in 2009, 685 physicians have entered the program and 141 have passed the examination to become medical specialists (as of December 2016). In total, 31 networks, 60 hospitals and 211 general practices have participated. The seminar sessions have been rated on average with 1.43 on a six-point Likert scale by the physician trainees (1=extremely satisfied, 6=extremely dissatisfied). Alongside the medical training, these physicians viewed the exchange of information and experiences with other physicians as very positive and important. In 185 seminars lasting 90 minutes each, the seminar program has presently covered 250 out of 320 units in the competency-based curriculum for general medicine. A total of 281 trainers have been trained in 13 train-the-trainer courses and have rated this course on average with 1.36 on a six-point Likert scale. Above all, the trainers emphasized the exchange of information and experiences with other trainers as very positive. In 2013 the DEGAM concept for its Verbundweiterbildung plus program was developed based on that of the VWB plus BW. Since 2008 over 40 articles on the topic of post-graduate medical education have been published. Conclusion: The steadily increasing number of participants over the years demonstrates that the VWB plus BW is relevant for recent medical graduates and contributes to the attractiveness of general practice. The consistently excellent evaluations of the training program and the train-the-trainer course affirm the focus on the needs of the target groups. The post-graduate VWB plus BW program advances structured, competency-based and quality-oriented specialist training and fosters professional sharing between physicians - something that could also be relevant for other fields. The increasing numbers of participating physicians and specialists in general practice in Baden-Württemberg lead to the conclusion that the VWB plus BW program positively influences the number of general practitioners.

Structural Effects of Network Sampling Coverage I: Nodes Missing at Random1.

PubMed

Smith, Jeffrey A; Moody, James

2013-10-01

Network measures assume a census of a well-bounded population. This level of coverage is rarely achieved in practice, however, and we have only limited information on the robustness of network measures to incomplete coverage. This paper examines the effect of node-level missingness on 4 classes of network measures: centrality, centralization, topology and homophily across a diverse sample of 12 empirical networks. We use a Monte Carlo simulation process to generate data with known levels of missingness and compare the resulting network scores to their known starting values. As with past studies (Borgatti et al 2006; Kossinets 2006), we find that measurement bias generally increases with more missing data. The exact rate and nature of this increase, however, varies systematically across network measures. For example, betweenness and Bonacich centralization are quite sensitive to missing data while closeness and in-degree are robust. Similarly, while the tau statistic and distance are difficult to capture with missing data, transitivity shows little bias even with very high levels of missingness. The results are also clearly dependent on the features of the network. Larger, more centralized networks are generally more robust to missing data, but this is especially true for centrality and centralization measures. More cohesive networks are robust to missing data when measuring topological features but not when measuring centralization. Overall, the results suggest that missing data may have quite large or quite small effects on network measurement, depending on the type of network and the question being posed.

Scalable training of artificial neural networks with adaptive sparse connectivity inspired by network science.

PubMed

Mocanu, Decebal Constantin; Mocanu, Elena; Stone, Peter; Nguyen, Phuong H; Gibescu, Madeleine; Liotta, Antonio

2018-06-19

Through the success of deep learning in various domains, artificial neural networks are currently among the most used artificial intelligence methods. Taking inspiration from the network properties of biological neural networks (e.g. sparsity, scale-freeness), we argue that (contrary to general practice) artificial neural networks, too, should not have fully-connected layers. Here we propose sparse evolutionary training of artificial neural networks, an algorithm which evolves an initial sparse topology (Erdős-Rényi random graph) of two consecutive layers of neurons into a scale-free topology, during learning. Our method replaces artificial neural networks fully-connected layers with sparse ones before training, reducing quadratically the number of parameters, with no decrease in accuracy. We demonstrate our claims on restricted Boltzmann machines, multi-layer perceptrons, and convolutional neural networks for unsupervised and supervised learning on 15 datasets. Our approach has the potential to enable artificial neural networks to scale up beyond what is currently possible.

Inferring causal molecular networks: empirical assessment through a community-based effort.

PubMed

Hill, Steven M; Heiser, Laura M; Cokelaer, Thomas; Unger, Michael; Nesser, Nicole K; Carlin, Daniel E; Zhang, Yang; Sokolov, Artem; Paull, Evan O; Wong, Chris K; Graim, Kiley; Bivol, Adrian; Wang, Haizhou; Zhu, Fan; Afsari, Bahman; Danilova, Ludmila V; Favorov, Alexander V; Lee, Wai Shing; Taylor, Dane; Hu, Chenyue W; Long, Byron L; Noren, David P; Bisberg, Alexander J; Mills, Gordon B; Gray, Joe W; Kellen, Michael; Norman, Thea; Friend, Stephen; Qutub, Amina A; Fertig, Elana J; Guan, Yuanfang; Song, Mingzhou; Stuart, Joshua M; Spellman, Paul T; Koeppl, Heinz; Stolovitzky, Gustavo; Saez-Rodriguez, Julio; Mukherjee, Sach

2016-04-01

It remains unclear whether causal, rather than merely correlational, relationships in molecular networks can be inferred in complex biological settings. Here we describe the HPN-DREAM network inference challenge, which focused on learning causal influences in signaling networks. We used phosphoprotein data from cancer cell lines as well as in silico data from a nonlinear dynamical model. Using the phosphoprotein data, we scored more than 2,000 networks submitted by challenge participants. The networks spanned 32 biological contexts and were scored in terms of causal validity with respect to unseen interventional data. A number of approaches were effective, and incorporating known biology was generally advantageous. Additional sub-challenges considered time-course prediction and visualization. Our results suggest that learning causal relationships may be feasible in complex settings such as disease states. Furthermore, our scoring approach provides a practical way to empirically assess inferred molecular networks in a causal sense.

Attitudes towards reforming primary care in Belgium: social network analysis in a pluralist context.

PubMed

Lorant, Vincent; Rihoux, Benoît; Nicaise, Pablo

2016-10-01

Health care policies are influenced by many groups which in turn influence each other. Our aim was to describe a network of nominated influential stakeholders and analyze how it affects attitudes to reforming primary care. Face-to-face interviews were carried out in Belgium with 102 influential people. Each respondent was asked to score solutions for improving the role of general practice in the health care system and to nominate up to six other influential stakeholders. Social network and multivariate analyses were used to describe the nomination network and its effect on attitudes to reform. The network was highly centralized and homophilous (tendency to bond with people who are similar) for language groups. Despite Belgium having a strong pluralist tradition of decision making, policy makers were central to the network (average indegree = 10.8) compared to professional representatives (6.9). Respondents supported an enhanced role for general practitioners but did not support radically new policies. Social network analysis contributes to understanding why health care reforms may languish in pluralistic, decentralized health care systems. The central position of a stakeholder in a network is related to perceived influence but does not favour a radical policy orientation. In addition, language-group homophily in the 'perceived influence network' leads to a weak coalition that only favours small-step reform. © The Author(s) 2016.

Evaluating the implementation of a quality improvement process in General Practice using a realist evaluation framework.

PubMed

Moule, Pam; Clompus, Susan; Fieldhouse, Jon; Ellis-Jones, Julie; Barker, Jacqueline

2018-05-25

Underuse of anticoagulants in atrial fibrillation is known to increase the risk of stroke and is an international problem. The National Institute for Health Care and Excellence guidance CG180 seeks to reduce atrial fibrillation related strokes through prescriptions of Non-vitamin K antagonist Oral Anticoagulants. A quality improvement programme was established by the West of England Academic Health Science Network (West of England AHSN) to implement this guidance into General Practice. A realist evaluation identified whether the quality improvement programme worked, determining how and in what circumstances. Six General Practices in 1 region, became the case study sites. Quality improvement team, doctor, and pharmacist meetings within each of the General Practices were recorded at 3 stages: initial planning, review, and final. Additionally, 15 interviews conducted with the practice leads explored experiences of the quality improvement process. Observation and interview data were analysed and compared against the initial programme theory. The quality improvement resources available were used variably, with the training being valued by all. The initial programme theories were refined. In particular, local workload pressures and individual General Practitioner experiences and pre-conceived ideas were acknowledged. Where key motivators were in place, such as prior experience, the programme achieved optimal outcomes and secured a lasting quality improvement legacy. The employment of a quality improvement programme can deliver practice change and improvement legacy outcomes when particular mechanisms are employed and in contexts where there is a commitment to improve service. © 2018 John Wiley & Sons, Ltd.

Temporal stability in human interaction networks

NASA Astrophysics Data System (ADS)

Fabbri, Renato; Fabbri, Ricardo; Antunes, Deborah Christina; Pisani, Marilia Mello; de Oliveira, Osvaldo Novais

2017-11-01

This paper reports on stable (or invariant) properties of human interaction networks, with benchmarks derived from public email lists. Activity, recognized through messages sent, along time and topology were observed in snapshots in a timeline, and at different scales. Our analysis shows that activity is practically the same for all networks across timescales ranging from seconds to months. The principal components of the participants in the topological metrics space remain practically unchanged as different sets of messages are considered. The activity of participants follows the expected scale-free trace, thus yielding the hub, intermediary and peripheral classes of vertices by comparison against the Erdös-Rényi model. The relative sizes of these three sectors are essentially the same for all email lists and the same along time. Typically, < 15% of the vertices are hubs, 15%-45% are intermediary and > 45% are peripheral vertices. Similar results for the distribution of participants in the three sectors and for the relative importance of the topological metrics were obtained for 12 additional networks from Facebook, Twitter and ParticipaBR. These properties are consistent with the literature and may be general for human interaction networks, which has important implications for establishing a typology of participants based on quantitative criteria.

[Changing medical practices and nosocomial infection rates in French maternity units from 1997 to 2000].

PubMed

Vincent-Boulétreau, A; Caillat-Vallet, E; Dumas, A M; Ayzac, L; Chapuis, C; Emery, M N; Girard, R; Haond, C; Lafarge-Leboucher, J; Tissot-Guerraz, F; Fabry, J

2005-04-01

In this study we describe the changes in medical practices and nosocomial infection rates in obstetrics observed through a surveillance network in the South East of France. The maternity units which belong to this network participated in voluntary surveillance using the network's methodology. The criteria for the diagnosis of nosocomial infections were in accordance with the methods described by the Centers for Disease Control and Prevention. 101240 pregnancies including 18503 caesareans (18.3%) were included in the network from 1997 to 2000. During the study period, nosocomial infection rates following caesarean section and vaginal delivery decreased respectively from 7.8% to 4.3% (p < 0.001) and from 2.2% to 0.9% (p < 0.001). This evolution was compared with the evolution of collected risk factors. In spite of the methodology limits, general value of surveillance and infection control programs in maternity units has been confirmed by the results of this surveillance network. During the study period, both obstetrics-related risk factors for nosocomial infection and observed hospital-acquired infection rates were dramatically reduced, what prove an improvement of quality of care in maternity units.

Artificial neural networks in biology and chemistry: the evolution of a new analytical tool.

PubMed

Cartwright, Hugh M

2008-01-01

Once regarded as an eccentric and unpromising algorithm for the analysis of scientific data, the neural network has been developed in the last decade into a powerful computational tool. Its use now spans all areas of science, from the physical sciences and engineering to the life sciences and allied subjects. Applications range from the assessment of epidemiological data or the deconvolution of spectra to highly practical applications, such as the electronic nose. This introductory chapter considers briefly the growth in the use of neural networks and provides some general background in preparation for the more detailed chapters that follow.

Changing Social Networks Among Homeless Individuals: A Prospective Evaluation of a Job- and Life-Skills Training Program.

PubMed

Gray, Heather M; Shaffer, Paige M; Nelson, Sarah E; Shaffer, Howard J

2016-10-01

Social networks play important roles in mental and physical health among the general population. Building healthier social networks might contribute to the development of self-sufficiency among people struggling to overcome homelessness and substance use disorders. In this study of homeless adults completing a job- and life-skills program (i.e., the Moving Ahead Program at St. Francis House, Boston), we prospectively examined changes in social network quality, size, and composition. Among the sample of participants (n = 150), we observed positive changes in social network quality over time. However, social network size and composition did not change among the full sample. The subset of participants who reported abstaining from alcohol during the months before starting the program reported healthy changes in their social networks; specifically, while completing the program, they re-structured their social networks such that fewer members of their network used alcohol to intoxication. We discuss practical implications of these findings.

Techniques and Materials Used by General Dentists during Root Canal Treatment Procedures: Findings from the National Dental Practice-Based Research Network

PubMed Central

Eleazer, Paul D.; Gilbert, Gregg H.; Funkhouser, Ellen; Reams, G.J.; Law, A.S.; Benjamin, Paul L.

2015-01-01

Background Little is known about which materials and techniques general dentists (GDs) use during root canal procedures. The objectives were to: (1) quantify GD’s use of specific endodontic armamentarium; (2) quantify inappropriate use; and (3) ascertain if inappropriate use is associated with dentists’ practice characteristics. Methods GDs in the National Dental Practice-Based Research Network reported in a questionnaire materials and techniques they use during root canal procedures. Results 1,490 (87%) of eligible GDs participated. Most (93%; n=1,383) used sodium hypochlorite to irrigate. The most commonly used sealers were zinc oxide-eugenol (43%) and resin (40%), followed by calcium hydroxide (26%). A majority (62%; n=920) used a compaction obturation technique; 36% (n=534) used a carrier-based method. Most (96%; n=1,423) used gutta percha as a filler; 5% used paste fillers. Few used irrigants (n=46), sealers (n=4), techniques (n=49) or fillers (n=10) that investigators classified as ‘inappropriate’. Conclusions GDs use a broad range of endodontic techniques and materials, often adapting to newer technologies as they become available. Few GDs use armamentarium that the investigators classified as inappropriate. Practical Implications GDs use many types of endodontic techniques and materials, but only a very small percentage is not appropriate. PMID:26562726

Citizen science networks in natural history and the collective validation of biodiversity data.

PubMed

Turnhout, Esther; Lawrence, Anna; Turnhout, Sander

2016-06-01

Biodiversity data are in increasing demand to inform policy and management. A substantial portion of these data is generated in citizen science networks. To ensure the quality of biodiversity data, standards and criteria for validation have been put in place. We used interviews and document analysis from the United Kingdom and The Netherlands to examine how data validation serves as a point of connection between the diverse people and practices in natural history citizen science networks. We found that rather than a unidirectional imposition of standards, validation was performed collectively. Specifically, it was enacted in ongoing circulations of biodiversity records between recorders and validators as they jointly negotiated the biodiversity that was observed and the validity of the records. These collective validation practices contributed to the citizen science character or natural history networks and tied these networks together. However, when biodiversity records were included in biodiversity-information initiatives on different policy levels and scales, the circulation of records diminished. These initiatives took on a more extractive mode of data use. Validation ceased to be collective with important consequences for the natural history networks involved and citizen science more generally. © 2016 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

[Indoor air quality and parents of asthmatic children practices].

PubMed

Larramendy Magnin, S; Desssome, B; Moret, L

2017-09-01

Indoor air pollution can worsen asthma in children. Better knowledge of factors determining parents' reception of recommendations to limit pollution of indoor air in the homes of asthmatic children would be helpful to improve implementation. A descriptive study evaluating practices known to have an impact on the quality of air in homes was conducted among parents of asthmatic children aged 3 to 16 years. From May to September 2013, parents answered anonymous self-administered questionnaires in waiting rooms of generalist practitioners, in the Nantes University pneumology pediatric outpatient clinic, and as part of therapeutic education sessions conducted by the Asthma-44 Network. There were 190 exploitable questionnaires: 88.2% of parents reported never smoking in the home; 48.4% used home fragrance in the living room at least once a week; 77.8% opened their children's bedroom windows more than 10minutes at least once a day; 32.6% used several cleaning products or bleach once or twice a week. Good practices concerning smoking in housing were applied less in homes where the child was monitored only by a general practitioner (OR=0.08; CI[0.02-0.34]). Good practices on the use of perfume were statistically linked to having an intermediate level occupation (OR=2.31; CI[1.01-5.32]) and being followed by the university hospital, by the asthma network or by a general practitioner if the child had already consulted a pneumo-pediatrician or an allergist (OR=0.24; CI[0.07-0.81]). Good ventilation practices forchildren's bedrooms were statistically linked to residing in a rural rather than urban setting (OR=4.72; CI[1.0-22.16]). Practices observed in parents of asthmatic children differ little from those of the general population. Recommendations on how to limit sources of chemical pollutants, with the exception of smoking, are still poorly applied. Specialist consultations and specific training for general practitioners should improve the penetration of public health messages to this vulnerable population. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Generalizing the Network Scale-Up Method: A New Estimator for the Size of Hidden Populations*

PubMed Central

Feehan, Dennis M.; Salganik, Matthew J.

2018-01-01

The network scale-up method enables researchers to estimate the size of hidden populations, such as drug injectors and sex workers, using sampled social network data. The basic scale-up estimator offers advantages over other size estimation techniques, but it depends on problematic modeling assumptions. We propose a new generalized scale-up estimator that can be used in settings with non-random social mixing and imperfect awareness about membership in the hidden population. Further, the new estimator can be used when data are collected via complex sample designs and from incomplete sampling frames. However, the generalized scale-up estimator also requires data from two samples: one from the frame population and one from the hidden population. In some situations these data from the hidden population can be collected by adding a small number of questions to already planned studies. For other situations, we develop interpretable adjustment factors that can be applied to the basic scale-up estimator. We conclude with practical recommendations for the design and analysis of future studies. PMID:29375167

A reverse engineering approach to optimize experiments for the construction of biological regulatory networks.

PubMed

Zhang, Xiaomeng; Shao, Bin; Wu, Yangle; Qi, Ouyang

2013-01-01

One of the major objectives in systems biology is to understand the relation between the topological structures and the dynamics of biological regulatory networks. In this context, various mathematical tools have been developed to deduct structures of regulatory networks from microarray expression data. In general, from a single data set, one cannot deduct the whole network structure; additional expression data are usually needed. Thus how to design a microarray expression experiment in order to get the most information is a practical problem in systems biology. Here we propose three methods, namely, maximum distance method, trajectory entropy method, and sampling method, to derive the optimal initial conditions for experiments. The performance of these methods is tested and evaluated in three well-known regulatory networks (budding yeast cell cycle, fission yeast cell cycle, and E. coli. SOS network). Based on the evaluation, we propose an efficient strategy for the design of microarray expression experiments.

Capacity Model and Constraints Analysis for Integrated Remote Wireless Sensor and Satellite Network in Emergency Scenarios

PubMed Central

Zhang, Wei; Zhang, Gengxin; Dong, Feihong; Xie, Zhidong; Bian, Dongming

2015-01-01

This article investigates the capacity problem of an integrated remote wireless sensor and satellite network (IWSSN) in emergency scenarios. We formulate a general model to evaluate the remote sensor and satellite network capacity. Compared to most existing works for ground networks, the proposed model is time varying and space oriented. To capture the characteristics of a practical network, we sift through major capacity-impacting constraints and analyze the influence of these constraints. Specifically, we combine the geometric satellite orbit model and satellite tool kit (STK) engineering software to quantify the trends of the capacity constraints. Our objective in analyzing these trends is to provide insights and design guidelines for optimizing the integrated remote wireless sensor and satellite network schedules. Simulation results validate the theoretical analysis of capacity trends and show the optimization opportunities of the IWSSN. PMID:26593919

Capacity Model and Constraints Analysis for Integrated Remote Wireless Sensor and Satellite Network in Emergency Scenarios.

PubMed

Zhang, Wei; Zhang, Gengxin; Dong, Feihong; Xie, Zhidong; Bian, Dongming

2015-11-17

This article investigates the capacity problem of an integrated remote wireless sensor and satellite network (IWSSN) in emergency scenarios. We formulate a general model to evaluate the remote sensor and satellite network capacity. Compared to most existing works for ground networks, the proposed model is time varying and space oriented. To capture the characteristics of a practical network, we sift through major capacity-impacting constraints and analyze the influence of these constraints. Specifically, we combine the geometric satellite orbit model and satellite tool kit (STK) engineering software to quantify the trends of the capacity constraints. Our objective in analyzing these trends is to provide insights and design guidelines for optimizing the integrated remote wireless sensor and satellite network schedules. Simulation results validate the theoretical analysis of capacity trends and show the optimization opportunities of the IWSSN.

Integrated solutions for sustainable fall prevention in primary care, the iSOLVE project: a type 2 hybrid effectiveness-implementation design.

PubMed

Clemson, Lindy; Mackenzie, Lynette; Roberts, Chris; Poulos, Roslyn; Tan, Amy; Lovarini, Meryl; Sherrington, Cathie; Simpson, Judy M; Willis, Karen; Lam, Mary; Tiedemann, Anne; Pond, Dimity; Peiris, David; Hilmer, Sarah; Pit, Sabrina Winona; Howard, Kirsten; Lovitt, Lorraine; White, Fiona

2017-02-07

Despite strong evidence giving guidance for effective fall prevention interventions in community-residing older people, there is currently no clear model for engaging general medical practitioners in fall prevention and routine use of allied health professionals in fall prevention has been slow, limiting widespread dissemination. This protocol paper outlines an implementation-effectiveness study of the Integrated Solutions for Sustainable Fall Prevention (iSOLVE) intervention which has developed integrated processes and pathways to identify older people at risk of falls and engage a whole of primary care approach to fall prevention. This protocol paper presents the iSOLVE implementation processes and change strategies and outlines the study design of a blended type 2 hybrid design. The study consists of a two-arm cluster randomized controlled trial in 28 general practices and recruiting 560 patients in Sydney, Australia, to evaluate effectiveness of the iSOLVE intervention in changing general practitioner fall management practices and reducing patient falls and the cost effectiveness from a healthcare funder perspective. Secondary outcomes include change in medications known to increase fall risk. We will simultaneously conduct a multi-methodology evaluation to investigate the workability and utility of the implementation intervention. The implementation evaluation includes in-depth interviews and surveys with general practitioners and allied health professionals to explore acceptability and uptake of the intervention, the coherence of the proposed changes for those in the work setting, and how to facilitate the collective action needed to implement changes in practice; social network mapping will explore professional relationships and influences on referral patterns; and, a survey of GPs in the geographical intervention zone will test diffusion of evidence-based fall prevention practices. The project works in partnership with a primary care health network, state fall prevention leaders, and a community of practice of fall prevention advocates. The design is aimed at providing clear direction for sustainability and informing decisions about generalization of the iSOLVE intervention processes and change strategies. While challenges exist in hybrid designs, there is a potential for significant outcomes as the iSOLVE pathways project brings together practice and research to collectively solve a major national problem with implications for policy service delivery. Australian New Zealand Clinial Trials Registry ACTRN12615000401550.

Experimental performance evaluation of software defined networking (SDN) based data communication networks for large scale flexi-grid optical networks.

PubMed

Zhao, Yongli; He, Ruiying; Chen, Haoran; Zhang, Jie; Ji, Yuefeng; Zheng, Haomian; Lin, Yi; Wang, Xinbo

2014-04-21

Software defined networking (SDN) has become the focus in the current information and communication technology area because of its flexibility and programmability. It has been introduced into various network scenarios, such as datacenter networks, carrier networks, and wireless networks. Optical transport network is also regarded as an important application scenario for SDN, which is adopted as the enabling technology of data communication networks (DCN) instead of general multi-protocol label switching (GMPLS). However, the practical performance of SDN based DCN for large scale optical networks, which is very important for the technology selection in the future optical network deployment, has not been evaluated up to now. In this paper we have built a large scale flexi-grid optical network testbed with 1000 virtual optical transport nodes to evaluate the performance of SDN based DCN, including network scalability, DCN bandwidth limitation, and restoration time. A series of network performance parameters including blocking probability, bandwidth utilization, average lightpath provisioning time, and failure restoration time have been demonstrated under various network environments, such as with different traffic loads and different DCN bandwidths. The demonstration in this work can be taken as a proof for the future network deployment.

Future provision of out of hours primary medical care: a survey with two general practitioner research networks.

PubMed Central

Lattimer, V.; Smith, H.; Hungin, P.; Glasper, A.; George, S.

1996-01-01

OBJECTIVE--To ascertain general practitioners' views about the future provision of out of hours primary medical care. DESIGN--Self completing postal questionnaire survey. SETTING--Wessex and north east England. SUBJECTS--116 general practitioners in the Wessex Primary Care Research Network and 83 in the Northern Primary Care Research Network. MAIN OUTCOME MEASURES--Intention to reduce or opt out of on call; plans for changing out of hours arrangements; the three most important changes needed to out of hours care; willingness to try, and perceived strengths and limitations of, three alternative out of hours care models--primary care emergency centres, telephone triage services, and cooperatives. RESULTS--The overall response rate was 74% (Wessex research network 77% (89/116), northern research network 71% (59/83)). Eighty three per cent of respondents (123/148) were willing to try at least one service model, primary care emergency centres being the most popular option. Key considerations were the potential for a model to reduce time on call and workload, to maintain continuity of care, and to fit the practice context. Sixty one per cent (91/148) hoped to reduce time on call and 25% (37/148) hoped to opt out completely. CONCLUSIONS--General practitioners were keen to try alternative arrangements for out of hours care delivery, despite the lack of formal trials. The increased flexibility in funding brought about by the recent agreement between the General Medical Services Committee and the Department of Health is likely to lead to a proliferation of different schemes. Careful monitoring will be necessary, and formal trials of new service models are needed urgently. PMID:8611835

Motivation in medical education and patient communication. The EGPRN meeting in Zurich, Switzerland, October 2010.

PubMed

Rethans, Jan-Joost; Donner-Banzhoff, Norbert

2011-06-01

The European General Practice Research Network held an international research meeting on 'Motivation in medical education and patient communication' in Zürich, Switzerland, in October 2010. The two authors were keynote speakers, who introduced the theme from different angles and summarized and reflected on individual papers presented at the conference. The theme of the conference underlined the importance of communication in general practice and of motivation in medical education in particular. There were a variety of papers each addressing in its own way the topic of this meeting. We conclude that it is still uncommon to use psychological theories on motivation in research on motivation and patient communication in general practice/family medicine. Motivation and readiness to change are essential concepts in experimental health services research. Research designs increasingly follow the Framework for the Evaluation of Complex Interventions in Health Care as suggested by the British Medical Research Council. However, there are also difficulties related to classical experimental designs that have to be critically discussed.

Exploring Practice-Research Networks for Critical Professional Learning

ERIC Educational Resources Information Center

Appleby, Yvon; Hillier, Yvonne

2012-01-01

This paper discusses the contribution that practice-research networks can make to support critical professional development in the Learning and Skills sector in England. By practice-research networks we mean groups or networks which maintain a connection between research and professional practice. These networks stem from the philosophy of…

Social networking policies in nursing education.

PubMed

Frazier, Blake; Culley, Joan M; Hein, Laura C; Williams, Amber; Tavakoli, Abbas S

2014-03-01

Social networking use has increased exponentially in the past few years. A literature review related to social networking and nursing revealed a research gap between nursing practice and education. Although there was information available on the appropriate use of social networking sites, there was limited research on the use of social networking policies within nursing education. The purpose of this study was to identify current use of social media by faculty and students and a need for policies within nursing education at one institution. A survey was developed and administered to nursing students (n = 273) and nursing faculty (n = 33). Inferential statistics included χ², Fisher exact test, t test, and General Linear Model. Cronbach's α was used to assess internal consistency of social media scales. The χ² result indicates that there were associations with the group and several social media items. t Test results indicate significant differences between student and faculty for average of policies are good (P = .0127), policies and discipline (P = .0315), and policy at the study school (P = .0013). General Linear Model analyses revealed significant differences for "friend" a patient with a bond, unprofessional posts, policy, and nursing with class level. Results showed that students and faculty supported the development of a social networking policy.

The PBRN Initiative

PubMed Central

Curro, F.A.; Vena, D.; Naftolin, F.; Terracio, L.; Thompson, V.P.

2012-01-01

The NIDCR-supported Practice-based Research Network initiative presents dentistry with an unprecedented opportunity by providing a pathway for modifying and advancing the profession. It encourages practitioner participation in the transfer of science into practice for the improvement of patient care. PBRNs vary in infrastructure and design, and sustaining themselves in the long term may involve clinical trial validation by regulatory agencies. This paper discusses the PBRN concept in general and uses the New York University College of Dentistry’s Practitioners Engaged in Applied Research and Learning (PEARL) Network as a model to improve patient outcomes. The PEARL Network is structured to ensure generalizability of results, data integrity, and to provide an infrastructure in which scientists can address clinical practitioner research interests. PEARL evaluates new technologies, conducts comparative effectiveness research, participates in multidisciplinary clinical studies, helps evaluate alternative models of healthcare, educates and trains future clinical faculty for academic positions, expands continuing education to include “benchmarking” as a form of continuous feedback to practitioners, adds value to dental schools’ educational programs, and collaborates with the oral health care and pharmaceutical industries and medical PBRNs to advance the dental profession and further the integration of dental research and practice into contemporary healthcare (NCT00867997, NCT01268605). PMID:22699662

A Bayesian network meta-analysis for binary outcome: how to do it.

PubMed

Greco, Teresa; Landoni, Giovanni; Biondi-Zoccai, Giuseppe; D'Ascenzo, Fabrizio; Zangrillo, Alberto

2016-10-01

This study presents an overview of conceptual and practical issues of a network meta-analysis (NMA), particularly focusing on its application to randomised controlled trials with a binary outcome of interest. We start from general considerations on NMA to specifically appraise how to collect study data, structure the analytical network and specify the requirements for different models and parameter interpretations, with the ultimate goal of providing physicians and clinician-investigators a practical tool to understand pros and cons of NMA. Specifically, we outline the key steps, from the literature search to sensitivity analysis, necessary to perform a valid NMA of binomial data, exploiting Markov Chain Monte Carlo approaches. We also apply this analytical approach to a case study on the beneficial effects of volatile agents compared to total intravenous anaesthetics for surgery to further clarify the statistical details of the models, diagnostics and computations. Finally, datasets and models for the freeware WinBUGS package are presented for the anaesthetic agent example. © The Author(s) 2013.

Technical Elements, Demonstration Projects, and Fiscal Models in Medicaid Managed Care for People with Developmental Disabilities.

ERIC Educational Resources Information Center

Kastner, Theodore A.; Walsh, Kevin K.; Criscione, Teri

1997-01-01

Presents a general model of the structure and functioning of managed care and describes elements (provider networks, fiscal elements, risk estimation, case-mix, management information systems, practice parameters, and quality improvement) critical to people with developmental disabilities. Managed care demonstration projects and a hypothetical…

49 CFR 1180.1 - General policy statement for merger or control of at least two Class I railroads.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE RAILROAD... the railroad industry (including Class II and III carriers) is a network of competing and... weight in our analysis. Applicants shall make a good faith effort to calculate the net public benefits...

49 CFR 1180.1 - General policy statement for merger or control of at least two Class I railroads.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE RAILROAD... the railroad industry (including Class II and III carriers) is a network of competing and... weight in our analysis. Applicants shall make a good faith effort to calculate the net public benefits...

49 CFR 1180.1 - General policy statement for merger or control of at least two Class I railroads.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE RAILROAD... the railroad industry (including Class II and III carriers) is a network of competing and... weight in our analysis. Applicants shall make a good faith effort to calculate the net public benefits...

49 CFR 1180.1 - General policy statement for merger or control of at least two Class I railroads.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE RAILROAD... the railroad industry (including Class II and III carriers) is a network of competing and... weight in our analysis. Applicants shall make a good faith effort to calculate the net public benefits...

Using Patient Flow Information to Determine Risk of Hospital Presentation: Protocol for a Proof-of-Concept Study.

PubMed

Pearce, Christopher M; McLeod, Adam; Patrick, Jon; Boyle, Douglas; Shearer, Marianne; Eustace, Paula; Pearce, Mary Catherine

2016-12-20

Every day, patients are admitted to the hospital with conditions that could have been effectively managed in the primary care sector. These admissions are expensive and in many cases are possible to avoid if early intervention occurs. General practitioners are in the best position to identify those at risk of imminent hospital presentation and admission; however, it is not always possible for all the factors to be considered. A lack of shared information contributes significantly to the challenge of understanding a patient's full medical history. Some health care systems around the world use algorithms to analyze patient data in order to predict events such as emergency presentation; however, those responsible for the design and use of such systems readily admit that the algorithms can only be used to assess the populations used to design the algorithm in the first place. The United Kingdom health care system has contributed data toward algorithm development, which is possible through the unified health care system in place there. The lack of unified patient records in Australia has made building an algorithm for local use a significant challenge. Our objective is to use linked patient records to track patient flow through primary and secondary health care in order to develop a tool that can be applied in real time at the general practice level. This algorithm will allow the generation of reports for general practitioners that indicate the relative risk of patients presenting to an emergency department. A previously designed tool was used to deidentify the general practice and hospital records of approximately 100,000 patients. Records were pooled for patients who had attended emergency departments within the Eastern Health Network of hospitals and general practices within the Eastern Health Network catchment. The next phase will involve development of a model using a predictive analytic machine learning algorithm. The model will be developed iteratively, testing the combination of variables that will provide the best predictive model. Records of approximately 97,000 patients who have attended both a general practice and an emergency department have been identified within the database. These records are currently being used to develop the predictive model. Records from general practice and emergency department visits have been identified and pooled for development of the algorithm. The next phase in the project will see validation and live testing of the algorithm in a practice setting. The algorithm will underpin a clinical decision support tool for general practitioners which will be tested for face validity in this initial study into its efficacy. ©Christopher M Pearce, Adam McLeod, Jon Patrick, Douglas Boyle, Marianne Shearer, Paula Eustace, Mary Catherine Pearce. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 20.12.2016.

Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).

PubMed

Patel, Puja; Hemmeger, Heather; Kozak, Mary Ann; Gernant, Stephanie A; Snyder, Margie E

2015-01-01

To describe the experiences and opinions of pharmacists serving as site coordinators for the Medication Safety Research Network of Indiana (Rx-SafeNet). Retail chain, independent, and hospital/health system outpatient community pharmacies throughout Indiana, with a total of 127 pharmacy members represented by 26 site coordinators. Rx-SafeNet, a statewide practice-based research network (PBRN) formed in 2010 and administered by the Purdue University College of Pharmacy. Barriers and facilitators to participation in available research studies, confidence participating in research, and satisfaction with overall network communication. 22 of 26 site coordinators participated, resulting in an 85% response rate. Most (72.2%) of the respondents had received a doctor of pharmacy degree, and 13.6% had postgraduate year (PGY)1 residency training. The highest reported benefits of PBRN membership were an enhanced relationship with the Purdue University College of Pharmacy (81% agreed or strongly agreed) and enhanced professional development (80% agreed or strongly agreed). Time constraints were identified as the greatest potential barrier to network participation, reported by 62% of respondents. In addition, the majority (59%) of survey respondents identified no prior research experience. Last, respondents' confidence in performing research appeared to increase substantially after becoming network members, with 43% reporting a lack of confidence in engaging in research before joining the network compared with 90% reporting confidence after joining the network. In general, Rx-SafeNet site coordinators appeared to experience increased confidence in research engagement after joining the network. While respondents identified a number of benefits associated with network participation, concerns about potential time constraints remained a key barrier to participation. These findings will assist network leadership in identifying opportunities to positively increase member participation in the future.

Longitudinal research and data collection in primary care.

PubMed

van Weel, Chris

2005-01-01

This article reviews examples of and experience with longitudinal research in family medicine. The objective is to use this empirical information to formulate recommendations for improving longitudinal research. The article discusses 3 longitudinal studies from the Nijmegen academic family practice research network: 1 on the prognosis of depression and 1 each on the prognosis of and outcomes of care for type 2 diabetes mellitus. The Nijmegen network has recorded all episodes of morbidity encountered in Dutch family medicine since 1971 in a stable practice population. This network's experience is evaluated to identify lessons that may help other practice-based research networks (PBRNs) in pursuing longitudinal research. In terms of external conditions (conditions related to the general setting), the stability of a population and a high level of continuity of care substantially enhance the ability to perform longitudinal research. In terms of internal conditions (conditions related to the PBRN), motivation of family physicians and their staff to conduct ongoing data collection, and their ownership of the data are key for success. Other critical internal conditions include standardization of data; collection of data by clinician-friendly means; training of family physicians and their staff in data collection, as well as meetings for discussion of this task; provision of feedback to practices on the research findings; use of standard procedures to promote adherence to data collection; availability of facilities for regular measurement of patients' health status or chart review; and use of mechanisms for tracking patients who leave the practice area. Insight from existing experience suggests that longitudinal research can be enhanced in PBRNs. The best way forward is to build longitudinal data collection by drawing on lessons from successful studies. Primary care research policy should advocate for a role of longitudinal research and stimulate its development in PBRNs under favorable population circumstances.

Identifying influencers from sampled social networks

NASA Astrophysics Data System (ADS)

Tsugawa, Sho; Kimura, Kazuma

2018-10-01

Identifying influencers who can spread information to many other individuals from a social network is a fundamental research task in the network science research field. Several measures for identifying influencers have been proposed, and the effectiveness of these influence measures has been evaluated for the case where the complete social network structure is known. However, it is difficult in practice to obtain the complete structure of a social network because of missing data, false data, or node/link sampling from the social network. In this paper, we investigate the effects of node sampling from a social network on the effectiveness of influence measures at identifying influencers. Our experimental results show that the negative effect of biased sampling, such as sample edge count, on the identification of influencers is generally small. For social media networks, we can identify influencers whose influence is comparable with that of those identified from the complete social networks by sampling only 10%-30% of the networks. Moreover, our results also suggest the possible benefit of network sampling in the identification of influencers. Our results show that, for some networks, nodes with higher influence can be discovered from sampled social networks than from complete social networks.

The relationship between waiting times and 'adherence' to the Scottish Intercollegiate Guidelines Network 98 guideline in autism spectrum disorder diagnostic services in Scotland.

PubMed

McKenzie, Karen; Forsyth, Kirsty; O'Hare, Anne; McClure, Iain; Rutherford, Marion; Murray, Aja; Irvine, Linda

2016-05-01

The aim of this study was to explore the extent to which the Scottish Intercollegiate Guidelines Network 98 guidelines on the assessment and diagnosis of autism spectrum disorder were adhered to in child autism spectrum disorder diagnostic services in Scotland and whether there was a significant relationship between routine practice which more closely reflected these recommendations (increased adherence) and increased waiting times. Retrospective, cross-sectional case note analysis was applied to data from 80 case notes. Adherence ranged from a possible 0 (no adherence) to 19 (full adherence). Overall, 17/22 of the recommendations were adhered to in over 50 of the 80 cases and in 70 or more cases for 11/22 of the recommendations, with a mean adherence score of 16 (standard deviation = 1.9). No significant correlation was found between adherence and total wait time for untransformed (r = 0.15, p = 0.32) or transformed data (r = 0.12, p = 0.20). The results indicated that the assessment and diagnostic practices were consistent with the relevant Scottish Intercollegiate Guidelines Network 98 guideline recommendations. Increased adherence to the 19 included recommendations was not significantly related to increased total waiting times, indicating that the Scottish Intercollegiate Guidelines Network 98 recommendations have generally been integrated into practice, without a resultant increase in patient waits. © The Author(s) 2015.

Family-centred care delivery: comparing models of primary care service delivery in Ontario.

PubMed

Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-11-01

To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Cross-sectional study. Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. A total of 137 practices, 363 providers, and 5144 patients. Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC.

Access to general practice for Pacific peoples: a place for cultural competency.

PubMed

Ludeke, Melissa; Puni, Ronald; Cook, Lynley; Pasene, Maria; Abel, Gillian; Sopoaga, Faafetai

2012-06-01

Access to primary health care services has been identified as a problem for Pacific peoples. Although cost is the most frequently cited barrier to Pacific service utilisation, some research has indicated that access may also be influenced by features of mainstream primary care services. This study aimed to identify features of mainstream general practice services that act as barriers to accessing these services for Pacific peoples in order to explore strategies that providers could adopt to enable their practices to be more welcoming, accessible and appropriate for Pacific peoples. Pacific participants were recruited through Pacific networks known to Pegasus Health and via 'snowball' sampling. In total, 20 participants participated in one of three focus groups. A semi-structured interview explored the participants' views and experiences of mainstream general practice care. Thematic analysis was utilised to interpret the data. The analysis revealed five themes highlighting non-financial features of mainstream general practice services that may influence the availability and acceptability of these services to Pacific peoples: language and communication; rushed consultations; appointment availability; reception; and Pacific presence. The findings indicate that all personnel within the primary care setting have the ability to directly engage in the improvement of the health status of Pacific peoples in New Zealand by developing cultural competency and incorporating flexibility and diversity into the care and service they provide.

Trends from the surveillance of suicidal behaviour by the Belgian Network of Sentinel General Practices over two decades: a retrospective observational study.

PubMed

Boffin, Nicole; Moreels, Sarah; Van Casteren, Viviane

2015-11-27

First, we describe trends in characteristics of suicidal events using new (2011-2012) and previous (1993-1995, 2000-2001 and 2007-2008) data reported by the Belgian Network of Sentinel General Practices (SGP); second, we examine patient age-related trends in on-site attendance of sentinel general practitioners (GPs) as first professional caregivers following suicidal behaviour; third, we investigate the accuracy of suicide incidence estimates derived from the SGP data. Retrospective observational study. General practices from the nationwide representative Belgian Network of SGP. Patient gender and age, suicide methods, whether the patient was new, whether the GP was the first caregiver on-site, and the outcome of the suicidal behaviour (fatal or not) were recorded on standard registration forms. The accuracy of suicide incidence estimates was tested against suicide mortality data. Over the four time periods, 1671 suicidal events were reported: 275 suicides, 1287 suicide attempts and 109 events of suicidal behaviour of unknown outcome. In 2011-2012, sentinel GPs' on-site attendance following the suicidal behaviour of patients <65 years had continued to decrease (from 71% in 1993-1995 to 58% in 2000-2001, 39% in 2007-2008 and 25% in 2011-2012). In 2011-2012, it had also decreased steeply in the population ≥65 years (from 70% in 1993-1995, 76% in 2000-2001 and 79% in 2007-2008 to 35% in 2011-2012). No significant differences were found between the SGP-based suicide incidence estimates for 2011-2012 and the available suicide mortality rates for people <65 and ≥65 years. GPs' on-site attendance as first professional caregivers following suicidal behaviour continues to decline since 2011-2012 also in the population ≥65 years. Unawareness of patients' suicidal behaviour endangers both care for surviving patients and the completeness of SGP surveillance data. Yet, the incidence of suicide for 2011-2012 was estimated accurately by the SGP. 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/

Structured data quality reports to improve EHR data quality.

PubMed

Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

2015-12-01

To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (p<0.01) over 12 months, but was not sufficient to comply with RACGP standards. Improvement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Primary care quality and safety systems in the English National Health Service: a case study of a new type of primary care provider.

PubMed

Baker, Richard; Willars, Janet; McNicol, Sarah; Dixon-Woods, Mary; McKee, Lorna

2014-01-01

Although the predominant model of general practice in the UK National Health Service (NHS) remains the small partnership owned and run by general practitioners (GPs), new types of provider are emerging. We sought to characterize the quality and safety systems and processes used in one large, privately owned company providing primary care through a chain of over 50 general practices in England. Senior staff with responsibility for policy on quality and safety were interviewed. We also undertook ethnographic observation in non-clinical areas and interviews with staff in three practices. A small senior executive team set policy and strategy on quality and safety, including a systematic incident reporting and investigation system and processes for disseminating learning with a strong emphasis on customer focus. Standardization of systems was possible because of the large number of practices. Policies appeared generally well implemented at practice level. However, there was some evidence of high staff turnover, particularly of GPs. This caused problems for continuity of care and challenges in inducting new GPs in the company's systems and procedures. A model of primary care delivery based on a corporate chain may be useful in standardizing policies and procedures, facilitating implementation of systems, and relieving clinical staff of administrative duties. However, the model also poses some risks, including those relating to stability. Provider forms that retain the long term, personal commitment of staff to their practices, such as federations or networks, should also be investigated; they may offer the benefits of a corporate chain combined with the greater continuity and stability of the more traditional general practice.

Increasing research capacity and changing the culture of primary care towards reflective inquiring practice: the experience of the West London Research Network (WeLReN).

PubMed

Thomas, P; While, A

2001-05-01

A number of primary care research networks were set up throughout England in 1998 in order to (1) improve the quality of primary care research (2) increase the research capacity of primary care, and (3) change the culture of primary care towards reflective inquiring practice (NHSE, 2000b). It is not clear how best to operate a network to achieve these diverse aims. This paper describes the first 30 months of a network that adopted a whole system approach in the belief that this would offer the best chance of simultaneously achieving the three aims. A cycle of activity was designed to facilitate the formation of multidisciplinary coalitions of interest for research with complementary 'top down' and 'bottom up' programmes of work co-existing. At least 330 people participated in the generation of research questions of whom one third (33%) were general practitioners, 16% community nurses, 6% practice managers and other primary care practitioners. Over two fifths (43%) were 'key allies'--academics, health authority staff, community workers and project workers. One fifth (110) of all practices (500) in the WeLReN area have collaborated in at least one research project. The ratio of doctor:nurse participation in the 24 research project teams was markedly different in the supported coalitions (2:1) compared to projects devised and led by more experienced researchers (6:1). The evidence suggests that it is possible to operate a primary care research network in a way that develops coalitions of interest from different parts of the health care system as well as both 'top down' and 'bottom up' led projects. It is too early to tell if the approach will be able to achieve its aims in the long-term but the activity data are encouraging. There is a need for more research on the theoretical basis of network operation.

[Datanet 1 and the convergence of the computer and telecommunications].

PubMed

de Wit, Onno

2008-01-01

This article describes the efforts of the Dutch national company for telecommunication, PTT, in introducing and developing a public network for data communication in the Netherlands in the last decades of the twentieth century. As early as the 1960s, private companies started to connect their local computers. As a result, small private computer networks started to emerge. As the state company offering general access to public services in telephony, the PTT strove to develop a public data network, accessible to every user and telephone subscriber. This ambition was realized with Datanet 1, the public data network which was officially opened in 1982. In the years that followed, Datanet became the dominant network for data transmission, despite competing efforts by private companies and computer manufacturers. The large-scale application of Datanet in public municipal administration serves as a case study for the development of data communication in practice, that shows that there was a gradual migration from X-25 to TCP/IP protocols. The article concludes by stating that the introduction and development of data transmission transformed the role of the PTT in Dutch society, brought new working practices, new services and new responsibilities, and resulted in a whole new phase in the history of the computer.

New tools for an old trade: a socio-technical appraisal of how electronic decision support is used by primary care practitioners.

PubMed

Peiris, David; Usherwood, Tim; Weeramanthri, Tarun; Cass, Alan; Patel, Anushka

2011-11-01

This article explores Australian general practitioners' (GPs) views on a novel electronic decision support (EDS) tool being developed for cardiovascular disease management. We use Timmermans and Berg's technology-in-practice approach to examine how technologies influence and are influenced by the social networks in which they are placed. In all, 21 general practitioners who piloted the tool were interviewed. The tool occupied an ill-defined middle ground in a dialectical relationship between GPs' routine care and factors promoting best practice. Drawing on Lipsky's concept of 'street-level bureaucrats', the tool's ability to process workloads expeditiously was of greatest appeal to GPs. This feature of the tool gave it the potential to alter the structure, process and content of healthcare encounters. The credibility of EDS tools appears to be mediated by fluid notions of best practice, based on an expert scrutiny of the evidence, synthesis via authoritative guidelines and dissemination through trusted and often informal networks. Balanced against this is the importance of 'soft' forms of knowledge such as intuition and timing in everyday decision-making. This resonates with Aristotle's theory of phronesis (practical wisdom) and may render EDS tools inconsequential if they merely process biomedical data. While EDS tools show promise in improving health practitioner performance, the socio-technical dimensions of their implementation warrant careful consideration. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Nourishing networks: A social-ecological analysis of a network intervention for improving household nutrition in Western Kenya.

PubMed

DeLorme, Autumn L; Gavenus, Erika R; Salmen, Charles R; Benard, Gor Ouma; Mattah, Brian; Bukusi, Elizabeth; Fiorella, Kathryn J

2018-01-01

A growing body of research emphasizes the need to engage social networks in maternal and child nutrition interventions. However, an understanding of how interventions functionally engage not only mothers but fathers, grandparents, friends, and other social network members remains limited. This study uses an adaptation of a social-ecological model to analyze the multiple levels at which the Kanyakla Nutrition Program operates to change behavior. This study analyzes focus group data (four groups; n = 35, 7 men and 28 women) following the implementation of the Kanyakla Nutrition Program, a novel nutrition intervention engaging social networks to increase nutrition knowledge, shift perceptions, and promote positive practices for infant and young child feeding and community nutrition in general. Participant perspectives indicate that the Kanyakla Nutrition Program contributed to nutrition knowledge and confidence, changed perceptions, and supported infant and child feeding practices at the individual, interpersonal, and institutional levels. However, many respondents report challenges in transcending barriers at the broader community and systems levels of influence, where environmental and economic constraints continue to affect food access. Analysis of the Kanyakla Nutrition Program suggests that for interventions addressing household level determinants of nutrition, simultaneously engaging the household's network of interpersonal and community relationships can play a role in building momentum and consensus to address persistent structural barriers to improved nutrition. Copyright © 2017 Elsevier Ltd. All rights reserved.

RRAM-based hardware implementations of artificial neural networks: progress update and challenges ahead

NASA Astrophysics Data System (ADS)

Prezioso, M.; Merrikh-Bayat, F.; Chakrabarti, B.; Strukov, D.

2016-02-01

Artificial neural networks have been receiving increasing attention due to their superior performance in many information processing tasks. Typically, scaling up the size of the network results in better performance and richer functionality. However, large neural networks are challenging to implement in software and customized hardware are generally required for their practical implementations. In this work, we will discuss our group's recent efforts on the development of such custom hardware circuits, based on hybrid CMOS/memristor circuits, in particular of CMOL variety. We will start by reviewing the basics of memristive devices and of CMOL circuits. We will then discuss our recent progress towards demonstration of hybrid circuits, focusing on the experimental and theoretical results for artificial neural networks based on crossbarintegrated metal oxide memristors. We will conclude presentation with the discussion of the remaining challenges and the most pressing research needs.

[A network of LIFE projects to promote the transfer and exchange of knowledge on environment and health].

PubMed

Cori, Liliana; Carducci, Annalaura; Donzelli, Gabriele; La Rocca, Cinzia; Bianchi, Fabrizio

2018-01-01

Eleven projects within the LIFE programme (through which the Directorate-General for Environment of the European Commission provides funding for projects aim at protecting environment and nature) addressing environmental-health-related issues have been involved in a collaborative network called KTE LIFE EnvHealth Network. The shared issues tackled by that projects are knowledge transfer and exchange (KTE). The objective of the LIFE programme is to support the implementation of the environmental legislation in the European Union, to provide new tools and knowledge that will help to better protect both the territory and the communities. Transferring knowledge to decision makers, at the appropriate and effective level, is therefore a central function of the projects. The Network promotes national and international networking, which intends to involve other projects, to provide methodological support, to make information and successful practices circulate, with the aim of multiplying the energies of each project involved.

Diagnostic layer integration in FPGA-based pipeline measurement systems for HEP experiments

NASA Astrophysics Data System (ADS)

Pozniak, Krzysztof T.

2007-08-01

Integrated triggering and data acquisition systems for high energy physics experiments may be considered as fast, multichannel, synchronous, distributed, pipeline measurement systems. A considerable extension of functional, technological and monitoring demands, which has recently been imposed on them, forced a common usage of large field-programmable gate array (FPGA), digital signal processing-enhanced matrices and fast optical transmission for their realization. This paper discusses modelling, design, realization and testing of pipeline measurement systems. A distribution of synchronous data stream flows is considered in the network. A general functional structure of a single network node is presented. A suggested, novel block structure of the node model facilitates full implementation in the FPGA chip, circuit standardization and parametrization, as well as integration of functional and diagnostic layers. A general method for pipeline system design was derived. This method is based on a unified model of the synchronous data network node. A few examples of practically realized, FPGA-based, pipeline measurement systems were presented. The described systems were applied in ZEUS and CMS.

A large-scale study of a poultry trading network in Bangladesh: implications for control and surveillance of avian influenza viruses.

PubMed

Moyen, N; Ahmed, G; Gupta, S; Tenzin, T; Khan, R; Khan, T; Debnath, N; Yamage, M; Pfeiffer, D U; Fournie, G

2018-01-12

Since its first report in 2007, avian influenza (AI) has been endemic in Bangladesh. While live poultry marketing is widespread throughout the country and known to influence AI dissemination and persistence, trading patterns have not been described. The aim of this study is to assess poultry trading practices and features of the poultry trading networks which could promote AI spread, and their potential implications for disease control and surveillance. Data on poultry trading practices was collected from 849 poultry traders during a cross-sectional survey in 138 live bird markets (LBMs) across 17 different districts of Bangladesh. The quantity and origins of traded poultry were assessed for each poultry type in surveyed LBMs. The network of contacts between farms and LBMs resulting from commercial movements of live poultry was constructed to assess its connectivity and to identify the key premises influencing it. Poultry trading practices varied according to the size of the LBMs and to the type of poultry traded. Industrial broiler chickens, the most commonly traded poultry, were generally sold in LBMs close to their production areas, whereas ducks and backyard chickens were moved over longer distances, and their transport involved several intermediates. The poultry trading network composed of 445 nodes (73.2% were LBMs) was highly connected and disassortative. However, the removal of only 5.6% of the nodes (25 LBMs with the highest betweenness scores), reduced the network's connectedness, and the maximum size of output and input domains by more than 50%. Poultry types need to be discriminated in order to understand the way in which poultry trading networks are shaped, and the level of risk of disease spread that these networks may promote. Knowledge of the network structure could be used to target control and surveillance interventions to a small number of LBMs.

Primary healthcare solo practices: homogeneous or heterogeneous?

PubMed

Pineault, Raynald; Borgès Da Silva, Roxane; Provost, Sylvie; Beaulieu, Marie-Dominique; Boivin, Antoine; Couture, Audrey; Prud'homme, Alexandre

2014-01-01

Introduction. Solo practices have generally been viewed as forming a homogeneous group. However, they may differ on many characteristics. The objective of this paper is to identify different forms of solo practice and to determine the extent to which they are associated with patient experience of care. Methods. Two surveys were carried out in two regions of Quebec in 2010: a telephone survey of 9180 respondents from the general population and a postal survey of 606 primary healthcare (PHC) practices. Data from the two surveys were linked through the respondent's usual source of care. A taxonomy of solo practices was constructed (n = 213), using cluster analysis techniques. Bivariate and multilevel analyses were used to determine the relationship of the taxonomy with patient experience of care. Results. Four models were derived from the taxonomy. Practices in the "resourceful networked" model contrast with those of the "resourceless isolated" model to the extent that the experience of care reported by their patients is more favorable. Conclusion. Solo practice is not a homogeneous group. The four models identified have different organizational features and their patients' experience of care also differs. Some models seem to offer a better organizational potential in the context of current reforms.

Constrained target controllability of complex networks

NASA Astrophysics Data System (ADS)

Guo, Wei-Feng; Zhang, Shao-Wu; Wei, Ze-Gang; Zeng, Tao; Liu, Fei; Zhang, Jingsong; Wu, Fang-Xiang; Chen, Luonan

2017-06-01

It is of great theoretical interest and practical significance to study how to control a system by applying perturbations to only a few driver nodes. Recently, a hot topic of modern network researches is how to determine driver nodes that allow the control of an entire network. However, in practice, to control a complex network, especially a biological network, one may know not only the set of nodes which need to be controlled (i.e. target nodes), but also the set of nodes to which only control signals can be applied (i.e. constrained control nodes). Compared to the general concept of controllability, we introduce the concept of constrained target controllability (CTC) of complex networks, which concerns the ability to drive any state of target nodes to their desirable state by applying control signals to the driver nodes from the set of constrained control nodes. To efficiently investigate the CTC of complex networks, we further design a novel graph-theoretic algorithm called CTCA to estimate the ability of a given network to control targets by choosing driver nodes from the set of constrained control nodes. We extensively evaluate the CTC of numerous real complex networks. The results indicate that biological networks with a higher average degree are easier to control than biological networks with a lower average degree, while electronic networks with a lower average degree are easier to control than web networks with a higher average degree. We also show that our CTCA can more efficiently produce driver nodes for target-controlling the networks than existing state-of-the-art methods. Moreover, we use our CTCA to analyze two expert-curated bio-molecular networks and compare to other state-of-the-art methods. The results illustrate that our CTCA can efficiently identify proven drug targets and new potentials, according to the constrained controllability of those biological networks.

Use of Online Sources of Information by Dental Practitioners: Findings from The Dental Practice-Based Research Network

PubMed Central

Funkhouser, Ellen; Agee, Bonita S.; Gordan, Valeria V.; Rindal, D. Brad; Fellows, Jeffrey L.; Qvist, Vibeke; McClelland, Jocelyn; Gilbert, Gregg H.

2013-01-01

Objectives Estimate the proportion of dental practitioners who use online sources of information for practice guidance. Methods From a survey of 657 dental practitioners in The Dental Practice Based Research Network, four indicators of online use for practice guidance were calculated: read journals online, obtained continuing education (CDE) through online sources, rated an online source as most influential, and reported frequently using an online source for guidance. Demographics, journals read, and use of various sources of information for practice guidance in terms of frequency and influence were ascertained for each. Results Overall, 21% (n=138) were classified into one of the four indicators of online use: 14% (n=89) rated an online source as most influential and 13% (n=87) reported frequently using an online source for guidance; few practitioners (5%, n=34) read journals online, fewer (3%, n=17) obtained CDE through online sources. Use of online information sources varied considerably by region and practice characteristics. In general, the 4 indicators represented practitioners with as many differences as similarities to each other and to offline users. Conclusion A relatively small proportion of dental practitioners use information from online sources for practice guidance. Variation exists regarding practitioners’ use of online source resources and how they rate the value of offline information sources for practice guidance. PMID:22994848

Research on NGN network control technology

NASA Astrophysics Data System (ADS)

Li, WenYao; Zhou, Fang; Wu, JianXue; Li, ZhiGuang

2004-04-01

Nowadays NGN (Next Generation Network) is the hotspot for discussion and research in IT section. The NGN core technology is the network control technology. The key goal of NGN is to realize the network convergence and evolution. Referring to overlay network model core on Softswitch technology, circuit switch network and IP network convergence realized. Referring to the optical transmission network core on ASTN/ASON, service layer (i.e. IP layer) and optical transmission convergence realized. Together with the distributing feature of NGN network control technology, on NGN platform, overview of combining Softswitch and ASTN/ASON control technology, the solution whether IP should be the NGN core carrier platform attracts general attention, and this is also a QoS problem on NGN end to end. This solution produces the significant practical meaning on equipment development, network deployment, network design and optimization, especially on realizing present network smooth evolving to the NGN. This is why this paper puts forward the research topic on the NGN network control technology. This paper introduces basics on NGN network control technology, then proposes NGN network control reference model, at the same time describes a realizable network structure of NGN. Based on above, from the view of function realization, NGN network control technology is discussed and its work mechanism is analyzed.

Building Professional Learning Communities in Special Education through Social Networking: Directions for Future Research

ERIC Educational Resources Information Center

Hardman, Elizabeth L.

2011-01-01

This paper examines the challenges inherent in building professional learning communities (PLCs) in special education and describes how two Web 2.0 tools were used to build a community that engages general and special education teachers, school administrators, and teacher educators in implementing research based inclusive practices that are known…

Benefits of Including a Capstone Simulation Course in Community College Business Curricula.

ERIC Educational Resources Information Center

Black, William L.

This article makes an argument for including a capstone, or end-of-term, business simulation course in community college business curricula. The International Business Practice Firm (IBPF), a worldwide virtual business network, is proposed as a foundation for such a course. The author argues that, in general, graduates of college business programs…

Four sexually transmitted infections (STIs) in Belgian general practice: first results (2013-2014) of a nationwide continuing surveillance study.

PubMed

Boffin, N; Moreels, S; Deblonde, J; Van Casteren, V

2017-01-27

To describe and explore data from the surveillance of chlamydia, syphilis, gonorrhoea and genital warts by the Belgian Network of Sentinel General Practices (SGP) over the first 2 years (2013 and 2014) and to estimate the incidence of these 4 sexually transmitted infections (STIs). A special focus is put on data quality. Retrospective observational study. General practices from the nationwide representative SGP network. Agreement between data distributions by year, agreement between SGP-based incidence and incidence based on mandatory notification, missingness of patient age or gender and incompleteness of sexual risk history of patients. 306 new STI episodes were reported from 298 patients, corresponding with an episode-based incidence of 91.9/100 000 (95% CI 81.9 to 102.8) general practice patients, with almost half of it due to chlamydia. The incidence of chlamydia in men was significantly higher in 2014 than in 2013. Population characteristics were similarly distributed in 2013 and 2014. The SGP-based incidence of gonorrhoea and syphilis in Flanders were in agreement with the incidence based on mandatory notification of cases. Patient age or gender was missing from 35 episodes (11.4%). Independent determinants of missingness of patient age or gender were the Flemish region (OR 3.46; 95% CI 1.02 to 11.73) and genital warts infection (OR 2.23; 95% CI 1.07 to 4.63). An incomplete sexual risk history was reported for 54.6% STI episodes. The odds for an incomplete sexual history were higher for older patients (OR 1.72; 95% CI 1.06 to 2.76) and for patients infected with syphilis, gonorrhoea or co-infection(s) (OR 1.71; 95% CI 1.03 to 2.83). Incompleteness of reports about patients with STI sexual risk histories is important from the perspective of quality of data and of quality of care. Together with the low rates of both HIV testing and discussion of partner notification, this suggests that a general practice guideline is needed. 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/.

A general modeling framework for describing spatially structured population dynamics

USGS Publications Warehouse

Sample, Christine; Fryxell, John; Bieri, Joanna; Federico, Paula; Earl, Julia; Wiederholt, Ruscena; Mattsson, Brady; Flockhart, Tyler; Nicol, Sam; Diffendorfer, James E.; Thogmartin, Wayne E.; Erickson, Richard A.; Norris, D. Ryan

2017-01-01

Variation in movement across time and space fundamentally shapes the abundance and distribution of populations. Although a variety of approaches model structured population dynamics, they are limited to specific types of spatially structured populations and lack a unifying framework. Here, we propose a unified network-based framework sufficiently novel in its flexibility to capture a wide variety of spatiotemporal processes including metapopulations and a range of migratory patterns. It can accommodate different kinds of age structures, forms of population growth, dispersal, nomadism and migration, and alternative life-history strategies. Our objective was to link three general elements common to all spatially structured populations (space, time and movement) under a single mathematical framework. To do this, we adopt a network modeling approach. The spatial structure of a population is represented by a weighted and directed network. Each node and each edge has a set of attributes which vary through time. The dynamics of our network-based population is modeled with discrete time steps. Using both theoretical and real-world examples, we show how common elements recur across species with disparate movement strategies and how they can be combined under a unified mathematical framework. We illustrate how metapopulations, various migratory patterns, and nomadism can be represented with this modeling approach. We also apply our network-based framework to four organisms spanning a wide range of life histories, movement patterns, and carrying capacities. General computer code to implement our framework is provided, which can be applied to almost any spatially structured population. This framework contributes to our theoretical understanding of population dynamics and has practical management applications, including understanding the impact of perturbations on population size, distribution, and movement patterns. By working within a common framework, there is less chance that comparative analyses are colored by model details rather than general principles

APINetworks: A general API for the treatment of complex networks in arbitrary computational environments

NASA Astrophysics Data System (ADS)

Niño, Alfonso; Muñoz-Caro, Camelia; Reyes, Sebastián

2015-11-01

The last decade witnessed a great development of the structural and dynamic study of complex systems described as a network of elements. Therefore, systems can be described as a set of, possibly, heterogeneous entities or agents (the network nodes) interacting in, possibly, different ways (defining the network edges). In this context, it is of practical interest to model and handle not only static and homogeneous networks but also dynamic, heterogeneous ones. Depending on the size and type of the problem, these networks may require different computational approaches involving sequential, parallel or distributed systems with or without the use of disk-based data structures. In this work, we develop an Application Programming Interface (APINetworks) for the modeling and treatment of general networks in arbitrary computational environments. To minimize dependency between components, we decouple the network structure from its function using different packages for grouping sets of related tasks. The structural package, the one in charge of building and handling the network structure, is the core element of the system. In this work, we focus in this API structural component. We apply an object-oriented approach that makes use of inheritance and polymorphism. In this way, we can model static and dynamic networks with heterogeneous elements in the nodes and heterogeneous interactions in the edges. In addition, this approach permits a unified treatment of different computational environments. Tests performed on a C++11 version of the structural package show that, on current standard computers, the system can handle, in main memory, directed and undirected linear networks formed by tens of millions of nodes and edges. Our results compare favorably to those of existing tools.

Disease Surveillance on Complex Social Networks.

PubMed

Herrera, Jose L; Srinivasan, Ravi; Brownstein, John S; Galvani, Alison P; Meyers, Lauren Ancel

2016-07-01

As infectious disease surveillance systems expand to include digital, crowd-sourced, and social network data, public health agencies are gaining unprecedented access to high-resolution data and have an opportunity to selectively monitor informative individuals. Contact networks, which are the webs of interaction through which diseases spread, determine whether and when individuals become infected, and thus who might serve as early and accurate surveillance sensors. Here, we evaluate three strategies for selecting sensors-sampling the most connected, random, and friends of random individuals-in three complex social networks-a simple scale-free network, an empirical Venezuelan college student network, and an empirical Montreal wireless hotspot usage network. Across five different surveillance goals-early and accurate detection of epidemic emergence and peak, and general situational awareness-we find that the optimal choice of sensors depends on the public health goal, the underlying network and the reproduction number of the disease (R0). For diseases with a low R0, the most connected individuals provide the earliest and most accurate information about both the onset and peak of an outbreak. However, identifying network hubs is often impractical, and they can be misleading if monitored for general situational awareness, if the underlying network has significant community structure, or if R0 is high or unknown. Taking a theoretical approach, we also derive the optimal surveillance system for early outbreak detection but find that real-world identification of such sensors would be nearly impossible. By contrast, the friends-of-random strategy offers a more practical and robust alternative. It can be readily implemented without prior knowledge of the network, and by identifying sensors with higher than average, but not the highest, epidemiological risk, it provides reasonably early and accurate information.

Inferring causal molecular networks: empirical assessment through a community-based effort

PubMed Central

Hill, Steven M.; Heiser, Laura M.; Cokelaer, Thomas; Unger, Michael; Nesser, Nicole K.; Carlin, Daniel E.; Zhang, Yang; Sokolov, Artem; Paull, Evan O.; Wong, Chris K.; Graim, Kiley; Bivol, Adrian; Wang, Haizhou; Zhu, Fan; Afsari, Bahman; Danilova, Ludmila V.; Favorov, Alexander V.; Lee, Wai Shing; Taylor, Dane; Hu, Chenyue W.; Long, Byron L.; Noren, David P.; Bisberg, Alexander J.; Mills, Gordon B.; Gray, Joe W.; Kellen, Michael; Norman, Thea; Friend, Stephen; Qutub, Amina A.; Fertig, Elana J.; Guan, Yuanfang; Song, Mingzhou; Stuart, Joshua M.; Spellman, Paul T.; Koeppl, Heinz; Stolovitzky, Gustavo; Saez-Rodriguez, Julio; Mukherjee, Sach

2016-01-01

Inferring molecular networks is a central challenge in computational biology. However, it has remained unclear whether causal, rather than merely correlational, relationships can be effectively inferred in complex biological settings. Here we describe the HPN-DREAM network inference challenge that focused on learning causal influences in signaling networks. We used phosphoprotein data from cancer cell lines as well as in silico data from a nonlinear dynamical model. Using the phosphoprotein data, we scored more than 2,000 networks submitted by challenge participants. The networks spanned 32 biological contexts and were scored in terms of causal validity with respect to unseen interventional data. A number of approaches were effective and incorporating known biology was generally advantageous. Additional sub-challenges considered time-course prediction and visualization. Our results constitute the most comprehensive assessment of causal network inference in a mammalian setting carried out to date and suggest that learning causal relationships may be feasible in complex settings such as disease states. Furthermore, our scoring approach provides a practical way to empirically assess the causal validity of inferred molecular networks. PMID:26901648

Using RDF to Model the Structure and Process of Systems

NASA Astrophysics Data System (ADS)

Rodriguez, Marko A.; Watkins, Jennifer H.; Bollen, Johan; Gershenson, Carlos

Many systems can be described in terms of networks of discrete elements and their various relationships to one another. A semantic network, or multi-relational network, is a directed labeled graph consisting of a heterogeneous set of entities connected by a heterogeneous set of relationships. Semantic networks serve as a promising general-purpose modeling substrate for complex systems. Various standardized formats and tools are now available to support practical, large-scale semantic network models. First, the Resource Description Framework (RDF) offers a standardized semantic network data model that can be further formalized by ontology modeling languages such as RDF Schema (RDFS) and the Web Ontology Language (OWL). Second, the recent introduction of highly performant triple-stores (i.e. semantic network databases) allows semantic network models on the order of 109 edges to be efficiently stored and manipulated. RDF and its related technologies are currently used extensively in the domains of computer science, digital library science, and the biological sciences. This article will provide an introduction to RDF/RDFS/OWL and an examination of its suitability to model discrete element complex systems.

Artificial neural networks applied to forecasting time series.

PubMed

Montaño Moreno, Juan J; Palmer Pol, Alfonso; Muñoz Gracia, Pilar

2011-04-01

This study offers a description and comparison of the main models of Artificial Neural Networks (ANN) which have proved to be useful in time series forecasting, and also a standard procedure for the practical application of ANN in this type of task. The Multilayer Perceptron (MLP), Radial Base Function (RBF), Generalized Regression Neural Network (GRNN), and Recurrent Neural Network (RNN) models are analyzed. With this aim in mind, we use a time series made up of 244 time points. A comparative study establishes that the error made by the four neural network models analyzed is less than 10%. In accordance with the interpretation criteria of this performance, it can be concluded that the neural network models show a close fit regarding their forecasting capacity. The model with the best performance is the RBF, followed by the RNN and MLP. The GRNN model is the one with the worst performance. Finally, we analyze the advantages and limitations of ANN, the possible solutions to these limitations, and provide an orientation towards future research.

47 CFR 73.658 - Affiliation agreements and network program practices; territorial exclusivity in non-network...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Affiliation agreements and network program practices; territorial exclusivity in non-network program arrangements. 73.658 Section 73.658... Television Broadcast Stations § 73.658 Affiliation agreements and network program practices; territorial...

47 CFR 73.658 - Affiliation agreements and network program practices; territorial exclusivity in non-network...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Affiliation agreements and network program practices; territorial exclusivity in non-network program arrangements. 73.658 Section 73.658... Television Broadcast Stations § 73.658 Affiliation agreements and network program practices; territorial...

47 CFR 73.658 - Affiliation agreements and network program practices; territorial exclusivity in non-network...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 4 2012-10-01 2012-10-01 false Affiliation agreements and network program practices; territorial exclusivity in non-network program arrangements. 73.658 Section 73.658... Television Broadcast Stations § 73.658 Affiliation agreements and network program practices; territorial...

47 CFR 73.658 - Affiliation agreements and network program practices; territorial exclusivity in non-network...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 4 2014-10-01 2014-10-01 false Affiliation agreements and network program practices; territorial exclusivity in non-network program arrangements. 73.658 Section 73.658... Television Broadcast Stations § 73.658 Affiliation agreements and network program practices; territorial...

47 CFR 73.658 - Affiliation agreements and network program practices; territorial exclusivity in non-network...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 4 2013-10-01 2013-10-01 false Affiliation agreements and network program practices; territorial exclusivity in non-network program arrangements. 73.658 Section 73.658... Television Broadcast Stations § 73.658 Affiliation agreements and network program practices; territorial...

Low Dose Isoflurane Exerts Opposing Effects on Neuronal Network Excitability in Neocortex and Hippocampus

PubMed Central

Ranft, Andreas; von Meyer, Ludwig; Zieglgänsberger, Walter; Kochs, Eberhard; Dodt, Hans-Ulrich

2012-01-01

The anesthetic excitement phase occurring during induction of anesthesia with volatile anesthetics is a well-known phenomenon in clinical practice. However, the physiological mechanisms underlying anesthetic-induced excitation are still unclear. Here we provide evidence from in vitro experiments performed on rat brain slices that the general anesthetic isoflurane at a concentration of about 0.1 mM can enhance neuronal network excitability in the hippocampus, while simultaneously reducing it in the neocortex. In contrast, isoflurane tissue concentrations above 0.3 mM expectedly caused a pronounced reduction in both brain regions. Neuronal network excitability was assessed by combining simultaneous multisite stimulation via a multielectrode array with recording intrinsic optical signals as a measure of neuronal population activity. PMID:22723999

Family-centred care delivery

PubMed Central

Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

2013-01-01

Abstract Objective To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Design Cross-sectional study. Setting Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. Participants A total of 137 practices, 363 providers, and 5144 patients. Main outcome measures Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Results Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Conclusion Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC. PMID:24235195

Microfluidic System Simulation Including the Electro-Viscous Effect

NASA Technical Reports Server (NTRS)

Rojas, Eileen; Chen, C. P.; Majumdar, Alok

2007-01-01

This paper describes a practical approach using a general purpose lumped-parameter computer program, GFSSP (Generalized Fluid System Simulation Program) for calculating flow distribution in a network of micro-channels including electro-viscous effects due to the existence of electrical double layer (EDL). In this study, an empirical formulation for calculating an effective viscosity of ionic solutions based on dimensional analysis is described to account for surface charge and bulk fluid conductivity, which give rise to electro-viscous effect in microfluidics network. Two dimensional slit micro flow data was used to determine the model coefficients. Geometry effect is then included through a Poiseuille number correlation in GFSSP. The bi-power model was used to calculate flow distribution of isotropically etched straight channel and T-junction microflows involving ionic solutions. Performance of the proposed model is assessed against experimental test data.

Disease Surveillance on Complex Social Networks

PubMed Central

Herrera, Jose L.; Srinivasan, Ravi; Brownstein, John S.; Galvani, Alison P.; Meyers, Lauren Ancel

2016-01-01

As infectious disease surveillance systems expand to include digital, crowd-sourced, and social network data, public health agencies are gaining unprecedented access to high-resolution data and have an opportunity to selectively monitor informative individuals. Contact networks, which are the webs of interaction through which diseases spread, determine whether and when individuals become infected, and thus who might serve as early and accurate surveillance sensors. Here, we evaluate three strategies for selecting sensors—sampling the most connected, random, and friends of random individuals—in three complex social networks—a simple scale-free network, an empirical Venezuelan college student network, and an empirical Montreal wireless hotspot usage network. Across five different surveillance goals—early and accurate detection of epidemic emergence and peak, and general situational awareness—we find that the optimal choice of sensors depends on the public health goal, the underlying network and the reproduction number of the disease (R0). For diseases with a low R0, the most connected individuals provide the earliest and most accurate information about both the onset and peak of an outbreak. However, identifying network hubs is often impractical, and they can be misleading if monitored for general situational awareness, if the underlying network has significant community structure, or if R0 is high or unknown. Taking a theoretical approach, we also derive the optimal surveillance system for early outbreak detection but find that real-world identification of such sensors would be nearly impossible. By contrast, the friends-of-random strategy offers a more practical and robust alternative. It can be readily implemented without prior knowledge of the network, and by identifying sensors with higher than average, but not the highest, epidemiological risk, it provides reasonably early and accurate information. PMID:27415615

[Linking: relationships between health professionals in the informal health networks].

PubMed

Sarradon-Eck, A; Vega, A; Faure, M; Humbert-Gaudart, A; Lustman, M

2008-07-01

During the last years, the french health system has been developing formal health networks. So, it was necessary to study informal health networks as networks. More precisely, we studied the nature of relationships between various stakeholders around general practionners wich are commonly considering as the stakeholder of the health system private sector. Fieldwork (ethnography based on direct observations and interviews) was conducted between October 2002 and april 2004, in the South-East of France. Ten monographs of general practioner's offices were achieved in a rural area; then, we achieved fieldwork of the informal health networks identified. There is a cultural frame wich is common to all private professionals. This frame includes a triple ideal (teamwork built up the hospital model, independance, and an relational approach with patients). This frame does not square with the real practices. In fact, regulation mechanisms preserve the balance of relashionships between professionnal groups, by restricting/promoting exchanges and complex alliance strategies. These mecanisms include: (1) a few professionnal's rule as disponibility (to the patients and to the professionnals), as communication about patient, as patient's reference, as obligation to communicate between professionals; (2) some constraints such as territory superposition and competition with other professional groups; (3) some needs for: rileiving (of emotions and worries connected to work), sharing (decisions, responsabilities), of delegation (medical treatment, practices), protection against social and legal risk through the creation of trust relationships. These trust relationships are based on several logics (affinity, solidarity, similarity). The study shows the major place of the patient who is often the main organizer of his network, and even though he makes an important structuring work between medical staff, and an information transfer (on his diagnosis, on his treatment, and < on > professionals). The patient's role of is underestimated. The results show that in studied informal networks, professionnals do not have a transversal view of the patient's care management. This is due to the lack of knowledge of each health agent about the work of others, to the symbolic compartmentalization between professional groups, and because the difficulties encountered (i.e. burden work).

CareTrack Kids—part 3. Adverse events in children's healthcare in Australia: study protocol for a retrospective medical record review

PubMed Central

Hibbert, Peter D; Hallahan, Andrew R; Muething, Stephen E; Lachman, Peter; Hooper, Tamara D; Wiles, Louise K; Jaffe, Adam; White, Les; Wheaton, Gavin R; Runciman, William B; Dalton, Sarah; Williams, Helena M; Braithwaite, Jeffrey

2015-01-01

Introduction A high-quality health system should deliver care that is free from harm. Few large-scale studies of adverse events have been undertaken in children's healthcare internationally, and none in Australia. The aim of this study is to measure the frequency and types of adverse events encountered in Australian paediatric care in a range of healthcare settings. Methods and analysis A form of retrospective medical record review, the Institute of Healthcare Improvement's Global Trigger Tool, will be modified to collect data. Records of children aged <16 years managed during 2012 and 2013 will be reviewed. We aim to review 6000–8000 records from a sample of healthcare practices (hospitals, general practices and specialists). Ethics and dissemination Human Research Ethics Committee approvals have been received from the Sydney Children's Hospital Network, Children's Health Queensland Hospital and Health Service, and the Women's and Children's Hospital Network in South Australia. An application is under review with the Royal Australian College of General Practitioners. The authors will submit the results of the study to relevant journals and undertake national and international oral presentations to researchers, clinicians and policymakers. PMID:25854978

Preliminary Evidence for the Emergence of a Health Care Online Community of Practice: Using a Netnographic Framework for Twitter Hashtag Analytics.

PubMed

Roland, Damian; Spurr, Jesse; Cabrera, Daniel

2017-07-14

Online communities of practice (oCoPs) may emerge from interactions on social media. These communities offer an open digital space and flat role hierarchy for information sharing and provide a strong group identity, rapid flow of information, content curation, and knowledge translation. To date, there is only a small body of evidence in medicine or health care to verify the existence of an oCoP. We aimed to examine the emergence of an oCoP through the study of social media interactions of the free open access medical education (FOAM) movement. We examined social media activity in Twitter by analyzing the network centrality metrics of tweets with the #FOAMed hashtag and compared them with previously validated criteria of a community of practice (CoP). The centrality analytics of the FOAM community showed concordance with aspects of a general CoP (in terms of community, domain, and practice), as well as some specific traits of a health care community, including social control, common purpose, flat hierarchy, and network-based and concrete achievement. This study demonstrated preliminary evidence of an oCoP focused on education and based on social media interactions. Further examination of the topology of the network is needed to definitely prove the existence of an oCoP. Given that these communities result in significant knowledge translation and practice change, further research in this area appears warranted. ©Damian Roland, Jesse Spurr, Daniel Cabrera. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 14.07.2017.

A novel algorithm for finding optimal driver nodes to target control complex networks and its applications for drug targets identification.

PubMed

Guo, Wei-Feng; Zhang, Shao-Wu; Shi, Qian-Qian; Zhang, Cheng-Ming; Zeng, Tao; Chen, Luonan

2018-01-19

The advances in target control of complex networks not only can offer new insights into the general control dynamics of complex systems, but also be useful for the practical application in systems biology, such as discovering new therapeutic targets for disease intervention. In many cases, e.g. drug target identification in biological networks, we usually require a target control on a subset of nodes (i.e., disease-associated genes) with minimum cost, and we further expect that more driver nodes consistent with a certain well-selected network nodes (i.e., prior-known drug-target genes). Therefore, motivated by this fact, we pose and address a new and practical problem called as target control problem with objectives-guided optimization (TCO): how could we control the interested variables (or targets) of a system with the optional driver nodes by minimizing the total quantity of drivers and meantime maximizing the quantity of constrained nodes among those drivers. Here, we design an efficient algorithm (TCOA) to find the optional driver nodes for controlling targets in complex networks. We apply our TCOA to several real-world networks, and the results support that our TCOA can identify more precise driver nodes than the existing control-fucus approaches. Furthermore, we have applied TCOA to two bimolecular expert-curate networks. Source code for our TCOA is freely available from http://sysbio.sibcb.ac.cn/cb/chenlab/software.htm or https://github.com/WilfongGuo/guoweifeng . In the previous theoretical research for the full control, there exists an observation and conclusion that the driver nodes tend to be low-degree nodes. However, for target control the biological networks, we find interestingly that the driver nodes tend to be high-degree nodes, which is more consistent with the biological experimental observations. Furthermore, our results supply the novel insights into how we can efficiently target control a complex system, and especially many evidences on the practical strategic utility of TCOA to incorporate prior drug information into potential drug-target forecasts. Thus applicably, our method paves a novel and efficient way to identify the drug targets for leading the phenotype transitions of underlying biological networks.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices.

PubMed

Verhees, Bart; van Kuijk, Kees; Simonse, Lianne

2017-12-21

Point-of-care testing (POCT)-laboratory tests performed with new mobile devices and online technologies outside of the central laboratory-is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP's network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices

PubMed Central

Verhees, Bart; van Kuijk, Kees

2017-01-01

Point-of-care testing (POCT)—laboratory tests performed with new mobile devices and online technologies outside of the central laboratory—is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP’s network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre. PMID:29267224

Differential receipt of sentinel lymph node biopsy within practice-based research networks

PubMed Central

Meyer, Anne-Marie; Reeder-Hayes, Katherine E.; Liu, Huan; Wheeler, Stephanie B.; Penn, Dolly; Weiner, Bryan J.; Carpenter, William R.

2013-01-01

Background Provider-based research networks (PBRNs) are promising for accelerating not only research, but also dissemination of research-based evidence into broader community practice. Sentinel lymph node biopsy (SLNB) is an innovation in breast cancer care associated with equivalent survival and lower morbidity, as compared to standard axillary lymph node dissection. We examined the diffusion of SLNB into practice and whether affiliation with the Community Clinical Oncology Program (CCOP), a cancer-focused PBRN, was associated with more rapid uptake of SLNB. Research Design Surveillance Epidemiology and End Results(SEER)-Medicare data were used to study women diagnosed with stage I or II breast cancer in the years 2000 to 2005 and undergoing breast conserving surgery with axillary staging (n=6,226). The primary outcome was undergoing SLNB. CCOP affiliation of the surgical physician was ascertained from NCI records. Multivariable generalized linear modeling with generalized estimating equations was used to measure association between CCOP exposure and undergoing SLNB, controlling for potential confounders. Results Women treated by a CCOP physician had significantly higher odds of receiving SLNB compared to women treated by a non-CCOP physician (OR 2.68; 95% CI 1.35, 5.34). The magnitude of this association was larger than that observed among patients treated by physicians operating in medical school-affiliated hospitals (OR 1.76; 95% CI 1.30–2.39). Conclusion Women treated by CCOP-affiliated physicians were more likely to undergo SLNB irrespective of the hospital’s medical school affiliation, suggesting that the CCOP PBRN may play a role in the rapid adoption of research-based innovation in community practice. PMID:23942221

Single- and dual-carrier microwave noise abatement in the deep space network. [microwave antennas

NASA Technical Reports Server (NTRS)

Bathker, D. A.; Brown, D. W.; Petty, S. M.

1975-01-01

The NASA/JPL Deep Space Network (DSN) microwave ground antenna systems are presented which simultaneously uplink very high power S-band signals while receiving very low level S- and X-band downlinks. Tertiary mechanisms associated with elements give rise to self-interference in the forms of broadband noise burst and coherent intermodulation products. A long-term program to reduce or eliminate both forms of interference is described in detail. Two DSN antennas were subjected to extensive interference testing and practical cleanup program; the initial performance, modification details, and final performance achieved at several planned stages are discussed. Test equipment and field procedures found useful in locating interference sources are discussed. Practices deemed necessary for interference-free operations in the DSN are described. Much of the specific information given is expected to be easily generalized for application in a variety of similar installations. Recommendations for future investigations and individual element design are given.

Perceptions of Pediatric Residents Regarding Counseling About Use of Social Networking Sites.

PubMed

Banker, Sumeet L; Fenick, Ada M; Qin, Li; Talwalkar, Jaideep S

2018-04-01

Increasing use of social networking sites (SNS) among youth prompted professional organizations to urge pediatricians to promote healthy media use. Electronic questionnaires were distributed to 76 pediatric residents at one academic center measuring attitudes, practices, and familiarity with SNS. Of 43 respondents (response rate = 57%), most reported personal SNS use (98%) and familiarity with SNS used by youth (72%), and 88% agreed that pediatricians should provide counseling on SNS use. Only 5% felt they had adequate training on SNS use in children, and just 26% felt comfortable advising families. Residents were less likely to discuss SNS use than general media use (19% vs 56%, P = .007). Media counseling was correlated with SNS counseling ( r = .38, P = .01). Pediatric residents recognize the importance of guiding families on SNS use, yet do not routinely provide counseling despite high levels of personal SNS use and familiarity. Focused training is necessary for pediatricians to prioritize practical guidance.

Taming the Wild World of Management, Performance and Communication - 13459

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

Ford, Laurie

2013-07-01

Management has evolved a long way from its original meaning of 'governing a horse'. The industrial revolution fostered 'scientific management'; 1930's Hawthorne studies discovered that people's social interactions could alter productivity; and the dawn of the computer age in the post-war 1950's brought general systems theory into management thinking. Today, mobile wireless connectivity aims to transform ever-changing networks of players, mandates, and markets into something that can be 'managed'. So why is there no clear and simple recipe for how to practice management? We talk about financial management, safety management, and operations management, but surely the 'management' part of thosemore » endeavors will share the same set of practices. Instead, we are still arguing for 'management' to include everything from developing people to negotiating contracts. A manager's job may include many things, but one of them, the job of management, needs to be nailed down. Three standard practices for managing in a network are developed: (a) support the dialogues that connect people vital to accomplishing a goal or objective; (b) develop and sustain the scoreboards that serve as a road-map to reach the goal; and (c) control the feedback to 'govern the horse'. These three practices are useful for more than reaching goals, as they also support coordinating across boundaries and running productive meetings. The dialogues for productive relationships, scoreboards for goals and deliverables, and feedback for performance together constitute a recipe for managing in a networked world. (authors)« less

The graph neural network model.

PubMed

Scarselli, Franco; Gori, Marco; Tsoi, Ah Chung; Hagenbuchner, Markus; Monfardini, Gabriele

2009-01-01

Many underlying relationships among data in several areas of science and engineering, e.g., computer vision, molecular chemistry, molecular biology, pattern recognition, and data mining, can be represented in terms of graphs. In this paper, we propose a new neural network model, called graph neural network (GNN) model, that extends existing neural network methods for processing the data represented in graph domains. This GNN model, which can directly process most of the practically useful types of graphs, e.g., acyclic, cyclic, directed, and undirected, implements a function tau(G,n) is an element of IR(m) that maps a graph G and one of its nodes n into an m-dimensional Euclidean space. A supervised learning algorithm is derived to estimate the parameters of the proposed GNN model. The computational cost of the proposed algorithm is also considered. Some experimental results are shown to validate the proposed learning algorithm, and to demonstrate its generalization capabilities.

Impact of targeted counseling on reported vaginal hygiene practices and bacterial vaginosis: the HIV Prevention Trials Network 035 study.

PubMed

Kasaro, Margaret P; Husnik, Marla J; Chi, Benjamin H; Reid, Cheri; Magure, Tsitsi; Makanani, Bonus; Tembo, Tchangani; Ramjee, Gita; Maslankowski, Lisa; Rabe, Lorna; Brad Guffey, M

2017-04-01

The objective of this study was to describe the impact of intense counseling to reduce vaginal hygiene practices and its effect on bacterial vaginosis. A secondary data analysis of the HIV Prevention Trials Network 035 study was undertaken, focusing on HIV-negative, nonpregnant women who were at least 18 years old, in seven African sites and one US site. At enrollment and during follow-up quarterly visits, vaginal hygiene practices were determined by face-to-face administration of a behavioral assessment questionnaire. Vaginal hygiene practices were categorized as insertion into the vagina of (1) nothing, (2) water only, and (3) other substances with or without water. Each practice was quantified by frequency and type/combination of inserted substances. At quarterly visits, diagnosis of bacterial vaginosis was made using the Nugent score. Trends for vaginal hygiene practices and bacterial vaginosis were evaluated using generalized estimating equation models. A total of 3087 participants from the HIV Prevention Trials Network 035 study were eligible for this analysis. At enrollment, 1859 (60%) reported recent vaginal hygiene practices. By one year, this figure had decreased to 1019 (33%) with counseling. However, bacterial vaginosis prevalence remained consistent across the study observation period, with 36%-38% of women testing positive for the condition ( p for trend = 0.27). Overall, those who reported douching with water only (AOR = 1.03, 95%CI: 0.94-1.13) and those who reported inserting other substances (AOR= 0.98, 95%CI: 0.88-1.09) in the past quarter were not more likely to have bacterial vaginosis compared to those who reported no insertions. However, in South Africa, an increase in bacterial vaginosis was seen among those who reported inserting other substances (AOR: 1.48, 95%CI: 1.17, 1.88). In conclusion, targeted counseling against vaginal hygiene practices resulted in change in self-reported behavior but did not have an impact on bacterial vaginosis diagnosis in all but one site.

Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act.

PubMed

van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

2010-04-01

The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalizing euthanasia under strict conditions influences the number and nature of euthanasia requests. To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Retrospective dynamic cohort study comparing 5 years before (1998-2002) and 5 years after (2003-2007) implementation of the Act. Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. The mean annual incidence of requests before implementation amounted to 3.1/10,000 and thereafter to 2.8/10,000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10,000 to 2.6/10,000 (P = 0.008); the requests by females increased non-significantly from 2.6/10,000 to 3.1/10,000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females.

Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act

PubMed Central

van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

2010-01-01

Background The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalising euthanasia under strict conditions influences the number and nature of euthanasia requests. Aim To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Design of study Retrospective dynamic cohort study comparing 5 years before (1998–2002) and 5 years after (2003–2007) implementation of the Act. Method Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. Results The mean annual incidence of requests before implementation amounted to 3.1/10 000 and thereafter to 2.8/10 000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10 000 to 2.6/10 000 (P = 0.008); the requests by females increased non-significantly from 2.6/10 000 to 3.1/10 000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). Conclusion There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females. PMID:20353671

Graphical models for optimal power flow

DOE PAGES

Dvijotham, Krishnamurthy; Chertkov, Michael; Van Hentenryck, Pascal; ...

2016-09-13

Optimal power flow (OPF) is the central optimization problem in electric power grids. Although solved routinely in the course of power grid operations, it is known to be strongly NP-hard in general, and weakly NP-hard over tree networks. In this paper, we formulate the optimal power flow problem over tree networks as an inference problem over a tree-structured graphical model where the nodal variables are low-dimensional vectors. We adapt the standard dynamic programming algorithm for inference over a tree-structured graphical model to the OPF problem. Combining this with an interval discretization of the nodal variables, we develop an approximation algorithmmore » for the OPF problem. Further, we use techniques from constraint programming (CP) to perform interval computations and adaptive bound propagation to obtain practically efficient algorithms. Compared to previous algorithms that solve OPF with optimality guarantees using convex relaxations, our approach is able to work for arbitrary tree-structured distribution networks and handle mixed-integer optimization problems. Further, it can be implemented in a distributed message-passing fashion that is scalable and is suitable for “smart grid” applications like control of distributed energy resources. In conclusion, numerical evaluations on several benchmark networks show that practical OPF problems can be solved effectively using this approach.« less

Practical approximation method for firing-rate models of coupled neural networks with correlated inputs

NASA Astrophysics Data System (ADS)

Barreiro, Andrea K.; Ly, Cheng

2017-08-01

Rapid experimental advances now enable simultaneous electrophysiological recording of neural activity at single-cell resolution across large regions of the nervous system. Models of this neural network activity will necessarily increase in size and complexity, thus increasing the computational cost of simulating them and the challenge of analyzing them. Here we present a method to approximate the activity and firing statistics of a general firing rate network model (of the Wilson-Cowan type) subject to noisy correlated background inputs. The method requires solving a system of transcendental equations and is fast compared to Monte Carlo simulations of coupled stochastic differential equations. We implement the method with several examples of coupled neural networks and show that the results are quantitatively accurate even with moderate coupling strengths and an appreciable amount of heterogeneity in many parameters. This work should be useful for investigating how various neural attributes qualitatively affect the spiking statistics of coupled neural networks.

DeepX: Deep Learning Accelerator for Restricted Boltzmann Machine Artificial Neural Networks.

PubMed

Kim, Lok-Won

2018-05-01

Although there have been many decades of research and commercial presence on high performance general purpose processors, there are still many applications that require fully customized hardware architectures for further computational acceleration. Recently, deep learning has been successfully used to learn in a wide variety of applications, but their heavy computation demand has considerably limited their practical applications. This paper proposes a fully pipelined acceleration architecture to alleviate high computational demand of an artificial neural network (ANN) which is restricted Boltzmann machine (RBM) ANNs. The implemented RBM ANN accelerator (integrating network size, using 128 input cases per batch, and running at a 303-MHz clock frequency) integrated in a state-of-the art field-programmable gate array (FPGA) (Xilinx Virtex 7 XC7V-2000T) provides a computational performance of 301-billion connection-updates-per-second and about 193 times higher performance than a software solution running on general purpose processors. Most importantly, the architecture enables over 4 times (12 times in batch learning) higher performance compared with a previous work when both are implemented in an FPGA device (XC2VP70).

Creating a NASA-Wide Museum Alliance

NASA Technical Reports Server (NTRS)

Sohus, Anita M.

2006-01-01

NASA's Museum Alliance is a nationwide network of informal educators at museums, science centers, and planetariums that present NASA information to their local audiences. Begun in 2002 as the Mars Museum Visualization Alliance with advisors from a dozen museums, the network has grown to over 300 people from 200 organizations, including a dozen or so international partners. The network has become a community of practice among these informal educators who work with students, educators, and the general public on a daily basis, presenting information and fielding questions about space exploration. Communications are primarily through an active listserve, regular telecons, and a pass word protected website. Professional development is delivered via telecons and downloadable presentations. Current content offerings include Mars exploration, Cassini, Stardust, Genesis, Deep Impact, Earth observations, STEREO, and missions to explore beyond our solar system.

NASA Museum Alliance

NASA Astrophysics Data System (ADS)

Sohus, Anita

2006-12-01

NASA’s Museum Alliance is a nationwide network of informal educators at museums, science centers, and planetariums that present NASA information to their local audiences. Begun in 2002 as the Mars Museum Visualization Alliance with advisors from a dozen museums, the network has grown to over 300 people from 200 organizations, including a dozen or so international partners. The network has become a community of practice among these informal educators who work with students, educators, and the general public on a daily basis, presenting information and fielding questions about space exploration. Communications are primarily through an active listserve, regular telecons, and a password-protected website. Professional development is delivered via telecons and downloadable presentations. Current content offerings include Mars exploration, Cassini, Stardust, Genesis, Deep Impact, Earth observations, STEREO, and missions to explore beyond our solar system.

Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles.

PubMed

Fleury, Marie-Josée; Grenier, Guy; Vallée, Catherine; Aubé, Denise; Farand, Lambert

2017-03-10

This study evaluates implementation of the Quebec Mental Health Reform (2005-2015), which promoted the development of integrated service networks, in 11 local service networks organized into four territorial groups according to socio-demographic characteristics and mental health services offered. Data were collected from documents concerning networks; structured questionnaires completed by 90 managers and by 16 respondent-psychiatrists; and semi-structured interviews with 102 network stakeholders. Factors associated with implementation and integration were organized according to: 1) reform characteristics; 2) implementation context; 3) organizational characteristics; and 4) integration strategies. While local networks were in a process of development and expansion, none were fully integrated at the time of the study. Facilitators and barriers to implementation and integration were primarily associated with organizational characteristics. Integration was best achieved in larger networks including a general hospital with a psychiatric department, followed by networks with a psychiatric hospital. Formalized integration strategies such as service agreements, liaison officers, and joint training reduced some barriers to implementation in networks experiencing less favourable conditions. Strategies for the implementation of healthcare reform and integrated service networks should include sustained support and training in best-practices, adequate performance indicators and resources, formalized integration strategies to improve network coordination and suitable initiatives to promote staff retention.

General practitioners' management of mental disorders: a rewarding practice with considerable obstacles.

PubMed

Fleury, Marie-Josée; Imboua, Armelle; Aubé, Denise; Farand, Lambert; Lambert, Yves

2012-03-16

Primary care improvement is the cornerstone of current reforms. Mental disorders (MDs) are a leading cause of morbidity worldwide and widespread in industrialised countries. MDs are treated mainly in primary care by general practitioners (GPs), even though the latter ability to detect, diagnose, and treat patients with MDs is often considered unsatisfactory. This article examines GPs' management of MDs in an effort to acquire more information regarding means by which GPs deal with MD cases, impact of such cases on their practices, factors that enable or hinder MD management, and patient-management strategies. This study employs a mixed-method approach with emphasis on qualitative investigation. Based on a previous survey of 398 GPs in Quebec, Canada, 60 GPs representing a variety of practice settings were selected for further study. A 10-minute-long questionnaire comprising 27 items was administered, and 70-minute-long interviews were conducted. Quantitative (SPSS) and qualitative (NVivo) analyses were performed. At least 20% of GP visits were MD-related. GPs were comfortable managing common MDs, but not serious MDs. GPs' based their treatment of MDs on pharmacotherapy, support therapy, and psycho-education. They used clinical intuition with few clinical tools, and closely followed their patients with MDs. Practice features (salary or hourly fees payment; psycho-social teams on-site; strong informal networks), and GPs' individual characteristics (continuing medical education; exposure and interest in MDs; traits like empathy) favoured MD management. Collaboration with psychologists and psychiatrists was considered key to good MD management. Limited access to specialists, system fragmentation, and underdeveloped group practice and shared-care models were impediments. MD management was seen as burdensome because it required more time, flexibility, and emotional investment. Strategies exist to reduce the burden (one-problem-per-visit rule; longer time slots). GPs found MD practice rewarding as patients were seen as grateful and more complying with medical recommendations compared to other patients, generally leading to positive outcomes. To improve MD management, this study highlights the importance of extending multidisciplinary GP practice settings with salary or hourly fee payment; access to psychotherapeutic and psychiatric expertise; and case-discussion training involving local networks of GPs and MD specialists that encourage both knowledge transfer and shared care.

General practitioners' management of mental disorders: A rewarding practice with considerable obstacles

PubMed Central

2012-01-01

Background Primary care improvement is the cornerstone of current reforms. Mental disorders (MDs) are a leading cause of morbidity worldwide and widespread in industrialised countries. MDs are treated mainly in primary care by general practitioners (GPs), even though the latter ability to detect, diagnose, and treat patients with MDs is often considered unsatisfactory. This article examines GPs' management of MDs in an effort to acquire more information regarding means by which GPs deal with MD cases, impact of such cases on their practices, factors that enable or hinder MD management, and patient-management strategies. Methods This study employs a mixed-method approach with emphasis on qualitative investigation. Based on a previous survey of 398 GPs in Quebec, Canada, 60 GPs representing a variety of practice settings were selected for further study. A 10-minute-long questionnaire comprising 27 items was administered, and 70-minute-long interviews were conducted. Quantitative (SPSS) and qualitative (NVivo) analyses were performed. Results At least 20% of GP visits were MD-related. GPs were comfortable managing common MDs, but not serious MDs. GPs' based their treatment of MDs on pharmacotherapy, support therapy, and psycho-education. They used clinical intuition with few clinical tools, and closely followed their patients with MDs. Practice features (salary or hourly fees payment; psycho-social teams on-site; strong informal networks), and GPs' individual characteristics (continuing medical education; exposure and interest in MDs; traits like empathy) favoured MD management. Collaboration with psychologists and psychiatrists was considered key to good MD management. Limited access to specialists, system fragmentation, and underdeveloped group practice and shared-care models were impediments. MD management was seen as burdensome because it required more time, flexibility, and emotional investment. Strategies exist to reduce the burden (one-problem-per-visit rule; longer time slots). GPs found MD practice rewarding as patients were seen as grateful and more complying with medical recommendations compared to other patients, generally leading to positive outcomes. Conclusions To improve MD management, this study highlights the importance of extending multidisciplinary GP practice settings with salary or hourly fee payment; access to psychotherapeutic and psychiatric expertise; and case-discussion training involving local networks of GPs and MD specialists that encourage both knowledge transfer and shared care. PMID:22423592

Promoting the APS Chapter Program by Sharing Its History, Best Practices, and How-to Guide for Establishing New Chapters

ERIC Educational Resources Information Center

Hopper, Mari K.

2017-01-01

Early establishment of physiological societies in Oklahoma and Ohio demonstrated the benefits of networking physiologists and paved the way for establishing the APS Chapter Program. Designed to promote the general objectives of the APS, the Chapter Program was officially launched in 1995, with Ohio being the first recognized chapter. There are 13…

Uptake of a Dashboard Designed to Give Realtime Feedback to a Sentinel Network About Key Data Required for Influenza Vaccine Effectiveness Studies.

PubMed

Pathirannehelage, Sameera; Kumarapeli, Pushpa; Byford, Rachel; Yonova, Ivelina; Ferreira, Filipa; de Lusignan, Simon

2018-01-01

Dashboards are technologies that bringing together a range of data sources for observational or analytical purposes. We have created a customised dashboard that includes all the key data elements required for monitoring flu vaccine effectiveness (FVE). This delivers a unique dashboard for each primary care provider (general practice) providing data to the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), one of the oldest European surveillance systems. These FVE studies use a test negative case control (TNCC) design. TNCC requires knowledge of practice denominator; vaccine exposure, and results of influenza virology swabs carried out to identify in an influenza-like-illness (ILI), a clinical diagnosis, really is influenza. The dashboard displays the denominator uploaded each week into the surveillance system, compared with the nationally known practice size (providing face-validity for the denominator); it identifies those exposed to the vaccine (by age group and risk category) and virology specimens taken and missed opportunities for surveillance (again by category). All sentinel practices can access in near real time (4 working days in areas) their rates of vaccine exposure and swabs conducted. Initial feedback is positive; 80% (32/40) practices responded positively.

40 years of biannual family medicine research meetings--the European General Practice Research Network (EGPRN).

PubMed

Buono, Nicola; Thulesius, Hans; Petrazzuoli, Ferdinando; Van Merode, Tiny; Koskela, Tuomas; Le Reste, Jean-Yves; Prick, Hanny; Soler, Jean Karl

2013-12-01

To document family medicine research in the 25 EGPRN member countries in 2010. Semi-structured survey with open-ended questions. Academic family medicine in 23 European countries, Israel, and Turkey. 25 EGPRN national representatives. Demographics of the general population and family medicine. Assessments, opinions, and suggestions. EGPRN has represented family medicine for almost half a billion people and > 300,000 general practitioners (GPs). Turkey had the largest number of family medicine departments and highest density of GPs, 2.1/1000 people, Belgium had 1.7, Austria 1.6, and France 1.5. Lowest GP density was reported from Israel 0.17, Greece 0.18, and Slovenia 0.4 GPs per 1000 people. Family medicine research networks were reported by 22 of 25 and undergraduate family medicine research education in 20 of the 25 member countries, and in 10 countries students were required to do research projects. Postgraduate family medicine research was reported by 18 of the member countries. Open-ended responses showed that EGPRN meetings promoted stimulating and interesting research questions such as comparative studies of chronic pain management, sleep disorders, elderly care, healthy lifestyle promotion, mental health, clinical competence, and appropriateness of specialist referrals. Many respondents reported a lack of interest in family medicine research related to poor incentives and low family medicine status in general and among medical students in particular. It was suggested that EGPRN exert political lobbying for family medicine research. Since 1974, EGPRN organizes biannual conferences that unite and promote primary care practice, clinical research and academic family medicine in 25 member countries.

Second language social networks and communication-related acculturative stress: the role of interconnectedness

PubMed Central

Doucerain, Marina M.; Varnaamkhaasti, Raheleh S.; Segalowitz, Norman; Ryder, Andrew G.

2015-01-01

Although a substantial amount of cross-cultural psychology research has investigated acculturative stress in general, little attention has been devoted specifically to communication-related acculturative stress (CRAS). In line with the view that cross-cultural adaptation and second language (L2) learning are social and interpersonal phenomena, the present study examines the hypothesis that migrants’ L2 social network size and interconnectedness predict CRAS. The main idea underlying this hypothesis is that L2 social networks play an important role in fostering social and cultural aspects of communicative competence. Specifically, higher interconnectedness may reflect greater access to unmodified natural cultural representations and L2 communication practices, thus fostering communicative competence through observational learning. As such, structural aspects of migrants’ L2 social networks may be protective against acculturative stress arising from chronic communication difficulties. Results from a study of first generation migrant students (N = 100) support this idea by showing that both inclusiveness and density of the participants’ L2 network account for unique variance in CRAS but not in general acculturative stress. These results support the idea that research on cross-cultural adaptation would benefit from disentangling the various facets of acculturative stress and that the structure of migrants’ L2 network matters for language related outcomes. Finally, this study contributes to an emerging body of work that attempts to integrate cultural/cross-cultural research on acculturation and research on intercultural communication and second language learning. PMID:26300809

Second language social networks and communication-related acculturative stress: the role of interconnectedness.

PubMed

Doucerain, Marina M; Varnaamkhaasti, Raheleh S; Segalowitz, Norman; Ryder, Andrew G

2015-01-01

Although a substantial amount of cross-cultural psychology research has investigated acculturative stress in general, little attention has been devoted specifically to communication-related acculturative stress (CRAS). In line with the view that cross-cultural adaptation and second language (L2) learning are social and interpersonal phenomena, the present study examines the hypothesis that migrants' L2 social network size and interconnectedness predict CRAS. The main idea underlying this hypothesis is that L2 social networks play an important role in fostering social and cultural aspects of communicative competence. Specifically, higher interconnectedness may reflect greater access to unmodified natural cultural representations and L2 communication practices, thus fostering communicative competence through observational learning. As such, structural aspects of migrants' L2 social networks may be protective against acculturative stress arising from chronic communication difficulties. Results from a study of first generation migrant students (N = 100) support this idea by showing that both inclusiveness and density of the participants' L2 network account for unique variance in CRAS but not in general acculturative stress. These results support the idea that research on cross-cultural adaptation would benefit from disentangling the various facets of acculturative stress and that the structure of migrants' L2 network matters for language related outcomes. Finally, this study contributes to an emerging body of work that attempts to integrate cultural/cross-cultural research on acculturation and research on intercultural communication and second language learning.

Online social network data as sociometric markers.

PubMed

Binder, Jens F; Buglass, Sarah L; Betts, Lucy R; Underwood, Jean D M

2017-10-01

Data from online social networks carry enormous potential for psychological research, yet their use and the ethical implications thereof are currently hotly debated. The present work aims to outline in detail the unique information richness of this data type and, in doing so, to support researchers when deciding on ethically appropriate ways of collecting, storing, publishing, and sharing data from online sources. Focusing on the very nature of social networks, their structural characteristics, and depth of information, we provide a detailed and accessible account of the challenges associated with data management and data storage. In particular, the general nonanonymity of network data sets is discussed, and an approach is developed to quantify the level of uniqueness that a particular online network bestows upon the individual maintaining it. Using graph enumeration techniques, we show that comparatively sparse information on a network is suitable as a sociometric marker that allows for the identification of an individual from the global population of online users. The impossibility of anonymizing specific types of network data carries implications for ethical guidelines and research practice. At the same time, network uniqueness opens up opportunities for novel research in psychology. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Role of Networks of Practice and Webs of Influencers on Farmers' Engagement with and Learning about Agricultural Innovations

ERIC Educational Resources Information Center

Oreszczyn, Sue; Lane, Andy; Carr, Susan

2010-01-01

Drawing on the UK research project, "Farmers' understandings of GM crops within local communities", this paper considers the application of the concepts of communities of practice and networks of practice in the agricultural context. A brief review of theories about communities of practice and networks of practice is given and some of…

[Active participation in research and teaching during post-graduate GP training: perspectives of future general practitioners].

PubMed

Haumann, Hannah; Flum, Elisabeth; Joos, Stefanie

2016-12-01

Academic institutions of general practice at German medical faculties have grown during the past years. This leads to an increase in the need of qualified young researchers and teachers in general practice (GP). Little is known about the interest in research and teaching skills and their training among general practice trainees and young GPs. This cross-sectional survey among GP trainees and young GPs examined 1. if there is an interest in the training in research and teaching skills during post-graduate GP training, 2. which fostering and hindering factors have an effect on this interest and 3. which roles are attributed to academic institutions of general practice. A web-based cross-sectional study was performed among members of "Verbundweiterbildung plus" , a network of GP trainees, as well as "Junge Allgemeinmedizin Deutschland", the German network of young GPs. Descriptive analysis was conducted. 148 GP trainees and young GPs participated in the study, 76% (n=109) of them were GP trainees. There was interest in a position in research and teaching during post-graduate GP training among 55% (n=78). Factors associated with the interest in a position in research and teaching during post-graduate GP training were (MV 5-point Likert scale ± SD): compatibility of clinical work and research/teaching and of family and career (4.4±0.8; 4.7±0.6 respectively). The roles of academic institutions of general practice were attributed to training of medical students (4.6±0.6), post-graduate GP training (4.5±0.7) and research (4.5±0.7). GP trainees assessed the importance of training in research and teaching skills during post-graduate GP training and of the compatibility of family and career differently from young GPs (3.7±1.0 vs. 4.1±0.8 p=0.027; 4.8±0.5 vs. 4.3±0.9, p=0.016). Those interested in a position in research and teaching during post-graduate GP training showed a stronger interest in specific training in research skills (3.7±1.1 vs. 2.8±1.1, p<0.001), a future clinical position in a research practice (3.8±1.2 vs. 2.5±1.2, p<0.001) and as a lecturer at an academic institution of general practice (4.3±0.9 vs. 3.9±1.1, p=0.04). There is an interest in professional involvement in research and teaching during post-graduate GP training among GP trainees and young GPs. For those interested, structured concepts (e.g. "clinician scientist") need to be developed in order to facilitate the combination of clinical work and a position in research and teaching during post-graduate GP training. In doing so, the existing potential could be better exploited and more future GPs could be involved in research and teaching. Copyright © 2016. Published by Elsevier GmbH.

Outcomes of endodontic therapy in general practice

PubMed Central

Bernstein, Susan D.; Horowitz, Allan J.; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A.; Collie, Damon; Matthews, Abigail G.; Curro, Frederick A.; Thompson, Van P.; Craig, Ronald G.

2014-01-01

Background The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Methods Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. Results P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. Conclusions These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. Clinical Implications The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical periodontitis. PMID:22547719

The Utrecht Pharmacy Practice network for Education and Research: a network of community and hospital pharmacies in the Netherlands.

PubMed

Koster, Ellen S; Blom, Lyda; Philbert, Daphne; Rump, Willem; Bouvy, Marcel L

2014-08-01

Practice-based networks can serve as effective mechanisms for the development of the profession of pharmacists, on the one hand by supporting student internships and on the other hand by collection of research data and implementation of research outcomes among public health practice settings. This paper presents the characteristics and benefits of the Utrecht Pharmacy Practice network for Education and Research, a practice based research network affiliated with the Department of Pharmaceutical Sciences of Utrecht University. Yearly, this network is used to realize approximately 600 student internships (in hospital and community pharmacies) and 20 research projects. To date, most research has been performed in community pharmacy and research questions frequently concerned prescribing behavior or adherence and subjects related to uptake of regulations in the pharmacy setting. Researchers gain access to different types of data from daily practice, pharmacists receive feedback on the functioning of their own pharmacy and students get in depth insight into pharmacy practice.

Quantity, topics, methods and findings of randomised controlled trials published by German university departments of general practice - systematic review.

PubMed

Heinmüller, Stefan; Schneider, Antonius; Linde, Klaus

2016-04-23

Academic infrastructures and networks for clinical research in primary care receive little funding in Germany. We aimed to provide an overview of the quantity, topics, methods and findings of randomised controlled trials published by German university departments of general practice. We searched Scopus (last search done in April 2015), publication lists of institutes and references of included articles. We included randomised trials published between January 2000 and December 2014 with a first or last author affiliated with a German university department of general practice or family medicine. Risk of bias was assessed with the Cochrane tool, and study findings were quantified using standardised mean differences (SMDs). Thirty-three trials met the inclusion criteria. Seventeen were cluster-randomised trials, with a majority investigating interventions aimed at improving processes compared with usual care. Sample sizes varied between 6 and 606 clusters and 168 and 7807 participants. The most frequent methodological problem was risk of selection bias due to recruitment of individuals after randomisation of clusters. Effects of interventions over usual care were mostly small (SMD <0.3). Sixteen trials randomising individual participants addressed a variety of treatment and educational interventions. Sample sizes varied between 20 and 1620 participants. The methodological quality of the trials was highly variable. Again, effects of experimental interventions over controls were mostly small. Despite limited funding, German university institutes of general practice or family medicine are increasingly performing randomised trials. Cluster-randomised trials on practice improvement are a focus, but problems with allocation concealment are frequent.

Providing end-of-life care in general practice: findings of a national GP questionnaire survey.

PubMed

Mitchell, Sarah; Loew, Joelle; Millington-Sanders, Catherine; Dale, Jeremy

2016-09-01

With increasing numbers of people living with complex life-limiting multimorbidity in the community, consideration must be given to improving the organisation and delivery of high-quality palliative and end-of-life care (EOLC). To provide insight into the experience of GPs providing EOLC in the community, particularly the facilitators and barriers to good-quality care. A web-based national UK questionnaire survey circulated via the Royal College of General Practitioners, NHS, Marie Curie, and Macmillan networks to GPs. Responses were analysed using descriptive statistics and an inductive thematic analysis. Responses were received from 516 GPs, who were widely distributed in terms of practice location. Of these, 97% felt that general practice plays a key role in the delivery of care to people approaching the end of life and their families. Four interdependent themes emerged from the data: continuity of care - which can be difficult to achieve because of resource concerns including time, staff numbers, increasing primary care workload, and lack of funding; patient and family factors - with challenges including early identification of palliative care needs and recognition of the end of life, opportunity for care planning discussions, and provision of support for families; medical management - including effective symptom-control and access to specialist palliative care services; and expertise and training - the need for training and professional development was recognised to enhance knowledge, skills, and attitudes towards EOLC. The findings reveal enduring priorities for policy, commissioning, practice development, and research in future primary palliative care. © British Journal of General Practice 2016.

Analytical Computation of the Epidemic Threshold on Temporal Networks

NASA Astrophysics Data System (ADS)

Valdano, Eugenio; Ferreri, Luca; Poletto, Chiara; Colizza, Vittoria

2015-04-01

The time variation of contacts in a networked system may fundamentally alter the properties of spreading processes and affect the condition for large-scale propagation, as encoded in the epidemic threshold. Despite the great interest in the problem for the physics, applied mathematics, computer science, and epidemiology communities, a full theoretical understanding is still missing and currently limited to the cases where the time-scale separation holds between spreading and network dynamics or to specific temporal network models. We consider a Markov chain description of the susceptible-infectious-susceptible process on an arbitrary temporal network. By adopting a multilayer perspective, we develop a general analytical derivation of the epidemic threshold in terms of the spectral radius of a matrix that encodes both network structure and disease dynamics. The accuracy of the approach is confirmed on a set of temporal models and empirical networks and against numerical results. In addition, we explore how the threshold changes when varying the overall time of observation of the temporal network, so as to provide insights on the optimal time window for data collection of empirical temporal networked systems. Our framework is of both fundamental and practical interest, as it offers novel understanding of the interplay between temporal networks and spreading dynamics.

Information exchange networks for chronic illness care in primary care practices: an observational study

PubMed Central

2010-01-01

Background Information exchange networks for chronic illness care may influence the uptake of innovations in patient care. Valid and feasible methods are needed to document and analyse information exchange networks in healthcare settings. This observational study aimed to examine the usefulness of methods to study information exchange networks in primary care practices, related to chronic heart failure, diabetes and chronic obstructive pulmonary disease. Methods The study was linked to a quality improvement project in the Netherlands. All health professionals in the practices were asked to complete a short questionnaire that documented their information exchange relations. Feasibility was determined in terms of response rates and reliability in terms of reciprocity of reports of receiving and providing information. For each practice, a number of network characteristics were derived for each of the chronic conditions. Results Ten of the 21 practices in the quality improvement project agreed to participate in this network study. The response rates were high in all but one of the participating practices. For the analysis, we used data from 67 health professionals from eight practices. The agreement between receiving and providing information was, on average, 65.6%. The values for density, centralization, hierarchy, and overlap of the information exchange networks showed substantial variation between the practices as well as between the chronic conditions. The most central individual in the information exchange network could be a nurse or a physician. Conclusions Further research is needed to refine the measure of information networks and to test the impact of network characteristics on the uptake of innovations. PMID:20205758

"Getting Practical" and the National Network of Science Learning Centres

ERIC Educational Resources Information Center

Chapman, Georgina; Langley, Mark; Skilling, Gus; Walker, John

2011-01-01

The national network of Science Learning Centres is a co-ordinating partner in the Getting Practical--Improving Practical Work in Science programme. The principle of training provision for the "Getting Practical" programme is a cascade model. Regional trainers employed by the national network of Science Learning Centres trained the cohort of local…

Teaching undergraduate students in rural general practice: an evaluation of a new rural campus in England.

PubMed

Bartlett, Maggie; Pritchard, Katie; Lewis, Leo; Hays, Richard B; Mckinley, Robert K

2016-01-01

One approach to facilitating student interactions with patient pathways at Keele University School of Medicine, England, is the placement of medical students for 25% of their clinical placement time in general practices. The largest component is a 15-week 'student attachment' in primary care during the final year, which required the development of a new network of teaching practices in a rural district of England about 90 km (60 mi) from the main campus in North Staffordshire. The new accommodation and education hub was established in 2011-2012 to enable students to become immersed in those communities and learn about medical practice within a rural and remote context. Objectives were to evaluate the rural teaching from the perspectives of four groups: patients, general practice tutors, community hospital staff and students. Learning outcomes (as measured by objective structured clinical examinations) of students learning in rural practices in the final year were compared with those in other practices. Data were gathered from a variety of sources. Students' scores in cohort-wide clinical assessment were compared with those in other locations. Semi-structured interviews were conducted with general practice tutors and community hospital staff. Serial focus groups explored the perceptions of the students, and questionnaires were used to gather the views of patients. Patients reported positive experiences of students in their consultations, with 97% expressing willingness to see students. The majority of patients considered that teaching in general practice was a good thing. They also expressed altruistic ideas about facilitating learning. The tutors were enthusiastic and perceived that teaching had positive impacts on their practices despite negative effects on their workload. The community hospital staff welcomed students and expressed altruistic ideas about helping them learn. There was no significant difference between the rurally placed students' objective structured clinical examination performance and that of their peers in other locations. Some students had difficulty with the isolation from peers and academic activities, and travel was a problem despite their accommodation close to the practices. Students valued the learning opportunities offered by the rural practice placements. The general practice tutors, patients and community hospital staff found teaching to be a positive experience overall and perceived a value to the health system and broader community in students learning locally for substantial periods of time. The evaluation has identified some student concerns about transport times and costs, social isolation, and access to resources and administrative tasks, and these are being addressed.

Female genital cosmetic surgery: Investigating the role of the general practitioner.

PubMed

Harding, Tristan; Hayes, Jenny; Simonis, Magdalena; Temple-Smith, Meredith

2015-01-01

Labiaplasty, the surgical reduction of the labia minora, has significantly increased in demand in Australia. Although general practice is one gatekeeper for patients requesting labiaplasty, as a referral is necessary to claim Medicare entitlements, there is little information available to assist general practitioners (GPs) in managing these requests for female genital cosmetic surgery. Semi-structured interviews were conducted with health professionals, including GPs, gynaecologists and plastic surgeons. Participants were recruited through the Victorian Primary Care Practice-based Research Network (VicReN), clinical teaching hospitals and snowball sampling. All interviews were digitally recorded, transcribed, and analysed using content and thematic analysis. Twenty-seven interviews were conducted. All participants were aware of genital labiaplasty; many had patients who were concerned about genital appearance, for which information had often been sought opportunistically. All participants agreed on the need for resources to inform women of normal genital appearance. This novel study demonstrates a need for clinical resources for GPs managing requests for genital labiaplasty.

Impact of faxed health alerts on the preparedness of general practitioners during communicable disease outbreaks.

PubMed

Rosewell, Alexander; Patel, Mahomed; Viney, Kerri; Marich, Andrew; Lawrence, Glenda L

2010-03-01

The NSW Department of Health (NSW Health) faxed health alerts to general medical practitioners during measles outbreaks in March and May 2006. We conducted a retrospective cohort study of randomly selected general practitioners (GPs) (1 per medical practice) in New South Wales to investigate the effectiveness of faxing health alerts to GPs during a communicable disease outbreak. Fax transmission data allowed comparison of GPs sent and not sent the measles alert for self-reported awareness and practice actions aimed at the prevention and control of measles. A total of 328 GPs participated in the study. GPs who were sent the alert were more likely to be aware of the measles outbreak (RR 1.18, 95% CI 1.02, 1.38). When analysed by whether a fax had been received from either NSW Health or the Australian General Practice Network, GPs who reported receiving a faxed measles alert were more likely to be aware of the outbreak (RR 2.56, 95% CI 1.84, 3.56), to offer vaccination to susceptible staff (RR 6.46, 95% CI 2.49, 16.78), and be aware of other infection control recommendations. Respondents reported that the faxed alerts were useful with 65% reporting that the alerts had reminded them to consider measles in the differential diagnosis. This study shows that faxed health alerts were useful for preparing GPs to respond effectively to a communicable disease outbreak. The fax alert system could be improved by ensuring that all general practices in New South Wales are included in the faxstream database and that their contact details are updated regularly.

No longer simply a Practice-based Research Network (PBRN) health improvement networks.

PubMed

Williams, Robert L; Rhyne, Robert L

2011-01-01

While primary care Practice-based Research Networks are best known for their original, research purpose, evidence accumulating over the last several years is demonstrating broader values of these collaborations. Studies have demonstrated their role in quality improvement and practice change, in continuing professional education, in clinician retention in medically underserved areas, and in facilitating transition of primary care organization. A role in informing and facilitating health policy development is also suggested. Taking into account this more robust potential, we propose a new title, the Health Improvement Network, and a new vision for Practice-based Research Networks.

Structural Behavioral Study on the General Aviation Network Based on Complex Network

NASA Astrophysics Data System (ADS)

Zhang, Liang; Lu, Na

2017-12-01

The general aviation system is an open and dissipative system with complex structures and behavioral features. This paper has established the system model and network model for general aviation. We have analyzed integral attributes and individual attributes by applying the complex network theory and concluded that the general aviation network has influential enterprise factors and node relations. We have checked whether the network has small world effect, scale-free property and network centrality property which a complex network should have by applying degree distribution of functions and proved that the general aviation network system is a complex network. Therefore, we propose to achieve the evolution process of the general aviation industrial chain to collaborative innovation cluster of advanced-form industries by strengthening network multiplication effect, stimulating innovation performance and spanning the structural hole path.

[Using social network analysis to examine care for older drug users in three major cities in Germany : Results of a pilot study].

PubMed

Kuhn, U; Hofmann, L; Hoff, T; Färber, N

2018-05-04

Compared with the general population, chronic drug addicts already start showing typical aging problems by the age of 40 years. The increasing number of older drug addicts leads to questions of what an adequate health and social care should look like. This discussion particularly takes place in the context of a sufficient integration of different care systems. A sufficient integration requires an improvement in the networking of substance treatment, nursing care and medical care services. The purpose of this study was to investigate the care structure of older people who use drugs and the services involved in a social network analysis. This was a descriptive design of the pilot study. The study objective was to gain first-hand knowledge about the health and social care situation, the quality of care concerning this client group and to identify supply gaps. Therefore, the three regions Cologne, Dusseldorf and Frankfurt/Main were exemplarily examined. The data for the social network analysis was gathered by a quantitative online questionnaire. Therefore, especially central network members were contacted and asked to participate. The survey was conducted in two waves. In total, 65 practitioners of all surveyed cities participated in the second wave. The centrality measures assessed indicated that in all regions institutions of the substance abuse service network hold central positions in terms of conveying information. The moderate density values of the networks suggest that there are sufficient cooperation structures. Care deficits were identified most frequently in the areas of housing and nursing care. The results provide the first systematic insights and a description of the cooperation practice in the care system. Because of the limitations, further research and practice issues are raised.

[Social networks in drinking behaviors among Japanese: support network, drinking network, and intervening network].

PubMed

Yoshihara, Chika; Shimizu, Shinji

2005-10-01

The national representative sample was analyzed to examine the relationship between respondents' drinking practice and the social network which was constructed of three different types of network: support network, drinking network, and intervening network. Non-parametric statistical analysis was conducted with chi square method and ANOVA analysis, due to the risk of small samples in some basic tabulation cells. The main results are as follows: (1) In the support network of workplace associates, moderate drinkers enjoyed much more sociable support care than both nondrinkers and hard drinkers, which might suggest a similar effect as the French paradox. Meanwhile in the familial and kinship network, the more intervening care support was provided, the harder respondents' drinking practice. (2) The drinking network among Japanese people for both sexes is likely to be convergent upon certain types of network categories and not decentralized in various categories. This might reflect of the drinking culture of Japan, which permits people to drink everyday as a practice, especially male drinkers. Subsequently, solitary drinking is not optional for female drinkers. (3) Intervening network analysis showed that the harder the respondents' drinking practices, the more frequently their drinking behaviors were checked in almost all the categories of network. A rather complicated gender double-standard was found in the network of hard drinkers with their friends, particularly for female drinkers. Medical professionals played a similar intervening role for men as family and kinship networks but to a less degree than friends for females. The social network is considerably associated with respondents' drinking, providing both sociability for moderate drinkers and intervention for hard drinkers, depending on network categories. To minimize the risk of hard drinking and advance self-healthy drinking there should be more research development on drinking practice and the social network.

Increasing chlamydia screening tests in general practice: a modified Zelen prospective Cluster Randomised Controlled Trial evaluating a complex intervention based on the Theory of Planned Behaviour.

PubMed

McNulty, Cliodna A M; Hogan, Angela H; Ricketts, Ellie J; Wallace, Louise; Oliver, Isabel; Campbell, Rona; Kalwij, Sebastian; O'Connell, Elaine; Charlett, Andre

2014-05-01

To determine if a structured complex intervention increases opportunistic chlamydia screening testing of patients aged 15-24 years attending English general practitioner (GP) practices. A prospective, Cluster Randomised Controlled Trial with a modified Zelen design involving 160 practices in South West England in 2010. The intervention was based on the Theory of Planned Behaviour (TPB). It comprised of practice-based education with up to two additional contacts to increase the importance of screening to GP staff and their confidence to offer tests through skill development (including videos). Practical resources (targets, posters, invitation cards, computer reminders, newsletters including feedback) aimed to actively influence social cognitions of staff, increasing their testing intention. Data from 76 intervention and 81 control practices were analysed. In intervention practices, chlamydia screening test rates were 2.43/100 15-24-year-olds registered preintervention, 4.34 during intervention and 3.46 postintervention; controls testing rates were 2.61/100 registered patients prior intervention, 3.0 during intervention and 2.82 postintervention. During the intervention period, testing in intervention practices was 1.76 times as great (CI 1.24 to 2.48) as controls; this persisted for 9 months postintervention (1.57 times as great, CI 1.27 to 2.30). Chlamydia infections detected increased in intervention practices from 2.1/1000 registered 15-24-year-olds prior intervention to 2.5 during the intervention compared with 2.0 and 2.3/1000 in controls (Estimated Rate Ratio intervention versus controls 1.4 (CI 1.01 to 1.93). This complex intervention doubled chlamydia screening tests in fully engaged practices. The modified Zelen design gave realistic measures of practice full engagement (63%) and efficacy of this educational intervention in general practice; it should be used more often. The trial was registered on the UK Clinical Research Network Study Portfolio database. UKCRN number 9722.

Knowledge management through two virtual communities of practice (Endobloc and Pneumobloc).

PubMed

Lara, Beatriz; Cañas, Francesca; Vidal, Antonieta; Nadal, Núria; Rius, Ferran; Paredes, Eugeni; Hernández, Marta; Maravall, Francisco J; Franch-Nadal, Josep; Barbé, Ferran; Mauricio, Dídac

2017-09-01

We developed two virtual communities of practice (Endobloc and Pneumobloc) to increase the interaction between general practitioners and nurses in primary care and hospital endocrinologists and pulmonologists. They were designed and developed using an existing web 2.0-based virtual network belonging to the local National Health System, and we quantitatively assessed the usefulness through the participation and use during the first 24 months after the launch in 2010. A total of 26,372 visits (47% Endobloc's visits) and 2351 contributions (Endobloc's contribution 38.9%) to both virtual communities of practice were registered during the first 24 months. The most popular sections were the e-Blog and the e-Consultations section in both virtual communities of practice, but some differences in the pattern of use in other sections were observed. Activity on the virtual communities of practice occurred throughout the day including weekends and holiday periods. We showed that virtual communities of practice are feasible under real-life clinical practice.

Artificial neural networks: fundamentals, computing, design, and application.

PubMed

Basheer, I A; Hajmeer, M

2000-12-01

Artificial neural networks (ANNs) are relatively new computational tools that have found extensive utilization in solving many complex real-world problems. The attractiveness of ANNs comes from their remarkable information processing characteristics pertinent mainly to nonlinearity, high parallelism, fault and noise tolerance, and learning and generalization capabilities. This paper aims to familiarize the reader with ANN-based computing (neurocomputing) and to serve as a useful companion practical guide and toolkit for the ANNs modeler along the course of ANN project development. The history of the evolution of neurocomputing and its relation to the field of neurobiology is briefly discussed. ANNs are compared to both expert systems and statistical regression and their advantages and limitations are outlined. A bird's eye review of the various types of ANNs and the related learning rules is presented, with special emphasis on backpropagation (BP) ANNs theory and design. A generalized methodology for developing successful ANNs projects from conceptualization, to design, to implementation, is described. The most common problems that BPANNs developers face during training are summarized in conjunction with possible causes and remedies. Finally, as a practical application, BPANNs were used to model the microbial growth curves of S. flexneri. The developed model was reasonably accurate in simulating both training and test time-dependent growth curves as affected by temperature and pH.

Improving the Efficiency and Effectiveness of Community Detection via Prior-Induced Equivalent Super-Network.

PubMed

Yang, Liang; Jin, Di; He, Dongxiao; Fu, Huazhu; Cao, Xiaochun; Fogelman-Soulie, Francoise

2017-03-29

Due to the importance of community structure in understanding network and a surge of interest aroused on community detectability, how to improve the community identification performance with pairwise prior information becomes a hot topic. However, most existing semi-supervised community detection algorithms only focus on improving the accuracy but ignore the impacts of priors on speeding detection. Besides, they always require to tune additional parameters and cannot guarantee pairwise constraints. To address these drawbacks, we propose a general, high-speed, effective and parameter-free semi-supervised community detection framework. By constructing the indivisible super-nodes according to the connected subgraph of the must-link constraints and by forming the weighted super-edge based on network topology and cannot-link constraints, our new framework transforms the original network into an equivalent but much smaller Super-Network. Super-Network perfectly ensures the must-link constraints and effectively encodes cannot-link constraints. Furthermore, the time complexity of super-network construction process is linear in the original network size, which makes it efficient. Meanwhile, since the constructed super-network is much smaller than the original one, any existing community detection algorithm is much faster when using our framework. Besides, the overall process will not introduce any additional parameters, making it more practical.

Data driven CAN node reliability assessment for manufacturing system

NASA Astrophysics Data System (ADS)

Zhang, Leiming; Yuan, Yong; Lei, Yong

2017-01-01

The reliability of the Controller Area Network(CAN) is critical to the performance and safety of the system. However, direct bus-off time assessment tools are lacking in practice due to inaccessibility of the node information and the complexity of the node interactions upon errors. In order to measure the mean time to bus-off(MTTB) of all the nodes, a novel data driven node bus-off time assessment method for CAN network is proposed by directly using network error information. First, the corresponding network error event sequence for each node is constructed using multiple-layer network error information. Then, the generalized zero inflated Poisson process(GZIP) model is established for each node based on the error event sequence. Finally, the stochastic model is constructed to predict the MTTB of the node. The accelerated case studies with different error injection rates are conducted on a laboratory network to demonstrate the proposed method, where the network errors are generated by a computer controlled error injection system. Experiment results show that the MTTB of nodes predicted by the proposed method agree well with observations in the case studies. The proposed data driven node time to bus-off assessment method for CAN networks can successfully predict the MTTB of nodes by directly using network error event data.

Praxis-based research networks: An emerging paradigm for research that is rigorous, relevant, and inclusive.

PubMed

Werner, James J; Stange, Kurt C

2014-01-01

Practice-based research networks (PBRNs) have developed a grounded approach to conducting practice-relevant and translational research in community practice settings. Seismic shifts in the health care landscape are shaping PBRNs that work across organizational and institutional margins to address complex problems. Praxis-based research networks combine PBRN knowledge generation with multistakeholder learning, experimentation, and application of practical knowledge. The catalytic processes in praxis-based research networks are cycles of action and reflection based on experience, observation, conceptualization, and experimentation by network members and partners. To facilitate co-learning and solution-building, these networks have a flexible architecture that allows pragmatic inclusion of stakeholders based on the demands of the problem and the needs of the network. Praxis-based research networks represent an evolving trend that combines the core values of PBRNs with new opportunities for relevance, rigor, and broad participation. © Copyright 2014 by the American Board of Family Medicine.

Individual and Social Network Sexual Behavior Norms of Homeless Youth at High Risk for HIV Infection

PubMed Central

Tyler, Kimberly A.; Melander, Lisa A.

2012-01-01

Although previous research shows that homeless youth engage in numerous risky sexual behaviors, little is known about whether or not specific rules govern this conduct within their social networks and how group norms influence subsequent sexual actions. The current study utilizes 19 in-depth interviews with homeless youth to investigate different elements of their sexual behavior. Findings reveal that their decision to have sex generally depends on chemistry and physical appearance whereas a potential partner’s risky sexual history and heavy substance use discourages youth from engaging in sex. Both males and females discuss condom usage as it relates to unknown sexual history, availability, pregnancy, and the prevention of sexually transmitted infections (STIs). Sixteen homeless youth indicate that they do not discuss safe sex practices with their partners or social network members. PMID:23162182

Individual and Social Network Sexual Behavior Norms of Homeless Youth at High Risk for HIV Infection.

PubMed

Tyler, Kimberly A; Melander, Lisa A

2012-12-01

Although previous research shows that homeless youth engage in numerous risky sexual behaviors, little is known about whether or not specific rules govern this conduct within their social networks and how group norms influence subsequent sexual actions. The current study utilizes 19 in-depth interviews with homeless youth to investigate different elements of their sexual behavior. Findings reveal that their decision to have sex generally depends on chemistry and physical appearance whereas a potential partner's risky sexual history and heavy substance use discourages youth from engaging in sex. Both males and females discuss condom usage as it relates to unknown sexual history, availability, pregnancy, and the prevention of sexually transmitted infections (STIs). Sixteen homeless youth indicate that they do not discuss safe sex practices with their partners or social network members.

The right friends in the right places: Understanding network structure as a predictor of voluntary turnover.

PubMed

Ballinger, Gary A; Cross, Rob; Holtom, Brooks C

2016-04-01

Research examining the relationship between social networks and employee retention has focused almost exclusively on the number of direct links and generally found that having more ties decreases the likelihood of turnover. The present research moves beyond simple measures of network centrality to investigate the relationship between 2 additional, and theoretically distinct, facets of social capital and voluntary turnover. In 2 organizations, we found consistent evidence of a negative relationship between reputation, as measured by relationships with highly sought-out others (incoming eigenvector centrality) and voluntary turnover. Further, we found that the negative relationship between brokerage (structural holes) and turnover is significant, but only for higher-level employees. The theoretical and practical implications of expanding the suite of social capital measures to understand voluntary turnover are discussed. (c) 2016 APA, all rights reserved).

Utilization of Non-Dentist Providers and Attitudes Toward New Provider Models: Findings from The National Dental Practice-Based Research Network

PubMed Central

Blue, Christine M.; Funkhouser, D. Ellen; Riggs, Sheila; Rindal, D. Brad; Worley, Donald; Pihlstrom, Daniel J.; Benjamin, Paul; Gilbert, Gregg H.

2014-01-01

Objectives The purpose of this study was to quantify within The National Dental Practice-Based Research Network current utilization of dental hygienists and assistants with expanded functions and quantify network dentists’ attitudes toward a new non-dentist provider model - the dental therapist. Methods Dental practice-based research network practitioner-investigators participated in a single, cross-sectional administration of a questionnaire. Results Current non-dentist providers are not being utilized by network practitioner-investigators to the fullest extent allowed by law. Minnesota practitioners, practitioners in large group practices, and those with prior experience with expanded function non-dentist providers delegate at a higher rate and had more-positive perceptions of the new dental therapist model. Conclusions Expanding scopes of practice for dental hygienists and assistants has not translated to the maximal delegation allowed by law among network practices. This finding may provide insight into dentists’ acceptance of newer non-dentist provider models. PMID:23668892

Translating research and into everyday clinical practice: Lessons learned from a USA national dental practice-based research network

PubMed Central

Gordan, Valeria V.

2012-01-01

Clinical studies are of paramount importance for testing and translation of the research findings to the community. Despite the existence of clinical studies, a significant delay exists between the generation of new knowledge and its application into the medical/dental community and their patients. One example is the repair of defective dental restorations. About 75% of practitioners in general dental practices do not consider the repair of dental restorations as a viable alternative to the replacement of defective restorations. Engaging and partnering with health practitioners in the field on studies addressing everyday clinical research questions may offer a solution to speed up the translation of the research findings. Practice-based research (PBR) offers a unique opportunity for practitioners to be involved in the research process, formulating clinical research questions. Additionally, PBR generates evidence-based knowledge with a broader spectrum that can be more readily generalized to the public. With PBR, clinicians are involved in the entire research process from its inception to its dissemination. Early practitioner interaction in the research process may result in ideas being more readily incorporated into practice. This paper discusses PBR as a mean to speed up the translation of research findings to clinical practice. It also reviews repair versus replacement of defective restorations as one example of the delay in the application of research findings to clinical practice. PMID:22889478

Information-Seeking Behaviors of Dental Practitioners in Three Practice-Based Research Networks

PubMed Central

Botello-Harbaum, Maria T.; Demko, Catherine A.; Curro, Frederick A.; Rindal, D. Brad; Collie, Damon; Gilbert, Gregg H.; Hilton, Thomas J.; Craig, Ronald G.; Wu, Juliann; Funkhouser, Ellen; Lehman, Maryann; McBride, Ruth; Thompson, Van; Lindblad, Anne

2013-01-01

Research on the information-seeking behaviors of dental practitioners is scarce. Knowledge of dentists’ information-seeking behaviors should advance the translational gap between clinical dental research and dental practice. A cross-sectional survey was conducted to examine the self-reported information-seeking behaviors of dentists in three dental practice-based research networks (PBRNs). A total of 950 dentists (65 percent response rate) completed the survey. Dental journals and continuing dental education (CDE) sources used and their influence on practice guidance were assessed. PBRN participation level and years since dental degree were measured. Full-participant dentists reported reading the Journal of the American Dental Association and General Dentistry more frequently than did their reference counterparts. Printed journals were preferred by most dentists. A lower proportion of full participants obtained their CDE credits at dental meetings compared to partial participants. Experienced dentists read other dental information sources more frequently than did less experienced dentists. Practitioners involved in a PBRN differed in their approaches to accessing information sources. Peer-reviewed sources were more frequently used by full participants and dentists with fifteen years of experience or more. Dental PBRNs potentially play a significant role in the dissemination of evidence-based information. This study found that specific educational sources might increase and disseminate knowledge among dentists. PMID:23382524

Multiple Assembly Rules Drive the Co-occurrence of Orthopteran and Plant Species in Grasslands: Combining Network, Functional and Phylogenetic Approaches

PubMed Central

Fournier, Bertrand; Mouly, Arnaud; Gillet, François

2016-01-01

Understanding the factors underlying the co-occurrence of multiple species remains a challenge in ecology. Biotic interactions, environmental filtering and neutral processes are among the main mechanisms evoked to explain species co-occurrence. However, they are most often studied separately or even considered as mutually exclusive. This likely hampers a more global understanding of species assembly. Here, we investigate the general hypothesis that the structure of co-occurrence networks results from multiple assembly rules and its potential implications for grassland ecosystems. We surveyed orthopteran and plant communities in 48 permanent grasslands of the French Jura Mountains and gathered functional and phylogenetic data for all species. We constructed a network of plant and orthopteran species co-occurrences and verified whether its structure was modular or nested. We investigated the role of all species in the structure of the network (modularity and nestedness). We also investigated the assembly rules driving the structure of the plant-orthopteran co-occurrence network by using null models on species functional traits, phylogenetic relatedness and environmental conditions. We finally compared our results to abundance-based approaches. We found that the plant-orthopteran co-occurrence network had a modular organization. Community assembly rules differed among modules for plants while interactions with plants best explained the distribution of orthopterans into modules. Few species had a disproportionately high positive contribution to this modular organization and are likely to have a key importance to modulate future changes. The impact of agricultural practices was restricted to some modules (3 out of 5) suggesting that shifts in agricultural practices might not impact the entire plant-orthopteran co-occurrence network. These findings support our hypothesis that multiple assembly rules drive the modular structure of the plant-orthopteran network. This modular structure is likely to play a key role in the response of grassland ecosystems to future changes by limiting the impact of changes in agricultural practices such as intensification to some modules leaving species from other modules poorly impacted. The next step is to understand the importance of this modular structure for the long-term maintenance of grassland ecosystem structure and functions as well as to develop tools to integrate network structure into models to improve their capacity to predict future changes. PMID:27582754

Data security and patient confidentiality: the manager's role.

PubMed

Fisher, F; Madge, B

1996-10-01

The maintenance of patient confidentiality is of utmost importance in the doctor patient relationship. With the advent of networks such as the National Health Service Wide Area Network in the UK, the potential to transmit identifiable clinical data will become greater. Links between general practitioners (GPs) and hospitals will allow the rapid transmission of data which if intercepted could be potentially embarrassing to the patient concerned. In 1994 the British Medical Association launched a draft bill on privacy and confidentiality and in association with this bill it is pushing for encryption of all clinical data across electronic networks. The manager's role within an acute hospital, community units and general practice, is to ensure that all employees are aware of the principles of data protection, security of hospital computer systems and that no obvious breaches of security can occur at publicly accessible terminals. Managers must be kept up to date with the latest developments in computer security such as digital signatures and be prepared to instigate these developments where practically possible. Managers must also take responsibility for the monitoring of access to terminals and be prepared to deal severely with staff who breach the code of confidentiality. Each manager must be kept informed of employees status with regard to their 'need to know' clearance level and also to promote confidentiality of patient details throughout the hospital. All of the management team must be prepared to train new staff in the principles of data security as they join the organisation and recognise their accountability if the programme fails. Data security and patient confidentiality is a broad responsibility in any healthcare organisation, with the Chief Executive accountable. In family practice, the partners are responsible and accountable. The British Medical Association believes as a matter of policy, that allowing access to personal health data without the patients consent, except in a legally allowable situation, should be a statutory offence.

Student evaluation of a primary care clerkship: quality assurance and identification of potential for improvement.

PubMed

Chenot, Jean-François; Kochen, Michael M; Himmel, Wolfgang

2009-04-15

In Germany, like many other countries, general practice clerkships have only recently become mandatory during medical education. The biggest challenges for the organisation of such clerkships are achieving a minimum level of standardisation, and developing and maintaining a system of quality assurance. The aim of this study is to assess the instructional quality in teaching practices using a benchmark system. Before commencing, students anonymously assessed the importance of core aspects of the mandatory primary care clerkship. After the clerkship, they evaluated learning opportunities and teaching performance. Based on this data, a benchmark system was developed to identify areas of strength and weakness for all practices as well as individual teaching practices. A total of 695 students evaluated 97 general practices belonging to a teaching network. Prior to the clerkship, most students considered recognition of frequent diseases (85%) and communication skills (65%) the most important learning goals. After the clerkship, nearly 90% of students confirmed that the general practitioner (GP) was good or excellent at teaching these two goals but only two-thirds thought the GP's teaching performance good or excellent in preventive medicine and screening. In an exemplary analysis, we identified the 2 best and the 2 worst practices that consistently received scores far above or below average, respectively. We were able to identify areas of weakness in teaching and identified specific GPs who did not meet the students' needs and expectations. This evaluation seems to be a useful quality assurance tool to identify the potential for improvement and faculty development.

47 CFR 36.311 - Network Support/General Support Expenses-Accounts 6110 and 6120 (Class B Telephone Companies...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Network Support/General Support Expenses... Operating Expenses and Taxes Network Support/general Support Expenses § 36.311 Network Support/General..., 6122, 6123, and 6124 (Class A Telephone Companies). (a) Network Support Expenses are expenses...

47 CFR 36.311 - Network Support/General Support Expenses-Accounts 6110 and 6120 (Class B Telephone Companies...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Network Support/General Support Expenses... Operating Expenses and Taxes Network Support/general Support Expenses § 36.311 Network Support/General..., 6122, 6123, and 6124 (Class A Telephone Companies). (a) Network Support Expenses are expenses...

[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.

International GPS Service for Geodynamics

NASA Technical Reports Server (NTRS)

Zumberge, J. F. (Editor); Urban, M. P. (Editor); Liu, R. (Editor); Neilan, R. E. (Editor)

1996-01-01

This 1995 annual report of the IGS International GPS (Global Positioning System) Service for Geodynamics - describes the second operational year of the service. It provides the many IGS contributing agencies and the rapidly growing user community with essential information on current organizational and technical matters promoting the IGS standards and products (including organizational framework, data processing strategies, and statistics showing the remarkable expansion of the GPS monitoring network, the improvement of IGS performance, and product quality). It also introduces important practical concepts for network densification by integration of regional stations and the combination of station coordinate solutions. There are groups of articles describing general aspects of the IGS, the Associate Analysis Centers (AACs), Data Centers, and IGS stations.

Design and Promotion Strategy of Marketing Platform of Aquatic Auction based on Internet

NASA Astrophysics Data System (ADS)

Peng, Jianliang

For the online trade and promotion of aquatic products and related materials through the network between supply and demand, the design content and effective promotional strategies of aquatic auctions online marketing platform is proposed in this paper. Design elements involve the location of customer service, the basic function of the platform including the purchase of general orders, online auctions, information dissemination, and recommendation of fine products, human services, and payment preferences. Based on network and mobile e-commerce transaction support, the auction platform makes the transaction of aquatic products well in advance. The results are important practical value for the design and application of online marketing platform of aquatic auction.

AHNS Series: Do you know your guidelines?Principles of radiation therapy for head and neck cancer: A review of the National Comprehensive Cancer Network guidelines.

PubMed

Gooi, Zhen; Fakhry, Carole; Goldenberg, David; Richmon, Jeremy; Kiess, Ana P

2016-07-01

This article is a continuation of the "Do You Know Your Guidelines" series, an initiative of the American Head and Neck Society's Education Committee to increase awareness of current best practices pertaining to head and neck cancer. The National Comprehensive Cancer Network guidelines for radiotherapy in the treatment for head and neck cancers are reviewed here in a systematic fashion according to site and stage. These guidelines outline indications for primary and adjuvant treatment, as well as general principles of radiotherapy. © 2016 Wiley Periodicals, Inc. Head Neck 38: 987-992, 2016. © 2016 Wiley Periodicals, Inc.

Digital Media for Primary Health Care in Austria.

PubMed

Kriegel, Johannes; Tuttle-Weidinger, Linda; Reckwitz, Luise

2017-01-01

Primary health care (PHC) is currently being improved in all developed industries. The aim is to make healthcare more patient-centered and close to the patient's place of residence. In addition to the organizational and interdisciplinary reorientation, the use of digital media is increasingly being emphasized. Through literature research and an online survey among Austrian doctors and general practitioners, the current and future challenges for the use of digital media in networked and regional primary health care were identified and prioritized. It becomes clear that basic functions like documentation, communication and coordination in the individual medical practice are at the forefront. In the future it will be necessary to support regional and interprofessional networking through digital media.

Assessing the self-development potential of a pharmacy management practitioner through self-assessment survey.

PubMed

Granko, Robert P; Wolfe, Adam S; Kelley, Lindsey R; Morton, Carolyn S; Delgado, Osmel

2015-01-15

The self-development potential of pharmacy management practitioners related to self-management, team development, and network management was assessed. A survey instrument consisting of 12 self-assessment questions and 11 questions about demographics was distributed to pharmacy management practitioners to assess their abilities to manage themselves, their teams, and their networks. The tool was distributed by e-mail hyperlink to 190 potential respondents. Only surveys from respondents who had a pharmacy degree and direct supervisory capacity were analyzed. Respondents rated their progress toward meeting the three imperatives on a scale of 1-5. Responses to the questions were analyzed as ordinal data, with median responses used for assessment. A total of 160 responses were received via e-mail, 149 (93%) of which met the inclusion criteria. About half of all respondents were practicing at institutions of 600 beds or more and supervised at least five employees. The majority of respondents identified their abilities to manage themselves, their teams, and their networks as areas of strength but also acknowledged that using all three of these skills on a daily basis was an area of opportunity. Respondents generally identified management of their network as an area needing work. The majority of survey respondents identified their skills in self-, team, and network management as areas of strength. Respondents generally identified management of their network as an area needing work. Respondents also identified the use of all three imperatives on a daily basis as an area of opportunity for improvement. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Boosting uptake of influenza immunisation: a randomised controlled trial of telephone appointing in general practice.

PubMed Central

Hull, Sally; Hagdrup, Nicola; Hart, Ben; Griffiths, Chris; Hennessy, Enid

2002-01-01

BACKGROUND: Immunisation against influenza is an effective intervention that reduces serologically confirmed cases by between 60% and 70%. Almost all influenza immunisation in the UK is done within general practice. Current evidence on the effectiveness of patient reminders for all types of immunisation programmes is largely based on North American studies. AIM: To determine whether telephone appointments offered bygeneral practice receptionists increase the uptake of irfluenza immunisation among the registered population aged over 65 years in east London practices. DESIGN OF STUDY: Randomised controlled trial. SETTING: Three research general practices within the East London and Essex network of researchers (ELENoR). METHOD: Participants were 1,820 low-risk patients aged 65 to 74 years who had not previously been in a recall system for influenza immunisation at their general practice. The intervention, during October 2000, was a telephone call from the practice receptionist to intervention group households, offering an appointment for influenza immunisation at a nurse-run. clinic Main outcome measures were the numbers of individuals in each group receiving immunisation, and practice costs of a telephone-appointing programme. RESULTS: intention to treat analysis showed an immunisation rate in the control group of 44%, compared with 50% in the intervention group (odds ratio = 1.29, 95% confidence interval = 1.03 to 1.63). Of the patients making a telephone appointment, 88% recieved immunisation, while 22% of those not wanting an appointment went on to be immunised. In the controlgroup, income generated was 11.35 pounds per immunisation, for each additional immunisation in the intervention group the income was 5.20 pounds. The 'number needed to telephone' was 17. CONCLUSION: Uptake of influenza immunisation among the low-risk older population in inner-city areas can be boosted by around 6% using a simple intervention by receptionists. Immunisation rates in this low-risk group fell well short of the 60% government target. Improving immunisation rates will require a sustained public health campaign. Retaining the item-of-service payments to practices should support costs of practice-based interventions. PMID:12236273

Mind-Body Practice Changes Fractional Amplitude of Low Frequency Fluctuations in Intrinsic Control Networks

PubMed Central

Wei, Gao-Xia; Gong, Zhu-Qing; Yang, Zhi; Zuo, Xi-Nian

2017-01-01

Cognitive control impairment is a typical symptom largely reported in populations with neurological disorders. Previous studies have provided evidence about the changes in cognitive control induced by mind-body training. However, the neural correlates underlying the effect of extensive mind-body practice on cognitive control remain largely unknown. Using resting-state functional magnetic resonance imaging, we characterized dynamic fluctuations in large-scale intrinsic connectivity networks associated with mind-body practice, and examined their differences between healthy controls and Tai Chi Chuan (TCC) practitioners. Compared with a control group, the TCC group revealed significantly decreased fractional Amplitude of Low Frequency Fluctuations (fALFF) in the bilateral frontoparietal network, default mode network and dorsal prefrontal-angular gyri network. Furthermore, we detected a significant association between mind-body practice experience and fALFF in the default mode network, as well as an association between cognitive control performance and fALFF of the frontoparietal network. This provides the first evidence of large-scale functional connectivity in brain networks associated with mind-body practice, shedding light on the neural network changes that accompany intensive mind-body training. It also highlights the functionally plastic role of the frontoparietal network in the context of the “immune system” of mental health recently developed in relation to flexible hub theory. PMID:28736535

Mind-Body Practice Changes Fractional Amplitude of Low Frequency Fluctuations in Intrinsic Control Networks.

PubMed

Wei, Gao-Xia; Gong, Zhu-Qing; Yang, Zhi; Zuo, Xi-Nian

2017-01-01

Cognitive control impairment is a typical symptom largely reported in populations with neurological disorders. Previous studies have provided evidence about the changes in cognitive control induced by mind-body training. However, the neural correlates underlying the effect of extensive mind-body practice on cognitive control remain largely unknown. Using resting-state functional magnetic resonance imaging, we characterized dynamic fluctuations in large-scale intrinsic connectivity networks associated with mind-body practice, and examined their differences between healthy controls and Tai Chi Chuan (TCC) practitioners. Compared with a control group, the TCC group revealed significantly decreased fractional Amplitude of Low Frequency Fluctuations (fALFF) in the bilateral frontoparietal network, default mode network and dorsal prefrontal-angular gyri network. Furthermore, we detected a significant association between mind-body practice experience and fALFF in the default mode network, as well as an association between cognitive control performance and fALFF of the frontoparietal network. This provides the first evidence of large-scale functional connectivity in brain networks associated with mind-body practice, shedding light on the neural network changes that accompany intensive mind-body training. It also highlights the functionally plastic role of the frontoparietal network in the context of the "immune system" of mental health recently developed in relation to flexible hub theory.

Oncology nurses' use of National Comprehensive Cancer Network clinical practice guidelines for chemotherapy-induced and febrile neutropenia.

PubMed

Nirenberg, Anita; Reame, Nancy K; Cato, Kenrick D; Larson, Elaine L

2010-11-01

To describe oncology nurses' use of National Comprehensive Cancer Network (NCCN) clinical practice guidelines for chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN). Cross-sectional survey design; descriptive, correlational analysis. E-mail invitation to Web-based survey. Random sample of 309 Oncology Nursing Society (ONS) members with e-mail addresses who provide care to adult patients receiving chemotherapy. The investigator-developed Neutropenia Oncology Nurses Survey was used. Descriptive tests compared respondents' personal and professional characteristics to those of general ONS members; nonparametric chi-square and Kruskal-Wallis tests were used to correlate respondents' survey subscale scores with demographic data. Significant associations were entered into multiple logistic regression models. The Neutropenia Oncology Nurses Survey's subscales measured subjective norm, attitude, perceived competence and confidence, perceived barriers, and use of NCCN clinical practice guidelines for CIN and FN. Response rate of nurses who opened the survey was 50%. Most practiced in community versus academic centers. Eighty percent reported using the NCCN clinical practice guidelines for CIN and FN. Respondents were more likely to use clinical practice guidelines when they were expected to by physician and nurse colleagues, they perceived fewer barriers, or they held advanced oncology certification. This study was the first to assess oncology nurses' reported use of NCCN clinical practice guidelines for CIN and FN. It also demonstrated the feasibility of partnering with ONS for Web-based survey research. The findings give insight into work-place barriers to evidence-based practice in various settings. Expanding dissemination and implementation of clinical practice guideline recommendations will support the development of oncology nursing standards for risk assessment, management, and patient and family education in CIN and FN.

Therapist effects on dropout from a college counseling center practice research network.

PubMed

Xiao, Henry; Castonguay, Louis G; Janis, Rebecca A; Youn, Soo Jeong; Hayes, Jeffrey A; Locke, Benjamin D

2017-07-01

Dropout has been a pervasive and costly problem in psychotherapy, particularly for college counseling centers. The present study examined potential predictors of dropout using a large data set (N = 10,147 clients, 481 therapists) that was gathered through a college counseling center practice research network as a replication and extension of recent findings regarding therapist effects on dropout. The final model resulted in a dropout rate of 15.9% and a therapist effect of 9.51% on dropout variance. Therapist demographic variables were investigated, though none were found to be significant. Variables found to be predictive of increased likelihood of dropping out included higher levels of general presenting concerns, alcohol-related distress, and current financial stress. Ultimately, this study showed that therapists may play an important role in the likelihood of client dropout, and that additional research should be conducted to identify additional predictors, particularly at the therapist and center level. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

General and craniofacial development are complex adaptive processes influenced by diversity.

PubMed

Brook, A H; O'Donnell, M Brook; Hone, A; Hart, E; Hughes, T E; Smith, R N; Townsend, G C

2014-06-01

Complex systems are present in such diverse areas as social systems, economies, ecosystems and biology and, therefore, are highly relevant to dental research, education and practice. A Complex Adaptive System in biological development is a dynamic process in which, from interacting components at a lower level, higher level phenomena and structures emerge. Diversity makes substantial contributions to the performance of complex adaptive systems. It enhances the robustness of the process, allowing multiple responses to external stimuli as well as internal changes. From diversity comes variation in outcome and the possibility of major change; outliers in the distribution enhance the tipping points. The development of the dentition is a valuable, accessible model with extensive and reliable databases for investigating the role of complex adaptive systems in craniofacial and general development. The general characteristics of such systems are seen during tooth development: self-organization; bottom-up emergence; multitasking; self-adaptation; variation; tipping points; critical phases; and robustness. Dental findings are compatible with the Random Network Model, the Threshold Model and also with the Scale Free Network Model which has a Power Law distribution. In addition, dental development shows the characteristics of Modularity and Clustering to form Hierarchical Networks. The interactions between the genes (nodes) demonstrate Small World phenomena, Subgraph Motifs and Gene Regulatory Networks. Genetic mechanisms are involved in the creation and evolution of variation during development. The genetic factors interact with epigenetic and environmental factors at the molecular level and form complex networks within the cells. From these interactions emerge the higher level tissues, tooth germs and mineralized teeth. Approaching development in this way allows investigation of why there can be variations in phenotypes from identical genotypes; the phenotype is the outcome of perturbations in the cellular systems and networks, as well as of the genotype. Understanding and applying complexity theory will bring about substantial advances not only in dental research and education but also in the organization and delivery of oral health care. © 2014 Australian Dental Association.

Assessing the Preconditions for Communication Influence on Decision Making: The North American Quitline Consortium

PubMed Central

Bonito, Joseph A.; Ruppel, Erin K.; Leischow, Scott J.; Saul, Jessie

2013-01-01

The network of North American quitlines is a loose confederation of telephone-based smoking cessation counseling providers. Each quitline has some leeway in the types of services it provides, and the purpose of this paper is to identify factors that explain such choices. Representatives from quitline organizations responded to a survey regarding the importance of several items that were hypothesized to influence general intentions to adopt and implement new cessation methods. Results indicate that internal (to the quitline) constraints are positively associated with consensus processes and that implementation of practices in general was more likely if consensus processes were used. Unilateral decision making (one person within an organization makes decisions for the quitline on his/her own) was unrelated to either internal or external constraints, and was negatively associated with adoption of quitline practices. Discussion focuses on factors that influence consensus decision making processes beyond those investigated in the paper. PMID:22582759

The development, design, testing, refinement, simulation and application of an evaluation framework for communities of practice and social-professional networks

PubMed Central

Braithwaite, Jeffrey; Westbrook, Johanna I; Ranmuthugala, Geetha; Cunningham, Frances; Plumb, Jennifer; Wiley, Janice; Ball, Dianne; Huckson, Sue; Hughes, Cliff; Johnston, Brian; Callen, Joanne; Creswick, Nerida; Georgiou, Andrew; Betbeder-Matibet, Luc; Debono, Deborah

2009-01-01

Background Communities of practice and social-professional networks are generally considered to enhance workplace experience and enable organizational success. However, despite the remarkable growth in interest in the role of collaborating structures in a range of industries, there is a paucity of empirical research to support this view. Nor is there a convincing model for their systematic evaluation, despite the significant potential benefits in answering the core question: how well do groups of professionals work together and how could they be organised to work together more effectively? This research project will produce a rigorous evaluation methodology and deliver supporting tools for the benefit of researchers, policymakers, practitioners and consumers within the health system and other sectors. Given the prevalence and importance of communities of practice and social networks, and the extent of investments in them, this project represents a scientific innovation of national and international significance. Methods and design Working in four conceptual phases the project will employ a combination of qualitative and quantitative methods to develop, design, field-test, refine and finalise an evaluation framework. Once available the framework will be used to evaluate simulated, and then later existing, health care communities of practice and social-professional networks to assess their effectiveness in achieving desired outcomes. Peak stakeholder groups have agreed to involve a wide range of members and participant organisations, and will facilitate access to various policy, managerial and clinical networks. Discussion Given its scope and size, the project represents a valuable opportunity to achieve breakthroughs at two levels; firstly, by introducing novel and innovative aims and methods into the social research process and, secondly, through the resulting evaluation framework and tools. We anticipate valuable outcomes in the improved understanding of organisational performance and delivery of care. The project's wider appeal lies in transferring this understanding to other health jurisdictions and to other industries and sectors, both nationally and internationally. This means not merely publishing the results, but contextually interpreting them, and translating them to advance the knowledge base and enable widespread institutional and organisational application. PMID:19754942

Aggregating quantum repeaters for the quantum internet

NASA Astrophysics Data System (ADS)

Azuma, Koji; Kato, Go

2017-09-01

The quantum internet holds promise for accomplishing quantum teleportation and unconditionally secure communication freely between arbitrary clients all over the globe, as well as the simulation of quantum many-body systems. For such a quantum internet protocol, a general fundamental upper bound on the obtainable entanglement or secret key has been derived [K. Azuma, A. Mizutani, and H.-K. Lo, Nat. Commun. 7, 13523 (2016), 10.1038/ncomms13523]. Here we consider its converse problem. In particular, we present a universal protocol constructible from any given quantum network, which is based on running quantum repeater schemes in parallel over the network. For arbitrary lossy optical channel networks, our protocol has no scaling gap with the upper bound, even based on existing quantum repeater schemes. In an asymptotic limit, our protocol works as an optimal entanglement or secret-key distribution over any quantum network composed of practical channels such as erasure channels, dephasing channels, bosonic quantum amplifier channels, and lossy optical channels.

An application of programmatic assessment for learning (PAL) system for general practice training.

PubMed

Schuwirth, Lambert; Valentine, Nyoli; Dilena, Paul

2017-01-01

Aim: Programmatic assessment for learning (PAL) is becoming more and more popular as a concept but its implementation is not without problems. In this paper we describe the design principles behind a PAL program in a general practice training context. Design principles: The PAL program was designed to optimise the meaningfulness of assessment information for the registrar and to make him/her use that information to self regulate their learning. The main principles in the program were cognitivist and transformative. The main cognitive principles we used were fostering the understanding of deep structures and stimulating transfer by making registrars constantly connect practice experiences with background knowledge. Ericsson's deliberate practice approach was built in with regard to the provision of feedback combined with Pintrich's model of self regulation. Mezirow's transformative learning and insights from social network theory on collaborative learning were used to support the registrars in their development to become GP professionals. Finally the principal of test enhanced learning was optimised. Epilogue: We have provided this example explain the design decisions behind our program, but not want to present our program as the solution to any given situation.

Characterizing Behavioral and Brain Changes Associated with Practicing Reasoning Skills

PubMed Central

Mackey, Allyson P.; Miller Singley, Alison T.; Wendelken, Carter; Bunge, Silvia A.

2015-01-01

We have reported previously that intensive preparation for a standardized test that taxes reasoning leads to changes in structural and functional connectivity within the frontoparietal network. Here, we investigated whether reasoning instruction transfers to improvement on unpracticed tests of reasoning, and whether these improvements are associated with changes in neural recruitment during reasoning task performance. We found behavioral evidence for transfer to a transitive inference task, but no evidence for transfer to a rule generation task. Across both tasks, we observed reduced lateral prefrontal activation in the trained group relative to the control group, consistent with other studies of practice-related changes in brain activation. In the transitive inference task, we observed enhanced suppression of task-negative, or default-mode, regions, consistent with work suggesting that better cognitive skills are associated with more efficient switching between networks. In the rule generation task, we found a pattern consistent with a training-related shift in the balance between phonological and visuospatial processing. Broadly, we discuss general methodological considerations related to the analysis and interpretation of training-related changes in brain activation. In summary, we present preliminary evidence for changes in brain activation associated with practice of high-level cognitive skills. PMID:26368278

Research on a practical telecom and CATV co-network transmission system

NASA Astrophysics Data System (ADS)

Mao, Youju

1998-12-01

A practical co-network transmission system of Telecom and CATV over installed Telecom network is designed. The system, making use of WDM and other technologies, has undergone experiments and performance tests on the Public Switched Telephone Network, which illustrate that optical fiber telecommunication network could be thereby transformed into a unified broadband network integrating VOICE, DATA, and VEDIO expeditiously and conveniently.

The Athletic Trainer's Role in Modifying Nutritional Behaviors of Adolescent Athletes: Putting Theory into Practice

PubMed Central

Hackman, Robert M.; Katra, Jane E.; Geertsen, Susan M.

1992-01-01

Nutritional practices influence athletic performance and recovery from injury. The athletic trainer is ideally positioned to effect dietary changes with adolescent athletes—a group at high-risk for nutritional imbalances. Research shows that young adults generally do not change dietary practices when given factual nutrition and health information. This article provides a variety of behavior change strategies, based on models derived from health education and health psychology, which are likely to influence dietary choices. Promoting self-efficacy by enhancing perception of choice and control, peer modeling, cooperative support networks, goal-setting techniques, and behavioral self-monitoring may provide the motivational framework necessary to enhance dietary compliance. Dietary behavior change techniques are a valuable part of an athletic trainer's resources. PMID:16558172

Embedding recurrent neural networks into predator-prey models.

PubMed

Moreau, Yves; Louiès, Stephane; Vandewalle, Joos; Brenig, Leon

1999-03-01

We study changes of coordinates that allow the embedding of ordinary differential equations describing continuous-time recurrent neural networks into differential equations describing predator-prey models-also called Lotka-Volterra systems. We transform the equations for the neural network first into quasi-monomial form (Brenig, L. (1988). Complete factorization and analytic solutions of generalized Lotka-Volterra equations. Physics Letters A, 133(7-8), 378-382), where we express the vector field of the dynamical system as a linear combination of products of powers of the variables. In practice, this transformation is possible only if the activation function is the hyperbolic tangent or the logistic sigmoid. From this quasi-monomial form, we can directly transform the system further into Lotka-Volterra equations. The resulting Lotka-Volterra system is of higher dimension than the original system, but the behavior of its first variables is equivalent to the behavior of the original neural network. We expect that this transformation will permit the application of existing techniques for the analysis of Lotka-Volterra systems to recurrent neural networks. Furthermore, our results show that Lotka-Volterra systems are universal approximators of dynamical systems, just as are continuous-time neural networks.

Inhibiting diffusion of complex contagions in social networks: theoretical and experimental results

PubMed Central

Anil Kumar, V.S.; Marathe, Madhav V.; Ravi, S.S.; Rosenkrantz, Daniel J.

2014-01-01

We consider the problem of inhibiting undesirable contagions (e.g. rumors, spread of mob behavior) in social networks. Much of the work in this context has been carried out under the 1-threshold model, where diffusion occurs when a node has just one neighbor with the contagion. We study the problem of inhibiting more complex contagions in social networks where nodes may have thresholds larger than 1. The goal is to minimize the propagation of the contagion by removing a small number of nodes (called critical nodes) from the network. We study several versions of this problem and prove that, in general, they cannot even be efficiently approximated to within any factor ρ ≥ 1, unless P = NP. We develop efficient and practical heuristics for these problems and carry out an experimental study of their performance on three well known social networks, namely epinions, wikipedia and slashdot. Our results show that these heuristics perform significantly better than five other known methods. We also establish an efficiently computable upper bound on the number of nodes to which a contagion can spread and evaluate this bound on many real and synthetic networks. PMID:25750583

Innovation in Indigenous Health and Medical Education: The Leaders in Indigenous Medical Education (LIME) Network as a Community of Practice.

PubMed

Mazel, Odette; Ewen, Shaun

2015-01-01

The Leaders in Indigenous Medical Education (LIME) Network aims to improve the quality and effectiveness of Indigenous health in medical education as well as best practice in the recruitment, retention, and graduation of Indigenous medical students. In this article we explore the utility of Etienne Wenger's "communities of practice" (CoP) concept in providing a theoretical framework to better understand the LIME Network as a form of social infrastructure to further knowledge and innovation in this important area of health care education reform. The Network operates across all medical schools in Australia and New Zealand. Utilizing a model of evaluation of communities of practice developed by Fung-Kee-Fung et al., we seek to analyze the outcomes of the LIME Network as a CoP and assess its approach and contribution to improving the implementation of Indigenous health in the medical curriculum and the graduation of Indigenous medical students. By reflecting on the Network through a community of practice lens, this article highlights the synthesis between the LIME Network and Wenger's theory and provides a framework with which to measure Network outputs. It also posits an opportunity to better capture the impact of Network activities into the future to ensure that it remains a relevant and sustainable entity.

At the coalface and the cutting edge: general practitioners’ accounts of the rewards of engaging with HIV medicine

PubMed Central

2013-01-01

Background HIV has become a chronic manageable infection in the developed world, and early and lifelong treatment has the potential to significantly reduce transmission rates in the community. A skilled and motivated HIV medical workforce will be required to achieve these health management and prevention outcomes, but concerns have been noted in a number of settings about the challenges of recruiting a new generation of clinicians to HIV medicine. Methods As part of a larger qualitative study of the HIV general practice workforce in Australia, in-depth interviews were conducted with 31 general practitioners accredited to prescribe HIV medications in community settings. A thematic analysis was conducted of the de-identified transcripts, and this paper describes and interprets accounts of the rewards of pursuing and sustaining an engagement with HIV medicine in general practice settings. Results The rewards of initially becoming involved in providing care to people living with HIV were described as interest and inspiration, community calling and right place, right time. The rewards which then supported and sustained that engagement over time were described as challenge and change, making a difference and enhanced professional identity. Participants viewed the role of primary care doctor with special expertise in HIV as occupying an ideal interface between the ‘coalface’ and the ‘cutting edge’, and offering a unique opportunity for general practitioners to feel intimately connected to both community needs and scientific change. Conclusions Approaches to recruiting and retaining the HIV medical workforce should build upon the intellectual and social rewards of this work, as well as the sense of professional belonging and connection which is imbued between both doctors and patients and across the global and national networks of HIV clinicians. Insights regarding the rewards of engaging with HIV medicine may also be useful in enhancing the prospect of general practice as a career, and strengthening retention and job satisfaction among the existing general practice workforce. PMID:23517462

GPs' perceptions of workload in England: a qualitative interview study.

PubMed

Croxson, Caroline Hd; Ashdown, Helen F; Hobbs, Fd Richard

2017-02-01

GPs report the lowest levels of morale among doctors, job satisfaction is low, and the GP workforce is diminishing. Workload is frequently cited as negatively impacting on commitment to a career in general practice, and many GPs report that their workload is unmanageable. To gather an in-depth understanding of GPs' perceptions and attitudes towards workload. All GPs working within NHS England were eligible. Advertisements were circulated via regional GP e-mail lists and national social media networks in June 2015. Of those GPs who responded, a maximum-variation sample was selected until data saturation was reached. Semi-structured, qualitative interviews were conducted. Data were analysed thematically. In total, 171 GPs responded, and 34 were included in this study. GPs described an increase in workload over recent years, with current working days being long and intense, raising concerns over the wellbeing of GPs and patients. Full-time partnership was generally not considered to be possible, and many participants felt workload was unsustainable, particularly given the diminishing workforce. Four major themes emerged to explain increased workload: increased patient needs and expectations; a changing relationship between primary and secondary care; bureaucracy and resources; and the balance of workload within a practice. Continuity of care was perceived as being eroded by changes in contracts and working patterns to deal with workload. This study highlights the urgent need to address perceived lack of investment and clinical capacity in general practice, and suggests that managing patient expectations around what primary care can deliver, and reducing bureaucracy, have become key issues, at least until capacity issues are resolved. © British Journal of General Practice 2017.

Diffusion of surgical techniques in early stage breast cancer: variables related to adoption and implementation of sentinel lymph node biopsy.

PubMed

Vanderveen, Kimberly A; Paterniti, Debora A; Kravitz, Richard L; Bold, Richard J

2007-05-01

Understanding how physicians acquire and adopt new technologies for cancer diagnosis and treatment is poorly understood, yet is critical to the dissemination of evidence-based practices. Sentinel lymph node biopsy (SLNB) has recently become a standard technique for axillary staging in early breast cancer and is an ideal platform for studying medical technology diffusion. We sought to describe the timing of SLNB adoption and patterns of surgeon interactions with the following educational sources: local university training program, surgical literature, national meetings/courses, national specialty centers, and other local surgeons. A cross-sectional survey that used semistructured interviews was used to assess timing of adoption, practice patterns, and learning sources for SLNB among surgical oncologists and general surgeons in a single metropolitan area. A total of 44 eligible surgeons were identified; 38 (86%) participated. All surgical oncologists (11 of 11) and most general surgeons (26 of 27) had implemented SLNB. Surgical oncologists were older (mean 51 vs. 48 years, P = .02) and had used SLNB longer (6.1 vs. 3.3 years, P = .01) than general surgeons. By use of social network diagrams, surgical oncologists and the university training program were shown to be key intermediaries between general surgeons and national specialty centers. Surgeons in group practice tended to use more learning sources than solo practitioners. Surgical oncologists and university-based surgeons play key educational roles in disseminating new cancer treatments and therefore have a professional responsibility to educate other community physicians to increase the use of the most current, evidence-based practices.

A reusability and efficiency oriented software design method for mobile land inspection

NASA Astrophysics Data System (ADS)

Cai, Wenwen; He, Jun; Wang, Qing

2008-10-01

Aiming at the requirement from the real-time land inspection domain, a land inspection handset system was presented in this paper. In order to increase the reusability of the system, a design pattern based framework was presented. Encapsulation for command like actions by applying COMMAND pattern was proposed for the problem of complex UI interactions. Integrating several GPS-log parsing engines into a general parsing framework was archived by introducing STRATEGY pattern. A network transmission module based network middleware was constructed. For mitigating the high coupling of complex network communication programs, FACTORY pattern was applied to facilitate the decoupling. Moreover, in order to efficiently manipulate huge GIS datasets, a VISITOR pattern and Quad-tree based multi-scale representation method was presented. It had been proved practically that these design patterns reduced the coupling between the subsystems, and improved the expansibility.

Laplacian Estrada and normalized Laplacian Estrada indices of evolving graphs.

PubMed

Shang, Yilun

2015-01-01

Large-scale time-evolving networks have been generated by many natural and technological applications, posing challenges for computation and modeling. Thus, it is of theoretical and practical significance to probe mathematical tools tailored for evolving networks. In this paper, on top of the dynamic Estrada index, we study the dynamic Laplacian Estrada index and the dynamic normalized Laplacian Estrada index of evolving graphs. Using linear algebra techniques, we established general upper and lower bounds for these graph-spectrum-based invariants through a couple of intuitive graph-theoretic measures, including the number of vertices or edges. Synthetic random evolving small-world networks are employed to show the relevance of the proposed dynamic Estrada indices. It is found that neither the static snapshot graphs nor the aggregated graph can approximate the evolving graph itself, indicating the fundamental difference between the static and dynamic Estrada indices.

Network influences on dissemination of evidence-based guidelines in state tobacco control programs.

PubMed

Luke, Douglas A; Wald, Lana M; Carothers, Bobbi J; Bach, Laura E; Harris, Jenine K

2013-10-01

Little is known regarding the social network relationships that influence dissemination of evidence-based public health practices and policies. In public health, it is critical that evidence-based guidelines, such as the Centers for Disease Control and Prevention's Best Practices for Comprehensive Tobacco Control Programs, are effectively and efficiently disseminated to intended stakeholders. To determine the organizational and network predictors of dissemination among state tobacco control programs, interviews with members of tobacco control networks across eight states were conducted between August 2009 and September 2010. Measures included partner attributes (e.g., agency type) and relationships among network members (frequency of contact, extent of collaboration, and dissemination of Best Practices). Exponential random graph modeling was used to examine attribute and structural predictors of collaboration and dissemination among partners in each network. Although density and centralization of dissemination ties varied across states, network analyses revealed a consistent prediction pattern across all eight states. State tobacco control dissemination networks were less dense but more centralized compared with organizational contact and collaboration networks. Tobacco control partners in each state were more likely to disseminate the Best Practices guidelines if they also had existing contact and collaboration relationships with one another. Evidence-based guidelines in public health need to be efficiently and broadly disseminated if we hope to translate science into practice. This study suggests that funders, advocacy groups, and public health agencies can take advantage of existing public health organizational relationships to support the communication and dissemination of evidence-based practices and policies.

Social media and your practice: navigating the surgeon-patient relationship.

PubMed

McLawhorn, Alexander S; De Martino, Ivan; Fehring, Keith A; Sculco, Peter K

2016-12-01

Utilization of social media both in the private and professional arenas has grown rapidly in the last decade. The rise of social media use within health care can be viewed as the Internet-based corollary of the patient-centered care movement, in which patient perspectives and values are central to the delivery of quality care. For orthopedic surgeons and their practices, general-purpose online social networks, such as Facebook and Twitter, are convenient platforms for marketing, providing patient education and generating referrals. Virtual health communities are used less frequently by orthopedic surgeons but provide forums for patient engagement and active surgeon-to-patient communication via blogs and ask-the-doctor platforms. This commentary reviews the current state of social media use in orthopedic practice, with particular emphasis on managing the extension of the surgeon-patient relationship online, including the unique practice risks social media poses, such as privacy concerns, potential liability, and time consumption.

Keep logging in! Experimental evidence showing the relation of affiliation needs to the idea of online social networking.

PubMed

Lee, Chun-Chia; Chiou, Wen-Bin

2013-06-01

As social networking sites (SNS) increasingly provide social connections that meet the need for affiliation, people are developing symbiotic relationships with these sites. Drawing on the notion that people motivated by affiliation may increase their attention to sources that provide social connections, we conducted a lab experiment to explore whether priming affiliation needs would prompt the idea of online social networking. Participants were randomly assigned to one of three between-subjects conditions (affiliation arousal, social exclusion, control) in which we employed the scrambled-sentence paradigm to manipulate affiliation motivations. Each experimental condition was followed by a modified Stroop task (a color naming task) to test reaction times to SNS and non-SNS terms (including general terms and brand names). People who were primed to think about a topic typically showed slowed reaction times for naming the color of related words (i.e., Stroop interference), as those words become more interesting and accessible. Confirming our hypothesis, participants took longer to name the font color of SNS-related words than that of matched general words when affiliation motivation was evoked. Moreover, priming with affiliation motivation created more Stroop interference for SNS brand names rather than for other global brand names. These results suggest that the idea of online social networking seems to have become deeply rooted in human social practices.

Medical education practice-based research networks: Facilitating collaborative research.

PubMed

Schwartz, Alan; Young, Robin; Hicks, Patricia J

2016-01-01

Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging. In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN). We searched for extant networks through peer-reviewed literature and the world-wide web. We identified 15 research networks in medical education founded since 2002 with membership ranging from 8 to 120 programs. Most focus on graduate medical education in primary care or emergency medicine specialties. We offer four recommendations for the further development and spread of medical education research networks: increasing faculty development, obtaining central resources, studying networks themselves, and developing networks of networks.

Medical education practice-based research networks: Facilitating collaborative research

PubMed Central

Schwartz, Alan; Young, Robin; Hicks, Patricia J.; APPD LEARN, For

2016-01-01

Abstract Background: Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging. Aims: In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN). Methods: We searched for extant networks through peer-reviewed literature and the world-wide web. Results: We identified 15 research networks in medical education founded since 2002 with membership ranging from 8 to 120 programs. Most focus on graduate medical education in primary care or emergency medicine specialties. Conclusions: We offer four recommendations for the further development and spread of medical education research networks: increasing faculty development, obtaining central resources, studying networks themselves, and developing networks of networks. PMID:25319404

The 'sense of alarm' ('gut feeling') in clinical practice. A survey among European general practitioners on recognition and expression.

PubMed

Stolper, Erik; van Royen, Paul; Dinant, Geert Jan

2010-06-01

Most general practitioners in the Netherlands and Flanders (Belgium) are familiar with that special feeling during certain consultations: 'There's something wrong here, though I have no specific indications yet'. This 'sense of alarm' alerts the doctor, activates the diagnostic process and induces him to initiate specific management to prevent serious health problems. We wanted to know whether this sense of alarm is a typical phenomenon among Dutch-speaking GPs or is also recognized by GPs elsewhere in Europe. A short questionnaire survey was held among 128 GPs in 28 countries included in the European General Practitioners Research Network (EGPRN). GPs were asked if they recognized our description of the 'sense of alarm' and if they used a typical phrase in their language to express this uneasy feeling. We received 30 replies from GPs in 16 European countries, plus Israel and South-Africa. They all recognized our description and 25 GPs reported typical expressions in their own language. The GPs' uneasy feeling was sometimes perceived as a bodily sensation. The 'sense of alarm' is a familiar phenomenon in general practices in Europe. We propose to use the English phrase 'gut feelings' in further research reports.

A decade of neural networks: Practical applications and prospects

NASA Technical Reports Server (NTRS)

Kemeny, Sabrina (Editor); Thakoor, Anil (Editor)

1994-01-01

On May 11-13, 1994, JPL's Center for Space Microelectronics Technology (CSMT) hosted a neural network workshop entitled, 'A Decade of Neural Networks: Practical Applications and Prospects,' sponsored by DOD and NASA. The past ten years of renewed activity in neural network research has brought the technology to a crossroads regarding the overall scope of its future practical applicability. The purpose of the workshop was to bring together the sponsoring agencies, active researchers, and the user community to formulate a vision for the next decade of neural network research and development prospects, with emphasis on practical applications. Of the 93 participants, roughly 15% were from government agencies, 30% were from industry, 20% were from universities, and 35% were from Federally Funded Research and Development Centers (FFRDC's).

Composing Networks: Writing Practices on Mobile Devices

ERIC Educational Resources Information Center

Swarts, Jason

2016-01-01

This article is an investigation of composing practices through which people create networks with mobile phones. By looking through the lens of actor-network theory, the author portrays the networking activity of mobile phone users as translation, what Latour describes as an infralanguage to which different disciplinary perspectives can be…

Introducing the idea of 'assumed shared food narratives' in the context of social networks: reflections from a qualitative study conducted in Nottingham, England.

PubMed

Bissell, Paul; Peacock, Marian; Holdsworth, Michelle; Powell, Katie; Wilcox, John; Clonan, Angie

2018-06-19

This study explores the ways in which social networks might shape accounts about food practices. Drawing on insights from the work of Christakis and Fowler () whose claims about the linkages between obesity and social networks have been the subject of vigorous debate in the sociological literature, we present qualitative data from a study of women's' accounts of social networks and food practices, conducted in Nottingham, England. We tentatively suggest that whilst social networks in their broadest sense, might shape what was perceived to be normal and acceptable in relation to food practices (and provide everyday discursive resources which normalise practice), the relationship between the two is more complex than the linear relationship proposed by Christakis and Fowler. Here, we introduce the idea of assumed shared food narratives (ASFNs), which, we propose, sheds light on motive talk about food practices, and which also provide practical and discursive resources to actors seeking to protect and defend against 'untoward' behaviour, in the context of public health messages around food and eating. We suggest that understanding ASFNs and the ways in which they are embedded in social networks represents a novel way of understanding food and eating practices from a sociological perspective. © 2018 Foundation for the Sociology of Health & Illness.

Readiness for the Patient-Centered Medical Home: structural capabilities of Massachusetts primary care practices.

PubMed

Friedberg, Mark W; Safran, Dana G; Coltin, Kathryn L; Dresser, Marguerite; Schneider, Eric C

2009-02-01

The Patient-Centered Medical Home (PCMH), a popular model for primary care reorganization, includes several structural capabilities intended to enhance quality of care. The extent to which different types of primary care practices have adopted these capabilities has not been previously studied. To measure the prevalence of recommended structural capabilities among primary care practices and to determine whether prevalence varies among practices of different size (number of physicians) and administrative affiliation with networks of practices. Cross-sectional analysis. One physician chosen at random from each of 412 primary care practices in Massachusetts was surveyed about practice capabilities during 2007. Practice size and network affiliation were obtained from an existing database. Presence of 13 structural capabilities representing 4 domains relevant to quality: patient assistance and reminders, culture of quality, enhanced access, and electronic health records (EHRs). Three hundred eight (75%) physicians responded, representing practices with a median size of 4 physicians (range 2-74). Among these practices, 64% were affiliated with 1 of 9 networks. The prevalence of surveyed capabilities ranged from 24% to 88%. Larger practice size was associated with higher prevalence for 9 of the 13 capabilities spanning all 4 domains (P < 0.05). Network affiliation was associated with higher prevalence of 5 capabilities (P < 0.05) in 3 domains. Associations were not substantively altered by statistical adjustment for other practice characteristics. Larger and network-affiliated primary care practices are more likely than smaller, non-affiliated practices to have adopted several recommended capabilities. In order to achieve PCMH designation, smaller non-affiliated practices may require the greatest investments.

Frameworks for Understanding the Nature of Interactions, Networking, and Community in a Social Networking Site for Academic Practice

ERIC Educational Resources Information Center

Conole, Grainne; Galley, Rebecca; Culver, Juliette

2011-01-01

This paper describes a new social networking site, Cloudworks, which has been developed to enable discussion and sharing of learning and teaching ideas/designs and to promote reflective academic practice. The site aims to foster new forms of social and participatory practices (peer critiquing, sharing, user-generated content, aggregation, and…

The Center for Collegiate Mental Health: An Example of a Practice-Research Network in University Counseling Centers

ERIC Educational Resources Information Center

Castonguay, Louis G.; Locke, Benjamin D.; Hayes, Jeffrey A.

2011-01-01

This article presents a model of a practice-research network that offers benefits for clinicians working at college and university counseling centers. We briefly describe the basic components of this practice-research network, challenges in developing it, and some of the empirical studies that have resulted from this initiative. We also describe…

Role of practice-based research networks in comparative effectiveness research.

PubMed

Hartung, Daniel M; Guise, Jeanne-Marie; Fagnan, Lyle J; Davis, Melinda M; Stange, Kurt C

2012-01-01

Comparative effectiveness research fundamentally reorients how clinical evidence is generated and used with the goal of providing actionable information to decision-makers. To achieve this, it is vital that decision-makers and the research enterprise are engaged from research inception, to evidence generation and translation. Practice-based research networks are affiliated clinicians in diverse communities with the goal of conducting research to improve care. Practice-based research networks have the potential to advance all phases of the comparative effectiveness research cycle. The aim of this paper is to explore current and potential roles of practice-based research networks in conducting comparative effectiveness research.

Role of practice-based research networks in comparative effectiveness research

PubMed Central

Hartung, Daniel M; Guise, Jeanne-Marie; Fagnan, Lyle J; Davis, Melinda M; Stange, Kurt C

2012-01-01

Comparative effectiveness research fundamentally reorients how clinical evidence is generated and used with the goal of providing actionable information to decision-makers. To achieve this, it is vital that decision-makers and the research enterprise are engaged from research inception, to evidence generation and translation. Practice-based research networks are affiliated clinicians in diverse communities with the goal of conducting research to improve care. Practice-based research networks have the potential to advance all phases of the comparative effectiveness research cycle. The aim of this paper is to explore current and potential roles of practice-based research networks in conducting comparative effectiveness research. PMID:23105964

Assessing respondent-driven sampling.

PubMed

Goel, Sharad; Salganik, Matthew J

2010-04-13

Respondent-driven sampling (RDS) is a network-based technique for estimating traits in hard-to-reach populations, for example, the prevalence of HIV among drug injectors. In recent years RDS has been used in more than 120 studies in more than 20 countries and by leading public health organizations, including the Centers for Disease Control and Prevention in the United States. Despite the widespread use and growing popularity of RDS, there has been little empirical validation of the methodology. Here we investigate the performance of RDS by simulating sampling from 85 known, network populations. Across a variety of traits we find that RDS is substantially less accurate than generally acknowledged and that reported RDS confidence intervals are misleadingly narrow. Moreover, because we model a best-case scenario in which the theoretical RDS sampling assumptions hold exactly, it is unlikely that RDS performs any better in practice than in our simulations. Notably, the poor performance of RDS is driven not by the bias but by the high variance of estimates, a possibility that had been largely overlooked in the RDS literature. Given the consistency of our results across networks and our generous sampling conditions, we conclude that RDS as currently practiced may not be suitable for key aspects of public health surveillance where it is now extensively applied.

Assessing respondent-driven sampling

PubMed Central

Goel, Sharad; Salganik, Matthew J.

2010-01-01

Respondent-driven sampling (RDS) is a network-based technique for estimating traits in hard-to-reach populations, for example, the prevalence of HIV among drug injectors. In recent years RDS has been used in more than 120 studies in more than 20 countries and by leading public health organizations, including the Centers for Disease Control and Prevention in the United States. Despite the widespread use and growing popularity of RDS, there has been little empirical validation of the methodology. Here we investigate the performance of RDS by simulating sampling from 85 known, network populations. Across a variety of traits we find that RDS is substantially less accurate than generally acknowledged and that reported RDS confidence intervals are misleadingly narrow. Moreover, because we model a best-case scenario in which the theoretical RDS sampling assumptions hold exactly, it is unlikely that RDS performs any better in practice than in our simulations. Notably, the poor performance of RDS is driven not by the bias but by the high variance of estimates, a possibility that had been largely overlooked in the RDS literature. Given the consistency of our results across networks and our generous sampling conditions, we conclude that RDS as currently practiced may not be suitable for key aspects of public health surveillance where it is now extensively applied. PMID:20351258

The Effect of Teachers' Social Networks on Teaching Practices and Class Composition

ERIC Educational Resources Information Center

Kim, Chong Min

2011-01-01

Central to this dissertation was an examination of the role teachers' social networks play in schools as living organizations through three studies. The first study investigated the impact of teachers' social networks on teaching practices. Recent evidence suggests that teachers' social networks have a significant effect on teachers' norms,…

Networked Improvement Communities: The Discipline of Improvement Science Meets the Power of Networks

ERIC Educational Resources Information Center

LeMahieu, Paul G.; Grunow, Alicia; Baker, Laura; Nordstrum, Lee E.; Gomez, Louis M.

2017-01-01

Purpose: The purpose of this paper is to delineate an approach to quality assurance in education called networked improvement communities (NICs) that focused on integrating the methodologies of improvement science with few of the networks. Quality improvement, the science and practice of continuously improving programs, practices, processes,…

Are Social Networking Sites Making Health Behavior Change Interventions More Effective? A Meta-Analytic Review.

PubMed

Yang, Qinghua

2017-03-01

The increasing popularity of social networking sites (SNSs) has drawn scholarly attention in recent years, and a large amount of efforts have been made in applying SNSs to health behavior change interventions. However, these interventions showed mixed results, with a large variance of effect sizes in Cohen's d ranging from -1.17 to 1.28. To provide a better understanding of SNS-based interventions' effectiveness, a meta-analysis of 21 studies examining the effects of health interventions using SNS was conducted. Results indicated that health behavior change interventions using SNS are effective in general, but the effects were moderated by health topic, methodological features, and participant features. Theoretical and practical implications of findings are discussed.

Primary health care and general practice attachment: establishing an undergraduate teaching network in rural Greek health centers.

PubMed

Smyrnakis, Emmanouil; Gavana, Magda; Kondilis, Elias; Giannakopoulos, Stathis; Panos, Alexandros; Chainoglou, Athanasia; Stardeli, Thomai; Kavaka, Niki; Benos, Alexis

2013-01-01

Exposure of undergraduate medical students to general practice and community healthcare services is common practice in the international medical curricula. Nevertheless, proponents of the hospital and biotechnology based paradigm, which is still dominant within the medical academic environment, question both the scope and the setting of this training procedure. Regarding the latter, the quality of teaching is often questioned in settings such as rural primary health centers, where health professionals have neither incentives nor accredited training skills. Therefore, the success of community based medical education depends substantially on the procedures implemented to involve non-academic staff as clinical teachers. This report describes the steps taken by the Aristotle University of Thessaloniki (AUTH) Medical School to establish and maintain a Rural Primary Health Care (PHC) Teaching Network in order to implement community oriented PHC and GP undergraduate medical education. A multi-professional teachers' network of healthcare staff, working in Rural Primary Health Centers, has been chosen, in order to expose students to the holistic approach of PHC. The enrollment of teachers to the Teaching Network was solely on a voluntary basis. The novelty of this procedure is that each professional is approached personally, instead through the Health Center (HC) that usually offers this service as a package in similar activities. In an attempt to attract health professionals committed to medical education, a self-selection procedure was adopted. Collaboration with the medical school was established but it was characterized by the School's inability to compensate teachers. A series of 'Training the Trainers' seminars were completed during the first implementation period in order to enhance the awareness of health professionals regarding undergraduate teaching in PHC; to present the educational needs of medical students; to expose them to the principles of medical teaching; and to strengthen their communication skills. Setting up sustainable community oriented medical education activities in a more or less unfriendly environment is a difficult task that calls for wisely selected functional steps. Pilot educational activities determine the quality of the implemented programs by evaluating difficulties and constraints. Recruiting teachers on a voluntary basis proved to be critical in enhancing the quality of this educational activity, and overcoming distance constraints. The educational activities which were offered created a homogenous group of PHC teachers with explicit educational aims and objectives.

Integrated care organizations in Switzerland.

PubMed

Berchtold, Peter; Peytremann-Bridevaux, Isabelle

2011-01-01

The Swiss health care system is characterized by its decentralized structure and high degree of local autonomy. Ambulatory care is provided by physicians working mainly independently in individual private practices. However, a growing part of primary care is provided by networks of physicians and health maintenance organizations (HMOs) acting on the principles of gatekeeping. The share of insured choosing an alternative (managed care) type of basic health insurance and therefore restrict their choice of doctors in return for lower premiums increased continuously since 1990. To date, an average of one out of eight insured person in Switzerland, and one out of three in the regions in north-eastern Switzerland, opted for the provision of care by general practitioners in one of the 86 physician networks or HMOs. About 50% of all general practitioners and more than 400 other specialists have joined a physician networks. Seventy-three of the 86 networks (84%) have contracts with the healthcare insurance companies in which they agree to assume budgetary co-responsibility, i.e., to adhere to set cost targets for particular groups of patients. Within and outside the physician networks, at regional and/or cantonal levels, several initiatives targeting chronic diseases have been developed, such as clinical pathways for heart failure and breast cancer patients or chronic disease management programs for patients with diabetes. Swiss physician networks and HMOs were all established solely by initiatives of physicians and health insurance companies on the sole basis of a healthcare legislation (Swiss Health Insurance Law, KVG) which allows for such initiatives and developments. The relevance of these developments towards more integration of healthcare as well as their implications for the future are discussed.

Integrated care organizations in Switzerland

PubMed Central

Berchtold, Peter; Peytremann-Bridevaux, Isabelle

2011-01-01

Introduction The Swiss health care system is characterized by its decentralized structure and high degree of local autonomy. Ambulatory care is provided by physicians working mainly independently in individual private practices. However, a growing part of primary care is provided by networks of physicians and health maintenance organizations (HMOs) acting on the principles of gatekeeping. Towards integrated care in Switzerland The share of insured choosing an alternative (managed care) type of basic health insurance and therefore restrict their choice of doctors in return for lower premiums increased continuously since 1990. To date, an average of one out of eight insured person in Switzerland, and one out of three in the regions in north-eastern Switzerland, opted for the provision of care by general practitioners in one of the 86 physician networks or HMOs. About 50% of all general practitioners and more than 400 other specialists have joined a physician networks. Seventy-three of the 86 networks (84%) have contracts with the healthcare insurance companies in which they agree to assume budgetary co-responsibility, i.e., to adhere to set cost targets for particular groups of patients. Within and outside the physician networks, at regional and/or cantonal levels, several initiatives targeting chronic diseases have been developed, such as clinical pathways for heart failure and breast cancer patients or chronic disease management programs for patients with diabetes. Conclusion and implications Swiss physician networks and HMOs were all established solely by initiatives of physicians and health insurance companies on the sole basis of a healthcare legislation (Swiss Health Insurance Law, KVG) which allows for such initiatives and developments. The relevance of these developments towards more integration of healthcare as well as their implications for the future are discussed. PMID:21677845

A multiobjective optimization framework for multicontaminant industrial water network design.

PubMed

Boix, Marianne; Montastruc, Ludovic; Pibouleau, Luc; Azzaro-Pantel, Catherine; Domenech, Serge

2011-07-01

The optimal design of multicontaminant industrial water networks according to several objectives is carried out in this paper. The general formulation of the water allocation problem (WAP) is given as a set of nonlinear equations with binary variables representing the presence of interconnections in the network. For optimization purposes, three antagonist objectives are considered: F(1), the freshwater flow-rate at the network entrance, F(2), the water flow-rate at inlet of regeneration units, and F(3), the number of interconnections in the network. The multiobjective problem is solved via a lexicographic strategy, where a mixed-integer nonlinear programming (MINLP) procedure is used at each step. The approach is illustrated by a numerical example taken from the literature involving five processes, one regeneration unit and three contaminants. The set of potential network solutions is provided in the form of a Pareto front. Finally, the strategy for choosing the best network solution among those given by Pareto fronts is presented. This Multiple Criteria Decision Making (MCDM) problem is tackled by means of two approaches: a classical TOPSIS analysis is first implemented and then an innovative strategy based on the global equivalent cost (GEC) in freshwater that turns out to be more efficient for choosing a good network according to a practical point of view. Copyright © 2011 Elsevier Ltd. All rights reserved.

Network evaluation: principles, structures and outcomes of the German working group of Health Promoting Universities.

PubMed

Stock, Christiane; Milz, Simone; Meier, Sabine

2010-03-01

With more than 60 participating universities, the German working group of Health Promoting Universities (German HPU network) is the largest and most active network of universities as healthy settings. This study aims at evaluating processes and effects of the German HPU network and at supporting the future development of the network. The evaluation was based on the multi faceted network assessment instrument developed by Broesskamp-Stone (7). We used a document analysis, two expert interviews and a survey among members (n = 33) to collect relevant data for the assessment. The analysis showed that the visions of the network can be regarded as fulfilled in most aspects. The members of the network received network support through trustful and mutual relationships. The network ranked high on general network principles like implementation of mutual relationships, sharing of information, risks and resources, equal access to resources, responsibility and consensus orientation. However, a high degree of centralization was found as a negative indicator. Other critical aspects of the network's structures and processes have been the regional predominance of universities from the northern and middle part of Germany, the low representation of students in the network, and the low proportion of members that could successfully implement health promotion into the guiding principles of their university. Overall, the evaluation has shown that the network has worked effectively, has developed meaningful processes and structures and has formulated practical guidelines. Since its 12 years of existence the German HPU network has been able to adapt and to adequately respond to changing contextual conditions regarding health promotion at universities in Germany. The network should develop strategies to counteract the critical aspects and detected imbalances in order to further increase its impact on universities as healthy settings.

Telestroke network fundamentals.

PubMed

Meyer, Brett C; Demaerschalk, Bart M

2012-10-01

The objectives of this manuscript are to identify key components to maintaining the logistic and/or operational sustainability of a telestroke network, to identify best practices to be considered for assessment and management of acute stroke when planning for and developing a telestroke network, to show practical steps to enable progress toward implementing a telestroke solution for optimizing acute stroke care, to incorporate evidence-based practice guidelines and care pathways into a telestroke network, to emphasize technology variables and options, and to propose metrics to use when determining the performance, outcomes, and quality of a telestroke network. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

77 FR 14370 - Agency Information Collection Activities; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

... Practice-based Research Networks (PBRNs) in Oregon and Wisconsin, and with the Health IT Regional Extension... AHRQ through its contractors, the Oregon Rural Practice-based Research Network (ORPRN) and the... effectiveness. Understanding clinical work practices and how they will be affected by practice innovations such...

77 FR 30011 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

... Practice-based Research Networks (PBRNs) in Oregon and Wisconsin, and with the Health IT Regional Extension... AHRQ through its contractors, the Oregon Rural Practice-based Research Network (ORPRN) and the... effectiveness. Understanding clinical work practices and how they will be affected by practice innovations such...

Towards Interactive Medical Content Delivery Between Simulated Body Sensor Networks and Practical Data Center.

PubMed

Shi, Xiaobo; Li, Wei; Song, Jeungeun; Hossain, M Shamim; Mizanur Rahman, Sk Md; Alelaiwi, Abdulhameed

2016-10-01

With the development of IoT (Internet of Thing), big data analysis and cloud computing, traditional medical information system integrates with these new technologies. The establishment of cloud-based smart healthcare application gets more and more attention. In this paper, semi-physical simulation technology is applied to cloud-based smart healthcare system. The Body sensor network (BSN) of system transmit has two ways of data collection and transmission. The one is using practical BSN to collect data and transmitting it to the data center. The other is transmitting real medical data to practical data center by simulating BSN. In order to transmit real medical data to practical data center by simulating BSN under semi-physical simulation environment, this paper designs an OPNET packet structure, defines a gateway node model between simulating BSN and practical data center and builds a custom protocol stack. Moreover, this paper conducts a large amount of simulation on the real data transmission through simulation network connecting with practical network. The simulation result can provides a reference for parameter settings of fully practical network and reduces the cost of devices and personnel involved.

Transforming phylogenetic networks: Moving beyond tree space.

PubMed

Huber, Katharina T; Moulton, Vincent; Wu, Taoyang

2016-09-07

Phylogenetic networks are a generalization of phylogenetic trees that are used to represent reticulate evolution. Unrooted phylogenetic networks form a special class of such networks, which naturally generalize unrooted phylogenetic trees. In this paper we define two operations on unrooted phylogenetic networks, one of which is a generalization of the well-known nearest-neighbor interchange (NNI) operation on phylogenetic trees. We show that any unrooted phylogenetic network can be transformed into any other such network using only these operations. This generalizes the well-known fact that any phylogenetic tree can be transformed into any other such tree using only NNI operations. It also allows us to define a generalization of tree space and to define some new metrics on unrooted phylogenetic networks. To prove our main results, we employ some fascinating new connections between phylogenetic networks and cubic graphs that we have recently discovered. Our results should be useful in developing new strategies to search for optimal phylogenetic networks, a topic that has recently generated some interest in the literature, as well as for providing new ways to compare networks. Copyright © 2016 Elsevier Ltd. All rights reserved.

The genomic applications in practice and prevention network.

PubMed

Khoury, Muin J; Feero, W Gregory; Reyes, Michele; Citrin, Toby; Freedman, Andrew; Leonard, Debra; Burke, Wylie; Coates, Ralph; Croyle, Robert T; Edwards, Karen; Kardia, Sharon; McBride, Colleen; Manolio, Teri; Randhawa, Gurvaneet; Rasooly, Rebekah; St Pierre, Jeannette; Terry, Sharon

2009-07-01

The authors describe the rationale and initial development of a new collaborative initiative, the Genomic Applications in Practice and Prevention Network. The network convened by the Centers for Disease Control and Prevention and the National Institutes of Health includes multiple stakeholders from academia, government, health care, public health, industry and consumers. The premise of Genomic Applications in Practice and Prevention Network is that there is an unaddressed chasm between gene discoveries and demonstration of their clinical validity and utility. This chasm is due to the lack of readily accessible information about the utility of most genomic applications and the lack of necessary knowledge by consumers and providers to implement what is known. The mission of Genomic Applications in Practice and Prevention Network is to accelerate and streamline the effective integration of validated genomic knowledge into the practice of medicine and public health, by empowering and sponsoring research, evaluating research findings, and disseminating high quality information on candidate genomic applications in practice and prevention. Genomic Applications in Practice and Prevention Network will develop a process that links ongoing collection of information on candidate genomic applications to four crucial domains: (1) knowledge synthesis and dissemination for new and existing technologies, and the identification of knowledge gaps, (2) a robust evidence-based recommendation development process, (3) translation research to evaluate validity, utility and impact in the real world and how to disseminate and implement recommended genomic applications, and (4) programs to enhance practice, education, and surveillance.

Study on pattern recognition of Raman spectrum based on fuzzy neural network

NASA Astrophysics Data System (ADS)

Zheng, Xiangxiang; Lv, Xiaoyi; Mo, Jiaqing

2017-10-01

Hydatid disease is a serious parasitic disease in many regions worldwide, especially in Xinjiang, China. Raman spectrum of the serum of patients with echinococcosis was selected as the research object in this paper. The Raman spectrum of blood samples from healthy people and patients with echinococcosis are measured, of which the spectrum characteristics are analyzed. The fuzzy neural network not only has the ability of fuzzy logic to deal with uncertain information, but also has the ability to store knowledge of neural network, so it is combined with the Raman spectrum on the disease diagnosis problem based on Raman spectrum. Firstly, principal component analysis (PCA) is used to extract the principal components of the Raman spectrum, reducing the network input and accelerating the prediction speed and accuracy of Network based on remaining the original data. Then, the information of the extracted principal component is used as the input of the neural network, the hidden layer of the network is the generation of rules and the inference process, and the output layer of the network is fuzzy classification output. Finally, a part of samples are randomly selected for the use of training network, then the trained network is used for predicting the rest of the samples, and the predicted results are compared with general BP neural network to illustrate the feasibility and advantages of fuzzy neural network. Success in this endeavor would be helpful for the research work of spectroscopic diagnosis of disease and it can be applied in practice in many other spectral analysis technique fields.

Determinants of successful clinical networks: the conceptual framework and study protocol.

PubMed

Haines, Mary; Brown, Bernadette; Craig, Jonathan; D'Este, Catherine; Elliott, Elizabeth; Klineberg, Emily; McInnes, Elizabeth; Middleton, Sandy; Paul, Christine; Redman, Sally; Yano, Elizabeth M

2012-03-13

Clinical networks are increasingly being viewed as an important strategy for increasing evidence-based practice and improving models of care, but success is variable and characteristics of networks with high impact are uncertain. This study takes advantage of the variability in the functioning and outcomes of networks supported by the Australian New South Wales (NSW) Agency for Clinical Innovation's non-mandatory model of clinical networks to investigate the factors that contribute to the success of clinical networks. The objective of this retrospective study is to examine the association between external support, organisational and program factors, and indicators of success among 19 clinical networks over a three-year period (2006-2008). The outcomes (health impact, system impact, programs implemented, engagement, user perception, and financial leverage) and explanatory factors will be collected using a web-based survey, interviews, and record review. An independent expert panel will provide judgements about the impact or extent of each network's initiatives on health and system impacts. The ratings of the expert panel will be the outcome used in multivariable analyses. Following the rating of network success, a qualitative study will be conducted to provide a more in-depth examination of the most successful networks. This is the first study to combine quantitative and qualitative methods to examine the factors that contribute to the success of clinical networks and, more generally, is the largest study of clinical networks undertaken. The adaptation of expert panel methods to rate the impacts of networks is the methodological innovation of this study. The proposed project will identify the conditions that should be established or encouraged by agencies developing clinical networks and will be of immediate use in forming strategies and programs to maximise the effectiveness of such networks.

Two-point resistance of an m × n resistor network with an arbitrary boundary and its application in RLC network

NASA Astrophysics Data System (ADS)

Zhi-Zhong, Tan

2016-05-01

A rectangular m × n resistor network with an arbitrary boundary is investigated, and a general resistance formula between two nodes on an arbitrary axis is derived by the Recursion-Transform (RT) method, a problem that has never been resolved before, for the Green’s function technique and the Laplacian matrix approach are inapplicable to it. To have the exact solution of resistance is important but it is difficult to obtain under the condition of arbitrary boundary. Our result is directly expressed in a single summation and mainly composed of characteristic roots, which contain both finite and infinite cases. Further, the current distribution is given explicitly as a byproduct of the method. Our framework can be effectively applied to RLC networks. As an application to the LC network, we find that our formulation leads to the occurrence of resonances at h 1 = 1 - cos ϕ i - sin ϕ i cot n ϕ i . This somewhat curious result suggests the possibility of practical applications of our formulae to resonant circuits. Project supported by the Prophase Preparatory Project of Natural Science Foundation of Nantong University, China (Grant No. 15ZY16).

Epidemic processes in complex networks

NASA Astrophysics Data System (ADS)

Pastor-Satorras, Romualdo; Castellano, Claudio; Van Mieghem, Piet; Vespignani, Alessandro

2015-07-01

In recent years the research community has accumulated overwhelming evidence for the emergence of complex and heterogeneous connectivity patterns in a wide range of biological and sociotechnical systems. The complex properties of real-world networks have a profound impact on the behavior of equilibrium and nonequilibrium phenomena occurring in various systems, and the study of epidemic spreading is central to our understanding of the unfolding of dynamical processes in complex networks. The theoretical analysis of epidemic spreading in heterogeneous networks requires the development of novel analytical frameworks, and it has produced results of conceptual and practical relevance. A coherent and comprehensive review of the vast research activity concerning epidemic processes is presented, detailing the successful theoretical approaches as well as making their limits and assumptions clear. Physicists, mathematicians, epidemiologists, computer, and social scientists share a common interest in studying epidemic spreading and rely on similar models for the description of the diffusion of pathogens, knowledge, and innovation. For this reason, while focusing on the main results and the paradigmatic models in infectious disease modeling, the major results concerning generalized social contagion processes are also presented. Finally, the research activity at the forefront in the study of epidemic spreading in coevolving, coupled, and time-varying networks is reported.

Hierarchical mutual information for the comparison of hierarchical community structures in complex networks

NASA Astrophysics Data System (ADS)

Perotti, Juan Ignacio; Tessone, Claudio Juan; Caldarelli, Guido

2015-12-01

The quest for a quantitative characterization of community and modular structure of complex networks produced a variety of methods and algorithms to classify different networks. However, it is not clear if such methods provide consistent, robust, and meaningful results when considering hierarchies as a whole. Part of the problem is the lack of a similarity measure for the comparison of hierarchical community structures. In this work we give a contribution by introducing the hierarchical mutual information, which is a generalization of the traditional mutual information and makes it possible to compare hierarchical partitions and hierarchical community structures. The normalized version of the hierarchical mutual information should behave analogously to the traditional normalized mutual information. Here the correct behavior of the hierarchical mutual information is corroborated on an extensive battery of numerical experiments. The experiments are performed on artificial hierarchies and on the hierarchical community structure of artificial and empirical networks. Furthermore, the experiments illustrate some of the practical applications of the hierarchical mutual information, namely the comparison of different community detection methods and the study of the consistency, robustness, and temporal evolution of the hierarchical modular structure of networks.

[A survey of Local Physicians and Psychotherapists on Cooperation in Regional Networks for Early Child Interventions in Saxony-Anhalt].

PubMed

Clauß, D; Fleischer, S; Mattern, E; Ayerle, G

2016-07-01

Early childhood interventions positively contribute to health related child development. For these interventions, networks are a necessary prerequisite as they promote interdisciplinary and interprofessional cooperation. This holds especially true for the integration of health system protagonists. In a cross-sectional survey local paediatrists, gynaecologists, general practitioners, and psychotherapists were asked about their knowledge, experiences, desires, and reservations regarding cooperation in early childhood intervention networks. 64 out of 1747 (3.7%) eligible clinicians answered the survey. On average they estimated that 10.1% of the families they are treating would benefit from early childhood interventions. Participants rated themselves as competent to offer appropriate early childhood interventions. The youth welfare service was judged as the most important institution for their own professional practice by 84.4%. Additionally to an applicable agenda, a fair group moderation of network meetings was seen as a substantial requirement in order to take part in network meetings. Health professionals are important protagonists in early childhood interventions. Clinicians should assess relevant problems in families and offer appropriate support on a regular basis. Alongside clearly defined regional contacts, interprofessional continuing education seems mandatory. © Georg Thieme Verlag KG Stuttgart · New York.

Brain Dynamics in Predicting Driving Fatigue Using a Recurrent Self-Evolving Fuzzy Neural Network.

PubMed

Liu, Yu-Ting; Lin, Yang-Yin; Wu, Shang-Lin; Chuang, Chun-Hsiang; Lin, Chin-Teng

2016-02-01

This paper proposes a generalized prediction system called a recurrent self-evolving fuzzy neural network (RSEFNN) that employs an on-line gradient descent learning rule to address the electroencephalography (EEG) regression problem in brain dynamics for driving fatigue. The cognitive states of drivers significantly affect driving safety; in particular, fatigue driving, or drowsy driving, endangers both the individual and the public. For this reason, the development of brain-computer interfaces (BCIs) that can identify drowsy driving states is a crucial and urgent topic of study. Many EEG-based BCIs have been developed as artificial auxiliary systems for use in various practical applications because of the benefits of measuring EEG signals. In the literature, the efficacy of EEG-based BCIs in recognition tasks has been limited by low resolutions. The system proposed in this paper represents the first attempt to use the recurrent fuzzy neural network (RFNN) architecture to increase adaptability in realistic EEG applications to overcome this bottleneck. This paper further analyzes brain dynamics in a simulated car driving task in a virtual-reality environment. The proposed RSEFNN model is evaluated using the generalized cross-subject approach, and the results indicate that the RSEFNN is superior to competing models regardless of the use of recurrent or nonrecurrent structures.

Mental illness disclosure decision making.

PubMed

Pahwa, Rohini; Fulginiti, Anthony; Brekke, John S; Rice, Eric

2017-01-01

Disclosure related to mental illness has been linked to various positive outcomes, including better mental health. However, many individuals with serious mental illness (SMI) continue to practice non-disclosure. Even though disclosure inherently occurs within the context of one's social relationships, research has generally conceptualized mental illness disclosure as an individual level phenomenon and neglected to consider preferences concerning to whom an individual discloses and the factors that influence this decision. The current study uses the disclosure decision-making model (DD-MM) by Greene (2009) to better understand the processes of mental illness disclosure preference and selective disclosure for individuals with SMI (n = 60) using multivariate random intercept logistic regression with an emphasis on the constituent factors of disclosure preference at both individual and relational levels. The majority of participants were found to practice selective disclosure, with 68% of the participants identifying at least 1 network member to whom they could disclose. Family members and friends were central to the selective disclosure process, comprising the greatest proportion of network members who, both were and were not identified as preferred confidants. Women were found to show higher odds of preference for mental illness disclosure than men. Having lower perceived social support was associated with lower odds of disclosure preference. Among relational factors, greater relationship availability and lower dyadic tangible social support were associated with lower odds of disclosure preference. Practice and research implications of using social network analysis to get a deeper understanding of disclosure and disclosure preference are discussed, including implications for future interventions targeting stigma reduction. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The implementation of best practice in medication administration across a health network: a multisite evidence-based audit and feedback project.

PubMed

Munn, Zachary; Scarborough, Alan; Pearce, Susanne; McArthur, Alexa; Kavanagh, Sheila; Girdler, Michelle; Stefan-Rasmus, Bernie; Breen, Helen; Farquhar, Shirley; Li, Jessie; Hutchinson, Steven; Stephenson, Matthew; McBeth, Helen; Kitson, Alison

2015-09-16

Medication errors present a significant risk to patient safety. The "rights" of medication administration represent one approach to potentially reducing this risk. The aim of this project was to implement an evidence-based audit and feedback project to improve compliance with best practice in this area across a health network. A baseline audit was conducted to determine compliance with evidence-based standards by trained observers. The results of this audit were analysed and fed back to staff. An analysis of barriers to compliance was undertaken by key staff within the organization, which was followed by the implementation of targeted strategies to improve compliance. A follow-up audit was conducted and the results compared to the baseline audit. There were improvements in the percentage of compliance across all of the eight criteria audited, with statistically significant improvements found in six of the eight. In general, compliance with the criteria was high in both the baseline and follow-up audits. This audit and feedback implementation project was successful in increasing compliance and knowledge in this area and providing future direction for sustaining evidence-based practice change. It is now planned to use this approach for rolling out future implementation projects within this health system. The Joanna Briggs Institute.

Modeling Blood Filtration in the Treatment of Septic Shock

NASA Astrophysics Data System (ADS)

Foster, Glenn; Hubler, Alfred

2007-03-01

Sepsis, the overreaction of the inflammation and coagulation responses to infection, is the leading cause of death in non-coronary intensive care unit patients in the US. Anti-mediator drugs have been generally ineffective, but by considering the network of cytokine interactions, we illustrate how filtering the cytokines in the blood leads to a reduced response. We further illustrate by applying an appropriate filter to existing immune response models as well as discuss both practical and optimal filter parameters.

Academic English Socialization through Individual Networks of Practice

ERIC Educational Resources Information Center

Zappa-Hollman, Sandra; Duff, Patricia A.

2015-01-01

This article introduces the notion of individual network of practice (INoP) as a viable construct for analyzing academic (discourse) socialization in second language (L2) contexts. The authors provide an overview of social practice theories that have informed the development of INoP--community of practice (CoP; Lave & Wenger, 1991; Wenger,…

Toward automatic time-series forecasting using neural networks.

PubMed

Yan, Weizhong

2012-07-01

Over the past few decades, application of artificial neural networks (ANN) to time-series forecasting (TSF) has been growing rapidly due to several unique features of ANN models. However, to date, a consistent ANN performance over different studies has not been achieved. Many factors contribute to the inconsistency in the performance of neural network models. One such factor is that ANN modeling involves determining a large number of design parameters, and the current design practice is essentially heuristic and ad hoc, this does not exploit the full potential of neural networks. Systematic ANN modeling processes and strategies for TSF are, therefore, greatly needed. Motivated by this need, this paper attempts to develop an automatic ANN modeling scheme. It is based on the generalized regression neural network (GRNN), a special type of neural network. By taking advantage of several GRNN properties (i.e., a single design parameter and fast learning) and by incorporating several design strategies (e.g., fusing multiple GRNNs), we have been able to make the proposed modeling scheme to be effective for modeling large-scale business time series. The initial model was entered into the NN3 time-series competition. It was awarded the best prediction on the reduced dataset among approximately 60 different models submitted by scholars worldwide.

Temporal Gillespie Algorithm: Fast Simulation of Contagion Processes on Time-Varying Networks

PubMed Central

Vestergaard, Christian L.; Génois, Mathieu

2015-01-01

Stochastic simulations are one of the cornerstones of the analysis of dynamical processes on complex networks, and are often the only accessible way to explore their behavior. The development of fast algorithms is paramount to allow large-scale simulations. The Gillespie algorithm can be used for fast simulation of stochastic processes, and variants of it have been applied to simulate dynamical processes on static networks. However, its adaptation to temporal networks remains non-trivial. We here present a temporal Gillespie algorithm that solves this problem. Our method is applicable to general Poisson (constant-rate) processes on temporal networks, stochastically exact, and up to multiple orders of magnitude faster than traditional simulation schemes based on rejection sampling. We also show how it can be extended to simulate non-Markovian processes. The algorithm is easily applicable in practice, and as an illustration we detail how to simulate both Poissonian and non-Markovian models of epidemic spreading. Namely, we provide pseudocode and its implementation in C++ for simulating the paradigmatic Susceptible-Infected-Susceptible and Susceptible-Infected-Recovered models and a Susceptible-Infected-Recovered model with non-constant recovery rates. For empirical networks, the temporal Gillespie algorithm is here typically from 10 to 100 times faster than rejection sampling. PMID:26517860

Temporal Gillespie Algorithm: Fast Simulation of Contagion Processes on Time-Varying Networks.

PubMed

Vestergaard, Christian L; Génois, Mathieu

2015-10-01

Stochastic simulations are one of the cornerstones of the analysis of dynamical processes on complex networks, and are often the only accessible way to explore their behavior. The development of fast algorithms is paramount to allow large-scale simulations. The Gillespie algorithm can be used for fast simulation of stochastic processes, and variants of it have been applied to simulate dynamical processes on static networks. However, its adaptation to temporal networks remains non-trivial. We here present a temporal Gillespie algorithm that solves this problem. Our method is applicable to general Poisson (constant-rate) processes on temporal networks, stochastically exact, and up to multiple orders of magnitude faster than traditional simulation schemes based on rejection sampling. We also show how it can be extended to simulate non-Markovian processes. The algorithm is easily applicable in practice, and as an illustration we detail how to simulate both Poissonian and non-Markovian models of epidemic spreading. Namely, we provide pseudocode and its implementation in C++ for simulating the paradigmatic Susceptible-Infected-Susceptible and Susceptible-Infected-Recovered models and a Susceptible-Infected-Recovered model with non-constant recovery rates. For empirical networks, the temporal Gillespie algorithm is here typically from 10 to 100 times faster than rejection sampling.

Enlightening discriminative network functional modules behind Principal Component Analysis separation in differential-omic science studies

PubMed Central

Ciucci, Sara; Ge, Yan; Durán, Claudio; Palladini, Alessandra; Jiménez-Jiménez, Víctor; Martínez-Sánchez, Luisa María; Wang, Yuting; Sales, Susanne; Shevchenko, Andrej; Poser, Steven W.; Herbig, Maik; Otto, Oliver; Androutsellis-Theotokis, Andreas; Guck, Jochen; Gerl, Mathias J.; Cannistraci, Carlo Vittorio

2017-01-01

Omic science is rapidly growing and one of the most employed techniques to explore differential patterns in omic datasets is principal component analysis (PCA). However, a method to enlighten the network of omic features that mostly contribute to the sample separation obtained by PCA is missing. An alternative is to build correlation networks between univariately-selected significant omic features, but this neglects the multivariate unsupervised feature compression responsible for the PCA sample segregation. Biologists and medical researchers often prefer effective methods that offer an immediate interpretation to complicated algorithms that in principle promise an improvement but in practice are difficult to be applied and interpreted. Here we present PC-corr: a simple algorithm that associates to any PCA segregation a discriminative network of features. Such network can be inspected in search of functional modules useful in the definition of combinatorial and multiscale biomarkers from multifaceted omic data in systems and precision biomedicine. We offer proofs of PC-corr efficacy on lipidomic, metagenomic, developmental genomic, population genetic, cancer promoteromic and cancer stem-cell mechanomic data. Finally, PC-corr is a general functional network inference approach that can be easily adopted for big data exploration in computer science and analysis of complex systems in physics. PMID:28287094

Video Games, Internet and Social Networks: A Study among French School students

PubMed

Dany, Lionel; Moreau, Laure; Guillet, Clémentine; Franchina, Carmelo

2016-11-25

Aim : Screen-based media use is gradually becoming a public health issue, especially among young people.Method : A local descriptive observational study was conducted in 11 colleges of the Bouches-du-Rhône department. All middle high school students were asked to fill in a questionnaire comprising questions about their demographic characteristics, their screen-based media use (Internet, video games, social networks), any problematic use (video games and social networks), self-esteem and quality of life.Results : A total of 950 college students (mean age : 12.96 years) participated in the research. The results show a high level and a very diverse screen-based media use. Boys more frequently played video games and girls go more frequently used social networks. The levels of problematic use were relatively low for all middle high school students. The level of problematic video game use was significantly higher in boys, and the level of problematic social network use was higher in girls.Conclusion : Differences in the use of video games or social networks raise the general issue of gender differences in society. This study indicates the need for more specific preventive interventions for screen-based media use. The addictive “nature” of certain practices needs to be studied in more detail.

Teacher Networks Companion Piece

ERIC Educational Resources Information Center

Hopkins, Ami Patel; Rulli, Carolyn; Schiff, Daniel; Fradera, Marina

2015-01-01

Network building vitally impacts career development, but in few professions does it impact daily practice more than in teaching. Teacher networks, known as professional learning communities, communities of practice, peer learning circles, virtual professional communities, as well as other names, play a unique and powerful role in education. In…

Network participation for unpromoted female dentists in relation to psychosocial support.

PubMed

Hjalmers, Karin; Söderfeldt, Björn; Axtelius, Björn; Krönstrom, Mats

2004-06-01

Studies have shown that female unpromoted general practice (GP) dentists have a taxing work situation with many problems related to their psychosocial work environment. This study aims to describe: 1) the participation of this group in organized network activity (support groups) in a region (Scania) in Sweden, 2) the sense of support compared with another organization and with a nationwide sample of GP dentists, and 3) the covariation of network participation with support. All unpromoted female dentists within the Public Dental Health Service (PDHS) in Scania received a questionnaire and 94% responded. Those participating in network activity < or =4 times a year constituted 12% of respondents. Cooperation between colleagues was lower than in the nationwide sample. Support from the PDHS was experienced as weak. It was not possible to explain why female unpromoted GP dentists participated < or =4 times a year, while those who felt lonely in their work were to a higher degree participants in a network. Almost 9 out of 10 reported being strengthened by the network both as a person and in a professional role. The female dentist was three times more likely to participate in a network if she had a male head of clinic. The main findings are a paucity of inter-colleague contact and a lack of association between support and network participation. The many affirmative comments indicated that network participation might be a good coping strategy for unpromoted female GP dentists.

A Decentralized VPN Service over Generalized Mobile Ad-Hoc Networks

NASA Astrophysics Data System (ADS)

Fujita, Sho; Shima, Keiichi; Uo, Yojiro; Esaki, Hiroshi

We present a decentralized VPN service that can be built over generalized mobile ad-hoc networks (Generalized MANETs), in which topologies can be represented as a time-varying directed multigraph. We address wireless ad-hoc networks and overlay ad-hoc networks as instances of Generalized MANETs. We first propose an architecture to operate on various kinds of networks through a single set of operations. Then, we design and implement a decentralized VPN service on the proposed architecture. Through the development and operation of a prototype system we implemented, we found that the proposed architecture makes the VPN service applicable to each instance of Generalized MANETs, and that the VPN service makes it possible for unmodified applications to operate on the networks.

Potential assessment of the "support vector machine" method in forecasting ambient air pollutant trends.

PubMed

Lu, Wei-Zhen; Wang, Wen-Jian

2005-04-01

Monitoring and forecasting of air quality parameters are popular and important topics of atmospheric and environmental research today due to the health impact caused by exposing to air pollutants existing in urban air. The accurate models for air pollutant prediction are needed because such models would allow forecasting and diagnosing potential compliance or non-compliance in both short- and long-term aspects. Artificial neural networks (ANN) are regarded as reliable and cost-effective method to achieve such tasks and have produced some promising results to date. Although ANN has addressed more attentions to environmental researchers, its inherent drawbacks, e.g., local minima, over-fitting training, poor generalization performance, determination of the appropriate network architecture, etc., impede the practical application of ANN. Support vector machine (SVM), a novel type of learning machine based on statistical learning theory, can be used for regression and time series prediction and have been reported to perform well by some promising results. The work presented in this paper aims to examine the feasibility of applying SVM to predict air pollutant levels in advancing time series based on the monitored air pollutant database in Hong Kong downtown area. At the same time, the functional characteristics of SVM are investigated in the study. The experimental comparisons between the SVM model and the classical radial basis function (RBF) network demonstrate that the SVM is superior to the conventional RBF network in predicting air quality parameters with different time series and of better generalization performance than the RBF model.

Assessing the preconditions for communication influence on decision making: the North American Quitline Consortium.

PubMed

Bonito, Joseph A; Ruppel, Erin K; Saul, Jessie E; Leischow, Scott J

2013-01-01

The network of North American quitlines is a loose confederation of telephone-based smoking cessation professionals, including smoking cessation counseling providers, funders, researcher and policy advocates. Each quitline has some leeway in the types of services it provides, and the purpose of this article is to identify factors that explain such choices. Representatives from quitline organizations responded to a survey regarding the importance of several items that were hypothesized to influence general intentions to adopt and implement new cessation methods. Results indicate that internal (to the quitline) constraints are positively associated with consensus processes and that implementation of practices in general was more likely if consensus processes were used. Unilateral decision making (one person within an organization makes decisions for the quitline on his/her own) was unrelated to either internal or external constraints and was negatively associated with adoption of quitline practices. Discussion focuses on factors that influence consensus decision-making processes beyond those investigated in the article.

Social capital and frequent attenders in general practice: a register-based cohort study.

PubMed

Pasgaard, Alexander A; Mæhlisen, Maiken H; Overgaard, Charlotte; Ejlskov, Linda; Torp-Pedersen, Christian; Bøggild, Henrik

2018-03-02

Frequent attendance to primary care constitutes a large use of resources for the health care system. The association between frequent attendance and illness-related factors has been examined in several studies, but little is known about the association between frequent attendance and individual social capital. The aim of this study is to explore this association. The analysis is conducted on responders to the North Denmark Region Health Profile 2010 (n = 23,384), individually linked with information from administrative registers. Social capital is operationalized at the individual level, and includes cognitive (interpersonal trust and norms of reciprocity) as well as structural (social network and civic engagement) dimensions. Frequent attendance is defined as the upper-quartile of the total number of measured consultations with a general practitioner over a period of 148 weeks. Using multiple logistic regression, we found that frequent attendance was associated with a lower score in interpersonal trust [OR 0.86 (0.79-0.94)] and social network [OR 0.88 (0.79-0.98)] for women, when adjusted for age, education, income and SF12 health scores. Norms of reciprocity and civic engagement were not significantly associated with frequent attendance for women [OR 1.05 (0.99-1.11) and OR 1.01 (0.92-1.11) respectively]. None of the associations were statistically significant for men. This study suggests that for women, some aspects of social capital are associated with frequent attendance in general practice, and the statistically significant dimensions belonged to both cognitive and structural aspects of social capital. This association was not seen for men. This indicates a multifaceted and heterogeneous relationship between social capital and frequent attendance among genders.

Higher Education Scholars' Participation and Practices on Twitter

ERIC Educational Resources Information Center

Veletsianos, G.

2012-01-01

Scholars participate in online social networks for professional purposes. In such networks, learning takes the form of participation and identity formation through engagement in and contribution to networked practices. While current literature describes the possible benefits of online participation, empirical research on scholars' use of online…

Experiences of Pioneers Facilitating Teacher Networks for Professional Development

ERIC Educational Resources Information Center

Hanraets, Irene; Hulsebosch, Joitske; de Laat, Maarten

2011-01-01

This study presents an exploration into facilitation practices of teacher professional development networks. Stimulating networked learning amongst teachers is a powerful way of creating an informal practice-based learning space driven by teacher needs. As such, it presents an additional channel (besides more formal traditional professional…

Embedding "Getting Practical" and ASE Improving Practical Work in Triple Science LSN Network

ERIC Educational Resources Information Center

Stephenson, Kay; Chapman, Georgina

2011-01-01

With the two-year pilot of "Getting Practical" drawing to a close, new ways to embed the key messages into existing CPD programmes are being sought. In "Embedding Getting Practical," the first author describes how she has been able to do this with the courses she is involved with. In "ASE Improving Practical Work in Triple Science LSN Network,"…

Using Social Network Analysis to Examine the Effect of Care Management Structure on Chronic Disease Management Communication Within Primary Care.

PubMed

Holtrop, Jodi Summers; Ruland, Sandra; Diaz, Stephanie; Morrato, Elaine H; Jones, Eric

2018-05-01

Care management and care managers are becoming increasingly prevalent in primary care medical practice as a means of improving population health and reducing unnecessary care. Care managers are often involved in chronic disease management and associated transitional care. In this study, we examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. We sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? Individual written surveys were given to all practice members in the participating practices. Survey questions assessed demographics as well as practice culture, quality improvement, care management activities, and communication regarding chronic disease care. Using social network analysis and other statistical methods, we analyzed the communication dynamics related to chronic disease care for each practice. The structure of chronic disease communication varies greatly from practice to practice. Care managers who were embedded in the practice or co-located were more likely to be in the core of the communication network than were off-site care managers. These care managers also had higher in-degree centrality, indicating that they acted as a hub for communication with team members in many other roles. Social network analysis provided a useful means of examining chronic disease communication in practice, and highlighted the central role of care managers in this communication when their role structure supported such communication. Structuring care managers as embedded team members within the practice has important implications for their role in chronic disease communication within primary care.

Nurses collaborating with cross disciplinary networks: starting to integrate genomics into practice.

PubMed

Adegbola, Maxine

2010-07-01

Nurses and other health-care providers are poised to include genetic discoveries into practice settings and to translate such knowledge for consumer benefit within culturally appropriate contexts. Nurses must seek collaboration with multi-disciplinary networks both locally and internationally. They must also capitalize on the expertise of other seasoned researchers in order to gain national and international exposure, recognition, and funding. Scholarly tailgating is using network relationships to achieve one's professional goals, and capitalizing on expert knowledge from seasoned researchers, educators, and practitioners from diverse international groups. By using scholarly tailgating principles, nurses can become important agents of change for multi-disciplinary networks, and thereby assist in decreasing health disparities. The purpose of this document is to encourage and inspire nurses to seek collaborative multi-disciplinary networks to enable genomic integration into health-care practice and education. Strategies for integrating genomics into practice settings are discussed.

'Healthy gums do matter': A case study of clinical leadership within primary dental care.

PubMed

Moore, D; Saleem, S; Hawthorn, E; Pealing, R; Ashley, M; Bridgman, C

2015-09-25

The Health and Social Care Act 2012 heralded wide reaching reforms intended to place clinicians at the heart of the health service. For NHS general dental practice, the conduits for this clinical leadership are the NHS England local professional networks. In Greater Manchester, the local professional network has developed and piloted a clinician led quality improvement project: 'Healthy Gums DO Matter, a Practitioner's Toolkit'. Used as a case study, the project highlighted the following facilitators to clinical leadership in dentistry: supportive environment; mentoring and transformational leadership; alignment of project goals with national policy; funding allowance; cross-boundary collaboration; determination; altruism; and support from wider academic and specialist colleagues. Barriers to clinical leadership identified were: the hierarchical nature of healthcare, territorialism and competing clinical commitments.

A Qualitative Study of Doctors of Chiropractic in a Nova Scotian Practice-based Research Network: Barriers and Facilitators to the Screening and Management of Psychosocial Factors for Patients With Low Back Pain.

PubMed

Stilwell, Peter; Hayden, Jill A; Des Rosiers, Piaf; Harman, Katherine; French, Simon D; Curran, Janet A; Hefford, Warren

2018-01-01

This study aimed to assess chiropractors' awareness of clinical practice guidelines for low back pain and to identify barriers and facilitators to the screening and management of psychosocial factors in patients with low back pain. This qualitative study used semi-structured interviews informed by the Theoretical Domains Framework with 10 Nova Scotian chiropractors who were members of a practice-based research network. The participants correctly identified what the guidelines generally recommend and described the value of psychosocial factors; however, none of the participants could name specific clinical practice guidelines for low back pain. We identified 6 themes related to barriers and facilitators for chiropractors screening and managing psychosocial factors. The themes revolved around the participants' desire to fulfill patients' anatomy-focused treatment expectations and a perceived lack of training for managing psychosocial factors. Participants had concerns about going beyond the chiropractic scope of practice, and they perceived a lack of practical psychosocial screening and management resources. Social factors, such as the influence of other health care practitioners, were reported as both barriers and facilitators to screening and managing psychosocial factors. The participants in this study reported that they mostly treated with an anatomical and biomechanical focus and that they did not always address psychosocial factors identified in their patients with low back pain. Although these findings are limited to Nova Scotian chiropractors, the barriers identified appeared to be potentially modifiable and could be considered in other groups. Low-cost interventions, such as continuing education using evidence-informed behavior change techniques, could be considered to address these barriers. Copyright © 2017. Published by Elsevier Inc.

Integrating network ecology with applied conservation: a synthesis and guide to implementation.

PubMed

Kaiser-Bunbury, Christopher N; Blüthgen, Nico

2015-07-10

Ecological networks are a useful tool to study the complexity of biotic interactions at a community level. Advances in the understanding of network patterns encourage the application of a network approach in other disciplines than theoretical ecology, such as biodiversity conservation. So far, however, practical applications have been meagre. Here we present a framework for network analysis to be harnessed to advance conservation management by using plant-pollinator networks and islands as model systems. Conservation practitioners require indicators to monitor and assess management effectiveness and validate overall conservation goals. By distinguishing between two network attributes, the 'diversity' and 'distribution' of interactions, on three hierarchical levels (species, guild/group and network) we identify seven quantitative metrics to describe changes in network patterns that have implications for conservation. Diversity metrics are partner diversity, vulnerability/generality, interaction diversity and interaction evenness, and distribution metrics are the specialization indices d' and [Formula: see text] and modularity. Distribution metrics account for sampling bias and may therefore be suitable indicators to detect human-induced changes to plant-pollinator communities, thus indirectly assessing the structural and functional robustness and integrity of ecosystems. We propose an implementation pathway that outlines the stages that are required to successfully embed a network approach in biodiversity conservation. Most importantly, only if conservation action and study design are aligned by practitioners and ecologists through joint experiments, are the findings of a conservation network approach equally beneficial for advancing adaptive management and ecological network theory. We list potential obstacles to the framework, highlight the shortfall in empirical, mostly experimental, network data and discuss possible solutions. Published by Oxford University Press on behalf of the Annals of Botany Company.

Establishing a Practice-Based Research Network: Lessons from the Massachusetts Experience

ERIC Educational Resources Information Center

Pulcini, Joyce; Sheetz, Anne; DeSisto, Marie

2008-01-01

This article describes the recently established Massachusetts School Nurse Research Network (MASNRN) which has a mission of establishing a practice-based research network (PBRN) comprised of a representative, collaborative group of professional school nurses, nurse academicians, and other interested parties for whom school health is a priority.…

Transnational Chinese Students' Literacy and Networking Practices

ERIC Educational Resources Information Center

Wang, Xiqiao

2017-01-01

Situated in the context of a first-year writing course at a Midwestern public university in the United States, this study examines Chinese international students' networking practices through the mediation of WeChat, a popular social networking application for smartphones. Based on interviews with 36 students and detailed accounts of one focal…

Identity Practices of Multilingual Writers in Social Networking Spaces

ERIC Educational Resources Information Center

Chen, Hsin-I

2013-01-01

This study examines the literacy practices of two multilingual writers in social networking communities. The findings show that the multilingual writers explored and reappropriated symbolic resources afforded by the social networking site as they aligned themselves with particular collective and personal identities at local and global levels.…

Common quandaries and their practical solutions in Bayesian network modeling

Treesearch

Bruce G. Marcot

2017-01-01

Use and popularity of Bayesian network (BN) modeling has greatly expanded in recent years, but many common problems remain. Here, I summarize key problems in BN model construction and interpretation,along with suggested practical solutions. Problems in BN model construction include parameterizing probability values, variable definition, complex network structures,...

[Physician's anxiety and physician's elegance. Problems in dealing with cost reduction, education of general practitioners and optimal size of practice networks in a cross-national comparison].

PubMed

Behrens, J

2000-03-01

The key reason for physicians networking in managed care is to get a better coping with uncertainty on action (treatment) decisions. The second reason for networking in managed care are financial benefits grounds. But this reason is very ambivalent. Three different action problems (role conflicts) in managed care network are to solved, which was also in single practices. In the lecture the decision strategies and decision resources has been compared. Observations are done using expert interviews, patient interviews and analysis of documents in USA, Germany and Switzerland. The first problem is the choosing of a cost reduction strategy which is not reducing the effectiveness. Such "ugly" solution strategies like exclusion of "expensive" patients and a rationing of necessary medical services in a kind of McDonalds network of physicians will fail the target. The optimost way is a saving of all unnecessary medical even injourious performances. The chosen cost reduction strategy is not real visible from outside but in fact limited cognizable and controllable. Evidence based health care can be a resource of treatment decisions and could train such decisions but it will not substitute these decisions. The second problem is the making of real family practitioners as gatekeepers. Knowledge about the care system is still not making a real family practitioner, even if this is the minimum condition of their work. Also contractual relationships between insurance and doctor as a gatekeeper or financial incentives for patients are still making not a real family practitioner as a gatekpeeper. Only throughout the trust of patients supported by second opinions is making the real family practitioner as a gatekeeper. "Doctor hopping" could be the reaction by scarcity of trustworthy family practitioners as gatekeepers. The third problem is the choosing of the optimal scale of a network due to the very different optimal size of networks regarding the requirement of risk spreeds, of the motivated engagement, of competition, incentives of inclusion of insurantes, they always need other net sizes. But it is possible, for each requirement there could function different networks. A practice (doctor's office) can be a member in different networks in several levels. The social transition from a small office to a network of offices is in all business lines a cultural shock involving not only benefits also psychical and social distress. In this there is no difference between health or agriculture or each other business of trade and industry. The destiny of the joint doctor's offices in Germany suggest due to a very serious power to scatter this networks. The comparative analysis of conflicts, strains, resources and strategies of associations and networks could yield from a developed methodical repository in sociology and social psychology what exists since 40 years (see also Meyer--in this journal). But therefore must be included also the action problems, which are only mentioned in passing of the according profession horizon.

Working Memory and Neurofeedback.

PubMed

YuLeung To, Eric; Abbott, Kathy; Foster, Dale S; Helmer, D'Arcy

2016-01-01

Impairments in working memory are typically associated with impairments in other cognitive faculties such as attentional processes and short-term memory. This paper briefly introduces neurofeedback as a treatment modality in general, and, more specifically, we review several of the current modalities successfully used in neurofeedback (NF) for the treatment of working memory deficits. Two case studies are presented to illustrate how neurofeedback is applied in treatment. The development of Low Resolution Electromagnetic Tomography (LORETA) and its application in neurofeedback now makes it possible to specifically target deep cortical/subcortical brain structures. Developments in neuroscience concerning neural networks, combined with highly specific yet practical NF technologies, makes neurofeedback of particular interest to neuropsychological practice, including the emergence of specific methodologies for treating very difficult working memory (WM) problems.

Partnering with patients to realize the benefits of social media.

PubMed

Colbert, James A; Lehmann, Lisa Soleymani

2015-03-01

Despite widespread concern about the potential risks of the use of social media, we are optimistic that social networks and blogs have the potential to enhance the practice of medicine by allowing clinicians to share ideas and information within the health care community, with patients, and with the general public. In particular, we believe that there can be value in posting information related to a patient encounter on social media, but only if care has been taken to consider the consequences of such a post from the patient's perspective. Thus, having a discussion with a patient and obtaining verbal consent before posting even deidentified patient information should become standard practice for all physicians who use social media. Copyright © 2015 Elsevier Inc. All rights reserved.

Identification of alkaptonuria in the general population: a United Kingdom experience describing the challenges, possible solutions and persistent barriers.

PubMed

Ranganath, L; Taylor, A M; Shenkin, A; Fraser, W D; Jarvis, J; Gallagher, J A; Sireau, N

2011-06-01

Progress in research into rare diseases is challenging. This paper discusses strategies to identify individuals with the rare genetic disease alkaptonuria (AKU) within the general population. Strategies used included a questionnaire survey of general practitioners, a dedicated website and patient network contact, targeted family screening and medical conference targeting. Primary care physicians of the UK were targeted by a postal survey that involved mailing 11,151 UK GPs; the response rate was 18.2%. We have identified 75 patients in the UK with AKU by the following means: postal survey (23), targeted family screening (11), patient networks and the website (41). Targeting medical conferences (AKU, rare diseases, rheumatology, clinical biochemistry, orthopaedics, general practitioners) did not lead to new identification in the UK but helped identify overseas cases. We are now aware of 626 patients worldwide including newly identified non-UK people with AKU in the following areas: Slovakia (208), the rest of Europe (including Turkey) (79), North America (including USA and Canada) (110), and the rest of the world (154). A mechanism for identifying individuals with AKU in the general population-not just in the UK but worldwide-has been established. Knowledge of patients with AKU, both in the UK and outside, is often confined to establishing their location in a particular GP practice or association with a particular medical professional. Mere identification, however, does not always lead to full engagement for epidemiological research purposes or targeting treatment since further barriers exist.

Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research.

PubMed

Brownson, Ross C; Fielding, Jonathan E; Green, Lawrence W

2018-04-01

Timely implementation of principles of evidence-based public health (EBPH) is critical for bridging the gap between discovery of new knowledge and its application. Public health organizations need sufficient capacity (the availability of resources, structures, and workforce to plan, deliver, and evaluate the preventive dose of an evidence-based intervention) to move science to practice. We review principles of EBPH, the importance of capacity building to advance evidence-based approaches, promising approaches for capacity building, and future areas for research and practice. Although there is general agreement among practitioners and scientists on the importance of EBPH, there is less clarity on the definition of evidence, how to find it, and how, when, and where to use it. Capacity for EBPH is needed among both individuals and organizations. Capacity can be strengthened via training, use of tools, technical assistance, assessment and feedback, peer networking, and incentives. Modest investments in EBPH capacity building will foster more effective public health practice.

Building capacity for evidence-based public health: Reconciling the pulls of practice and the push of research

PubMed Central

Fielding, Jonathan E.; Green, Lawrence W.

2018-01-01

Timely implementation of principles of evidence-based public health (EBPH) is critical for bridging the gap between discovery of new knowledge and application. Public health organizations need sufficient capacity (the availability of resources, structures, and workforce to plan deliver and evaluate the “preventive dose” of an evidence-based intervention) to move science to practice. We review principles of EBPH, the importance of capacity building to advance evidence-based approaches, promising approaches for capacity building, and future areas for research and practice. While there is general agreement on the importance of EBPH, there is less clarity on the definition of evidence, how to find it, and how, when and where to use it. Capacity for EBPH is needed among both individuals and organizations. Capacity can be strengthened via training, use of tools, technical assistance, assessment and feedback, peer networking, and incentives. Modest investments in EBPH capacity-building will foster more effective public health practice. PMID:29166243

Effective prediction of biodiversity in tidal flat habitats using an artificial neural network.

PubMed

Yoo, Jae-Won; Lee, Yong-Woo; Lee, Chang-Gun; Kim, Chang-Soo

2013-02-01

Accurate predictions of benthic macrofaunal biodiversity greatly benefit the efficient planning and management of habitat restoration efforts in tidal flat habitats. Artificial neural network (ANN) prediction models for such biodiversity were developed and tested based on 13 biophysical variables, collected from 50 sites of tidal flats along the coast of Korea during 1991-2006. The developed model showed high predictions during training, cross-validation and testing. Besides the training and testing procedures, an independent dataset from a different time period (2007-2010) was used to test the robustness and practical usage of the model. High prediction on the independent dataset (r = 0.84) validated the networks proper learning of predictive relationship and its generality. Key influential variables identified by follow-up sensitivity analyses were related with topographic dimension, environmental heterogeneity, and water column properties. Study demonstrates the successful application of ANN for the accurate prediction of benthic macrofaunal biodiversity and understanding of dynamics of candidate variables. Copyright © 2012 Elsevier Ltd. All rights reserved.

Exploiting Bounded Signal Flow for Graph Orientation Based on Cause-Effect Pairs

NASA Astrophysics Data System (ADS)

Dorn, Britta; Hüffner, Falk; Krüger, Dominikus; Niedermeier, Rolf; Uhlmann, Johannes

We consider the following problem: Given an undirected network and a set of sender-receiver pairs, direct all edges such that the maximum number of "signal flows" defined by the pairs can be routed respecting edge directions. This problem has applications in communication networks and in understanding protein interaction based cell regulation mechanisms. Since this problem is NP-hard, research so far concentrated on polynomial-time approximation algorithms and tractable special cases. We take the viewpoint of parameterized algorithmics and examine several parameters related to the maximum signal flow over vertices or edges. We provide several fixed-parameter tractability results, and in one case a sharp complexity dichotomy between a linear-time solvable case and a slightly more general NP-hard case. We examine the value of these parameters for several real-world network instances. For many relevant cases, the NP-hard problem can be solved to optimality. In this way, parameterized analysis yields both deeper insight into the computational complexity and practical solving strategies.

Wavelet neural networks: a practical guide.

PubMed

Alexandridis, Antonios K; Zapranis, Achilleas D

2013-06-01

Wavelet networks (WNs) are a new class of networks which have been used with great success in a wide range of applications. However a general accepted framework for applying WNs is missing from the literature. In this study, we present a complete statistical model identification framework in order to apply WNs in various applications. The following subjects were thoroughly examined: the structure of a WN, training methods, initialization algorithms, variable significance and variable selection algorithms, model selection methods and finally methods to construct confidence and prediction intervals. In addition the complexity of each algorithm is discussed. Our proposed framework was tested in two simulated cases, in one chaotic time series described by the Mackey-Glass equation and in three real datasets described by daily temperatures in Berlin, daily wind speeds in New York and breast cancer classification. Our results have shown that the proposed algorithms produce stable and robust results indicating that our proposed framework can be applied in various applications. Copyright © 2013 Elsevier Ltd. All rights reserved.

EMQN best practice guidelines for the molecular genetic testing and reporting of chromosome 11p15 imprinting disorders: Silver–Russell and Beckwith–Wiedemann syndrome

PubMed Central

Eggermann, Katja; Bliek, Jet; Brioude, Frédéric; Algar, Elizabeth; Buiting, Karin; Russo, Silvia; Tümer, Zeynep; Monk, David; Moore, Gudrun; Antoniadi, Thalia; Macdonald, Fiona; Netchine, Irène; Lombardi, Paolo; Soellner, Lukas; Begemann, Matthias; Prawitt, Dirk; Maher, Eamonn R; Mannens, Marcel; Riccio, Andrea; Weksberg, Rosanna; Lapunzina, Pablo; Grønskov, Karen; Mackay, Deborah JG; Eggermann, Thomas

2016-01-01

Molecular genetic testing for the 11p15-associated imprinting disorders Silver–Russell and Beckwith–Wiedemann syndrome (SRS, BWS) is challenging because of the molecular heterogeneity and complexity of the affected imprinted regions. With the growing knowledge on the molecular basis of these disorders and the demand for molecular testing, it turned out that there is an urgent need for a standardized molecular diagnostic testing and reporting strategy. Based on the results from the first external pilot quality assessment schemes organized by the European Molecular Quality Network (EMQN) in 2014 and in context with activities of the European Network of Imprinting Disorders (EUCID.net) towards a consensus in diagnostics and management of SRS and BWS, best practice guidelines have now been developed. Members of institutions working in the field of SRS and BWS diagnostics were invited to comment, and in the light of their feedback amendments were made. The final document was ratified in the course of an EMQN best practice guideline meeting and is in accordance with the general SRS and BWS consensus guidelines, which are in preparation. These guidelines are based on the knowledge acquired from peer-reviewed and published data, as well as observations of the authors in their practice. However, these guidelines can only provide a snapshot of current knowledge at the time of manuscript submission and readers are advised to keep up with the literature. PMID:27165005

Net one, net two: the primary care network income statement.

PubMed

Halley, M D; Little, A W

1999-10-01

Although hospital-owned primary care practices have been unprofitable for most hospitals, some hospitals are achieving competitive advantage and sustainable practice operations. A key to the success of some has been a net income reporting tool that separates practice operating expenses from the costs of creating and operating a network of practices to help healthcare organization managers, physicians, and staff to identify opportunities to improve the network's financial performance. This "Net One, Net Two" reporting allows operations leadership to be held accountable for Net One expenses and strategic leadership to be held accountable for Net Two expenses.

Characterizing multi-photon quantum interference with practical light sources and threshold single-photon detectors

NASA Astrophysics Data System (ADS)

Navarrete, Álvaro; Wang, Wenyuan; Xu, Feihu; Curty, Marcos

2018-04-01

The experimental characterization of multi-photon quantum interference effects in optical networks is essential in many applications of photonic quantum technologies, which include quantum computing and quantum communication as two prominent examples. However, such characterization often requires technologies which are beyond our current experimental capabilities, and today's methods suffer from errors due to the use of imperfect sources and photodetectors. In this paper, we introduce a simple experimental technique to characterize multi-photon quantum interference by means of practical laser sources and threshold single-photon detectors. Our technique is based on well-known methods in quantum cryptography which use decoy settings to tightly estimate the statistics provided by perfect devices. As an illustration of its practicality, we use this technique to obtain a tight estimation of both the generalized Hong‑Ou‑Mandel dip in a beamsplitter with six input photons and the three-photon coincidence probability at the output of a tritter.

The practice of travel medicine in Europe.

PubMed

Schlagenhauf, P; Santos-O'Connor, F; Parola, P

2010-03-01

Europe, because of its geographical location, strategic position on trade routes, and colonial past, has a long history of caring for travellers' health. Within Europe, there is great diversity in the practice of travel medicine. Some countries have travel medicine societies and provisions for a periodic distribution of recommendations, but many countries have no national pre-travel guidelines and follow international recommendations such as those provided by the WHO. Providers of travel medicine include tropical medicine specialists, general practice nurses and physicians, specialist 'travel clinics', occupational physicians, and pharmacists. One of the core functions of the European Centre for Disease Prevention and Control-funded network of travel and tropical medicine professionals, EuroTravNet, is to document the status quo of travel medicine in Europe. A three-pronged approach is used, with a real-time online questionnaire, a structured interview with experts in each country, and web searching.

Telescope Networks in Education: Where We Are Now and Where We Are Headed

NASA Astrophysics Data System (ADS)

Freed, R.

2017-12-01

Remote telescopes have become more common and accessible over the past 20 years as technology has evolved, and there has been a corresponding interest in bringing telescopes and astronomy into the educational arena. Numerous telescope networks (i.e. Las Cumbres Observatory, the Faulkes Telescopes, Skynet, the Harvard-Smithsonian Center for Astrophysics MicroObservatory, the SPIRIT Telescopes, iTelescope, telescope.org and others) as well as curriculum development groups and national and international programs have been developed during this time to connect students and the public with the technology and the science. While some programs and networks have come and gone, we are now at a time where sustainable communities of practice around astronomical research, ground-based telescope networks, and education can take hold and grow. The global connectivity that today's technology affords makes possible many more types of astronomical studies than in previous decades as we now have the capacity for continual sky coverage in both hemispheres by larger numbers of people and larger telescopes. Astronomy is one of few scientific fields that captures the imagination of the masses and as an undergraduate general science course it is often the last exposure to formal science that students will have and as such can play a critical role in STEM education. As the advances in computer and space exploration technologies continue, and the amount of data coming from remote observatories and space exploration missions increases astronomically, integrating remote telescope networks into educational settings, in tandem with teaching students and the general public about the nature and processes of scientific inquiry is vital not only for the field of astronomy but in helping to develop a generation of critical thinkers and informed citizens.

Physician professionalism and accountability: the role of collaborative improvement networks.

PubMed

Miles, Paul V; Conway, Patrick H; Pawlson, L Gregory

2013-06-01

The medical profession is facing an imperative to deliver more patient-centered care, improve quality, and reduce unnecessary costs and waste. With significant unexplained variation in resource use and outcomes, even physicians and health care organizations with "the best" reputations cannot assume they always deliver the best care possible. Going forward, physicians will need to demonstrate professionalism and accountability in a different way: to their peers, to society in general, and to individual patients. The new accountability includes quality and clinical outcomes but also resource utilization, appropriateness and patient-centeredness of recommended care, and the responsibility to help improve systems of care. The pediatric collaborative improvement network model represents an important framework for helping transform health care. For individual physicians, participation in a multisite network offers the opportunity to demonstrate accountability by measuring and improving care as part of an approach that addresses the problems of small sample size, attribution, and unnecessary variation in care by pooling patients from individual practices and requiring standardization of care to participate. For patients and families, the model helps ensure that they are likely to receive the current best evidence-based recommendation. Finally, this model aligns with payers' goals of purchasing value-based care, rewarding quality and improvement, and reducing unnecessary variation around current best evidenced-based, effective, and efficient care. In addition, within the profession, the American Board of Pediatrics recognizes participation in a multisite quality improvement network as one of the most rigorous and meaningful approaches for a diplomate to meet practice performance maintenance of certification requirements.

Prevalence of pain in the orofacial regions in patients visiting general dentists in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network.

PubMed

Horst, Orapin V; Cunha-Cruz, Joana; Zhou, Lingmei; Manning, Walter; Mancl, Lloyd; DeRouen, Timothy A

2015-10-01

This study aimed to measure prevalence of pain in the orofacial regions and determine association with demographics, treatment history, and oral health conditions in dental patients visiting clinics in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) research network. Data were recorded in a survey with systematic random sampling of patients (n = 1,668, 18 to 93 years old, 56% female) visiting 100 general dentists in the Northwest PRECEDENT research network. Prevalence ratios (PR) of orofacial pain by each variable were estimated by generalized estimating equations for Poisson regression. The prevalence of orofacial pain during the past year was 16.1% (95% confidence interval [CI], 13.4-18.9), of which the most prevalent pain locations were dentoalveolar (9.1%; 95% CI, 7.0-11.2) and musculoligamentous tissues (6.6%; 95% CI, 4.5-8.7). Other locations included soft tissues (0.5%; 95% CI, 0.2-0.8) and nonspecific areas (0.6%; 95% CI, 0.2-1.0). The prevalence of dentoalveolar but not musculoligamentous pain decreased with age. When comparing the 18- to 29-year-old patients, dentoalveolar pain decreased significantly in 45- to 64-year-old patients (PR, 0.59; 95% CI, 0.4-0.9) and in those 65 years or older (PR, 0.5; 95% CI, 0.3-0.9). Sex significantly affected the prevalence of musculoligamentous but not dentoalveolar pain. Women (PR, 3.2; 95% CI, 2.0-5.1) were more likely to have musculoligamentous pain. The prevalence of dentoalveolar and musculoligamentous pain did not vary significantly by ethnicity. Dentoalveolar pain was reported more frequently in patients who did not receive dental maintenance (PR, 2.9; 95% CI, 2.1-4.2) and those visiting community-based public health clinics (PR, 2.2; 95% CI, 1.2-3.7). One in 6 patients visiting a general dentist had experienced orofacial pain during the past year. Dentoalveolar and musculoligamentous pains were the most prevalent types of pain. Pain in the muscles and temporomandibular joints was reported as frequently as that in the teeth and surrounding tissues in patients visiting general dentists. Although the dental curriculum is concentrated on the diagnosis and management of pain and related conditions from teeth and surrounding tissues, it is imperative to include the training for other types of orofacial pain, particularly those from temporomandibular joint and musculoligamentous tissues. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

Readiness for the Patient-Centered Medical Home: Structural Capabilities of Massachusetts Primary Care Practices

PubMed Central

Friedberg, Mark W.; Safran, Dana G.; Coltin, Kathryn L.; Dresser, Marguerite

2008-01-01

Background The Patient-Centered Medical Home (PCMH), a popular model for primary care reorganization, includes several structural capabilities intended to enhance quality of care. The extent to which different types of primary care practices have adopted these capabilities has not been previously studied. Objective To measure the prevalence of recommended structural capabilities among primary care practices and to determine whether prevalence varies among practices of different size (number of physicians) and administrative affiliation with networks of practices. Design Cross-sectional analysis. Participants One physician chosen at random from each of 412 primary care practices in Massachusetts was surveyed about practice capabilities during 2007. Practice size and network affiliation were obtained from an existing database. Measurements Presence of 13 structural capabilities representing 4 domains relevant to quality: patient assistance and reminders, culture of quality, enhanced access, and electronic health records (EHRs). Main Results Three hundred eight (75%) physicians responded, representing practices with a median size of 4 physicians (range 2–74). Among these practices, 64% were affiliated with 1 of 9 networks. The prevalence of surveyed capabilities ranged from 24% to 88%. Larger practice size was associated with higher prevalence for 9 of the 13 capabilities spanning all 4 domains (P < 0.05). Network affiliation was associated with higher prevalence of 5 capabilities (P < 0.05) in 3 domains. Associations were not substantively altered by statistical adjustment for other practice characteristics. Conclusions Larger and network-affiliated primary care practices are more likely than smaller, non-affiliated practices to have adopted several recommended capabilities. In order to achieve PCMH designation, smaller non-affiliated practices may require the greatest investments. Electronic supplementary material The online version of this article (doi:10.1007/s11606-008-0856-x) contains supplementary material, which is available to authorized users. PMID:19050977

Network planning under uncertainties

NASA Astrophysics Data System (ADS)

Ho, Kwok Shing; Cheung, Kwok Wai

2008-11-01

One of the main focuses for network planning is on the optimization of network resources required to build a network under certain traffic demand projection. Traditionally, the inputs to this type of network planning problems are treated as deterministic. In reality, the varying traffic requirements and fluctuations in network resources can cause uncertainties in the decision models. The failure to include the uncertainties in the network design process can severely affect the feasibility and economics of the network. Therefore, it is essential to find a solution that can be insensitive to the uncertain conditions during the network planning process. As early as in the 1960's, a network planning problem with varying traffic requirements over time had been studied. Up to now, this kind of network planning problems is still being active researched, especially for the VPN network design. Another kind of network planning problems under uncertainties that has been studied actively in the past decade addresses the fluctuations in network resources. One such hotly pursued research topic is survivable network planning. It considers the design of a network under uncertainties brought by the fluctuations in topology to meet the requirement that the network remains intact up to a certain number of faults occurring anywhere in the network. Recently, the authors proposed a new planning methodology called Generalized Survivable Network that tackles the network design problem under both varying traffic requirements and fluctuations of topology. Although all the above network planning problems handle various kinds of uncertainties, it is hard to find a generic framework under more general uncertainty conditions that allows a more systematic way to solve the problems. With a unified framework, the seemingly diverse models and algorithms can be intimately related and possibly more insights and improvements can be brought out for solving the problem. This motivates us to seek a generic framework for solving the network planning problem under uncertainties. In addition to reviewing the various network planning problems involving uncertainties, we also propose that a unified framework based on robust optimization can be used to solve a rather large segment of network planning problem under uncertainties. Robust optimization is first introduced in the operations research literature and is a framework that incorporates information about the uncertainty sets for the parameters in the optimization model. Even though robust optimization is originated from tackling the uncertainty in the optimization process, it can serve as a comprehensive and suitable framework for tackling generic network planning problems under uncertainties. In this paper, we begin by explaining the main ideas behind the robust optimization approach. Then we demonstrate the capabilities of the proposed framework by giving out some examples of how the robust optimization framework can be applied to the current common network planning problems under uncertain environments. Next, we list some practical considerations for solving the network planning problem under uncertainties with the proposed framework. Finally, we conclude this article with some thoughts on the future directions for applying this framework to solve other network planning problems.

Settlement Networks in Polish Spatial Development Regional Plans

NASA Astrophysics Data System (ADS)

Sołtys, Jacek

2017-10-01

In 1999, ten years after the great political changes in Poland, 16 self-governed regions (in Polish: voivodeship) were created. According to Polish law, voivodeship spatial development plans, or regional plans in short, determine basic elements of the settlement network. No detailed regulations indicate the specific elements of the settlement network or what features of these elements should be determined. For this reason, centres as elements of the settlement network are variously named in different regions and take the form of various models. The purposes of the research described in this article are: (1) recognition and systematization of settlement network models determined in regional plans; and (2) assessment of the readability of determination in planning and its usefulness in the practice of regional policy. Six models of settlement networks in regional plans have been identified and classified into types and sub-types. Names of specific levels of centres indicate that they were classified according to two criteria: (1) level of services, which concerns only 5 voivodships; and (2) importance in development, which concerns the 11 other voivodships. The hierarchical model referring to the importance of development is less understandable than the one related to services. In the text of most plans, centres of services and centres of development are treated independently from their names. In some plans the functional types of towns and cities are indicated. In some voivodships, specifications in the plan text are too general and seem to be rather useless in the practice of regional policy. The author suggests that regional plans should determine two kinds of centres: hierarchical service centres and non-hierarchical centres of development. These centres should be further distinguished according to: (1) their role in the activation of surroundings; (2) their level of development and the necessity of action for their development; and (3) the types of actions indicated in the regional policy.

The Practices of Student Network as Cooperative Learning in Ethiopia

ERIC Educational Resources Information Center

Reda, Weldemariam Nigusse; Hagos, Girmay Tsegay

2015-01-01

Student network is a teaching strategy introduced as cooperative learning to all educational levels above the upper primary schools (grade 5 and above) in Ethiopia. The study was, therefore, aimed at investigating to what extent the student network in Ethiopia is actually practiced in line with the principles of cooperative learning. Consequently,…

Nurturing Global Collaboration and Networked Learning in Higher Education

ERIC Educational Resources Information Center

Cronin, Catherine; Cochrane, Thomas; Gordon, Averill

2016-01-01

We consider the principles of communities of practice (CoP) and networked learning in higher education, illustrated with a case study. iCollab has grown from an international community of practice connecting students and lecturers in seven modules across seven higher education institutions in six countries, to a global network supporting the…

Increasing social capital via local networks: analysis in the context of a surgical practice.

PubMed

Thakur, Anjani; Yang, Isaac; Lee, Michael Y; Goel, Arpan; Ashok, Ashwin; Fonkalsrud, Eric W

2002-09-01

The relationship between social capital (support, trust, patient awareness, and increased practice revenue) and local networks (university hospital) in communities has received little attention. The development of computer-based communication networks (social networks) has added a new dimension to the argument, posing the question of whether local networks can (re-)create social capital in local communities. This relationship is examined through a review of the literature on local networks and social capital and a surgeon's practice management from 1990 to 2001 with respect to repair of pectus chest deformities. With respect to pectus repair there was a consistent but small number of new referrals (15-20 new patients/year), lack of patient awareness (eight to 12 self-referred patients/year), and modest practice revenue. Since the inception of an Internet website (social network) dedicated to pectus repair in 1996 there has been increased social participation (n = 630 hits/year to the website); facilitation of spread of information through E-mail messages (n = 430 messages/year); and a greater participation of groups such as women, minorities, adults, and those with disability (n = 120 patients/year). The dissemination of information via the local network has also allowed an "outward movement" with increased participation by interconnecting communities (n = 698,300 global Internet participants based on statistical ratios). We conclude that local networks have enhanced social networks providing new grounds for the development of relationships based on choice and shared interest.

Guided Practice: Use of Low-Cost Networking.

ERIC Educational Resources Information Center

Gersten, Russell; And Others

This study investigated the effectiveness of the use of computer networking in providing guided practice in teaching reading comprehension to middle school students (grades 6-8) in remedial reading class. (Guided practice is defined as the phase of instruction immediately following the presentation of a new skill, concept, or strategy, in which…

Soldiers in the Blogosphere Using New Media to Help Win the War for Public Opinion

DTIC Science & Technology

2009-04-01

relaxed its policy on blogging, but still bans the use of community networking sites such as MySpace on government computers . The Army has practically...of community networking sites such as MySpace on government computers . The Army has practically ignored these new media sources to get its story...its policy on blogging, but still bans the use of community networking sites such as MySpace on government computers . The Army has practically

Assessing physician job satisfaction and mental workload.

PubMed

Boultinghouse, Oscar W; Hammack, Glenn G; Vo, Alexander H; Dittmar, Mary Lynne

2007-12-01

Physician job satisfaction and mental workload were evaluated in a pilot study of five physicians engaged in a telemedicine practice at The University of Texas Medical Branch at Galveston Electronic Health Network. Several previous studies have examined physician satisfaction with specific telemedicine applications; however, few have attempted to identify the underlying factors that contribute to physician satisfaction or lack thereof. One factor that has been found to affect well-being and functionality in the workplace-particularly with regard to human interaction with complex systems and tasks as seen in telemedicine-is mental workload. Workload is generally defined as the "cost" to a person for performing a complex task or tasks; however, prior to this study, it was unexplored as a variable that influences physician satisfaction. Two measures of job satisfaction were used: The Job Descriptive Index and the Job In General scales. Mental workload was evaluated by means of the National Aeronautics and Space Administration Task Load Index. The measures were administered by means of Web-based surveys and were given twice over a 6-month period. Nonparametric statistical analyses revealed that physician job satisfaction was generally high relative to that of the general population and other professionals. Mental workload scores associated with the practice of telemedicine in this environment are also high, and appeared stable over time. In addition, they are commensurate with scores found in individuals practicing tasks with elevated information-processing demands, such as quality control engineers and air traffic controllers. No relationship was found between the measures of job satisfaction and mental workload.

Influenza testing trends in sentinel surveillance general practices in Victoria 2007 to 2014.

PubMed

Cowie, Genevieve A; Cowie, Benjamin C; Fielding, James E

2017-03-31

The Victorian Sentinel Practice Influenza Network conducts syndromic surveillance for influenza-like illness (ILI), with testing for laboratory confirmation of a proportion of cases at the discretion of general practitioners. The aim of this study was to evaluate the consistency of sentinel general practitioners' swabbing practice within and between influenza seasons. Aggregated, weekly, non-identified data for May to October each year from 2007 to 2014 were used to calculate the proportion of patients presenting with ILI (defined as cough, fever and fatigue), proportion of ILI patients swabbed and proportion of swabs positive for influenza. Data on the proportion of consultations for ILI and the proportion of ILI patients swabbed were aggregated into time-period quintiles for each year. Analysis of variance was used to compare ILI patients swabbed for each aggregated time-period quintile over all 8 years. Spearman's correlation and Bland-Altman analyses were used to measure association and agreement respectively between ILI proportions of consultations and swabs positive for influenza in time period quintiles within each year. Data were aggregated by year for the rest of the analyses. Between 2007 and 2014 there was a slight decrease in the proportion of positive tests and the proportion of ILI patients was generally a good proxy for influenza test positivity. There was consistency in testing within and between seasons, despite an overall testing increase between 2007 and 2014. There was no evidence for temporal sampling bias in these data despite testing not being performed on a systematic basis. This sampling regimen could also be considered in other similar surveillance systems.

A neural network construction method for surrogate modeling of physics-based analysis

NASA Astrophysics Data System (ADS)

Sung, Woong Je

In this thesis existing methodologies related to the developmental methods of neural networks have been surveyed and their approaches to network sizing and structuring are carefully observed. This literature review covers the constructive methods, the pruning methods, and the evolutionary methods and questions about the basic assumption intrinsic to the conventional neural network learning paradigm, which is primarily devoted to optimization of connection weights (or synaptic strengths) for the pre-determined connection structure of the network. The main research hypothesis governing this thesis is that, without breaking a prevailing dichotomy between weights and connectivity of the network during learning phase, the efficient design of a task-specific neural network is hard to achieve because, as long as connectivity and weights are searched by separate means, a structural optimization of the neural network requires either repetitive re-training procedures or computationally expensive topological meta-search cycles. The main contribution of this thesis is designing and testing a novel learning mechanism which efficiently learns not only weight parameters but also connection structure from a given training data set, and positioning this learning mechanism within the surrogate modeling practice. In this work, a simple and straightforward extension to the conventional error Back-Propagation (BP) algorithm has been formulated to enable a simultaneous learning for both connectivity and weights of the Generalized Multilayer Perceptron (GMLP) in supervised learning tasks. A particular objective is to achieve a task-specific network having reasonable generalization performance with a minimal training time. The dichotomy between architectural design and weight optimization is reconciled by a mechanism establishing a new connection for a neuron pair which has potentially higher error-gradient than one of the existing connections. Interpreting an instance of the absence of connection as a zero-weight connection, the potential contribution to training error reduction of any present or absent connection can readily be evaluated using the BP algorithm. Instead of being broken, the connections that contribute less remain frozen with constant weight values optimized to that point but they are excluded from further weight optimization until reselected. In this way, a selective weight optimization is executed only for the dynamically maintained pool of high gradient connections. By searching the rapidly changing weights and concentrating optimization resources on them, the learning process is accelerated without either a significant increase in computational cost or a need for re-training. This results in a more task-adapted network connection structure. Combined with another important criterion for the division of a neuron which adds a new computational unit to a network, a highly fitted network can be grown out of the minimal random structure. This particular learning strategy can belong to a more broad class of the variable connectivity learning scheme and the devised algorithm has been named Optimal Brain Growth (OBG). The OBG algorithm has been tested on two canonical problems; a regression analysis using the Complicated Interaction Regression Function and a classification of the Two-Spiral Problem. A comparative study with conventional Multilayer Perceptrons (MLPs) consisting of single- and double-hidden layers shows that OBG is less sensitive to random initial conditions and generalizes better with only a minimal increase in computational time. This partially proves that a variable connectivity learning scheme has great potential to enhance computational efficiency and reduce efforts to select proper network architecture. To investigate the applicability of the OBG to more practical surrogate modeling tasks, the geometry-to-pressure mapping of a particular class of airfoils in the transonic flow regime has been sought using both the conventional MLP networks with pre-defined architecture and the OBG-developed networks started from the same initial MLP networks. Considering wide variety in airfoil geometry and diversity of flow conditions distributed over a range of flow Mach numbers and angles of attack, the new method shows a great potential to capture fundamentally nonlinear flow phenomena especially related to the occurrence of shock waves on airfoil surfaces in transonic flow regime. (Abstract shortened by UMI.).

Social networking and young adults' drinking practices: innovative qualitative methods for health behavior research.

PubMed

Lyons, Antonia C; Goodwin, Ian; McCreanor, Tim; Griffin, Christine

2015-04-01

Understandings of health behaviors can be enriched by using innovative qualitative research designs. We illustrate this with a project that used multiple qualitative methods to explore the confluence of young adults' drinking behaviors and social networking practices in Aotearoa, New Zealand. Participants were 18-25 year old males and females from diverse ethnic, class, and occupational backgrounds. In Stage 1, 34 friendship focus group discussions were video-recorded with 141 young adults who talked about their drinking and social networking practices. In Stage 2, 23 individual interviews were conducted using screen-capture software and video to record participants showing and discussing their Facebook pages. In Stage 3, a database of Web-based material regarding drinking and alcohol was developed and analyzed. In friendship group data, young adults co-constructed accounts of drinking practices and networking about drinking via Facebook as intensely social and pleasurable. However, this pleasure was less prominent in individual interviews, where there was greater explication of unpleasant or problematic experiences and practices. The pleasure derived from drinking and social networking practices was also differentiated by ethnicity, gender, and social class. Juxtaposing the Web-based data with participants' talk about their drinking and social media use showed the deep penetration of online alcohol marketing into young people's social worlds. Multiple qualitative methods, generating multimodal datasets, allowed valuable nuanced insights into young adults' drinking practices and social networking behaviors. This knowledge can usefully inform health policy, health promotion strategies, and targeted health interventions. (c) 2015 APA, all rights reserved).

Formation of Community-Based Hypertension Practice Networks: Success, Obstacles, and Lessons Learned

PubMed Central

Dart, Richard A.; Egan, Brent M.

2014-01-01

Community-based practice networks for research and improving the quality of care are growing in size and number but have variable success rates. In this paper we review recent efforts to initiate a community-based hypertension network modeled after the successful Outpatient Quality Improvement Network (O’QUIN) project, located at the Medical University of South Carolina. We highlight key lessons learned and new directions to be explored. PMID:24666425

Tooth wear and the role of salivary measures in general practice patients

PubMed Central

Rothen, Marilynn; Scott, JoAnna; Cunha-Cruz, Joana

2014-01-01

Objectives The goal of this study was to investigate the association between tooth wear and salivary measures in a random sample of patients from practices of dentist members of a practice-based research network. Materials and methods Patients completed a questionnaire on oral self-care, health, dietary habits, medications, and socio-demographic variables. Six salivary characteristics (consistency, resting salivary flow, resting salivary pH, stimulated salivary flow, stimulated salivary pH, and buffering capacity) were measured, and a dental examination included categorizing patients according to the dentist’s judgment of the degree of tooth wear (i.e., none/minimal, some, or severe/extreme). Bivariate and multinomial logistic regression models were used to relate salivary characteristics and other factors to the outcome of tooth wear. Results Data are reported from 1,323 patients (age range 16–97 years) from 61 practices. Patient age, gender, number of teeth, and perception of dry mouth were associated with tooth wear, but salivary and dietary factors were either weakly or not related. Conclusions The findings of this cross-sectional assessment suggest that using these salivary tests and dietary assessments in real-life clinical settings is unlikely to be useful in assessing tooth wear risk. Suggestions are offered about risk assessment for tooth wear. Clinical relevance Assessing a dental patient’s risk of tooth wear using salivary measures and dietary assessments as described is not recommended for general dental practice until stronger evidence exists indicating its utility. PMID:24647789

Development of a university-based emergency department network: lessons learned.

PubMed

Pimentel, Laura; Hirshon, Jon Mark; Barrueto, Fermin; Browne, Brian J

2012-10-01

As part of the growth of emergency medical care in our state, our university-based emergency medicine practice developed a network of affiliated emergency department (ED) practices. The original practices were academic and based on a faculty practice model; more recent network development incorporated a community practice model less focused on academics. This article discusses the growth of that network, with a focus on the recent addition of a county-wide two-hospital emergency medicine practice. During the transition of the two EDs from a contract management group to the university network, six critical areas in need of restructuring were identified: 1) departmental leadership, 2) recruitment and retention of clinical staff members, 3) staffing strategies, 4) relationships with key constituents, 5) clinical operations, supplies, and equipment, and 6) compensation structure. The impact of changes was measured by comparison of core measures, efficiency metrics, patient volumes, admissions, and transfers to the academic medical center before and after the implementation of our practice model. Our review and modification of these components significantly improved the quality and efficiency of care at the community hospital system. The consistent presence of board certified emergency physicians optimized utilization of clinical resources in the community hospital and the academic health system. This dynamic led to a mutually beneficial merger of these major state healthcare systems. Copyright © 2012 Elsevier Inc. All rights reserved.

'A politics of what': the enactment of peritoneal dialysis in indigenous Australians.

PubMed

McCarthy, Alexandra; Martin-McDonald, Kristine

2007-01-01

This paper explores, on the one hand, the requirements of the technologies and practices that have been developed for a particular type of renal patient and health network in Australia. On the other, we examine the cultural and practical specificities entailed in the performance of these technologies and practices in the Indigenous Australian context. The praxiographic orientation of the actor-network approach - which has been called 'the politics of what' (Mol 2002) - enabled us to understand the difficulties involved in translating renal healthcare networks across cultural contexts in Australia; to understand the dynamic and contested nature of these networks; and to suggest possible strategies that make use of the tensions between these two disparate networks in ways that might ensure better healthcare for Indigenous renal patients.

[Regional geriatric care concept in the District of Lippe : Structural effects and network formation in the case management-based model project].

PubMed

Şahin, Charlotte; Iseringhausen, Olaf; Hower, Kira; Liebe, Constanze; Rethmeier-Hanke, Anja; Wedmann, Bernd

2018-04-01

Regional planning of healthcare requires special consideration for the complex needs of elderly, multimorbid people living in a domestic environment. In the District of Lippe, a hospital (Klinikum Lippe) and network of ambulatory care physicians (Ärztenetz Lippe) developed and tested a geriatric care network based on case management for geriatric patients living in a domestic environment. The establishment of the geriatric care network (e.g. promoting networking acceptance and implementation) was formatively evaluated, e. g. with qualitative methods. Data were acquired by guideline-based interviews with experts and analyzed by qualitative content analysis according to Mayring. Structural effects included forming a cross-sectoral and interdisciplinary network for a functioning care network and a geriatric care pathway. The practical work of case managers (CM) is essential for communication with patients, family members and care providers as well as integrating providers into the network. A critical factor was working together with general practitioners and the close cooperation with the hospital's department of geriatric. The quality of care is improved because of exchange of information between sectors and continuity in the course of care. In the District of Lippe the quality of care was improved and structures of care were integrated by the network according to the needs of the target group. The integrative perspective was achieved in particular by the geriatric care pathway and integration of providers into the communication and care process; however, the scope of this care model could not be extended into routine care due to the rigid and subdivided health care system.

Functional connectivity dynamics during film viewing reveal common networks for different emotional experiences.

PubMed

Raz, Gal; Touroutoglou, Alexandra; Wilson-Mendenhall, Christine; Gilam, Gadi; Lin, Tamar; Gonen, Tal; Jacob, Yael; Atzil, Shir; Admon, Roee; Bleich-Cohen, Maya; Maron-Katz, Adi; Hendler, Talma; Barrett, Lisa Feldman

2016-08-01

Recent theoretical and empirical work has highlighted the role of domain-general, large-scale brain networks in generating emotional experiences. These networks are hypothesized to process aspects of emotional experiences that are not unique to a specific emotional category (e.g., "sadness," "happiness"), but rather that generalize across categories. In this article, we examined the dynamic interactions (i.e., changing cohesiveness) between specific domain-general networks across time while participants experienced various instances of sadness, fear, and anger. We used a novel method for probing the network connectivity dynamics between two salience networks and three amygdala-based networks. We hypothesized, and found, that the functional connectivity between these networks covaried with the intensity of different emotional experiences. Stronger connectivity between the dorsal salience network and the medial amygdala network was associated with more intense ratings of emotional experience across six different instances of the three emotion categories examined. Also, stronger connectivity between the dorsal salience network and the ventrolateral amygdala network was associated with more intense ratings of emotional experience across five out of the six different instances. Our findings demonstrate that a variety of emotional experiences are associated with dynamic interactions of domain-general neural systems.

GHSI EMERGENCY RADIONUCLIDE BIOASSAY LABORATORY NETWORK: SUMMARY OF A RECENT EXERCISE.

PubMed

Li, Chunsheng; Ansari, Armin; Bartizel, Christine; Battisti, Paolo; Franck, Didier; Gerstmann, Udo; Giardina, Isabella; Guichet, Claude; Hammond, Derek; Hartmann, Martina; Jones, Robert L; Kim, Eunjoo; Ko, Raymond; Morhard, Ryan; Quayle, Deborah; Sadi, Baki; Saunders, David; Paquet, Francois

2016-11-01

The Global Health Security Initiative (GHSI) established a laboratory network within the GHSI community to develop their collective surge capacity for radionuclide bioassay in response to a radiological or nuclear emergency. A recent exercise was conducted to test the participating laboratories for their capabilities in screening and in vitro assay of biological samples, performing internal dose assessment and providing advice on medical intervention, if necessary, using a urine sample spiked with a single radionuclide, 241 Am. The laboratories were required to submit their reports according to the exercise schedule and using pre-formatted templates. Generally, the participating laboratories were found to be capable with respect to rapidly screening samples for radionuclide contamination, measuring the radionuclide in the samples, assessing the intake and radiation dose, and providing advice on medical intervention. However, gaps in bioassay measurement and dose assessment have been identified. The network may take steps to ensure that procedures and practices within this network be harmonised and a follow-up exercise be organised on a larger scale, with potential participation of laboratories from the networks coordinated by the International Atomic Energy Agency and the World Health Organization. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Tough Self-Healing Elastomers by Molecular Enforced Integration of Covalent and Reversible Networks.

PubMed

Wu, Jinrong; Cai, Li-Heng; Weitz, David A

2017-10-01

Self-healing polymers crosslinked by solely reversible bonds are intrinsically weaker than common covalently crosslinked networks. Introducing covalent crosslinks into a reversible network would improve mechanical strength. It is challenging, however, to apply this concept to "dry" elastomers, largely because reversible crosslinks such as hydrogen bonds are often polar motifs, whereas covalent crosslinks are nonpolar motifs. These two types of bonds are intrinsically immiscible without cosolvents. Here, we design and fabricate a hybrid polymer network by crosslinking randomly branched polymers carrying motifs that can form both reversible hydrogen bonds and permanent covalent crosslinks. The randomly branched polymer links such two types of bonds and forces them to mix on the molecular level without cosolvents. This enables a hybrid "dry" elastomer that is very tough with fracture energy 13500 Jm -2 comparable to that of natural rubber. Moreover, the elastomer can self-heal at room temperature with a recovered tensile strength 4 MPa, which is 30% of its original value, yet comparable to the pristine strength of existing self-healing polymers. The concept of forcing covalent and reversible bonds to mix at molecular scale to create a homogenous network is quite general and should enable development of tough, self-healing polymers of practical usage. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Magnetoencephalography Reveals a Widespread Increase in Network Connectivity in Idiopathic/Genetic Generalized Epilepsy

PubMed Central

Elshahabi, Adham; Klamer, Silke; Sahib, Ashish Kaul; Lerche, Holger; Braun, Christoph; Focke, Niels K.

2015-01-01

Idiopathic/genetic generalized epilepsy (IGE/GGE) is characterized by seizures, which start and rapidly engage widely distributed networks, and result in symptoms such as absences, generalized myoclonic and primary generalized tonic-clonic seizures. Although routine magnetic resonance imaging is apparently normal, many studies have reported structural alterations in IGE/GGE patients using diffusion tensor imaging and voxel-based morphometry. Changes have also been reported in functional networks during generalized spike wave discharges. However, network function in the resting-state without epileptiforme discharges has been less well studied. We hypothesize that resting-state networks are more representative of the underlying pathophysiology and abnormal network synchrony. We studied functional network connectivity derived from whole-brain magnetoencephalography recordings in thirteen IGE/GGE and nineteen healthy controls. Using graph theoretical network analysis, we found a widespread increase in connectivity in patients compared to controls. These changes were most pronounced in the motor network, the mesio-frontal and temporal cortex. We did not, however, find any significant difference between the normalized clustering coefficients, indicating preserved gross network architecture. Our findings suggest that increased resting state connectivity could be an important factor for seizure spread and/or generation in IGE/GGE, and could serve as a biomarker for the disease. PMID:26368933

Walk-based measure of balance in signed networks: Detecting lack of balance in social networks

NASA Astrophysics Data System (ADS)

Estrada, Ernesto; Benzi, Michele

2014-10-01

There is a longstanding belief that in social networks with simultaneous friendly and hostile interactions (signed networks) there is a general tendency to a global balance. Balance represents a state of the network with a lack of contentious situations. Here we introduce a method to quantify the degree of balance of any signed (social) network. It accounts for the contribution of all signed cycles in the network and gives, in agreement with empirical evidence, more weight to the shorter cycles than to the longer ones. We found that, contrary to what is generally believed, many signed social networks, in particular very large directed online social networks, are in general very poorly balanced. We also show that unbalanced states can be changed by tuning the weights of the social interactions among the agents in the network.

New Practices in Doing Academic Development: Twitter as an Informal Learning Space

ERIC Educational Resources Information Center

McPherson, Megan; Budge, Kylie; Lemon, Narelle

2015-01-01

Using social media platforms to build informal learning processes and social networks is significant in academic development practices within higher education. We present three vignettes illustrating academic practices occurring on Twitter to show that using social media is beneficial for building networks of academics, locally and globally,…

Virtual Learning Environments as Sociomaterial Agents in the Network of Teaching Practice

ERIC Educational Resources Information Center

Johannesen, Monica; Erstad, Ola; Habib, Laurence

2012-01-01

This article presents findings related to the sociomaterial agency of educators and their practice in Norwegian education. Using actor-network theory, we ask how Virtual Learning Environments (VLEs) negotiate the agency of educators and how they shape their teaching practice. Since the same kinds of VLE tools have been widely implemented…

Social Networking Practices in School Psychology: Have Moral Panic Concerns Been Overstated?

ERIC Educational Resources Information Center

Segool, Natasha K.; Goforth, Anisa N.; Bowman, Nicholas; Pham, Andy

2016-01-01

The almost ubiquitous use of Facebook and other social networking sites (SNSs) by adults in the United States raises important practice considerations for school psychologists. This study examined the SNS practices of school psychologists, graduate trainers, and graduate students to explore (a) SNS use training experiences for school…

Adaptive Synchronization of Fractional Order Complex-Variable Dynamical Networks via Pinning Control

NASA Astrophysics Data System (ADS)

Ding, Da-Wei; Yan, Jie; Wang, Nian; Liang, Dong

2017-09-01

In this paper, the synchronization of fractional order complex-variable dynamical networks is studied using an adaptive pinning control strategy based on close center degree. Some effective criteria for global synchronization of fractional order complex-variable dynamical networks are derived based on the Lyapunov stability theory. From the theoretical analysis, one concludes that under appropriate conditions, the complex-variable dynamical networks can realize the global synchronization by using the proper adaptive pinning control method. Meanwhile, we succeed in solving the problem about how much coupling strength should be applied to ensure the synchronization of the fractional order complex networks. Therefore, compared with the existing results, the synchronization method in this paper is more general and convenient. This result extends the synchronization condition of the real-variable dynamical networks to the complex-valued field, which makes our research more practical. Finally, two simulation examples show that the derived theoretical results are valid and the proposed adaptive pinning method is effective. Supported by National Natural Science Foundation of China under Grant No. 61201227, National Natural Science Foundation of China Guangdong Joint Fund under Grant No. U1201255, the Natural Science Foundation of Anhui Province under Grant No. 1208085MF93, 211 Innovation Team of Anhui University under Grant Nos. KJTD007A and KJTD001B, and also supported by Chinese Scholarship Council

[Application of artificial neural networks on the prediction of surface ozone concentrations].

PubMed

Shen, Lu-Lu; Wang, Yu-Xuan; Duan, Lei

2011-08-01

Ozone is an important secondary air pollutant in the lower atmosphere. In order to predict the hourly maximum ozone one day in advance based on the meteorological variables for the Wanqingsha site in Guangzhou, Guangdong province, a neural network model (Multi-Layer Perceptron) and a multiple linear regression model were used and compared. Model inputs are meteorological parameters (wind speed, wind direction, air temperature, relative humidity, barometric pressure and solar radiation) of the next day and hourly maximum ozone concentration of the previous day. The OBS (optimal brain surgeon) was adopted to prune the neutral work, to reduce its complexity and to improve its generalization ability. We find that the pruned neural network has the capacity to predict the peak ozone, with an agreement index of 92.3%, the root mean square error of 0.0428 mg/m3, the R-square of 0.737 and the success index of threshold exceedance 77.0% (the threshold O3 mixing ratio of 0.20 mg/m3). When the neural classifier was added to the neural network model, the success index of threshold exceedance increased to 83.6%. Through comparison of the performance indices between the multiple linear regression model and the neural network model, we conclud that that neural network is a better choice to predict peak ozone from meteorological forecast, which may be applied to practical prediction of ozone concentration.

Efficient Cancer Detection Using Multiple Neural Networks.

PubMed

Shell, John; Gregory, William D

2017-01-01

The inspection of live excised tissue specimens to ascertain malignancy is a challenging task in dermatopathology and generally in histopathology. We introduce a portable desktop prototype device that provides highly accurate neural network classification of malignant and benign tissue. The handheld device collects 47 impedance data samples from 1 Hz to 32 MHz via tetrapolar blackened platinum electrodes. The data analysis was implemented with six different backpropagation neural networks (BNN). A data set consisting of 180 malignant and 180 benign breast tissue data files in an approved IRB study at the Aurora Medical Center, Milwaukee, WI, USA, were utilized as a neural network input. The BNN structure consisted of a multi-tiered consensus approach autonomously selecting four of six neural networks to determine a malignant or benign classification. The BNN analysis was then compared with the histology results with consistent sensitivity of 100% and a specificity of 100%. This implementation successfully relied solely on statistical variation between the benign and malignant impedance data and intricate neural network configuration. This device and BNN implementation provides a novel approach that could be a valuable tool to augment current medical practice assessment of the health of breast, squamous, and basal cell carcinoma and other excised tissue without requisite tissue specimen expertise. It has the potential to provide clinical management personnel with a fast non-invasive accurate assessment of biopsied or sectioned excised tissue in various clinical settings.

Efficient Cancer Detection Using Multiple Neural Networks

PubMed Central

Gregory, William D.

2017-01-01

The inspection of live excised tissue specimens to ascertain malignancy is a challenging task in dermatopathology and generally in histopathology. We introduce a portable desktop prototype device that provides highly accurate neural network classification of malignant and benign tissue. The handheld device collects 47 impedance data samples from 1 Hz to 32 MHz via tetrapolar blackened platinum electrodes. The data analysis was implemented with six different backpropagation neural networks (BNN). A data set consisting of 180 malignant and 180 benign breast tissue data files in an approved IRB study at the Aurora Medical Center, Milwaukee, WI, USA, were utilized as a neural network input. The BNN structure consisted of a multi-tiered consensus approach autonomously selecting four of six neural networks to determine a malignant or benign classification. The BNN analysis was then compared with the histology results with consistent sensitivity of 100% and a specificity of 100%. This implementation successfully relied solely on statistical variation between the benign and malignant impedance data and intricate neural network configuration. This device and BNN implementation provides a novel approach that could be a valuable tool to augment current medical practice assessment of the health of breast, squamous, and basal cell carcinoma and other excised tissue without requisite tissue specimen expertise. It has the potential to provide clinical management personnel with a fast non-invasive accurate assessment of biopsied or sectioned excised tissue in various clinical settings. PMID:29282435

Data analysis-based autonomic bandwidth adjustment in software defined multi-vendor optical transport networks.

PubMed

Li, Yajie; Zhao, Yongli; Zhang, Jie; Yu, Xiaosong; Jing, Ruiquan

2017-11-27

Network operators generally provide dedicated lightpaths for customers to meet the demand for high-quality transmission. Considering the variation of traffic load, customers usually rent peak bandwidth that exceeds the practical average traffic requirement. In this case, bandwidth provisioning is unmetered and customers have to pay according to peak bandwidth. Supposing that network operators could keep track of traffic load and allocate bandwidth dynamically, bandwidth can be provided as a metered service and customers would pay for the bandwidth that they actually use. To achieve cost-effective bandwidth provisioning, this paper proposes an autonomic bandwidth adjustment scheme based on data analysis of traffic load. The scheme is implemented in a software defined networking (SDN) controller and is demonstrated in the field trial of multi-vendor optical transport networks. The field trial shows that the proposed scheme can track traffic load and realize autonomic bandwidth adjustment. In addition, a simulation experiment is conducted to evaluate the performance of the proposed scheme. We also investigate the impact of different parameters on autonomic bandwidth adjustment. Simulation results show that the step size and adjustment period have significant influences on bandwidth savings and packet loss. A small value of step size and adjustment period can bring more benefits by tracking traffic variation with high accuracy. For network operators, the scheme can serve as technical support of realizing bandwidth as metered service in the future.

Formation of community-based hypertension practice networks: success, obstacles, and lessons learned.

PubMed

Dart, Richard A; Egan, Brent M

2014-06-01

Community-based practice networks for research and improving the quality of care are growing in size and number but have variable success rates. In this paper, the authors review recent efforts to initiate a community-based hypertension network modeled after the successful Outpatient Quality Improvement Network (O'QUIN) project, located at the Medical University of South Carolina. Key lessons learned and new directions to be explored are highlighted. ©2014 Wiley Periodicals, Inc.

A qualitative evaluation of a Local Professional Network programme "Baby Teeth DO Matter".

PubMed

Brocklehurst, P; Bridgman, C; Davies, G

2013-12-01

The objective of this study was to use a qualitative approach to examine the perceptions of dentists who led a health promotion programme entitled "Baby Teeth DO Matter". Semi-structured interviews were undertaken with a variety of participants in a health promotional programme facilitated by a shadow Local Professional Network. These were then recorded and transcribed verbatim. The transcripts were line numbered and subjected to thematic analysis to develop a coding frame. Overarching themes were developed from the coded transcripts by organising them into clusters based on the similarity of their meaning and checked against the coded extracts and the raw data. General Dental Practice. General Dental Practitioners. A Greater Manchester-wide prevention programme entitled "Baby teeth DO Matter". To determine the perceptions of involved clinicians and whether "clinically owned and clinically led" services add value. Eight codes were generated: "Success of the project", "Down-stream to up-stream", "Importance of clinically led and clinically owned", "Keeping the approach simple", "Importance of networking", "Importance of Dental Public Health", "Importance of task and finish" and "Threats to the future of the Local Professional Network". These were organised into three over-arching themes. "Clinically Led and Clinically Owned" projects appear to empower local practitioners and add value. They encourage community-facing practitioners, build capacity and develop personal skills;--all in accordance with the fundamental principles of the Ottawa Charter. Distributed leadership was seen to be effective and Dental Public Health input, "Task and Finishing", resources and clarity of communication were all considered to be of critical importance.

A Fast and Robust Extrinsic Calibration for RGB-D Camera Networks.

PubMed

Su, Po-Chang; Shen, Ju; Xu, Wanxin; Cheung, Sen-Ching S; Luo, Ying

2018-01-15

From object tracking to 3D reconstruction, RGB-Depth (RGB-D) camera networks play an increasingly important role in many vision and graphics applications. Practical applications often use sparsely-placed cameras to maximize visibility, while using as few cameras as possible to minimize cost. In general, it is challenging to calibrate sparse camera networks due to the lack of shared scene features across different camera views. In this paper, we propose a novel algorithm that can accurately and rapidly calibrate the geometric relationships across an arbitrary number of RGB-D cameras on a network. Our work has a number of novel features. First, to cope with the wide separation between different cameras, we establish view correspondences by using a spherical calibration object. We show that this approach outperforms other techniques based on planar calibration objects. Second, instead of modeling camera extrinsic calibration using rigid transformation, which is optimal only for pinhole cameras, we systematically test different view transformation functions including rigid transformation, polynomial transformation and manifold regression to determine the most robust mapping that generalizes well to unseen data. Third, we reformulate the celebrated bundle adjustment procedure to minimize the global 3D reprojection error so as to fine-tune the initial estimates. Finally, our scalable client-server architecture is computationally efficient: the calibration of a five-camera system, including data capture, can be done in minutes using only commodity PCs. Our proposed framework is compared with other state-of-the-arts systems using both quantitative measurements and visual alignment results of the merged point clouds.

A Fast and Robust Extrinsic Calibration for RGB-D Camera Networks †

PubMed Central

Shen, Ju; Xu, Wanxin; Luo, Ying

2018-01-01

From object tracking to 3D reconstruction, RGB-Depth (RGB-D) camera networks play an increasingly important role in many vision and graphics applications. Practical applications often use sparsely-placed cameras to maximize visibility, while using as few cameras as possible to minimize cost. In general, it is challenging to calibrate sparse camera networks due to the lack of shared scene features across different camera views. In this paper, we propose a novel algorithm that can accurately and rapidly calibrate the geometric relationships across an arbitrary number of RGB-D cameras on a network. Our work has a number of novel features. First, to cope with the wide separation between different cameras, we establish view correspondences by using a spherical calibration object. We show that this approach outperforms other techniques based on planar calibration objects. Second, instead of modeling camera extrinsic calibration using rigid transformation, which is optimal only for pinhole cameras, we systematically test different view transformation functions including rigid transformation, polynomial transformation and manifold regression to determine the most robust mapping that generalizes well to unseen data. Third, we reformulate the celebrated bundle adjustment procedure to minimize the global 3D reprojection error so as to fine-tune the initial estimates. Finally, our scalable client-server architecture is computationally efficient: the calibration of a five-camera system, including data capture, can be done in minutes using only commodity PCs. Our proposed framework is compared with other state-of-the-arts systems using both quantitative measurements and visual alignment results of the merged point clouds. PMID:29342968

What have we learned about vaginal infections and preterm birth?

PubMed

Carey, J Christopher; Klebanoff, Mark A

2003-06-01

Asymptomatic maternal genital tract infection during pregnancy, particularly bacterial vaginosis, has been consistently associated with preterm birth. In response to this evidence, the Maternal-Fetal Medicine Units Network (MFMU) designed and conducted 2 large randomized, placebo-controlled clinical trials of metronidazole treatment of asymptomatic pregnant women with bacterial vaginosis or trichomoniasis in a general obstetrical population. These studies showed that treatment of women with bacterial vaginosis failed to prevent preterm birth, regardless of their history of prior preterm birth. Metronidazole treatment of women with trichomoniasis significantly increased the risk of preterm birth compared to placebo. These results formed the basis of the US Preventive Services Task Force recommendation that screening for bacterial vaginosis not be undertaken in low-risk pregnant women, and show that MFMU network studies can have a direct and immediate impact on obstetrical practice.

A Survey of Models and Algorithms for Social Influence Analysis

NASA Astrophysics Data System (ADS)

Sun, Jimeng; Tang, Jie

Social influence is the behavioral change of a person because of the perceived relationship with other people, organizations and society in general. Social influence has been a widely accepted phenomenon in social networks for decades. Many applications have been built based around the implicit notation of social influence between people, such as marketing, advertisement and recommendations. With the exponential growth of online social network services such as Facebook and Twitter, social influence can for the first time be measured over a large population. In this chapter, we survey the research on social influence analysis with a focus on the computational aspects. First, we present statistical measurements related to social influence. Second, we describe the literature on social similarity and influences. Third, we present the research on social influence maximization which has many practical applications including marketing and advertisement.

The topology of metabolic isotope labeling networks.

PubMed

Weitzel, Michael; Wiechert, Wolfgang; Nöh, Katharina

2007-08-29

Metabolic Flux Analysis (MFA) based on isotope labeling experiments (ILEs) is a widely established tool for determining fluxes in metabolic pathways. Isotope labeling networks (ILNs) contain all essential information required to describe the flow of labeled material in an ILE. Whereas recent experimental progress paves the way for high-throughput MFA, large network investigations and exact statistical methods, these developments are still limited by the poor performance of computational routines used for the evaluation and design of ILEs. In this context, the global analysis of ILN topology turns out to be a clue for realizing large speedup factors in all required computational procedures. With a strong focus on the speedup of algorithms the topology of ILNs is investigated using graph theoretic concepts and algorithms. A rigorous determination of all cyclic and isomorphic subnetworks, accompanied by the global analysis of ILN connectivity is performed. Particularly, it is proven that ILNs always brake up into a large number of small strongly connected components (SCCs) and, moreover, there are natural isomorphisms between many of these SCCs. All presented techniques are universal, i.e. they do not require special assumptions on the network structure, bidirectionality of fluxes, measurement configuration, or label input. The general results are exemplified with a practically relevant metabolic network which describes the central metabolism of E. coli comprising 10390 isotopomer pools. Exploiting the topological features of ILNs leads to a significant speedup of all universal algorithms for ILE evaluation. It is proven in theory and exemplified with the E. coli example that a speedup factor of about 1000 compared to standard algorithms is achieved. This widely opens the door for new high performance algorithms suitable for high throughput applications and large ILNs. Moreover, for the first time the global topological analysis of ILNs allows to comprehensively describe and understand the general patterns of label flow in complex networks. This is an invaluable tool for the structural design of new experiments and the interpretation of measured data.

General, crystallized and fluid intelligence are not associated with functional global network efficiency: A replication study with the human connectome project 1200 data set.

PubMed

Kruschwitz, J D; Waller, L; Daedelow, L S; Walter, H; Veer, I M

2018-05-01

One hallmark example of a link between global topological network properties of complex functional brain connectivity and cognitive performance is the finding that general intelligence may depend on the efficiency of the brain's intrinsic functional network architecture. However, although this association has been featured prominently over the course of the last decade, the empirical basis for this broad association of general intelligence and global functional network efficiency is quite limited. In the current study, we set out to replicate the previously reported association between general intelligence and global functional network efficiency using the large sample size and high quality data of the Human Connectome Project, and extended the original study by testing for separate association of crystallized and fluid intelligence with global efficiency, characteristic path length, and global clustering coefficient. We were unable to provide evidence for the proposed association between general intelligence and functional brain network efficiency, as was demonstrated by van den Heuvel et al. (2009), or for any other association with the global network measures employed. More specifically, across multiple network definition schemes, ranging from voxel-level networks to networks of only 100 nodes, no robust associations and only very weak non-significant effects with a maximal R 2 of 0.01 could be observed. Notably, the strongest (non-significant) effects were observed in voxel-level networks. We discuss the possibility that the low power of previous studies and publication bias may have led to false positive results fostering the widely accepted notion of general intelligence being associated to functional global network efficiency. Copyright © 2018 Elsevier Inc. All rights reserved.

Healthcare improvement as planned system change or complex responsive processes? a longitudinal case study in general practice

PubMed Central

2013-01-01

Background Interest in how to implement evidence-based practices into routine health care has never been greater. Primary care faces challenges in managing the increasing burden of chronic disease in an ageing population. Reliable prescriptions for translating knowledge into practice, however, remain elusive, despite intense research and publication activity. This study seeks to explore this dilemma in general practice by challenging the current way of thinking about healthcare improvement and asking what can be learned by looking at change through a complexity lens. Methods This paper reports the local level of an embedded case study of organisational change for better chronic illness care over more than a decade. We used interviews, document review and direct observation to explore how improved chronic illness care developed in one practice. This formed a critical case to compare, using pattern matching logic, to the common prescription for local implementation of best evidence and a rival explanation drawn from complexity sciences interpreted through modern sociology and psychology. Results The practice changed continuously over more than a decade to deliver better chronic illness care in line with research findings and policy initiatives – re-designing care processes, developing community linkages, supporting patient self-management, using guidelines and clinical information systems, and integrating nurses into the practice team. None of these improvements was designed and implemented according to an explicit plan in response to a documented gap in chronic disease care. The process that led to high quality chronic illness care exhibited clear complexity elements of co-evolution, non-linearity, self-organisation, emergence and edge of chaos dynamics in a network of agents and relationships where a stable yet evolving way of organizing emerged from local level communicative interaction, power relating and values based choices. Conclusions The current discourse of implementation science as planned system change did not match organisational reality in this critical case of improvement in general practice. Complexity concepts translated in human terms as complex responsive processes of relating fit the pattern of change more accurately. They do not provide just another fashionable blueprint for change but inform how researchers, policymakers and providers participate in improving healthcare. PMID:23617833

A transmission power optimization with a minimum node degree for energy-efficient wireless sensor networks with full-reachability.

PubMed

Chen, Yi-Ting; Horng, Mong-Fong; Lo, Chih-Cheng; Chu, Shu-Chuan; Pan, Jeng-Shyang; Liao, Bin-Yih

2013-03-20

Transmission power optimization is the most significant factor in prolonging the lifetime and maintaining the connection quality of wireless sensor networks. Un-optimized transmission power of nodes either interferes with or fails to link neighboring nodes. The optimization of transmission power depends on the expected node degree and node distribution. In this study, an optimization approach to an energy-efficient and full reachability wireless sensor network is proposed. In the proposed approach, an adjustment model of the transmission range with a minimum node degree is proposed that focuses on topology control and optimization of the transmission range according to node degree and node density. The model adjusts the tradeoff between energy efficiency and full reachability to obtain an ideal transmission range. In addition, connectivity and reachability are used as performance indices to evaluate the connection quality of a network. The two indices are compared to demonstrate the practicability of framework through simulation results. Furthermore, the relationship between the indices under the conditions of various node degrees is analyzed to generalize the characteristics of node densities. The research results on the reliability and feasibility of the proposed approach will benefit the future real deployments.

A Transmission Power Optimization with a Minimum Node Degree for Energy-Efficient Wireless Sensor Networks with Full-Reachability

PubMed Central

Chen, Yi-Ting; Horng, Mong-Fong; Lo, Chih-Cheng; Chu, Shu-Chuan; Pan, Jeng-Shyang; Liao, Bin-Yih

2013-01-01

Transmission power optimization is the most significant factor in prolonging the lifetime and maintaining the connection quality of wireless sensor networks. Un-optimized transmission power of nodes either interferes with or fails to link neighboring nodes. The optimization of transmission power depends on the expected node degree and node distribution. In this study, an optimization approach to an energy-efficient and full reachability wireless sensor network is proposed. In the proposed approach, an adjustment model of the transmission range with a minimum node degree is proposed that focuses on topology control and optimization of the transmission range according to node degree and node density. The model adjusts the tradeoff between energy efficiency and full reachability to obtain an ideal transmission range. In addition, connectivity and reachability are used as performance indices to evaluate the connection quality of a network. The two indices are compared to demonstrate the practicability of framework through simulation results. Furthermore, the relationship between the indices under the conditions of various node degrees is analyzed to generalize the characteristics of node densities. The research results on the reliability and feasibility of the proposed approach will benefit the future real deployments. PMID:23519351

Geographic location, network patterns and population distribution of rural settlements in Greece

NASA Astrophysics Data System (ADS)

Asimakopoulos, Avraam; Mogios, Emmanuel; Xenikos, Dimitrios G.

2016-10-01

Our work addresses the problem of how social networks are embedded in space, by studying the spread of human population over complex geomorphological terrain. We focus on villages or small cities up to a few thousand inhabitants located in mountainous areas in Greece. This terrain presents a familiar tree-like structure of valleys and land plateaus. Cities are found more often at lower altitudes and exhibit preference on south orientation. Furthermore, the population generally avoids flat land plateaus and river beds, preferring locations slightly uphill, away from the plateau edge. Despite the location diversity regarding geomorphological parameters, we find certain quantitative norms when we examine location and population distributions relative to the (man-made) transportation network. In particular, settlements at radial distance ℓ away from road network junctions have the same mean altitude, practically independent of ℓ ranging from a few meters to 10 km. Similarly, the distribution of the settlement population at any given ℓ is the same for all ℓ. Finally, the cumulative distribution of the number of rural cities n(ℓ) is fitted to the Weibull distribution, suggesting that human decisions for creating settlements could be paralleled to mechanisms typically attributed to this particular statistical distribution.

Ensemble Nonlinear Autoregressive Exogenous Artificial Neural Networks for Short-Term Wind Speed and Power Forecasting.

PubMed

Men, Zhongxian; Yee, Eugene; Lien, Fue-Sang; Yang, Zhiling; Liu, Yongqian

2014-01-01

Short-term wind speed and wind power forecasts (for a 72 h period) are obtained using a nonlinear autoregressive exogenous artificial neural network (ANN) methodology which incorporates either numerical weather prediction or high-resolution computational fluid dynamics wind field information as an exogenous input. An ensemble approach is used to combine the predictions from many candidate ANNs in order to provide improved forecasts for wind speed and power, along with the associated uncertainties in these forecasts. More specifically, the ensemble ANN is used to quantify the uncertainties arising from the network weight initialization and from the unknown structure of the ANN. All members forming the ensemble of neural networks were trained using an efficient particle swarm optimization algorithm. The results of the proposed methodology are validated using wind speed and wind power data obtained from an operational wind farm located in Northern China. The assessment demonstrates that this methodology for wind speed and power forecasting generally provides an improvement in predictive skills when compared to the practice of using an "optimal" weight vector from a single ANN while providing additional information in the form of prediction uncertainty bounds.

Ensemble Nonlinear Autoregressive Exogenous Artificial Neural Networks for Short-Term Wind Speed and Power Forecasting

PubMed Central

Lien, Fue-Sang; Yang, Zhiling; Liu, Yongqian

2014-01-01

Short-term wind speed and wind power forecasts (for a 72 h period) are obtained using a nonlinear autoregressive exogenous artificial neural network (ANN) methodology which incorporates either numerical weather prediction or high-resolution computational fluid dynamics wind field information as an exogenous input. An ensemble approach is used to combine the predictions from many candidate ANNs in order to provide improved forecasts for wind speed and power, along with the associated uncertainties in these forecasts. More specifically, the ensemble ANN is used to quantify the uncertainties arising from the network weight initialization and from the unknown structure of the ANN. All members forming the ensemble of neural networks were trained using an efficient particle swarm optimization algorithm. The results of the proposed methodology are validated using wind speed and wind power data obtained from an operational wind farm located in Northern China. The assessment demonstrates that this methodology for wind speed and power forecasting generally provides an improvement in predictive skills when compared to the practice of using an “optimal” weight vector from a single ANN while providing additional information in the form of prediction uncertainty bounds. PMID:27382627

Correlates of root caries experience in middle-aged and older adults in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network.

PubMed

Chi, Donald L; Berg, Joel H; Kim, Amy S; Scott, JoAnna

2013-05-01

The authors examined the correlates of root caries experience for middle-aged adults (aged 45-64 years) and older adults (65 years and older) to test the hypothesis that the factors related to root caries are different for middle-aged adults than they are for older adults. The authors conducted an observational cross-sectional study that focused on adult patients aged 45 to 97 years recruited from the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network (N = 775). The outcome variable was any root caries experience (no/yes). The authors hypothesized that sociodemographic, intra- oral and behavioral factors were root caries correlates. The authors used Poisson regression models to generate overall and age-stratified prevalence ratios (PRs) of root caries, and they used generalized estimating equations to account for practice-level clustering of participants. A total of 19.6 percent of adults had any root caries. A dentist's assessment that the patient was at high risk of developing any caries was associated with greater prevalence of root caries experience in both middle-aged adults (PR, 2.70; 95 percent confidence interval [CI], 1.63-4.46) and older adults (PR, 1.87; 95 percent CI, 1.19-2.95). The following factors were associated significantly with increased root caries prevalence but only for middle-aged adults: male sex (P = .02), self-reported dry mouth (P < .001), exposed roots (P = .03) and increased frequency of eating or drinking between meals (P = .03). No other covariates were related to root caries experience for older adults. Within a practice-based research network, the factors associated with root caries experience were different for middle-aged adults than they were for older adults. Research is needed to identify relevant root caries correlates for adults 65 years and older. Practical Implications. Interventions aimed at preventing root caries are likely to be different for middle-aged adults than for older adults. Dentists should use root caries prevention programs that address appropriate aged-based risk factors.

Translating research into practice: the role of provider-based research networks in the diffusion of an evidence-based colon cancer treatment innovation.

PubMed

Carpenter, William R; Meyer, Anne-Marie; Wu, Yang; Qaqish, Bahjat; Sanoff, Hanna K; Goldberg, Richard M; Weiner, Bryan J

2012-08-01

Provider-based research networks (PBRNs)--collaborative research partnerships between academic centers and community-based practitioners--are a promising model for accelerating the translation of research into practice; however, empirical evidence of accelerated translation is limited. Oxaliplatin in adjuvant combination chemotherapy is an innovation with clinical trial-proven survival benefit compared with prior therapies. The goal of this study is to examine the diffusion of oxaliplatin into community practice, and whether affiliation with the National Cancer Institute's (NCI's) Community Clinical Oncology Program (CCOP)--a nationwide cancer-focused PBRN--is associated with accelerated innovation adoption. This retrospective observational study used linked Surveillance, Epidemiology, and End Results-Medicare and NCI CCOP data to examine Medicare participants with stage III colon cancer initiating treatment in 2003 through 2006, the years surrounding oxaliplatin's Food and Drug Administration approval. A fixed-effects analysis examined chemotherapy use among patients treated outside academic centers at CCOP-affiliated practices compared with non-CCOP practices. Two-group modeling controlled for multiple levels of clustering, year of chemotherapy initiation, tumor characteristics, patient age, race, comorbidity, Medicaid dual-eligibility status, and education. Of 4055 community patients, 35% received 5-fluoruracil, 20% received oxaliplatin, 7% received another chemotherapy, and 38% received no chemotherapy. Twenty-five percent of CCOP patients received oxaliplatin, compared with 19% of non-CCOP patients. In multivariable analysis, CCOP exposure was associated with higher odds of receiving guideline-concordant treatment in general, and oxaliplatin specifically. These findings contribute to a growing set of evidence linking PBRNs with a greater probability of receiving treatment innovations and high-quality cancer care, with implications for clinical and research policy.

Neural Networks In Mining Sciences - General Overview And Some Representative Examples

NASA Astrophysics Data System (ADS)

Tadeusiewicz, Ryszard

2015-12-01

The many difficult problems that must now be addressed in mining sciences make us search for ever newer and more efficient computer tools that can be used to solve those problems. Among the numerous tools of this type, there are neural networks presented in this article - which, although not yet widely used in mining sciences, are certainly worth consideration. Neural networks are a technique which belongs to so called artificial intelligence, and originates from the attempts to model the structure and functioning of biological nervous systems. Initially constructed and tested exclusively out of scientific curiosity, as computer models of parts of the human brain, neural networks have become a surprisingly effective calculation tool in many areas: in technology, medicine, economics, and even social sciences. Unfortunately, they are relatively rarely used in mining sciences and mining technology. The article is intended to convince the readers that neural networks can be very useful also in mining sciences. It contains information how modern neural networks are built, how they operate and how one can use them. The preliminary discussion presented in this paper can help the reader gain an opinion whether this is a tool with handy properties, useful for him, and what it might come in useful for. Of course, the brief introduction to neural networks contained in this paper will not be enough for the readers who get convinced by the arguments contained here, and want to use neural networks. They will still need a considerable portion of detailed knowledge so that they can begin to independently create and build such networks, and use them in practice. However, an interested reader who decides to try out the capabilities of neural networks will also find here links to references that will allow him to start exploration of neural networks fast, and then work with this handy tool efficiently. This will be easy, because there are currently quite a few ready-made computer programs, easily available, which allow their user to quickly and effortlessly create artificial neural networks, run them, train and use in practice. The key issue is the question how to use these networks in mining sciences. The fact that this is possible and desirable is shown by convincing examples included in the second part of this study. From the very rich literature on the various applications of neural networks, we have selected several works that show how and what neural networks are used in the mining industry, and what has been achieved thanks to their use. The review of applications will continue in the next article, filed already for publication in the journal "Archives of Mining Sciences". Only studying these two articles will provide sufficient knowledge for initial guidance in the area of issues under consideration here.

Neural dynamic programming and its application to control systems

NASA Astrophysics Data System (ADS)

Seong, Chang-Yun

There are few general practical feedback control methods for nonlinear MIMO (multi-input-multi-output) systems, although such methods exist for their linear counterparts. Neural Dynamic Programming (NDP) is proposed as a practical design method of optimal feedback controllers for nonlinear MIMO systems. NDP is an offspring of both neural networks and optimal control theory. In optimal control theory, the optimal solution to any nonlinear MIMO control problem may be obtained from the Hamilton-Jacobi-Bellman equation (HJB) or the Euler-Lagrange equations (EL). The two sets of equations provide the same solution in different forms: EL leads to a sequence of optimal control vectors, called Feedforward Optimal Control (FOC); HJB yields a nonlinear optimal feedback controller, called Dynamic Programming (DP). DP produces an optimal solution that can reject disturbances and uncertainties as a result of feedback. Unfortunately, computation and storage requirements associated with DP solutions can be problematic, especially for high-order nonlinear systems. This dissertation presents an approximate technique for solving the DP problem based on neural network techniques that provides many of the performance benefits (e.g., optimality and feedback) of DP and benefits from the numerical properties of neural networks. We formulate neural networks to approximate optimal feedback solutions whose existence DP justifies. We show the conditions under which NDP closely approximates the optimal solution. Finally, we introduce the learning operator characterizing the learning process of the neural network in searching the optimal solution. The analysis of the learning operator provides not only a fundamental understanding of the learning process in neural networks but also useful guidelines for selecting the number of weights of the neural network. As a result, NDP finds---with a reasonable amount of computation and storage---the optimal feedback solutions to nonlinear MIMO control problems that would be very difficult to solve with DP. NDP was demonstrated on several applications such as the lateral autopilot logic for a Boeing 747, the minimum fuel control of a double-integrator plant with bounded control, the backward steering of a two-trailer truck, and the set-point control of a two-link robot arm.

Networking Biology: The Origins of Sequence-Sharing Practices in Genomics.

PubMed

Stevens, Hallam

2015-10-01

The wide sharing of biological data, especially nucleotide sequences, is now considered to be a key feature of genomics. Historians and sociologists have attempted to account for the rise of this sharing by pointing to precedents in model organism communities and in natural history. This article supplements these approaches by examining the role that electronic networking technologies played in generating the specific forms of sharing that emerged in genomics. The links between early computer users at the Stanford Artificial Intelligence Laboratory in the 1960s, biologists using local computer networks in the 1970s, and GenBank in the 1980s, show how networking technologies carried particular practices of communication, circulation, and data distribution from computing into biology. In particular, networking practices helped to transform sequences themselves into objects that had value as a community resource.

Filtered Push: Annotating Distributed Data for Quality Control and Fitness for Use Analysis

NASA Astrophysics Data System (ADS)

Morris, P. J.; Kelly, M. A.; Lowery, D. B.; Macklin, J. A.; Morris, R. A.; Tremonte, D.; Wang, Z.

2009-12-01

The single greatest problem with the federation of scientific data is the assessment of the quality and validity of the aggregated data in the context of particular research problems, that is, its fitness for use. There are three critical data quality issues in networks of distributed natural science collections data, as in all scientific data: identifying and correcting errors, maintaining currency, and assessing fitness for use. To this end, we have designed and implemented a prototype network in the domain of natural science collections. This prototype is built over the open source Map-Reduce platform Hadoop with a network client in the open source collections management system Specify 6. We call this network “Filtered Push” as, at its core, annotations are pushed from the network edges to relevant authoritative repositories, where humans and software filter the annotations before accepting them as changes to the authoritative data. The Filtered Push software is a domain-neutral framework for originating, distributing, and analyzing record-level annotations. Network participants can subscribe to notifications arising from ontology-based analyses of new annotations or of purpose-built queries against the network's global history of annotations. Quality and fitness for use of distributed natural science collections data can be addressed with Filtered Push software by implementing a network that allows data providers and consumers to define potential errors in data, develop metrics for those errors, specify workflows to analyze distributed data to detect potential errors, and to close the quality management cycle by providing a network architecture to pushing assertions about data quality such as corrections back to the curators of the participating data sets. Quality issues in distributed scientific data have several things in common: (1) Statements about data quality should be regarded as hypotheses about inconsistencies between perhaps several records, data sets, or practices of science. (2) Data quality problems often cannot be detected only from internal statistical correlations or logical analysis, but may need the application of defined workflows that signal illogical output. (3) Changes in scientific theory or practice over time can result in changes of what QC tests should be applied to legacy data. (4) The frequency of some classes of error in a data set may be identifiable without the ability to assert that a particular record is in error. To address these issues requires, as does science itself, framing QC hypotheses against data that may be anywhere and may arise at any time in the future. In short, QC for science data is a never ending process. It must provide for notice to an agent (human or software) that a given dataset supports a hypothesis of inconsistency with a current scientific resource or model, or with potential generalizations of the concepts in a metadata ontology. Like quality control in general, quality control of distributed data is a repeated cyclical process. In implementing a Filtered Push network for quality control, we have a model in which the cost of QC forever is not substantially greater than QC once.

Bringing Ideals into Dialogue with Practices: On the Principles and Practices of the Nordic Network for Action Research

ERIC Educational Resources Information Center

Rönnerman, Karin; Salo, Petri; Furu, Eli Moksnes; Lund, Torbjørn; Olin, Anette; Jakhelln, Rachel

2016-01-01

In this article we present the Nordic Network for Action Research, established in 2004. We describe how the network has explored, bridged and nurtured the inherent action research dynamics of ideology and methodology. This has been done through an understanding anchored in educational traditions, and by focus on three important ideal-shaping…

Exploring Knowledge Processes Based on Teacher Research in a School-University Research Network of a Master's Program

ERIC Educational Resources Information Center

Cornelissen, Frank; van Swet, Jacqueline; Beijaard, Douwe; Bergen, Theo

2013-01-01

School-university research networks aim at closer integration of research and practice by means of teacher research. Such practice-oriented research can benefit both schools and universities. This paper reports on a multiple-case study of five participants in a school-university research network in a Dutch master's program. The research question…

Recovery time after localized perturbations in complex dynamical networks

NASA Astrophysics Data System (ADS)

Mitra, Chiranjit; Kittel, Tim; Choudhary, Anshul; Kurths, Jürgen; Donner, Reik V.

2017-10-01

Maintaining the synchronous motion of dynamical systems interacting on complex networks is often critical to their functionality. However, real-world networked dynamical systems operating synchronously are prone to random perturbations driving the system to arbitrary states within the corresponding basin of attraction, thereby leading to epochs of desynchronized dynamics with a priori unknown durations. Thus, it is highly relevant to have an estimate of the duration of such transient phases before the system returns to synchrony, following a random perturbation to the dynamical state of any particular node of the network. We address this issue here by proposing the framework of single-node recovery time (SNRT) which provides an estimate of the relative time scales underlying the transient dynamics of the nodes of a network during its restoration to synchrony. We utilize this in differentiating the particularly slow nodes of the network from the relatively fast nodes, thus identifying the critical nodes which when perturbed lead to significantly enlarged recovery time of the system before resuming synchronized operation. Further, we reveal explicit relationships between the SNRT values of a network, and its global relaxation time when starting all the nodes from random initial conditions. Earlier work on relaxation time generally focused on investigating its dependence on macroscopic topological properties of the respective network. However, we employ the proposed concept for deducing microscopic relationships between topological features of nodes and their respective SNRT values. The framework of SNRT is further extended to a measure of resilience of the different nodes of a networked dynamical system. We demonstrate the potential of SNRT in networks of Rössler oscillators on paradigmatic topologies and a model of the power grid of the United Kingdom with second-order Kuramoto-type nodal dynamics illustrating the conceivable practical applicability of the proposed concept.

Which positive factors determine the GP satisfaction in clinical practice? A systematic literature review.

PubMed

Le Floch, B; Bastiaens, H; Le Reste, J Y; Lingner, H; Hoffman, R D; Czachowski, S; Assenova, R; Koskela, T H; Klemenc-Ketis, Z; Nabbe, P; Sowinska, A; Montier, T; Peremans, L

2016-09-13

Looking at what makes General Practitioners (GPs) happy in their profession, may be important in increasing the GP workforce in the future. The European General Practice Research Network (EGPRN) created a research team (eight national groups) in order to clarify the factors involved in GP job satisfaction throughout Europe. The first step of this study was a literature review to explore how the satisfaction of GPs had been studied before. The research question was "Which factors are related to GP satisfaction in Clinical Practice?" Systematic literature review according to the PRISMA statement. The databases searched were Pubmed, Embase and Cochrane. All articles were identified, screened and included by two separate research teams, according to inclusion or exclusion criteria. Then, a qualitative appraisal was undertaken. Next, a thematic analysis process was undertaken to capture any issue relevant to the research question. The number of records screened was 458. One hundred four were eligible. Finally, 17 articles were included. The data revealed 13 subthemes, which were grouped into three major themes for GP satisfaction. First there were general profession-related themes, applicable to many professions. A second group of issues related specifically to a GP setting. Finally, a third group was related to professional life and personal issues. A number of factors leading to GP job satisfaction, exist in literature They should be used by policy makers within Europe to increase the GP workforce. The research team needs to undertake qualitative studies to confirm or enhance those results.

Social networking and Internet use among pelvic floor patients: a multicenter survey.

PubMed

Mazloomdoost, Donna; Kanter, Gregory; Chan, Robert C; Deveaneau, Nicolette; Wyman, Allison M; Von Bargen, Emily C; Chaudhry, Zaid; Elshatanoufy, Solafa; Miranne, Jeannine M; Chu, Christine M; Pauls, Rachel N; Arya, Lily A; Antosh, Danielle D

2016-11-01

Internet resources are becoming increasingly important for patients seeking medical knowledge. It is imperative to understand patient use and preferences for using the Internet and social networking websites to optimize patient education. The purpose of this study was to evaluate social networking and Internet use among women with pelvic floor complaints to seek information for their conditions as well as describe the likelihood, preferences, and predictors of website usage. This was a cross-sectional, multicenter study of women presenting to clinical practices of 10 female pelvic medicine and reconstructive surgery fellowship programs across the United States, affiliated with the Fellows' Pelvic Research Network. New female patients presenting with pelvic floor complaints, including urinary incontinence, pelvic organ prolapse, and fecal incontinence were eligible. Participants completed a 24 item questionnaire designed by the authors to assess demographic information, general Internet use, preferences regarding social networking websites, referral patterns, and resources utilized to learn about their pelvic floor complaints. Internet use was quantified as high (≥4 times/wk), moderate (2-3 times/wk), or minimal (≤1 time/wk). Means were used for normally distributed data and medians for data not meeting this assumption. Fisher's exact and χ 2 tests were used to evaluate the associations between variables and Internet use. A total of 282 surveys were analyzed. The majority of participants, 83.3%, were white. The mean age was 55.8 years old. Referrals to urogynecology practices were most frequently from obstetrician/gynecologists (39.9%) and primary care providers (27.8%). Subjects were well distributed geographically, with the largest representation from the South (38.0%). Almost one third (29.9%) were most bothered by prolapse complaints, 22.0% by urgency urinary incontinence, 20.9% by stress urinary incontinence, 14.9% by urgency/frequency symptoms, and 4.1% by fecal incontinence. The majority, 75.0%, described high Internet use, whereas 8.5% moderately and 4.8% minimally used the Internet. Women most often used the Internet for personal motivations including medical research (76.4%), and 42.6% reported Google to be their primary search engine. Despite this, only 4.9% primarily used the Internet to learn about their pelvic floor condition, more commonly consulting an obstetrician-gynecologist for this information (39.4%). The majority (74.1%) held a social networking account, and 45.9% visited these daily. Nearly half, 41.7%, expressed the desire to use social networking websites to learn about their condition. Women <65 years old were significantly more likely to have high Internet use (83.4% vs 68.8%, P = .018) and to desire using social networking websites to learn about their pelvic floor complaint (P = .008). The presenting complaint was not associated with Internet use (P = .905) or the desire to use social networking websites to learn about pelvic floor disorders (P = .201). Women presenting to urogynecology practices have high Internet use and a desire to learn about their conditions via social networking websites. Despite this, obstetrician-gynecologists remain a common resource for information. Nonetheless, urogynecology practices and national organizations would likely benefit from increasing their Internet resources for patient education in pelvic floor disorders, though patients should be made aware of available resources. Copyright © 2016 Elsevier Inc. All rights reserved.

Creature comforts: personal communities, pets and the work of managing a long-term condition.

PubMed

Brooks, Helen L; Rogers, Anne; Kapadia, Dharmi; Pilgrim, Jack; Reeves, David; Vassilev, Ivaylo

2013-06-01

To explore in the context of peoples' personal social networks, the contribution that pets make to 'the work' associated with the management of long-term conditions. Mixed methods survey with nested parallel qualitative study; 300 participants were drawn from diabetes and chronic heart disease registers of General Practices across Greater Manchester in the North West of England. Notions of 'work' were used to describe the illness and everyday activities associated with chronic illness. Nineteen percent of participants identified at least one pet within their network. Pets contributed mostly to managing emotions (emotional work), to enhancing a sense of self identity (biographical work) and to a lesser extent practical tasks (everyday work). There were indicators that pets mediated relationships for people living with a long-term condition through very weak ties with others in domestic and community settings. The findings suggest that pets have unique qualities and are not simply substitutes for human relationships in long-term condition management. The study has potential implications for furthering a social contextual analysis of chronic illness, the understanding of relationships, and the meaning and the role of companion animals in long-term condition management.

Creature comforts: personal communities, pets and the work of managing a long-term condition

PubMed Central

Brooks, Helen L; Rogers, Anne; Kapadia, Dharmi; Pilgrim, Jack; Reeves, David; Vassilev, Ivaylo

2013-01-01

Objectives: To explore in the context of peoples’ personal social networks, the contribution that pets make to ‘the work’ associated with the management of long-term conditions. Method: Mixed methods survey with nested parallel qualitative study; 300 participants were drawn from diabetes and chronic heart disease registers of General Practices across Greater Manchester in the North West of England. Notions of ‘work’ were used to describe the illness and everyday activities associated with chronic illness. Results: Nineteen percent of participants identified at least one pet within their network. Pets contributed mostly to managing emotions (emotional work), to enhancing a sense of self identity (biographical work) and to a lesser extent practical tasks (everyday work). There were indicators that pets mediated relationships for people living with a long-term condition through very weak ties with others in domestic and community settings. Conclusion: The findings suggest that pets have unique qualities and are not simply substitutes for human relationships in long-term condition management. The study has potential implications for furthering a social contextual analysis of chronic illness, the understanding of relationships, and the meaning and the role of companion animals in long-term condition management. PMID:22777565

Building a pan-Canadian primary care sentinel surveillance network: initial development and moving forward.

PubMed

Birtwhistle, Richard; Keshavjee, Karim; Lambert-Lanning, Anita; Godwin, Marshall; Greiver, Michelle; Manca, Donna; Lagacé, Claudia

2009-01-01

The development of a pan-Canadian network of primary care research networks for studying issues in primary care has been the vision of Canadian primary care researchers for many years. With the opportunity for funding from the Public Health Agency of Canada and the support of the College of Family Physicians of Canada, we have planned and developed a project to assess the feasibility of a network of networks of family medicine practices that exclusively use electronic medical records. The Canadian Primary Care Sentinel Surveillance Network will collect longitudinal data from practices across Canada to assess the primary care epidemiology and management of 5 chronic diseases: hypertension, diabetes, depression, chronic obstructive lung disease, and osteoarthritis. This article reports on the 7-month first phase of the feasibility project of 7 regional networks in Canada to develop a business plan, including governance, mission, and vision; develop memorandum of agreements with the regional networks and their respective universities; develop and obtain approval of research ethics board applications; develop methods for data extraction, a Canadian Primary Care Sentinel Surveillance Network database, and initial assessment of the types of data that can be extracted; and recruitment of 10 practices at each network that use electronic medical records. The project will continue in phase 2 of the feasibility testing until April 2010.

Programs That Work, from the Promising Practices Network on Children, Families and Communities. RAND Tool

ERIC Educational Resources Information Center

Kilburn, M. Rebecca, Ed.

2014-01-01

The Promising Practices Network (PPN) on Children, Families and Communities (www.promisingpractices.net) began as a partnership between four state-level organizations that help public and private organizations improve the well-being of children and families. The PPN website, archived in June 2014, featured summaries of programs and practices that…

Questioning the Character and Significance of Convergence between Social Network and Professional Practices in Teacher Education

ERIC Educational Resources Information Center

Turvey, Keith

2012-01-01

This paper captures and characterises the interplay between a group of student teachers' narratives of social network practice and their emergent professional practice with technologies. Teachers on an Initial Teacher Education programme in the UK spent a semester studying a module that synthesised university-based lectures with a professional…

Developing laboratory networks: a practical guide and application.

PubMed

Kirk, Carol J; Shult, Peter A

2010-01-01

The role of the public health laboratory (PHL) in support of public health response has expanded beyond testing to include a number of other core functions, such as emergency response, training and outreach, communications, laboratory-based surveillance, and laboratory data management. These functions can only be accomplished by a network that includes public health and other agency laboratories and clinical laboratories. It is a primary responsibility of the PHL to develop and maintain such a network. In this article, we present practical recommendations-based on 17 years of network development experience-for the development of statewide laboratory networks. These recommendations, and examples of current laboratory networks, are provided to facilitate laboratory network development in other states. The development of laboratory networks will enhance each state's public health system and is critical to the development of a robust national Laboratory Response Network.

General psychopathology in anorexia nervosa: the role of psychosocial factors.

PubMed

Karatzias, Thanos; Chouliara, Zoë; Power, Kevin; Collin, Paula; Yellowlees, Alex; Grierson, David

2010-01-01

The aim of the present study was to investigate psychosocial correlates of comorbid psychopathology. Data were collected from a total of 90 female inpatients with anorexia nervosa (AN). Higher levels of general psychopathology were detected in depression, interpersonal sensitivity, obsessive-compulsive and anxiety subscales of the Symptom Checklist (SCL)-90. Regression analysis also revealed that higher levels of psychopathology across SCL-90 subscales in AN patients are significantly associated with an earlier age of onset of the condition, higher levels of anorectic psychopathology as measured by Eating Disorders Examination, lower self-esteem as measured by Multidimensional Self-Esteem Inventory and social support levels as measured by Quality of Social Network and Social Support Questionnaire. Considering the high levels of general psychopathology in people with AN, routine clinical practice should aim for a comprehensive assessment of such. Given the strong association between psychosocial factors such as self-esteem, social support and general psychopathology, psychological therapies could play an important role in facilitating emotional recovery. Copyright © 2010 John Wiley & Sons, Ltd.

Topology reduction in deep convolutional feature extraction networks

NASA Astrophysics Data System (ADS)

Wiatowski, Thomas; Grohs, Philipp; Bölcskei, Helmut

2017-08-01

Deep convolutional neural networks (CNNs) used in practice employ potentially hundreds of layers and 10,000s of nodes. Such network sizes entail significant computational complexity due to the large number of convolutions that need to be carried out; in addition, a large number of parameters needs to be learned and stored. Very deep and wide CNNs may therefore not be well suited to applications operating under severe resource constraints as is the case, e.g., in low-power embedded and mobile platforms. This paper aims at understanding the impact of CNN topology, specifically depth and width, on the network's feature extraction capabilities. We address this question for the class of scattering networks that employ either Weyl-Heisenberg filters or wavelets, the modulus non-linearity, and no pooling. The exponential feature map energy decay results in Wiatowski et al., 2017, are generalized to O(a-N), where an arbitrary decay factor a > 1 can be realized through suitable choice of the Weyl-Heisenberg prototype function or the mother wavelet. We then show how networks of fixed (possibly small) depth N can be designed to guarantee that ((1 - ɛ) · 100)% of the input signal's energy are contained in the feature vector. Based on the notion of operationally significant nodes, we characterize, partly rigorously and partly heuristically, the topology-reducing effects of (effectively) band-limited input signals, band-limited filters, and feature map symmetries. Finally, for networks based on Weyl-Heisenberg filters, we determine the prototype function bandwidth that minimizes - for fixed network depth N - the average number of operationally significant nodes per layer.

Third sector primary health care in New Zealand.

PubMed

Crampton, P; Dowell, A C; Bowers, S

2000-03-24

To describe key organisational characteristics of selected third sector (non-profit and non-government) primary health care organisations. Data were collected, in 1997 and 1998, from 15 third sector primary care organisations that were members of a network of third sector primary care providers, Health Care Aotearoa (HCA). Data were collected by face-to-face interviews of managers and key informants using a semi-structured interview schedule, and from practice computer information systems. Overall the populations served were young: only 4% of patients were aged 65 years or older, and the ethnicity profile was highly atypical, with 21.8% European, 36% Maori, 22.7% Pacific Island, 12% other, and 7.5% not stated. Community services card holding rates were higher than recorded in other studies, and registered patients tended to live in highly deprived areas. HCA organisations had high patient to doctor ratios, in general over 2000:1, and there were significant differences in management structures between HCA practices and more traditional general practice. Third sector organisations provide services for populations that are disadvantaged in many respects. It is likely that New Zealand will continue to develop a diverse range of primary care organisational arrangements. Effort is now required to measure quality and effectiveness of services provided by different primary care organisations serving comparable populations.

Injecting buprenorphine-naloxone film: Findings from an explorative qualitative study.

PubMed

White, Nancy; Flaherty, Ian; Higgs, Peter; Larance, Briony; Nielsen, Suzanne; Degenhardt, Louisa; Ali, Robert; Lintzeris, Nicholas

2015-11-01

Experiences of buprenorphine-naloxone (BNX) sublingual film injection are not well documented or understood. We examined how people who inject BNX film seek and share information about this practice, document the methods used to prepare BNX film for injection, and report participants' experiences of this practice. Interviews were (n = 16) conducted with people who indicated that they had injected BNX film since its introduction onto the Australian market. Semistructured interviews were recorded and transcribed. NVivo10 program (QSR International) was used to analyse the data using qualitative description methodology. Participants largely reported similar BNX film preparation techniques, although the texture of BNX film during preparation to inject was reported to be unusual (gluggy), and there were many varied accounts associated with the amount of water used. Physical harms reported as associated with injecting BNX film were described (including local and systemic issues); participants reported injecting the film to enhance its immediate effects, yet generally reported that sublingual administration provided longer-lasting effects. Understanding knowledge acquisition about injecting new formulations of opioid substitution therapy is crucial in developing more effective harm-reduction strategies. Dissemination by peer networks to those who are currently or planning to inject BNX film regarding the 'gelatine like' texture when mixing, using only cold water and double filtering is important to ensure safer injecting practices. Findings from this study highlight the importance of peer networks for the dissemination of harm-reduction information. Introduction of new formulations internationally requires more qualitative studies to inform safer practices. © 2015 Australasian Professional Society on Alcohol and other Drugs.

The Cancer Prevention and Control Research Network: An Interactive Systems Approach to Advancing Cancer Control Implementation Research and Practice

PubMed Central

Fernández, María E.; Melvin, Cathy L.; Leeman, Jennifer; Ribisl, Kurt M.; Allen, Jennifer D.; Kegler, Michelle C.; Bastani, Roshan; Ory, Marcia G.; Risendal, Betsy C.; Hannon, Peggy A.; Kreuter, Matthew W.; Hebert, James R.

2018-01-01

Background Although cancer research has advanced at a rapid pace, a gap remains between what is known about how to improve cancer prevention and control (CPC) and what is implemented as best practices within health care systems and communities. The Cancer Prevention and Control Research Network (CPCRN), with more than 10 years of dissemination and implementation research experience, aims to accelerate the uptake and use of evidence-based CPC interventions. Methods The collective work of the CPCRN has facilitated the analysis and categorization of research and implementation efforts according to the Interactive Systems Framework for Dissemination and Implementation (ISF), providing a useful heuristic for bridging the gap between prevention research and practice. The ISF authors have called for examples of its application as input to help refine the model. Results We provide examples of how the collaborative activities supported by the CPCRN, using community-engaged processes, accelerated the synthesis and translation of evidence, built both general and innovation-specific capacity, and worked with delivery systems to advance cancer control research and practice. Conclusions The work of the CPCRN has provided real-world examples of the application of the ISF and demonstrated that synthesizing and translating evidence can increase the potential that evidence-based CPC programs will be used and that capacity building for both the support system and the delivery system is crucial for the successful implementation and maintenance of evidence-based cancer control. Impact Adoption and implementation of CPC can be enhanced by better understanding ISF systems and intervening to improve them. PMID:25155759

Diffusion Dynamics of Energy Saving Practices in Large Heterogeneous Online Networks

PubMed Central

Mohammadi, Neda; Wang, Qi; Taylor, John E.

2016-01-01

Online social networks are today’s fastest growing communications channel and a popular source of information for many, so understanding their contribution to building awareness and shaping public perceptions of climate change is of utmost importance. Today’s online social networks are composed of complex combinations of entities and communication channels and it is not clear which communicators are the most influential, what the patterns of communication flow are, or even whether the widely accepted two-step flow of communication model applies in this new arena. This study examines the diffusion of energy saving practices in a large online social network across organizations, opinion leaders, and the public by tracking 108,771 communications on energy saving practices among 1,084 communicators, then analyzing the flow of information and influence over a 28 day period. Our findings suggest that diffusion networks of messages advocating energy saving practices are predominantly led by the activities of dedicated organizations but their attempts do not result in substantial public awareness, as most of these communications are effectively trapped in organizational loops in which messages are simply shared between organizations. Despite their comparably significant influential values, opinion leaders played a weak role in diffusing energy saving practices to a wider audience. Thus, the two-step flow of communication model does not appear to describe the sharing of energy conservation practices in large online heterogeneous networks. These results shed new light on the underlying mechanisms driving the diffusion of important societal issues such as energy efficiency, particularly in the context of large online social media outlets. PMID:27736912

Diffusion Dynamics of Energy Saving Practices in Large Heterogeneous Online Networks.

PubMed

Mohammadi, Neda; Wang, Qi; Taylor, John E

2016-01-01

Online social networks are today's fastest growing communications channel and a popular source of information for many, so understanding their contribution to building awareness and shaping public perceptions of climate change is of utmost importance. Today's online social networks are composed of complex combinations of entities and communication channels and it is not clear which communicators are the most influential, what the patterns of communication flow are, or even whether the widely accepted two-step flow of communication model applies in this new arena. This study examines the diffusion of energy saving practices in a large online social network across organizations, opinion leaders, and the public by tracking 108,771 communications on energy saving practices among 1,084 communicators, then analyzing the flow of information and influence over a 28 day period. Our findings suggest that diffusion networks of messages advocating energy saving practices are predominantly led by the activities of dedicated organizations but their attempts do not result in substantial public awareness, as most of these communications are effectively trapped in organizational loops in which messages are simply shared between organizations. Despite their comparably significant influential values, opinion leaders played a weak role in diffusing energy saving practices to a wider audience. Thus, the two-step flow of communication model does not appear to describe the sharing of energy conservation practices in large online heterogeneous networks. These results shed new light on the underlying mechanisms driving the diffusion of important societal issues such as energy efficiency, particularly in the context of large online social media outlets.

Dimensions and dynamics of citizen observatories: The case of online amateur weather networks

NASA Astrophysics Data System (ADS)

Gharesifard, Mohammad; Wehn, Uta; van der Zaag, Pieter

2016-04-01

Crowd-sourced environmental observations are being increasingly considered as having the potential to enhance the spatial and temporal resolution of current data streams from terrestrial and areal sensors. The rapid diffusion of ICTs during the past decades has facilitated the process of data collection and sharing by the general public (so-called citizen science) and has resulted in the formation of various online environmental citizen observatory networks. Online amateur weather networks are a particular example of such ICT-mediated citizen observatories as one of the oldest and most widely practiced citizen science activities. The objective of this paper is to introduce a conceptual framework that enables a systematic review of different dimensions of these mushrooming/expanding networks. These dimensions include the geographic scope and types of network participants; the network's establishment mechanism, revenue stream(s) and existing communication paradigm; efforts required by citizens and support offered by platform providers; and issues such as data accessibility, availability and quality. An in-depth understanding of these dimensions helps to analyze various dynamics such as interactions between different stakeholders, motivations to run these networks, sustainability of the platforms, data ownership and level of transparency of each network. This framework is then utilized to perform a critical and normative review of six existing online amateur weather networks based on publicly available data. The main findings of this analysis suggest that: (1) There are several key stakeholders such as emergency services and local authorities that are not (yet) engaged in these networks. (2) The revenue stream(s) of online amateur weather networks is one of the least discussed but most important dimensions that is crucial for the sustainability of these networks. (3) Although all of the networks included in this study have one or more explicit pattern of two-way communications, there is no sign (yet) of interactive information exchange among the triangle of weather observers, data aggregators and policy makers. KEYWORDS Citizen Science, Citizen Observatories, ICT-enabled citizen participation, online amateur weather networks

Primary Care Research Team Assessment (PCRTA): development and evaluation.

PubMed

Carter, Yvonne H; Shaw, Sara; Macfarlane, Fraser

2002-02-01

Since the early 1990s the United Kingdom (UK) Department of Health has explicitly promoted a research and development (R&D) strategy for the National Health Service (NHS). General practitioners (GPs) and other members of the primary care team are in a unique position to undertake research activity that will complement and inform the research undertaken by basic scientists and hospital-based colleagues and lead directly to a better evidence base for decision making by primary care professionals. Opportunities to engage in R&D in primary care are growing and the scope for those wishing to become involved is finally widening. Infrastructure funding for research-active practices and the establishment of a range of support networks have helped to improve the research capacity and blur some of the boundaries between academic departments and clinical practice. This is leading to a supportive environment for primary care research. There is thus a need to develop and validate nationally accepted quality standards and accreditation of performance to ensure that funders, collaborators and primary care professionals can deliver high quality primary care research. Several strategies have been described in national policy documents in order to achieve an improvement in teaching and clinical care, as well as enhancing research capacity in primary care. The development of both research practices and primary care research networks has been recognised as having an important contribution to make in enabling health professionals to devote more protected time to undertake research methods training and to undertake research in a service setting. The recognition and development of primary care research has also brought with it an emphasis on quality and standards, including an approach to the new research governance framework. In 1998, the NHS Executive South and West, and later the London Research and Development Directorate, provided funding for a pilot project based at the Royal College of General Practitioners (RCGP) to develop a scheme to accredit UK general practices undertaking primary care R&D. The pilot began with initial consultation on the development of the process, as well as the standards and criteria for assessment. The resulting assessment schedule allowed for assessment at one of two levels: Collaborative Research Practice (Level I), with little direct experience of gaining project or infrastructure funding Established Research Practice (Level II), with more experience of research funding and activity and a sound infrastructure to allow for growth in capacity. The process for assessment of practices involved the assessment of written documentation, followed by a half-day assessment visit by a multidisciplinary team of three assessors. IMPLEMENTATION--THE PILOT PROJECT: Pilot practices were sampled in two regions. Firstly, in the NHS Executive South West Region, where over 150 practices expressed an interest in participating. From these a purposive sample of 21 practices was selected, providing a range of research and service activity. A further seven practices were identified and included within the project through the East London and Essex Network of Researchers (ELENoR). Many in this latter group received funding and administrative support and advice from ELENoR in order to prepare written submissions for assessment. Some sample loss was encountered within the pilot project, which was attributable largely to conflicting demands on participants' time. Indeed, the preparation of written submissions within the South West coincided with the introduction of primary care groups (PCGs) in April 1999, which several practices cited as having a major impact on their participation in the pilot project. A final sample of 15 practices (nine in the South West and six through ELENoR) underwent assessment through the pilot project. A formal evaluation of the Primary Care Research Team Assessment (PCRTA) pilot was undertaken by an independent researcher (FM). This was supplemented with feedback from the assessment team members. The qualitative aspect of the evaluation, which included face-to-face and telephone interviews with assessors, lead researchers and other practice staff within the pilot research practices, as well as members of the project management group, demonstrated a positive view of the pilot scheme. Several key areas were identified in relation to particular strengths of research practices and areas for development including: Strengths Level II practices were found to have a strong primary care team ethos in research. Level II practices tended to have a greater degree of strategic thinking in relation to research. Development areas Level I practices were found to lack a clear and explicit research strategy. Practices at both levels had scope to develop their communication processes for dissemination of research and also for patient involvement. Practices at both levels needed mechanisms for supporting professional development in research methodology. The evaluation demonstrated that practices felt that they had gained from their participation and assessors felt that the scheme had worked well. Some specific issues were raised by different respondents within the qualitative evaluation relating to consistency of interpretation of standards and also the possible overlap of the assessment scheme with other RCGP quality initiatives. The pilot project has been very successful and recommendations have been made to progress to a UK scheme. Management and review of the scheme will remain largely the same, with a few changes focusing on the assessment process and support for practices entering the scheme. Specific changes include: development of the support and mentoring role of the primary care research networks increased peer and external support and mentoring for research practices undergoing assessment development of assessor training in line with other schemes within the RCGP Assessment Network work to ensure consistency across RCGP accreditation schemes in relation to key criteria, thereby facilitating comparable assessment processes refinement of the definition of the two groups, with Level I practices referred to as Collaborators and Level II practices as Investigator-Led. The project has continued to generate much enthusiasm and support and continues to reflect current policy. Indeed, recent developments include the proposed new funding arrangements for primary care R&D, which refer to the RCGP assessment scheme and recognise it as a key component in the future R&D agenda. The assessment scheme will help primary care trusts (PCTs) and individual practices to prepare and demonstrate their approach to research governance in a systematic way. It will also provide a more explicit avenue for primary care trusts to explore local service and development priorities identified within health improvement programmes and the research priorities set nationally for the NHS.

Understanding Challenges, Strategies, and the Role of Support Networks in Medication Self-management Among Patients With Type 2 Diabetes.

PubMed

Bernhard, Gerda; Ose, Dominik; Baudendistel, Ines; Seidling, Hanna M; Stützle, Marion; Szecsenyi, Joachim; Wensing, Michel; Mahler, Cornelia

2017-04-01

Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients' self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients' needs and priorities and guide patient-centered interventions to support patients' self-management activities. Community and social support networks operating in patients' lives need to be engaged in the self-management support.

Managing cancer care through service delivery networks: The role of professional collaboration in two European cancer networks.

PubMed

Prades, Joan; Morando, Verdiana; Tozzi, Valeria D; Verhoeven, Didier; Germà, Jose R; Borras, Josep M

2017-01-01

Background The study examines two meso-strategic cancer networks, exploring to what extent collaboration can strengthen or hamper network effectiveness. Unlike macro-strategic networks, meso-strategic networks have no hierarchical governance structures nor are they institutionalised within healthcare services' delivery systems. This study aims to analyse the models of professional cooperation and the tools developed for managing clinical practice within two meso-strategic, European cancer networks. Methods Multiple case study design based on the comparative analysis of two cancer networks: Iridium, in Antwerp, Belgium and the Institut Català d'Oncologia in Catalonia, Spain. The case studies applied mixed methods, with qualitative research based on semi-structured interviews ( n = 35) together with case-site observation and material collection. Results The analysis identified four levels of collaborative intensity within medical specialties as well as in multidisciplinary settings, which became both platforms for crosscutting clinical work between hubs' experts and local care teams and the levers for network-based tools development. The organisation of clinical practice relied on professional-based cooperative processes and tiers, lacking vertical integration mechanisms. Conclusions The intensity of professional linkages largely shaped the potential of meso-strategic cancer networks to influence clinical practice organisation. Conversely, the introduction of managerial techniques or network governance structures, without introducing vertical hierarchies, was found to be critical solutions.

Single-phase power distribution system power flow and fault analysis

NASA Technical Reports Server (NTRS)

Halpin, S. M.; Grigsby, L. L.

1992-01-01

Alternative methods for power flow and fault analysis of single-phase distribution systems are presented. The algorithms for both power flow and fault analysis utilize a generalized approach to network modeling. The generalized admittance matrix, formed using elements of linear graph theory, is an accurate network model for all possible single-phase network configurations. Unlike the standard nodal admittance matrix formulation algorithms, the generalized approach uses generalized component models for the transmission line and transformer. The standard assumption of a common node voltage reference point is not required to construct the generalized admittance matrix. Therefore, truly accurate simulation results can be obtained for networks that cannot be modeled using traditional techniques.

Static and transient performance prediction for CFB boilers using a Bayesian-Gaussian Neural Network

NASA Astrophysics Data System (ADS)

Ye, Haiwen; Ni, Weidou

1997-06-01

A Bayesian-Gaussian Neural Network (BGNN) is put forward in this paper to predict the static and transient performance of Circulating Fluidized Bed (CFB) boilers. The advantages of this network over Back-Propagation Neural Networks (BPNNs), easier determination of topology, simpler and time saving in training process as well as self-organizing ability, make this network more practical in on-line performance prediction for complicated processes. Simulation shows that this network is comparable to the BPNNs in predicting the performance of CFB boilers. Good and practical on-line performance predictions are essential for operation guide and model predictive control of CFB boilers, which are under research by the authors.

Design of a national distributed health data network.

PubMed

Maro, Judith C; Platt, Richard; Holmes, John H; Strom, Brian L; Hennessy, Sean; Lazarus, Ross; Brown, Jeffrey S

2009-09-01

A distributed health data network is a system that allows secure remote analysis of separate data sets, each comprising a different medical organization's or health plan's records. Distributed health data networks are currently being planned that could cover millions of people, permitting studies of comparative clinical effectiveness, best practices, diffusion of medical technologies, and quality of care. These networks could also support assessment of medical product safety and other public health needs. Distributed network technologies allow data holders to control all uses of their data, which overcomes many practical obstacles related to confidentiality, regulation, and proprietary interests. Some of the challenges and potential methods of operation of a multipurpose, multi-institutional distributed health data network are described.

Towards Reproducible Descriptions of Neuronal Network Models

PubMed Central

Nordlie, Eilen; Gewaltig, Marc-Oliver; Plesser, Hans Ekkehard

2009-01-01

Progress in science depends on the effective exchange of ideas among scientists. New ideas can be assessed and criticized in a meaningful manner only if they are formulated precisely. This applies to simulation studies as well as to experiments and theories. But after more than 50 years of neuronal network simulations, we still lack a clear and common understanding of the role of computational models in neuroscience as well as established practices for describing network models in publications. This hinders the critical evaluation of network models as well as their re-use. We analyze here 14 research papers proposing neuronal network models of different complexity and find widely varying approaches to model descriptions, with regard to both the means of description and the ordering and placement of material. We further observe great variation in the graphical representation of networks and the notation used in equations. Based on our observations, we propose a good model description practice, composed of guidelines for the organization of publications, a checklist for model descriptions, templates for tables presenting model structure, and guidelines for diagrams of networks. The main purpose of this good practice is to trigger a debate about the communication of neuronal network models in a manner comprehensible to humans, as opposed to machine-readable model description languages. We believe that the good model description practice proposed here, together with a number of other recent initiatives on data-, model-, and software-sharing, may lead to a deeper and more fruitful exchange of ideas among computational neuroscientists in years to come. We further hope that work on standardized ways of describing—and thinking about—complex neuronal networks will lead the scientific community to a clearer understanding of high-level concepts in network dynamics, and will thus lead to deeper insights into the function of the brain. PMID:19662159

A Practical Application Combining Wireless Sensor Networks and Internet of Things: Safety Management System for Tower Crane Groups

PubMed Central

Zhong, Dexing; Lv, Hongqiang; Han, Jiuqiang; Wei, Quanrui

2014-01-01

The so-called Internet of Things (IoT) has attracted increasing attention in the field of computer and information science. In this paper, a specific application of IoT, named Safety Management System for Tower Crane Groups (SMS-TC), is proposed for use in the construction industry field. The operating status of each tower crane was detected by a set of customized sensors, including horizontal and vertical position sensors for the trolley, angle sensors for the jib and load, tilt and wind speed sensors for the tower body. The sensor data is collected and processed by the Tower Crane Safety Terminal Equipment (TC-STE) installed in the driver's operating room. Wireless communication between each TC-STE and the Local Monitoring Terminal (LMT) at the ground worksite were fulfilled through a Zigbee wireless network. LMT can share the status information of the whole group with each TC-STE, while the LMT records the real-time data and reports it to the Remote Supervision Platform (RSP) through General Packet Radio Service (GPRS). Based on the global status data of the whole group, an anti-collision algorithm was executed in each TC-STE to ensure the safety of each tower crane during construction. Remote supervision can be fulfilled using our client software installed on a personal computer (PC) or smartphone. SMS-TC could be considered as a promising practical application that combines a Wireless Sensor Network with the Internet of Things. PMID:25196106

A practical application combining wireless sensor networks and Internet of Things: Safety Management System for Tower Crane Groups.

PubMed

Zhong, Dexing; Lv, Hongqiang; Han, Jiuqiang; Wei, Quanrui

2014-07-30

The so-called Internet of Things (IoT) has attracted increasing attention in the field of computer and information science. In this paper, a specific application of IoT, named Safety Management System for Tower Crane Groups (SMS-TC), is proposed for use in the construction industry field. The operating status of each tower crane was detected by a set of customized sensors, including horizontal and vertical position sensors for the trolley, angle sensors for the jib and load, tilt and wind speed sensors for the tower body. The sensor data is collected and processed by the Tower Crane Safety Terminal Equipment (TC-STE) installed in the driver's operating room. Wireless communication between each TC-STE and the Local Monitoring Terminal (LMT) at the ground worksite were fulfilled through a Zigbee wireless network. LMT can share the status information of the whole group with each TC-STE, while the LMT records the real-time data and reports it to the Remote Supervision Platform (RSP) through General Packet Radio Service (GPRS). Based on the global status data of the whole group, an anti-collision algorithm was executed in each TC-STE to ensure the safety of each tower crane during construction. Remote supervision can be fulfilled using our client software installed on a personal computer (PC) or smartphone. SMS-TC could be considered as a promising practical application that combines a Wireless Sensor Network with the Internet of Things.

Building a Community of Practice for Researchers: The International Network for Simulation-Based Pediatric Innovation, Research and Education.

PubMed

Cheng, Adam; Auerbach, Marc; Calhoun, Aaron; Mackinnon, Ralph; Chang, Todd P; Nadkarni, Vinay; Hunt, Elizabeth A; Duval-Arnould, Jordan; Peiris, Nicola; Kessler, David

2018-06-01

The scope and breadth of simulation-based research is growing rapidly; however, few mechanisms exist for conducting multicenter, collaborative research. Failure to foster collaborative research efforts is a critical gap that lies in the path of advancing healthcare simulation. The 2017 Research Summit hosted by the Society for Simulation in Healthcare highlighted how simulation-based research networks can produce studies that positively impact the delivery of healthcare. In 2011, the International Network for Simulation-based Pediatric Innovation, Research and Education (INSPIRE) was formed to facilitate multicenter, collaborative simulation-based research with the aim of developing a community of practice for simulation researchers. Since its formation, the network has successfully completed and published numerous collaborative research projects. In this article, we describe INSPIRE's history, structure, and internal processes with the goal of highlighting the community of practice model for other groups seeking to form a simulation-based research network.

Gut feelings as a third track in general practitioners' diagnostic reasoning.

PubMed

Stolper, Erik; Van de Wiel, Margje; Van Royen, Paul; Van Bokhoven, Marloes; Van der Weijden, Trudy; Dinant, Geert Jan

2011-02-01

General practitioners (GPs) are often faced with complicated, vague problems in situations of uncertainty that they have to solve at short notice. In such situations, gut feelings seem to play a substantial role in their diagnostic process. Qualitative research distinguished a sense of alarm and a sense of reassurance. However, not every GP trusted their gut feelings, since a scientific explanation is lacking. This paper explains how gut feelings arise and function in GPs' diagnostic reasoning. The paper reviews literature from medical, psychological and neuroscientific perspectives. Gut feelings in general practice are based on the interaction between patient information and a GP's knowledge and experience. This is visualized in a knowledge-based model of GPs' diagnostic reasoning emphasizing that this complex task combines analytical and non-analytical cognitive processes. The model integrates the two well-known diagnostic reasoning tracks of medical decision-making and medical problem-solving, and adds gut feelings as a third track. Analytical and non-analytical diagnostic reasoning interacts continuously, and GPs use elements of all three tracks, depending on the task and the situation. In this dual process theory, gut feelings emerge as a consequence of non-analytical processing of the available information and knowledge, either reassuring GPs or alerting them that something is wrong and action is required. The role of affect as a heuristic within the physician's knowledge network explains how gut feelings may help GPs to navigate in a mostly efficient way in the often complex and uncertain diagnostic situations of general practice. Emotion research and neuroscientific data support the unmistakable role of affect in the process of making decisions and explain the bodily sensation of gut feelings.The implications for health care practice and medical education are discussed.

Gut Feelings as a Third Track in General Practitioners’ Diagnostic Reasoning

PubMed Central

Van de Wiel, Margje; Van Royen, Paul; Van Bokhoven, Marloes; Van der Weijden, Trudy; Dinant, Geert Jan

2010-01-01

Background General practitioners (GPs) are often faced with complicated, vague problems in situations of uncertainty that they have to solve at short notice. In such situations, gut feelings seem to play a substantial role in their diagnostic process. Qualitative research distinguished a sense of alarm and a sense of reassurance. However, not every GP trusted their gut feelings, since a scientific explanation is lacking. Objective This paper explains how gut feelings arise and function in GPs’ diagnostic reasoning. Approach The paper reviews literature from medical, psychological and neuroscientific perspectives. Conclusions Gut feelings in general practice are based on the interaction between patient information and a GP’s knowledge and experience. This is visualized in a knowledge-based model of GPs’ diagnostic reasoning emphasizing that this complex task combines analytical and non-analytical cognitive processes. The model integrates the two well-known diagnostic reasoning tracks of medical decision-making and medical problem-solving, and adds gut feelings as a third track. Analytical and non-analytical diagnostic reasoning interacts continuously, and GPs use elements of all three tracks, depending on the task and the situation. In this dual process theory, gut feelings emerge as a consequence of non-analytical processing of the available information and knowledge, either reassuring GPs or alerting them that something is wrong and action is required. The role of affect as a heuristic within the physician’s knowledge network explains how gut feelings may help GPs to navigate in a mostly efficient way in the often complex and uncertain diagnostic situations of general practice. Emotion research and neuroscientific data support the unmistakable role of affect in the process of making decisions and explain the bodily sensation of gut feelings.The implications for health care practice and medical education are discussed. PMID:20967509

Describing spatial pattern in stream networks: A practical approach

USGS Publications Warehouse

Ganio, L.M.; Torgersen, C.E.; Gresswell, R.E.

2005-01-01

The shape and configuration of branched networks influence ecological patterns and processes. Recent investigations of network influences in riverine ecology stress the need to quantify spatial structure not only in a two-dimensional plane, but also in networks. An initial step in understanding data from stream networks is discerning non-random patterns along the network. On the other hand, data collected in the network may be spatially autocorrelated and thus not suitable for traditional statistical analyses. Here we provide a method that uses commercially available software to construct an empirical variogram to describe spatial pattern in the relative abundance of coastal cutthroat trout in headwater stream networks. We describe the mathematical and practical considerations involved in calculating a variogram using a non-Euclidean distance metric to incorporate the network pathway structure in the analysis of spatial variability, and use a non-parametric technique to ascertain if the pattern in the empirical variogram is non-random.

Report: Improvements Needed in EPA’s Network Traffic Management Practices

EPA Pesticide Factsheets

Report #11-P-0159, March 14, 2011. OEI does not have consistent, repeatable intrusion detection system monitoring practices in place, which inhibits EPA’s ability to monitor unusual network activity and thus protect Agency systems and associated data.

Social Networks in Medical Education in Bosnia and Herzegovina

PubMed Central

Masic, Izet; Sivic, Suad; Pandza, Haris

2012-01-01

Introduction: Beginning with the late twentieth and early twenty-first century, the Internet was a significant additional tool in the education of teenagers. Later, it takes more and more significant role in educating students and professionals. Goal: The aim of this paper is to investigate, to what extent and how effectively the Internet is used today by students of biomedical faculties in Bosnia and Herzegovina. In addition, more specifically, this paper will research the implications of the well-known social networks in education of students and health professionals in Bosnia and Herzegovina. We compared the ratio of using Social networks by students for spreading medical information as basics for health education at medical faculties at 3 universities in Bosnia and Herzegovina (B&H). Results and discussion: The results showed that only 11.6% of professors use Facebook type of social network, 49.3% of them have a profile on BiomedExperts scientific social network and 79% have available articles in the largest biomedical literature database MEDLINE. Students are also frequent users of general social networks and educational clips from You Tube, which they prefer to utilize considerably more than the other types of professionals. Students rarely use the facilities of professional social networks, because they contain mainly data and information needed for further, postgraduate professional education. Conclusion: In B&H there are decent conditions for the use of online social networks in the education of health professionals. While students enthusiastically embraced these opportunities, this is not so much a case with health care professionals in practice; while scientific health care workers have not shown greater interest in the use of social networks, both for purposes of scientific research and in terms of self-education and training of students. PMID:23922524

Computationally Efficient Nonlinear Bell Inequalities for Quantum Networks

NASA Astrophysics Data System (ADS)

Luo, Ming-Xing

2018-04-01

The correlations in quantum networks have attracted strong interest with new types of violations of the locality. The standard Bell inequalities cannot characterize the multipartite correlations that are generated by multiple sources. The main problem is that no computationally efficient method is available for constructing useful Bell inequalities for general quantum networks. In this work, we show a significant improvement by presenting new, explicit Bell-type inequalities for general networks including cyclic networks. These nonlinear inequalities are related to the matching problem of an equivalent unweighted bipartite graph that allows constructing a polynomial-time algorithm. For the quantum resources consisting of bipartite entangled pure states and generalized Greenberger-Horne-Zeilinger (GHZ) states, we prove the generic nonmultilocality of quantum networks with multiple independent observers using new Bell inequalities. The violations are maximal with respect to the presented Tsirelson's bound for Einstein-Podolsky-Rosen states and GHZ states. Moreover, these violations hold for Werner states or some general noisy states. Our results suggest that the presented Bell inequalities can be used to characterize experimental quantum networks.

Optimal exponential synchronization of general chaotic delayed neural networks: an LMI approach.

PubMed

Liu, Meiqin

2009-09-01

This paper investigates the optimal exponential synchronization problem of general chaotic neural networks with or without time delays by virtue of Lyapunov-Krasovskii stability theory and the linear matrix inequality (LMI) technique. This general model, which is the interconnection of a linear delayed dynamic system and a bounded static nonlinear operator, covers several well-known neural networks, such as Hopfield neural networks, cellular neural networks (CNNs), bidirectional associative memory (BAM) networks, and recurrent multilayer perceptrons (RMLPs) with or without delays. Using the drive-response concept, time-delay feedback controllers are designed to synchronize two identical chaotic neural networks as quickly as possible. The control design equations are shown to be a generalized eigenvalue problem (GEVP) which can be easily solved by various convex optimization algorithms to determine the optimal control law and the optimal exponential synchronization rate. Detailed comparisons with existing results are made and numerical simulations are carried out to demonstrate the effectiveness of the established synchronization laws.

Connecting the dots and merging meaning: using mixed methods to study primary care delivery transformation.

PubMed

Scammon, Debra L; Tomoaia-Cotisel, Andrada; Day, Rachel L; Day, Julie; Kim, Jaewhan; Waitzman, Norman J; Farrell, Timothy W; Magill, Michael K

2013-12-01

To demonstrate the value of mixed methods in the study of practice transformation and illustrate procedures for connecting methods and for merging findings to enhance the meaning derived. An integrated network of university-owned, primary care practices at the University of Utah (Community Clinics or CCs). CC has adopted Care by Design, its version of the Patient Centered Medical Home. Convergent case study mixed methods design. Analysis of archival documents, internal operational reports, in-clinic observations, chart audits, surveys, semistructured interviews, focus groups, Centers for Medicare and Medicaid Services database, and the Utah All Payer Claims Database. Each data source enriched our understanding of the change process and understanding of reasons that certain changes were more difficult than others both in general and for particular clinics. Mixed methods enabled generation and testing of hypotheses about change and led to a comprehensive understanding of practice change. Mixed methods are useful in studying practice transformation. Challenges exist but can be overcome with careful planning and persistence. © Health Research and Educational Trust.

Connecting the Dots and Merging Meaning: Using Mixed Methods to Study Primary Care Delivery Transformation

PubMed Central

Scammon, Debra L; Tomoaia-Cotisel, Andrada; Day, Rachel L; Day, Julie; Kim, Jaewhan; Waitzman, Norman J; Farrell, Timothy W; Magill, Michael K

2013-01-01

Objective. To demonstrate the value of mixed methods in the study of practice transformation and illustrate procedures for connecting methods and for merging findings to enhance the meaning derived. Data Source/Study Setting. An integrated network of university-owned, primary care practices at the University of Utah (Community Clinics or CCs). CC has adopted Care by Design, its version of the Patient Centered Medical Home. Study Design. Convergent case study mixed methods design. Data Collection/Extraction Methods. Analysis of archival documents, internal operational reports, in-clinic observations, chart audits, surveys, semistructured interviews, focus groups, Centers for Medicare and Medicaid Services database, and the Utah All Payer Claims Database. Principal Findings. Each data source enriched our understanding of the change process and understanding of reasons that certain changes were more difficult than others both in general and for particular clinics. Mixed methods enabled generation and testing of hypotheses about change and led to a comprehensive understanding of practice change. Conclusions. Mixed methods are useful in studying practice transformation. Challenges exist but can be overcome with careful planning and persistence. PMID:24279836

Effectiveness and cost-effectiveness of implementing HIV testing in primary care in East London: protocol for an interrupted time series analysis.

PubMed

Leber, Werner; Beresford, Lee; Nightingale, Claire; Barbosa, Estela Capelas; Morris, Stephen; El-Shogri, Farah; McMullen, Heather; Boomla, Kambiz; Delpech, Valerie; Brown, Alison; Hutchinson, Jane; Apea, Vanessa; Symonds, Merle; Gilliham, Samantha; Creighton, Sarah; Shahmanesh, Maryam; Fulop, Naomi; Estcourt, Claudia; Anderson, Jane; Figueroa, Jose; Griffiths, Chris

2017-12-14

HIV remains underdiagnosed. Guidelines recommend routine HIV testing in primary care, but evidence on implementing testing is lacking. In a previous study, the Rapid HIV Assessment 2 (RHIVA2) cluster randomised controlled trial, we showed that providing training and rapid point-of-care HIV testing at general practice registration (RHIVA2 intervention) in Hackney led to cost-effective, increased and earlier diagnosis of HIV. However, interventions effective in a trial context may be less so when implemented in routine practice. We describe the protocol for an MRC phase IV implementation programme, evaluating the impact of rolling out the RHIVA2 intervention in a post-trial setting. We will use a longitudinal study to examine if the post-trial implementation in Hackney practices is effective and cost-effective, and a cross-sectional study to compare Hackney with two adjacent boroughs providing usual primary care (Newham) and an enhanced service promoting HIV testing in primary care (Tower Hamlets). Service evaluation using interrupted time series and cost-effectiveness analyses. We will include all general practices in three contiguous high HIV prevalence East London boroughs. All adults aged 16 and above registered with the practices will be included. The interventions to be examined are: a post-trial RHIVA2 implementation programme (including practice-based education and training, external quality assurance, incentive payments for rapid HIV testing and incorporation of rapid HIV testing in the sexual health Local Enhanced Service) in Hackney; the general practice sexual health Network Improved Service in Tower Hamlets and usual care in Newham. Coprimary outcomes are rates of HIV testing and new HIV diagnoses. The chair of the Camden and Islington NHS Research Ethics Committee, London, has endorsed this programme as an evaluation of routine care. Study results will be published in peer-reviewed journals and reported to commissioners. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Exponential H(infinity) synchronization of general discrete-time chaotic neural networks with or without time delays.

PubMed

Qi, Donglian; Liu, Meiqin; Qiu, Meikang; Zhang, Senlin

2010-08-01

This brief studies exponential H(infinity) synchronization of a class of general discrete-time chaotic neural networks with external disturbance. On the basis of the drive-response concept and H(infinity) control theory, and using Lyapunov-Krasovskii (or Lyapunov) functional, state feedback controllers are established to not only guarantee exponential stable synchronization between two general chaotic neural networks with or without time delays, but also reduce the effect of external disturbance on the synchronization error to a minimal H(infinity) norm constraint. The proposed controllers can be obtained by solving the convex optimization problems represented by linear matrix inequalities. Most discrete-time chaotic systems with or without time delays, such as Hopfield neural networks, cellular neural networks, bidirectional associative memory networks, recurrent multilayer perceptrons, Cohen-Grossberg neural networks, Chua's circuits, etc., can be transformed into this general chaotic neural network to be H(infinity) synchronization controller designed in a unified way. Finally, some illustrated examples with their simulations have been utilized to demonstrate the effectiveness of the proposed methods.

A simple approach to improve recording of concerns about childmaltreatment in primary care records: developing a quality improvement intervention

PubMed Central

Woodman, Jenny; Allister, Janice; Rafi, Imran; de Lusignan, Simon; Belsey, Jonathan; Petersen, Irene; Gilbert, Ruth

2012-01-01

Background Information is lacking on how concerns about child maltreatment are recorded in primary care records. Aim To determine how the recording of child maltreatment concerns can be improved. Design and setting Development of a quality improvement intervention involving: clinical audit, a descriptive survey, telephone interviews, a workshop, database analyses, and consensus development in UK general practice. Method Descriptive analyses and incidence estimates were carried out based on 11 study practices and 442 practices in The Health Improvement Network (THIN). Telephone interviews, a workshop, and a consensus development meeting were conducted with lead GPs from 11 study practices. Results The rate of children with at least one maltreatment-related code was 8.4/1000 child years (11 study practices, 2009–2010), and 8.0/1000 child years (THIN, 2009–2010). Of 25 patients with known maltreatment, six had no maltreatment-related codes recorded, but all had relevant free text, scanned documents, or codes. When stating their reasons for undercoding maltreatment concerns, GPs cited damage to the patient relationship, uncertainty about which codes to use, and having concerns about recording information on other family members in the child’s records. Consensus recommendations are to record the code ‘child is cause for concern’ as a red flag whenever maltreatment is considered, and to use a list of codes arranged around four clinical concepts, with an option for a templated short data entry form. Conclusion GPs under-record maltreatment-related concerns in children’s electronic medical records. As failure to use codes makes it impossible to search or audit these cases, an approach designed to be simple and feasible to implement in UK general practice was recommended. PMID:22781996

Training radial basis function networks for wind speed prediction using PSO enhanced differential search optimizer

PubMed Central

2018-01-01

This paper presents an integrated hybrid optimization algorithm for training the radial basis function neural network (RBF NN). Training of neural networks is still a challenging exercise in machine learning domain. Traditional training algorithms in general suffer and trap in local optima and lead to premature convergence, which makes them ineffective when applied for datasets with diverse features. Training algorithms based on evolutionary computations are becoming popular due to their robust nature in overcoming the drawbacks of the traditional algorithms. Accordingly, this paper proposes a hybrid training procedure with differential search (DS) algorithm functionally integrated with the particle swarm optimization (PSO). To surmount the local trapping of the search procedure, a new population initialization scheme is proposed using Logistic chaotic sequence, which enhances the population diversity and aid the search capability. To demonstrate the effectiveness of the proposed RBF hybrid training algorithm, experimental analysis on publicly available 7 benchmark datasets are performed. Subsequently, experiments were conducted on a practical application case for wind speed prediction to expound the superiority of the proposed RBF training algorithm in terms of prediction accuracy. PMID:29768463

Training radial basis function networks for wind speed prediction using PSO enhanced differential search optimizer.

PubMed

Rani R, Hannah Jessie; Victoire T, Aruldoss Albert

2018-01-01

This paper presents an integrated hybrid optimization algorithm for training the radial basis function neural network (RBF NN). Training of neural networks is still a challenging exercise in machine learning domain. Traditional training algorithms in general suffer and trap in local optima and lead to premature convergence, which makes them ineffective when applied for datasets with diverse features. Training algorithms based on evolutionary computations are becoming popular due to their robust nature in overcoming the drawbacks of the traditional algorithms. Accordingly, this paper proposes a hybrid training procedure with differential search (DS) algorithm functionally integrated with the particle swarm optimization (PSO). To surmount the local trapping of the search procedure, a new population initialization scheme is proposed using Logistic chaotic sequence, which enhances the population diversity and aid the search capability. To demonstrate the effectiveness of the proposed RBF hybrid training algorithm, experimental analysis on publicly available 7 benchmark datasets are performed. Subsequently, experiments were conducted on a practical application case for wind speed prediction to expound the superiority of the proposed RBF training algorithm in terms of prediction accuracy.

Effects of social support and conflict on parenting among homeless mothers.

PubMed

Marra, Jaime V; McCarthy, Elissa; Lin, Hsiu-Ju; Ford, Julian; Rodis, Eleni; Frisman, Linda K

2009-07-01

Research has shown that having a supportive social network is generally beneficial for individuals, particularly those who are homeless or at risk of homelessness. However, conflict within these networks may diminish the positive effects of social support on well-being, and these effects may be felt acutely within a vulnerable population with multiple needs. This study examined the impact of conflict and social support on parenting behaviors in a sample of mothers who are homeless and were involved in a study of case management interventions of varying intensity. We found that women who reported high emotional and instrumental social support self-reported greater improvements in parenting consistency over time than those who reported lower levels of support. However, three-way interactions showed that conflict in support networks was a risk factor for harsh parenting practices among participants who reported lower levels of instrumental social support. Results suggest that social support may enhance homeless mothers' ability to provide consistent parenting, but that these benefits may be undermined if conflict occurs in combination with limited levels of instrumental social support.

The European general practice research network presents the translations of its comprehensive definition of multimorbidity in family medicine in ten European languages.

PubMed

Le Reste, Jean Yves; Nabbe, Patrice; Rivet, Charles; Lygidakis, Charilaos; Doerr, Christa; Czachowski, Slawomir; Lingner, Heidrun; Argyriadou, Stella; Lazic, Djurdjica; Assenova, Radost; Hasaganic, Melida; Munoz, Miquel Angel; Thulesius, Hans; Le Floch, Bernard; Derriennic, Jeremy; Sowinska, Agnieska; Van Marwijk, Harm; Lietard, Claire; Van Royen, Paul

2015-01-01

Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. Forward translation of the EGPRN's definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached. 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care.

[Comparison of predictive effect between the single auto regressive integrated moving average (ARIMA) model and the ARIMA-generalized regression neural network (GRNN) combination model on the incidence of scarlet fever].

PubMed

Zhu, Yu; Xia, Jie-lai; Wang, Jing

2009-09-01

Application of the 'single auto regressive integrated moving average (ARIMA) model' and the 'ARIMA-generalized regression neural network (GRNN) combination model' in the research of the incidence of scarlet fever. Establish the auto regressive integrated moving average model based on the data of the monthly incidence on scarlet fever of one city, from 2000 to 2006. The fitting values of the ARIMA model was used as input of the GRNN, and the actual values were used as output of the GRNN. After training the GRNN, the effect of the single ARIMA model and the ARIMA-GRNN combination model was then compared. The mean error rate (MER) of the single ARIMA model and the ARIMA-GRNN combination model were 31.6%, 28.7% respectively and the determination coefficient (R(2)) of the two models were 0.801, 0.872 respectively. The fitting efficacy of the ARIMA-GRNN combination model was better than the single ARIMA, which had practical value in the research on time series data such as the incidence of scarlet fever.

The European General Practice Research Network Presents the Translations of Its Comprehensive Definition of Multimorbidity in Family Medicine in Ten European Languages

PubMed Central

Le Reste, Jean Yves; Nabbe, Patrice; Rivet, Charles; Lygidakis, Charilaos; Doerr, Christa; Czachowski, Slawomir; Lingner, Heidrun; Argyriadou, Stella; Lazic, Djurdjica; Assenova, Radost; Hasaganic, Melida; Munoz, Miquel Angel; Thulesius, Hans; Le Floch, Bernard; Derriennic, Jeremy; Sowinska, Agnieska; Van Marwijk, Harm; Lietard, Claire; Van Royen, Paul

2015-01-01

Background Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. Objective To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. Method Forward translation of the EGPRN’s definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached Results 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. Conclusion A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care. PMID:25607642

Gross anatomy of network security

NASA Technical Reports Server (NTRS)

Siu, Thomas J.

2002-01-01

Information security involves many branches of effort, including information assurance, host level security, physical security, and network security. Computer network security methods and implementations are given a top-down description to permit a medically focused audience to anchor this information to their daily practice. The depth of detail of network functionality and security measures, like that of the study of human anatomy, can be highly involved. Presented at the level of major gross anatomical systems, this paper will focus on network backbone implementation and perimeter defenses, then diagnostic tools, and finally the user practices (the human element). Physical security measures, though significant, have been defined as beyond the scope of this presentation.

[Four years of specialized outpatient palliative care in a rural area : Cooperation and acceptability from general practitioners' view].

PubMed

Kaiser, Florian; Sohm, Michael; Illig, Daniela; Vehling-Kaiser, Ursula; Haas, Michael

2016-07-01

In 2011, a specialized palliative home care was introduced in the counties of Landshut and Dingolfing. The aim of the current survey was to evaluate the cooperation, acceptance and need of palliative measures for patients particulary from the general practitioner's perspective. From January to March 2015, 198 general practitioners from the counties of Landshut and Dingolfing were contacted with questionnaires. The questionnaires consisted of 16 questions covering five different issues, and drew upon the practical experiences of the authors and earlier surveys from the literature. The questionnaires were sent by post containing a self-addressed and postpaid envelope. Completed questionnaires from 40 out of 198 contacted general practitioners (33 % female and 53 % male). Of these 85 % had cooperated with a SAPV team, 23 % had taken part in training for palliative medicine, 10 % intended to acquire a qualification and 10 % could imagine working in a SAPV team. In addition, 75 % stated that hospitalizations were avoided through the use of SAPV while 73 % felt that time and costs were saved for their own practices. The majority of general practitioners were satisfied with the work provided by the SAPV and the cooperation. Regarding additional palliative care for geriatric patients, 60 % believed that this was sensible. One main critique was that the information about including a patient in the SAPV program was transferred to the general practitioner too late. The current data show that general practitioners recognize the need for palliative medicine skills and predominately welcome the work of a specialized palliative care team in treating their patients. However, close cooperation and communication is necessary for a successful network between generalists and specialists in palliative care.

Correlation Research of Medical Security Management System Network Platform in Medical Practice

NASA Astrophysics Data System (ADS)

Jie, Wang; Fan, Zhang; Jian, Hao; Li-nong, Yu; Jun, Fei; Ping, Hao; Ya-wei, Shen; Yue-jin, Chang

Objective-The related research of medical security management system network in medical practice. Methods-Establishing network platform of medical safety management system, medical security network host station, medical security management system(C/S), medical security management system of departments and sections, comprehensive query, medical security disposal and examination system. Results-In medical safety management, medical security management system can reflect the hospital medical security problem, and can achieve real-time detection and improve the medical security incident detection rate. Conclusion-The application of the research in the hospital management implementation, can find hospital medical security hidden danger and the problems of medical disputes, and can help in resolving medical disputes in time and achieve good work efficiency, which is worth applying in the hospital practice.

Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice

PubMed Central

Rodrigues, Laura C; Viviani, Laura; Dodds, Julie P; Evans, Meirion R; Hunter, Paul R; Gray, Jim J; Letley, Louise H; Rait, Greta; Tompkins, David S; O'Brien, Sarah J

2011-01-01

Objectives To estimate, overall and by organism, the incidence of infectious intestinal disease (IID) in the community, presenting to general practice (GP) and reported to national surveillance. Design Prospective, community cohort study and prospective study of GP presentation conducted between April 2008 and August 2009. Setting Eighty-eight GPs across the UK recruited from the Medical Research Council General Practice Research Framework and the Primary Care Research Networks. Participants 6836 participants registered with the 88 participating practices in the community study; 991 patients with UK-acquired IID presenting to one of 37 practices taking part in the GP presentation study. Main outcome measures IID rates in the community, presenting to GP and reported to national surveillance, overall and by organism; annual IID cases and GP consultations by organism. Results The overall rate of IID in the community was 274 cases per 1000 person-years (95% CI 254 to 296); the rate of GP consultations was 17.7 per 1000 person-years (95% CI 14.4 to 21.8). There were 147 community cases and 10 GP consultations for every case reported to national surveillance. Norovirus was the most common organism, with incidence rates of 47 community cases per 1000 person-years and 2.1 GP consultations per 1000 person-years. Campylobacter was the most common bacterial pathogen, with a rate of 9.3 cases per 1000 person-years in the community, and 1.3 GP consultations per 1000 person-years. We estimate that there are up to 17 million sporadic, community cases of IID and 1 million GP consultations annually in the UK. Of these, norovirus accounts for 3 million cases and 130 000 GP consultations, and Campylobacter is responsible for 500 000 cases and 80 000 GP consultations. Conclusions IID poses a substantial community and healthcare burden in the UK. Control efforts must focus particularly on reducing the burden due to Campylobacter and enteric viruses. PMID:21708822

Association of Structural Global Brain Network Properties with Intelligence in Normal Aging

PubMed Central

Fischer, Florian U.; Wolf, Dominik; Scheurich, Armin; Fellgiebel, Andreas

2014-01-01

Higher general intelligence attenuates age-associated cognitive decline and the risk of dementia. Thus, intelligence has been associated with cognitive reserve or resilience in normal aging. Neurophysiologically, intelligence is considered as a complex capacity that is dependent on a global cognitive network rather than isolated brain areas. An association of structural as well as functional brain network characteristics with intelligence has already been reported in young adults. We investigated the relationship between global structural brain network properties, general intelligence and age in a group of 43 cognitively healthy elderly, age 60–85 years. Individuals were assessed cross-sectionally using Wechsler Adult Intelligence Scale-Revised (WAIS-R) and diffusion-tensor imaging. Structural brain networks were reconstructed individually using deterministic tractography, global network properties (global efficiency, mean shortest path length, and clustering coefficient) were determined by graph theory and correlated to intelligence scores within both age groups. Network properties were significantly correlated to age, whereas no significant correlation to WAIS-R was observed. However, in a subgroup of 15 individuals aged 75 and above, the network properties were significantly correlated to WAIS-R. Our findings suggest that general intelligence and global properties of structural brain networks may not be generally associated in cognitively healthy elderly. However, we provide first evidence of an association between global structural brain network properties and general intelligence in advanced elderly. Intelligence might be affected by age-associated network deterioration only if a certain threshold of structural degeneration is exceeded. Thus, age-associated brain structural changes seem to be partially compensated by the network and the range of this compensation might be a surrogate of cognitive reserve or brain resilience. PMID:24465994

Quantification of network structural dissimilarities.

PubMed

Schieber, Tiago A; Carpi, Laura; Díaz-Guilera, Albert; Pardalos, Panos M; Masoller, Cristina; Ravetti, Martín G

2017-01-09

Identifying and quantifying dissimilarities among graphs is a fundamental and challenging problem of practical importance in many fields of science. Current methods of network comparison are limited to extract only partial information or are computationally very demanding. Here we propose an efficient and precise measure for network comparison, which is based on quantifying differences among distance probability distributions extracted from the networks. Extensive experiments on synthetic and real-world networks show that this measure returns non-zero values only when the graphs are non-isomorphic. Most importantly, the measure proposed here can identify and quantify structural topological differences that have a practical impact on the information flow through the network, such as the presence or absence of critical links that connect or disconnect connected components.

Diabetes mellitus type II as a risk factor for depression: a lower than expected risk in a general practice setting.

PubMed

Aarts, S; van den Akker, M; van Boxtel, M P J; Jolles, J; Winkens, B; Metsemakers, J F M

2009-01-01

The aim of the present study was to determine whether a diagnosis of diabetes mellitus (DM) in a primary setting is associated with an increased risk of subsequent depression. A retrospective cohort design was used based on the Registration Network Family Practice (RNH) database. Patients diagnosed with diabetes mellitus at or after the age of 40 and who were diagnosed between 01-01-1980 and 01-01-2007 (N = 6,140), were compared with age-matched controls from a reference group (N = 18,416) without a history of diabetes. Both groups were followed for an emerging first diagnosis of depression (and/or depressive feelings) until January 1, 2008. 2.0% of the people diagnosed with diabetes mellitus developed a depressive disorder, compared to 1.6% of the reference group. After statistical correction for confounding factors diabetes mellitus was associated with an increased risk of developing subsequent depression (HR 1.26; 95% CI: 1.12-1.42) and/or depressive feelings (HR 1.33; 95% CI: 1.18-1.46). After statistical adjustment practice identification code, age and depression preceding diabetes, were significantly related to a diagnosis of depression. Patients with diabetes mellitus are more likely to develop subsequent depression than persons without a history of diabetes. Results from this large longitudinal study based on a general practice population indicate that this association is weaker than previously found in cross-sectional research using self-report surveys. Several explanations for this dissimilarity are discussed

Towards the distribution network of time and frequency

NASA Astrophysics Data System (ADS)

Lipiński, M.; Krehlik, P.; Śliwczyński, Ł.; Buczek, Ł.; Kołodziej, J.; Nawrocki, J.; Nogaś, P.; Dunst, P.; Lemański, D.; Czubla, A.; Pieczerak, J.; Adamowicz, W.; Pawszak, T.; Igalson, J.; Binczewski, A.; Bogacki, W.; Ostapowicz, P.; Stroiński, M.; Turza, K.

2014-05-01

In the paper the genesis, current stage and perspectives of the OPTIME project are described. The main goal of the project is to demonstrate that the newdeveloped at AGH technology of fiber optic transfer of the atomic clocks reference signals is ready to be used in building the domestic Time and Frequency distribution network. In the first part we summarize the two-year continuous operation of 420 kmlong link connecting the Laboratory of Time and Frequency at Central Office of Measures GUM in Warsaw and Time Service Laboratory at Astrogeodynamic Obserwatory AOS in Borowiec near Poznan. For the first time, we are reporting the two year comparison of UTC(PL) and UTC(AOS) atomic timescales with this link, and we refer it to the results of comparisons performed by GPS-based methods. We also address some practical aspects of maintaining time and frequency dissemination over fiber optical network. In the second part of the paper the concept of the general architecture of the distribution network with two Reference Time and Frequency Laboratories and local repositories is proposed. Moreover the brief project of the second branch connecting repositories in Poznan Polish Supercomputing and Networking Center and Torun Nicolaus Copernicus University with the first end-users in Torun such as National Laboratory of Atomic, Molecular and Optical Physics and Nicolaus Copernicus Astronomical Center is described. In the final part the perspective of developing the network both in the domestic range as far as extention with the international connections possibilities are presented.

Piecewise convexity of artificial neural networks.

PubMed

Rister, Blaine; Rubin, Daniel L

2017-10-01

Although artificial neural networks have shown great promise in applications including computer vision and speech recognition, there remains considerable practical and theoretical difficulty in optimizing their parameters. The seemingly unreasonable success of gradient descent methods in minimizing these non-convex functions remains poorly understood. In this work we offer some theoretical guarantees for networks with piecewise affine activation functions, which have in recent years become the norm. We prove three main results. First, that the network is piecewise convex as a function of the input data. Second, that the network, considered as a function of the parameters in a single layer, all others held constant, is again piecewise convex. Third, that the network as a function of all its parameters is piecewise multi-convex, a generalization of biconvexity. From here we characterize the local minima and stationary points of the training objective, showing that they minimize the objective on certain subsets of the parameter space. We then analyze the performance of two optimization algorithms on multi-convex problems: gradient descent, and a method which repeatedly solves a number of convex sub-problems. We prove necessary convergence conditions for the first algorithm and both necessary and sufficient conditions for the second, after introducing regularization to the objective. Finally, we remark on the remaining difficulty of the global optimization problem. Under the squared error objective, we show that by varying the training data, a single rectifier neuron admits local minima arbitrarily far apart, both in objective value and parameter space. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prioritizing recovery of urban lifelines in the aftermath of hazards: Transportation in post-Harvey Houston

NASA Astrophysics Data System (ADS)

Warner, M. E.; Bhatia, U.; Sela, L.; Wang, R.; Kodra, E.; Ganguly, A. R.

2017-12-01

A well-designed recovery strategy for lifeline infrastructure networks can lead to faster and more reliable restoration of essential services in the aftermath of natural catastrophes such as hurricanes or earthquakes. Urban and regional lifelines impact one another, while the recovery of urban lifelines in turn impacts regional infrastructural resilience, owing to the interdependence of lifelines across scales. Prior work by our team, often in collaboration, has led to the development of new recovery approaches based on network science and engineering, including centrality measures from network science, information theoretic metrics, and network optimization approaches. We have developed proof-of-concept demonstrations at both regional scales, such as for the Indian Railways Network and the US National Airspace System both subjected to multiple hazards, and to urban settings, such as the post-Hurricane recovery of combined power-subway system-of-systems in Boston and the New York City MTA after Hurricane Sandy. Here we make an attempt to understand how such methods may have been, or continue to be, applicable to the transportation network in Houston post-Harvey, and more broadly, how and to what extent lessons learned in urban and regional resilience may generalize across cases. We make an assessment of the state of the literature, process understanding, simulation models, data science methods, and best practices, necessary to address problems of this nature, with a particular focus on post-Harvey recovery of transportation services in Houston.

Using genetic algorithms to determine near-optimal pricing, investment and operating strategies in the electric power industry

NASA Astrophysics Data System (ADS)

Wu, Dongjun

Network industries have technologies characterized by a spatial hierarchy, the "network," with capital-intensive interconnections and time-dependent, capacity-limited flows of products and services through the network to customers. This dissertation studies service pricing, investment and business operating strategies for the electric power network. First-best solutions for a variety of pricing and investment problems have been studied. The evaluation of genetic algorithms (GA, which are methods based on the idea of natural evolution) as a primary means of solving complicated network problems, both w.r.t. pricing: as well as w.r.t. investment and other operating decisions, has been conducted. New constraint-handling techniques in GAs have been studied and tested. The actual application of such constraint-handling techniques in solving practical non-linear optimization problems has been tested on several complex network design problems with encouraging initial results. Genetic algorithms provide solutions that are feasible and close to optimal when the optimal solution is know; in some instances, the near-optimal solutions for small problems by the proposed GA approach can only be tested by pushing the limits of currently available non-linear optimization software. The performance is far better than several commercially available GA programs, which are generally inadequate in solving any of the problems studied in this dissertation, primarily because of their poor handling of constraints. Genetic algorithms, if carefully designed, seem very promising in solving difficult problems which are intractable by traditional analytic methods.

Net benefits: assessing the effectiveness of clinical networks in Australia through qualitative methods

PubMed Central

2012-01-01

Background In the 21st century, government and industry are supplementing hierarchical, bureaucratic forms of organization with network forms, compatible with principles of devolved governance and decentralization of services. Clinical networks are employed as a key health policy approach to engage clinicians in improving patient care in Australia. With significant investment in such networks in Australia and internationally, it is important to assess their effectiveness and sustainability as implementation mechanisms. Methods In two purposively selected, musculoskeletal clinical networks, members and stakeholders were interviewed to ascertain their perceptions regarding key factors relating to network effectiveness and sustainability. We adopted a three-level approach to evaluating network effectiveness: at the community, network, and member levels, across the network lifecycle. Results Both networks studied are advisory networks displaying characteristics of the ‘enclave’ type of non-hierarchical network. They are hybrids of the mandated and natural network forms. In the short term, at member level, both networks were striving to create connectivity and collaboration of members. Over the short to medium term, at network level, both networks applied multi-disciplinary engagement in successfully developing models of care as key outputs, and disseminating information to stakeholders. In the long term, at both community and network levels, stakeholders would measure effectiveness by the broader statewide influence of the network in changing and improving practice. At community level, in the long term, stakeholders acknowledged both networks had raised the profile, and provided a ‘voice’ for musculoskeletal conditions, evidencing some progress with implementation of the network mission while pursuing additional implementation strategies. Conclusions This research sheds light on stakeholders’ perceptions of assessing clinical network effectiveness at community, network, and member levels during the network’s timeline, and on the role of networks and their contribution. Overall, stakeholders reported positive momentum and useful progress in network growth and development, and saw their networks as providing valuable mechanisms for meeting instrumental goals and pursuing collaborative interests. Network forms can prove their utility in addressing ‘wicked problems,’ and these Australian clinical networks present a practical approach to the difficult issue of clinician engagement in state-level implementation of best practice for improving patient care and outcomes. PMID:23122000

The use of existing environmental networks for the post-market monitoring of GM crop cultivation in the EU.

PubMed

Smets, G; Alcalde, E; Andres, D; Carron, D; Delzenne, P; Heise, A; Legris, G; Martinez Parrilla, M; Verhaert, J; Wandelt, C; Ilegems, M; Rüdelsheim, P

2014-07-01

The European Union (EU) Directive 2001/18/EC on the deliberate release of genetically modified organisms (GMOs) into the environment requires that both Case-Specific Monitoring (CSM) and General Surveillance (GS) are considered as post-market implementing measures. Whereas CSM is directed to monitor potential adverse effects of GMOs or their use identified in the environmental risk assessment, GS aims to detect un-intended adverse effects of GMOs or their use on human and animal health or the environment. Guidance documents on the monitoring of genetically modified (GM) plants from the Commission and EFSA clarify that, as appropriate, GS can make use of established routine surveillance practices. Networks involved in routine surveillance offer recognised expertise in a particular domain and are designed to collect information on important environmental aspects over a large geographical area. However, as the suitability of existing monitoring networks to provide relevant data for monitoring impacts of GMOs is not known, plant biotechnology companies developed an approach to describe the processes and criteria that will be used for selecting and evaluating existing monitoring systems. In this paper, the availability of existing monitoring networks for this purpose is evaluated. By cataloguing the existing environmental monitoring networks in the EU, it can be concluded that they can only be used, in the context of GMO cultivation monitoring, as secondary tools to collect baseline information.

From elementary flux modes to elementary flux vectors: Metabolic pathway analysis with arbitrary linear flux constraints.

PubMed

Klamt, Steffen; Regensburger, Georg; Gerstl, Matthias P; Jungreuthmayer, Christian; Schuster, Stefan; Mahadevan, Radhakrishnan; Zanghellini, Jürgen; Müller, Stefan

2017-04-01

Elementary flux modes (EFMs) emerged as a formal concept to describe metabolic pathways and have become an established tool for constraint-based modeling and metabolic network analysis. EFMs are characteristic (support-minimal) vectors of the flux cone that contains all feasible steady-state flux vectors of a given metabolic network. EFMs account for (homogeneous) linear constraints arising from reaction irreversibilities and the assumption of steady state; however, other (inhomogeneous) linear constraints, such as minimal and maximal reaction rates frequently used by other constraint-based techniques (such as flux balance analysis [FBA]), cannot be directly integrated. These additional constraints further restrict the space of feasible flux vectors and turn the flux cone into a general flux polyhedron in which the concept of EFMs is not directly applicable anymore. For this reason, there has been a conceptual gap between EFM-based (pathway) analysis methods and linear optimization (FBA) techniques, as they operate on different geometric objects. One approach to overcome these limitations was proposed ten years ago and is based on the concept of elementary flux vectors (EFVs). Only recently has the community started to recognize the potential of EFVs for metabolic network analysis. In fact, EFVs exactly represent the conceptual development required to generalize the idea of EFMs from flux cones to flux polyhedra. This work aims to present a concise theoretical and practical introduction to EFVs that is accessible to a broad audience. We highlight the close relationship between EFMs and EFVs and demonstrate that almost all applications of EFMs (in flux cones) are possible for EFVs (in flux polyhedra) as well. In fact, certain properties can only be studied with EFVs. Thus, we conclude that EFVs provide a powerful and unifying framework for constraint-based modeling of metabolic networks.

From elementary flux modes to elementary flux vectors: Metabolic pathway analysis with arbitrary linear flux constraints

PubMed Central

Klamt, Steffen; Gerstl, Matthias P.; Jungreuthmayer, Christian; Mahadevan, Radhakrishnan; Müller, Stefan

2017-01-01

Elementary flux modes (EFMs) emerged as a formal concept to describe metabolic pathways and have become an established tool for constraint-based modeling and metabolic network analysis. EFMs are characteristic (support-minimal) vectors of the flux cone that contains all feasible steady-state flux vectors of a given metabolic network. EFMs account for (homogeneous) linear constraints arising from reaction irreversibilities and the assumption of steady state; however, other (inhomogeneous) linear constraints, such as minimal and maximal reaction rates frequently used by other constraint-based techniques (such as flux balance analysis [FBA]), cannot be directly integrated. These additional constraints further restrict the space of feasible flux vectors and turn the flux cone into a general flux polyhedron in which the concept of EFMs is not directly applicable anymore. For this reason, there has been a conceptual gap between EFM-based (pathway) analysis methods and linear optimization (FBA) techniques, as they operate on different geometric objects. One approach to overcome these limitations was proposed ten years ago and is based on the concept of elementary flux vectors (EFVs). Only recently has the community started to recognize the potential of EFVs for metabolic network analysis. In fact, EFVs exactly represent the conceptual development required to generalize the idea of EFMs from flux cones to flux polyhedra. This work aims to present a concise theoretical and practical introduction to EFVs that is accessible to a broad audience. We highlight the close relationship between EFMs and EFVs and demonstrate that almost all applications of EFMs (in flux cones) are possible for EFVs (in flux polyhedra) as well. In fact, certain properties can only be studied with EFVs. Thus, we conclude that EFVs provide a powerful and unifying framework for constraint-based modeling of metabolic networks. PMID:28406903

Social network-related risk factors for bloodborne virus infections among injection drug users receiving syringes through secondary exchange.

PubMed

De, Prithwish; Cox, Joseph; Boivin, Jean-François; Platt, Robert W; Jolly, Ann M

2008-01-01

Secondary syringe exchange (SSE) refers to the exchange of sterile syringes between injection drug users (IDUs). To date there has been limited examination of SSE in relation to the social networks of IDUs. This study aimed to identify characteristics of drug injecting networks associated with the receipt of syringes through SSE. Active IDUs were recruited from syringe exchange and methadone treatment programs in Montreal, Canada, between April 2004 and January 2005. Information on each participant and on their drug-injecting networks was elicited using a structured, interviewer-administered questionnaire. Subjects' network characteristics were examined in relation to SSE using regression models with generalized estimating equations. Of 218 participants, 126 were SSE recipients with 186 IDUs in their injecting networks. The 92 non-recipients reported 188 network IDUs. Networks of SSE recipients and non-recipients were similar with regard to network size and demographics of network members. In multivariate analyses adjusted for age and gender, SSE recipients were more likely than non-recipients to self-report being HIV-positive (OR=3.56 [1.54-8.23]); require or provide help with injecting (OR=3.74 [2.01-6.95]); have a social network member who is a sexual partner (OR=1.90 [1.11-3.24]), who currently attends a syringe exchange or methadone program (OR=2.33 [1.16-4.70]), injects daily (OR=1.77 [1.11-2.84]), and shares syringes with the subject (OR=2.24 [1.13-4.46]). SSE is associated with several injection-related risk factors that could be used to help focus public health interventions for risk reduction. Since SSE offers an opportunity for the dissemination of important prevention messages, SSE-based networks should be used to improve public health interventions. This approach can optimize the benefits of SSE while minimizing the potential risks associated with the practice of secondary exchange.

Neural-Network Computer Transforms Coordinates

NASA Technical Reports Server (NTRS)

Josin, Gary M.

1990-01-01

Numerical simulation demonstrated ability of conceptual neural-network computer to generalize what it has "learned" from few examples. Ability to generalize achieved with even simple neural network (relatively few neurons) and after exposure of network to only few "training" examples. Ability to obtain fairly accurate mappings after only few training examples used to provide solutions to otherwise intractable mapping problems.

Integration and segregation of large-scale brain networks during short-term task automatization

PubMed Central

Mohr, Holger; Wolfensteller, Uta; Betzel, Richard F.; Mišić, Bratislav; Sporns, Olaf; Richiardi, Jonas; Ruge, Hannes

2016-01-01

The human brain is organized into large-scale functional networks that can flexibly reconfigure their connectivity patterns, supporting both rapid adaptive control and long-term learning processes. However, it has remained unclear how short-term network dynamics support the rapid transformation of instructions into fluent behaviour. Comparing fMRI data of a learning sample (N=70) with a control sample (N=67), we find that increasingly efficient task processing during short-term practice is associated with a reorganization of large-scale network interactions. Practice-related efficiency gains are facilitated by enhanced coupling between the cingulo-opercular network and the dorsal attention network. Simultaneously, short-term task automatization is accompanied by decreasing activation of the fronto-parietal network, indicating a release of high-level cognitive control, and a segregation of the default mode network from task-related networks. These findings suggest that short-term task automatization is enabled by the brain's ability to rapidly reconfigure its large-scale network organization involving complementary integration and segregation processes. PMID:27808095

Linux thin-client conversion in a large cardiology practice: initial experience.

PubMed

Echt, Martin P; Rosen, Jordan

2004-01-01

Capital Cardiology Associates (CCA) is a single-specialty cardiology practice with offices in New York and Massachusetts. In 2003, CCA converted its IT system from a Microsoft-based network to a Linux network employing Linux thin-client technology with overall positive outcomes.

Effectiveness of intensive practice nurse counselling versus brief general practitioner advice, both combined with varenicline, for smoking cessation: a randomized pragmatic trial in primary care.

PubMed

van Rossem, Carolien; Spigt, Mark; Viechtbauer, Wolfgang; Lucas, Annelies E M; van Schayck, Onno C P; Kotz, Daniel

2017-12-01

To study the effectiveness of intensive counselling by a practice nurse (PN) versus brief advice by a general practitioner (GP), each combined with pharmacotherapy, for 6 months' tobacco abstinence (primary outcome). Secondary outcomes included 12-month abstinence, medication adherence and incremental costs per life-year gained. A multi-site (n = 10), two-group, parallel, pragmatic randomized controlled trial. A network of primary health-care centres in the Netherlands. A total of 295 adult daily smokers (mean age = 48 years; mean cigarettes/day = 19). Patients were randomized to receive individual counselling by a practice nurse (PN) (n = 149) or brief advice by a general practitioner (GP) (146). All patients received 12 weeks of open-label varenicline. The primary outcome was prolonged biochemically validated abstinence from weeks 9 to 26 after treatment initiation. Secondary outcomes included abstinence from weeks 9 to 52, good dosing adherence (> 80% days taken) and incremental costs per life-year gained. Abstinence rates in the PN versus GP groups were 32.2% (n = 48) versus 39.0% [n = 57; odds ratio (OR) = 0.71; 95% confidence interval (CI) = 0.44-1.16] from weeks 9 to 26 and 25.5% (n = 38) versus 28.8% (n = 42; OR = 0.84, 95% CI = 0.50-1.43) from weeks 9 to 52, respectively. Values of the Bayes factor indicated that the PN and GP were equally effective. Good dosing adherence was significantly lower in the PN (45.5%, n = 56/123) than in the GP group (62.0%, n = 75/121; OR = 0.45, 95% CI = 0.26-0.77), and the incremental costs per life-year gained were -€416.10. Among people seeking help to stop smoking from their general practice, one-off brief advice from a general practitioner appears to be as effective as several sessions of behavioural support from a practice nurse when smoking cessation medication is provided. © 2017 Society for the Study of Addiction.

Interpersonal Influence Among Public Health Leaders in the United States Department of Health and Human Services

PubMed Central

Harris, Jenine K.; Carothers, Bobbi J.; Wald, Lana M.; Shelton, Sarah C.; Leischow, Scott J.

2012-01-01

Background In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS). Design and Methods Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91%) responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Results Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Conclusions Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership. PMID:25170448

Interpersonal influence among public health leaders in the United States department of health and human services.

PubMed

Harris, Jenine K; Carothers, Bobbi J; Wald, Lana M; Shelton, Sarah C; Leischow, Scott J

2012-02-17

In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS). Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91%) responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.

The Study on Network Examinational Database based on ASP Technology

NASA Astrophysics Data System (ADS)

Zhang, Yanfu; Han, Yuexiao; Zhou, Yanshuang

This article introduces the structure of the general test base system based on .NET technology, discussing the design of the function modules and its implementation methods. It focuses on key technology of the system, proposing utilizing the WEB online editor control to solve the input problem and regular expression to solve the problem HTML code, making use of genetic algorithm to optimize test paper and the automated tools of WORD to solve the problem of exporting papers and others. Practical effective design and implementation technology can be used as reference for the development of similar systems.

Knowledge engineering in volcanology: Practical claims and general approach

NASA Astrophysics Data System (ADS)

Pshenichny, Cyril A.

2014-10-01

Knowledge engineering, being a branch of artificial intelligence, offers a variety of methods for elicitation and structuring of knowledge in a given domain. Only a few of them (ontologies and semantic nets, event/probability trees, Bayesian belief networks and event bushes) are known to volcanologists. Meanwhile, the tasks faced by volcanology and the solutions found so far favor a much wider application of knowledge engineering, especially tools for handling dynamic knowledge. This raises some fundamental logical and mathematical problems and requires an organizational effort, but may strongly improve panel discussions, enhance decision support, optimize physical modeling and support scientific collaboration.

Diversity in Family Medicine: The Art of Thinking Independently Together – Reflections on the RCGP exchange 2016

PubMed Central

Figueiredo, Ana Beatriz; Pesolillo, Gabriella; Kanwal, Sidra; Tezen, Amelia

2017-01-01

This narrative summarizes the reflections of a UK conference exchange experience of four young general practitioners (GPs) from Peru, Portugal, Italy, and Pakistan. This article was written after participating in a RCGP exchange program in October 2016. This consisted of 2 days of observation in a GP practice in Liverpool followed by attendance at the RCGP preconference and annual conference. The exchange was organized by the RCGP Junior International Committee, which links to the Vasco da Gama Movement, a European network of new and future GPs. PMID:29564249

Patients, practices, and relationships: challenges and lessons learned from the Kentucky Ambulatory Network (KAN) CaRESS clinical trial.

PubMed

Love, Margaret M; Pearce, Kevin A; Williamson, M Ann; Barron, Mary A; Shelton, Brent J

2006-01-01

The Cardiovascular Risk Education and Social Support (CaRESS) study is a randomized controlled trial that evaluates a social support intervention toward reducing cardiovascular risk in type 2 diabetic patients. It involves multiple community-based practice sites from the Kentucky Ambulatory Network (KAN), which is a regional primary care practice-based research network (PBRN). CaRESS also implements multiple modes of data collection. The purpose of this methods article is to share lessons learned that might be useful to others developing or implementing complex studies that consent patients in PBRNs. Key points include building long-term relationships with the clinicians, adaptability when integrating into practice sites, adequate funding to support consistent data management and statistical support during all phases of the study, and creativity and perseverance for recruiting patients and practices while maintaining the integrity of the protocol.

Continuous-variable Measurement-device-independent Quantum Relay Network with Phase-sensitive Amplifiers

NASA Astrophysics Data System (ADS)

Li, Fei; Zhao, Wei; Guo, Ying

2018-01-01

Continuous-variable (CV) measurement-device-independent (MDI) quantum cryptography is now heading towards solving the practical problem of implementing scalable quantum networks. In this paper, we show that a solution can come from deploying an optical amplifier in the CV-MDI system, aiming to establish a high-rate quantum network. We suggest an improved CV-MDI protocol using the EPR states coupled with optical amplifiers. It can implement a practical quantum network scheme, where the legal participants create the secret correlations by using EPR states connecting to an untrusted relay via insecure links and applying the multi-entangled Greenberger-Horne-Zeilinger (GHZ) state analysis at relay station. Despite the possibility that the relay could be completely tampered with and imperfect links are subject to the powerful attacks, the legal participants are still able to extract a secret key from network communication. The numerical simulation indicates that the quantum network communication can be achieved in an asymmetric scenario, fulfilling the demands of a practical quantum network. Furthermore, we show that the use of optical amplifiers can compensate the inherent imperfections and improve the secret key rate of the CV-MDI system.

Carbon emissions tax policy of urban road traffic and its application in Panjin, China

PubMed Central

Yang, Longhai; Fang, Lin

2018-01-01

How to effectively solve traffic congestion and transportation pollution in urban development is a main research emphasis for transportation management agencies. A carbon emissions tax can affect travelers’ generalized costs and will lead to changes in passenger demand, mode choice and traffic flow equilibrium in road networks, which are of significance in green travel and low-carbon transportation management. This paper first established a mesoscopic model to calculate the carbon emissions tax and determined the value of this charge in China, which was based on road traffic flow, vehicle speed, and carbon emissions. Referring to existing research results to calibrate the value of time, this paper modified the traveler’s generalized cost function, including the carbon emissions tax, fuel surcharge and travel time cost, which can be used in the travel impedance model with the consideration of the carbon emissions tax. Then, a method for analyzing urban road network traffic flow distribution was put forward, and a joint traffic distribution model was established, which considered the relationship between private cars and taxis. Finally, this paper took the city of Panjin as an example to analyze the road traffic carbon emissions tax’s impact. The results illustrated that the carbon emissions tax has a positive effect on road network flow equilibrium and carbon emission reduction. This paper will have good reference value and practical significance for the calculation and implementation of urban traffic carbon emissions taxes in China. PMID:29738580

Carbon emissions tax policy of urban road traffic and its application in Panjin, China.

PubMed

Yang, Longhai; Hu, Xiaowei; Fang, Lin

2018-01-01

How to effectively solve traffic congestion and transportation pollution in urban development is a main research emphasis for transportation management agencies. A carbon emissions tax can affect travelers' generalized costs and will lead to changes in passenger demand, mode choice and traffic flow equilibrium in road networks, which are of significance in green travel and low-carbon transportation management. This paper first established a mesoscopic model to calculate the carbon emissions tax and determined the value of this charge in China, which was based on road traffic flow, vehicle speed, and carbon emissions. Referring to existing research results to calibrate the value of time, this paper modified the traveler's generalized cost function, including the carbon emissions tax, fuel surcharge and travel time cost, which can be used in the travel impedance model with the consideration of the carbon emissions tax. Then, a method for analyzing urban road network traffic flow distribution was put forward, and a joint traffic distribution model was established, which considered the relationship between private cars and taxis. Finally, this paper took the city of Panjin as an example to analyze the road traffic carbon emissions tax's impact. The results illustrated that the carbon emissions tax has a positive effect on road network flow equilibrium and carbon emission reduction. This paper will have good reference value and practical significance for the calculation and implementation of urban traffic carbon emissions taxes in China.

A Fresh Look at Internet Protocol Version 6 (IPv6) for Department of Defense (DoD) Networks

DTIC Science & Technology

2010-08-01

since system administration practices (such as the use of security appliances) depend heavily on tools for network management, diagnosis and protection...are mobile ad hoc networks (MANETs) and yet there is limited practical experience with MANETs and their performance. Further, the interaction between...Systems FCS Future Combat System IETF Internet Engineering Task Force ISAT Information Science and Technology BAST Board on Army Science and

Tensor network states and algorithms in the presence of a global SU(2) symmetry

NASA Astrophysics Data System (ADS)

Singh, Sukhwinder; Vidal, Guifre

2012-11-01

The benefits of exploiting the presence of symmetries in tensor network algorithms have been extensively demonstrated in the context of matrix product states (MPSs). These include the ability to select a specific symmetry sector (e.g., with a given particle number or spin), to ensure the exact preservation of total charge, and to significantly reduce computational costs. Compared to the case of a generic tensor network, the practical implementation of symmetries in the MPS is simplified by the fact that tensors only have three indices (they are trivalent, just as the Clebsch-Gordan coefficients of the symmetry group) and are organized as a one-dimensional array of tensors, without closed loops. Instead, a more complex tensor network, one where tensors have a larger number of indices and/or a more elaborate network structure, requires a more general treatment. In two recent papers, namely, (i) [Singh, Pfeifer, and Vidal, Phys. Rev. APLRAAN1050-294710.1103/PhysRevA.82.050301 82, 050301 (2010)] and (ii) [Singh, Pfeifer, and Vidal, Phys. Rev. BPRBMDO1098-012110.1103/PhysRevB.83.115125 83, 115125 (2011)], we described how to incorporate a global internal symmetry into a generic tensor network algorithm based on decomposing and manipulating tensors that are invariant under the symmetry. In (i) we considered a generic symmetry group G that is compact, completely reducible, and multiplicity free, acting as a global internal symmetry. Then, in (ii) we described the implementation of Abelian group symmetries in much more detail, considering a U(1) symmetry (e.g., conservation of global particle number) as a concrete example. In this paper, we describe the implementation of non-Abelian group symmetries in great detail. For concreteness, we consider an SU(2) symmetry (e.g., conservation of global quantum spin). Our formalism can be readily extended to more exotic symmetries associated with conservation of total fermionic or anyonic charge. As a practical demonstration, we describe the SU(2)-invariant version of the multiscale entanglement renormalization ansatz and apply it to study the low-energy spectrum of a quantum spin chain with a global SU(2) symmetry.

Building research infrastructure in community health centers: a Community Health Applied Research Network (CHARN) report.

PubMed

Likumahuwa, Sonja; Song, Hui; Singal, Robbie; Weir, Rosy Chang; Crane, Heidi; Muench, John; Sim, Shao-Chee; DeVoe, Jennifer E

2013-01-01

This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and "matchmaking" between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings.

Building Research Infrastructure in Community Health Centers: A Community Health Applied Research Network (CHARN) Report

PubMed Central

Likumahuwa, Sonja; Song, Hui; Singal, Robbie; Weir, Rosy Chang; Crane, Heidi; Muench, John; Sim, Shao-Chee; DeVoe, Jennifer E.

2015-01-01

This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and “matchmaking” between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings. PMID:24004710

Opportunities and methodological challenges in EEG and MEG resting state functional brain network research.

PubMed

van Diessen, E; Numan, T; van Dellen, E; van der Kooi, A W; Boersma, M; Hofman, D; van Lutterveld, R; van Dijk, B W; van Straaten, E C W; Hillebrand, A; Stam, C J

2015-08-01

Electroencephalogram (EEG) and magnetoencephalogram (MEG) recordings during resting state are increasingly used to study functional connectivity and network topology. Moreover, the number of different analysis approaches is expanding along with the rising interest in this research area. The comparison between studies can therefore be challenging and discussion is needed to underscore methodological opportunities and pitfalls in functional connectivity and network studies. In this overview we discuss methodological considerations throughout the analysis pipeline of recording and analyzing resting state EEG and MEG data, with a focus on functional connectivity and network analysis. We summarize current common practices with their advantages and disadvantages; provide practical tips, and suggestions for future research. Finally, we discuss how methodological choices in resting state research can affect the construction of functional networks. When taking advantage of current best practices and avoid the most obvious pitfalls, functional connectivity and network studies can be improved and enable a more accurate interpretation and comparison between studies. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

A community of practice for knowledge translation trainees: an innovative approach for learning and collaboration.

PubMed

Urquhart, Robin; Cornelissen, Evelyn; Lal, Shalini; Colquhoun, Heather; Klein, Gail; Richmond, Sarah; Witteman, Holly O

2013-01-01

A growing number of researchers and trainees identify knowledge translation (KT) as their field of study or practice. Yet, KT educational and professional development opportunities and established KT networks remain relatively uncommon, making it challenging for trainees to develop the necessary skills, networks, and collaborations to optimally work in this area. The Knowledge Translation Trainee Collaborative is a trainee-initiated and trainee-led community of practice established by junior knowledge translation researchers and practitioners to: examine the diversity of knowledge translation research and practice, build networks with other knowledge translation trainees, and advance the field through knowledge generation activities. In this article, we describe how the collaborative serves as an innovative community of practice for continuing education and professional development in knowledge translation and present a logic model that provides a framework for designing an evaluation of its impact as a community of practice. The expectation is that formal and informal networking will lead to knowledge sharing and knowledge generation opportunities that improve individual members' competencies (eg, combination of skills, abilities, and knowledge) in knowledge translation research and practice and contribute to the development and advancement of the knowledge translation field. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Network Leadership: An Emerging Practice

ERIC Educational Resources Information Center

Tremblay, Christopher W.

2012-01-01

Network leadership is an emerging approach that can have an impact on change in education and in society. According to Merriam-Webster (2011), a network is "an interconnected or interrelated chain, group, or system." Intentional interconnectedness is what separates network leadership from other leadership theories. Network leadership has the…

Network Framing of Pest Management Knowledge and Practice

ERIC Educational Resources Information Center

Moore, Keith M.

2008-01-01

Conventional technology transfer is based on the assumption that autonomous individuals independently make behavioral decisions. In contrast, Actor-Network Theory (ANT) suggests that people and technologies are interconnected in ways that reinforce and reproduce some types of knowledge and consequent behavioral practices, but not others. Research…

College Students' Nutrition Information Networks.

ERIC Educational Resources Information Center

Hertzler, Ann A.; Frary, Robert B.

1995-01-01

Use of nutrition information networks (consumer market, media, authority, family, and high school classes), food choices, fat practices, and nutrient intake were rated by 179 male and 300 female undergraduates. Family was an important influence; media and consumer market influenced fat practices, especially for women. No source was used very…

Outcasts on the Inside: Academics Reinventing Themselves Online

ERIC Educational Resources Information Center

Costa, Cristina

2015-01-01

Recent developments in digital scholarship point out that academic practices supported by technologies may not only be transformed through the obvious process of digitization, but also renovated through distributed knowledge networks that digital technologies enable, and the practices of openness that such networks develop. Yet, this apparent…

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.

Modeling and Density Estimation of an Urban Freeway Network Based on Dynamic Graph Hybrid Automata

PubMed Central

Chen, Yangzhou; Guo, Yuqi; Wang, Ying

2017-01-01

In this paper, in order to describe complex network systems, we firstly propose a general modeling framework by combining a dynamic graph with hybrid automata and thus name it Dynamic Graph Hybrid Automata (DGHA). Then we apply this framework to model traffic flow over an urban freeway network by embedding the Cell Transmission Model (CTM) into the DGHA. With a modeling procedure, we adopt a dual digraph of road network structure to describe the road topology, use linear hybrid automata to describe multi-modes of dynamic densities in road segments and transform the nonlinear expressions of the transmitted traffic flow between two road segments into piecewise linear functions in terms of multi-mode switchings. This modeling procedure is modularized and rule-based, and thus is easily-extensible with the help of a combination algorithm for the dynamics of traffic flow. It can describe the dynamics of traffic flow over an urban freeway network with arbitrary topology structures and sizes. Next we analyze mode types and number in the model of the whole freeway network, and deduce a Piecewise Affine Linear System (PWALS) model. Furthermore, based on the PWALS model, a multi-mode switched state observer is designed to estimate the traffic densities of the freeway network, where a set of observer gain matrices are computed by using the Lyapunov function approach. As an example, we utilize the PWALS model and the corresponding switched state observer to traffic flow over Beijing third ring road. In order to clearly interpret the principle of the proposed method and avoid computational complexity, we adopt a simplified version of Beijing third ring road. Practical application for a large-scale road network will be implemented by decentralized modeling approach and distributed observer designing in the future research. PMID:28353664

Modeling and Density Estimation of an Urban Freeway Network Based on Dynamic Graph Hybrid Automata.

PubMed

Chen, Yangzhou; Guo, Yuqi; Wang, Ying

2017-03-29

In this paper, in order to describe complex network systems, we firstly propose a general modeling framework by combining a dynamic graph with hybrid automata and thus name it Dynamic Graph Hybrid Automata (DGHA). Then we apply this framework to model traffic flow over an urban freeway network by embedding the Cell Transmission Model (CTM) into the DGHA. With a modeling procedure, we adopt a dual digraph of road network structure to describe the road topology, use linear hybrid automata to describe multi-modes of dynamic densities in road segments and transform the nonlinear expressions of the transmitted traffic flow between two road segments into piecewise linear functions in terms of multi-mode switchings. This modeling procedure is modularized and rule-based, and thus is easily-extensible with the help of a combination algorithm for the dynamics of traffic flow. It can describe the dynamics of traffic flow over an urban freeway network with arbitrary topology structures and sizes. Next we analyze mode types and number in the model of the whole freeway network, and deduce a Piecewise Affine Linear System (PWALS) model. Furthermore, based on the PWALS model, a multi-mode switched state observer is designed to estimate the traffic densities of the freeway network, where a set of observer gain matrices are computed by using the Lyapunov function approach. As an example, we utilize the PWALS model and the corresponding switched state observer to traffic flow over Beijing third ring road. In order to clearly interpret the principle of the proposed method and avoid computational complexity, we adopt a simplified version of Beijing third ring road. Practical application for a large-scale road network will be implemented by decentralized modeling approach and distributed observer designing in the future research.

Use of the internet by Italian pediatricians: habits, impact on clinical practice and expectations.

PubMed

Romano, Mariateresa; Gesualdo, Francesco; Pandolfi, Elisabetta; Tozzi, Alberto E; Ugazio, Alberto G

2012-03-28

Medical professionals go online for literature searches and communication with families.We administered a questionnaire to members of the Italian Society of Pediatrics to assess determinants of their use of the Internet, of social platforms and of personal health records during clinical practice. All the 9180 members of the Italian Society of Pediatrics were invited to fill in a questionnaire concerning use of the Internet and usefulness of Internet-based tools during clinical practice. The questionnaire was administered through the SurveyMonkey® web platform. Logistic regression analysis was used to study factors affecting use and influence of the Internet in clinical practice. A total of 1335 (14.5%) members returned the questionnaire. Mean age was 49.2 years, 58.6% were female. 32.3% had access to the Internet through a Smartphone. 71.9% of respondents used the Internet during clinical practice, mainly searching for guidelines and drug references. Use of the Internet during clinical practice was more frequent among younger pediatricians (OR 0.964; 95% CI 0.591-0.978), males (OR 1.602; 95% CI 1.209-2.123) and those living in Northern and Central Italy (OR 1.441; 95% CI 1.111-1.869), while it was lower among family pediatricians. 94.6% of respondents were influenced in their clinical practice by information found on the Internet, in particular younger pediatricians (OR 0.96, 95% CI 0.932-0.989), hospital pediatricians (OR 2.929, 95% CI 1.708-5.024), and other pediatric profiles (OR 6.143, 95%CI 1.848-20.423). 15.9% of respondents stated that social networks may be useful in pediatric practice. Slightly more than half (50.5%) of respondents stated that personal health records may be clinically relevant. Registrars and hospital pediatricians were more likely to perceive personal health records as useful tools for clinical practice. Additional resources pediatricians would like to access were free bibliographic databases and tools for interacting with families. Italian pediatricians frequently use the Internet during their practice. One-third of them access the Internet through a Smartphone. Interaction with families and their empowerment can be improved by the use of Internet tools, including personal health records, toward which respondents show a significant interest. Though, they show a general resistance to the introduction of social networks in clinical practice.

Use of the internet by Italian pediatricians: habits, impact on clinical practice and expectations

PubMed Central

2012-01-01

Background Medical professionals go online for literature searches and communication with families. We administered a questionnaire to members of the Italian Society of Pediatrics to assess determinants of their use of the Internet, of social platforms and of personal health records during clinical practice. Methods All the 9180 members of the Italian Society of Pediatrics were invited to fill in a questionnaire concerning use of the Internet and usefulness of Internet-based tools during clinical practice. The questionnaire was administered through the SurveyMonkey® web platform. Logistic regression analysis was used to study factors affecting use and influence of the Internet in clinical practice. Results A total of 1335 (14.5%) members returned the questionnaire. Mean age was 49.2 years, 58.6% were female. 32.3% had access to the Internet through a Smartphone. 71.9% of respondents used the Internet during clinical practice, mainly searching for guidelines and drug references. Use of the Internet during clinical practice was more frequent among younger pediatricians (OR 0.964; 95% CI 0.591-0.978), males (OR 1.602; 95% CI 1.209-2.123) and those living in Northern and Central Italy (OR 1.441; 95% CI 1.111-1.869), while it was lower among family pediatricians. 94.6% of respondents were influenced in their clinical practice by information found on the Internet, in particular younger pediatricians (OR 0.96, 95% CI 0.932-0.989), hospital pediatricians (OR 2.929, 95% CI 1.708-5.024), and other pediatric profiles (OR 6.143, 95%CI 1.848-20.423). 15.9% of respondents stated that social networks may be useful in pediatric practice. Slightly more than half (50.5%) of respondents stated that personal health records may be clinically relevant. Registrars and hospital pediatricians were more likely to perceive personal health records as useful tools for clinical practice. Additional resources pediatricians would like to access were free bibliographic databases and tools for interacting with families. Conclusions Italian pediatricians frequently use the Internet during their practice. One-third of them access the Internet through a Smartphone. Interaction with families and their empowerment can be improved by the use of Internet tools, including personal health records, toward which respondents show a significant interest. Though, they show a general resistance to the introduction of social networks in clinical practice. PMID:22455671

Convergence and Periodic Solutions for the Input Impedance of a Standard Ladder Network

ERIC Educational Resources Information Center

Ucak, C.; Acar, C.

2007-01-01

The input impedance of an infinite ladder network is computed by using the recursive relation and by assuming that the input impedance does not change when a new block is added to the network. However, this assumption is not true in general and standard textbooks do not always treat these networks correctly. This paper develops a general solution…

Large-scale coupling dynamics of instructed reversal learning.

PubMed

Mohr, Holger; Wolfensteller, Uta; Ruge, Hannes

2018-02-15

The ability to rapidly learn from others by instruction is an important characteristic of human cognition. A recent study found that the rapid transfer from initial instructions to fluid behavior is supported by changes of functional connectivity between and within several large-scale brain networks, and particularly by the coupling of the dorsal attention network (DAN) with the cingulo-opercular network (CON). In the present study, we extended this approach to investigate how these brain networks interact when stimulus-response mappings are altered by novel instructions. We hypothesized that residual stimulus-response associations from initial practice might negatively impact the ability to implement novel instructions. Using functional imaging and large-scale connectivity analysis, we found that functional coupling between the CON and DAN was generally at a higher level during initial than reversal learning. Examining the learning-related connectivity dynamics between the CON and DAN in more detail by means of multivariate patterns analyses, we identified a specific subset of connections which showed a particularly high increase in connectivity during initial learning compared to reversal learning. This finding suggests that the CON-DAN connections can be separated into two functionally dissociable yet spatially intertwined subsystems supporting different aspects of short-term task automatization. Copyright © 2017 Elsevier Inc. All rights reserved.

General practice and the Internet revolution. Use of an Internet social network to communicate information on prevention in France.

PubMed

Veuillotte, Isabelle; Morel, Gilles; Pitois, Stephane; Haler, Renaud; Mercier, Patricia; Aubry, Catherine; Cannet, Didier

2015-03-01

The popularity of social networks and the huge number of exchanges have made them immensely important for the communication of information. This French study explored prevention in hereditary breast cancer using a social Internet network to communicate information. The principal objective was to inform French women aged from 20 to 50 years, using the social network Facebook, about the warning signs of breast cancer in cases of a predisposition to the disease due to a genetic mutation. The secondary objectives were to inform people about screening. An information page entitled "hereditary breast cancer: and if I was concerned?" was distributed in 3 different ways: from friend to friend, via groups of persons, and by targeted advertising. Four articles and 11 messages were distributed over 27 days. The total number of visits for this period amounted to 1019. A total of 81 percent of the Internauts were women and 55 percent of the visitors were aged between 25 and 44 years. Other information campaigns concerning public health issues could be conducted using this tool. A legal framework is necessary to preserve the quality of the medical information provided. This new means of communication, used for prevention purposes, will add to other frequently used methods of communication. © The Author(s) 2013.

Overlapping Modularity at the Critical Point of k-Clique Percolation

NASA Astrophysics Data System (ADS)

Tóth, Bálint; Vicsek, Tamás; Palla, Gergely

2013-05-01

One of the most remarkable social phenomena is the formation of communities in social networks corresponding to families, friendship circles, work teams, etc. Since people usually belong to several different communities at the same time, the induced overlaps result in an extremely complicated web of the communities themselves. Thus, uncovering the intricate community structure of social networks is a non-trivial task with great potential for practical applications, gaining a notable interest in the recent years. The Clique Percolation Method (CPM) is one of the earliest overlapping community finding methods, which was already used in the analysis of several different social networks. In this approach the communities correspond to k-clique percolation clusters, and the general heuristic for setting the parameters of the method is to tune the system just below the critical point of k-clique percolation. However, this rule is based on simple physical principles and its validity was never subject to quantitative analysis. Here we examine the quality of the partitioning in the vicinity of the critical point using recently introduced overlapping modularity measures. According to our results on real social and other networks, the overlapping modularities show a maximum close to the critical point, justifying the original criteria for the optimal parameter settings.

Cloud Image Data Center for Healthcare Network in Taiwan.

PubMed

Weng, Shao-Jen; Lai, Lai-Shiun; Gotcher, Donald; Wu, Hsin-Hung; Xu, Yeong-Yuh; Yang, Ching-Wen

2016-04-01

This paper investigates how a healthcare network in Taiwan uses a practical cloud image data center (CIDC) to communicate with its constituent hospital branches. A case study approach was used. The study was carried out in the central region of Taiwan, with four hospitals belonging to the Veterans Hospital healthcare network. The CIDC provides synchronous and asynchronous consultation among these branches. It provides storage, platforms, and services on demand to the hospitals. Any branch-client can pull up the patient's medical images from any hospital off this cloud. Patients can be examined at the branches, and the images and reports can be further evaluated by physicians in the main Taichung Veterans General Hospital (TVGH) to enhance the usage and efficiency of equipment in the various branches, thereby shortening the waiting time of patients. The performance of the CIDC over 5 years shows: (1) the total number of cross-hospital images accessed with CDC in the branches was 132,712; and (2) TVGH assisted the branches in keying in image reports using the CIDC 4,424 times; and (3) Implementation of the system has improved management, efficiency, speed and quality of care. Therefore, the results lead to the recommendation of continuing and expanding the cloud computing architecture to improve information sharing among branches in the healthcare network.