Energy Digest.

ERIC Educational Resources Information Center

Gaddy, Carol T., Ed.; Wells, Kathy, Ed.

This collection of reprints offers practical solutions, not readily available elsewhere, to everyday energy problems, such as high utility bills, insulating windows, getting more gas mileage, or buying a more efficient washer or refrigerator. The Arkansas Energy Office provides a weekly column of energy news and conservation tips to newspapers,…

C style guide

NASA Technical Reports Server (NTRS)

Doland, Jerry; Valett, Jon

1994-01-01

This document discusses recommended practices and style for programmers using the C language in the Flight Dynamics Division environment. Guidelines are based on generally recommended software engineering techniques, industry resources, and local convention. The Guide offers preferred solutions to common C programming issues and illustrates through examples of C Code.

What Is Evidence-Based Behavior Analysis?

PubMed Central

Smith, Tristram

2013-01-01

Although applied behavior analysts often say they engage in evidence-based practice, they express differing views on what constitutes “evidence” and “practice.” This article describes a practice as a service offered by a provider to help solve a problem presented by a consumer. Solving most problems (e.g., increasing or decreasing a behavior and maintaining this change) requires multiple intervention procedures (i.e., a package). Single-subject studies are invaluable in investigating individual procedures, but researchers still need to integrate the procedures into a package. The package must be standardized enough for independent providers to replicate yet flexible enough to allow individualization; intervention manuals are the primary technology for achieving this balance. To test whether the package is effective in solving consumers' problems, researchers must evaluate outcomes of the package as a whole, usually in group studies such as randomized controlled trials. From this perspective, establishing an evidence-based practice involves more than analyzing the effects of discrete intervention procedures on behavior; it requires synthesizing information so as to offer thorough solutions to problems. Recognizing the need for synthesis offers behavior analysts many promising opportunities to build on their existing research to increase the quality and quantity of evidence-based practices. PMID:25729130

Innovative Approaches in Chronic Disease Management: Health Literacy Solutions and Opportunities for Research Validation.

PubMed

Villaire, Michael; Gonzalez, Diana Peña; Johnson, Kirby L

2017-01-01

This chapter discusses the need for innovative health literacy solutions to combat extensive chronic disease prevalence and costs. The authors explore the intersection of chronic disease management and health literacy. They provide specific examples of successful health literacy interventions for managing several highly prevalent chronic diseases. This is followed by suggestions on pairing research and practice to support effective disease management programs. In addition, the authors discuss strategies for collection and dissemination of knowledge gained from collaborations between researchers and practitioners. They identify current challenges specific to disseminating information from the health literacy field and offer potential solutions. The chapter concludes with a brief look at future directions and organizational opportunities to integrate health literacy practices to address the need for effective chronic disease management.

Automating Phase Change Lines and Their Labels Using Microsoft Excel(R).

PubMed

Deochand, Neil

2017-09-01

Many researchers have rallied against drawn in graphical elements and offered ways to avoid them, especially regarding the insertion of phase change lines (Deochand, Costello, & Fuqua, 2015; Dubuque, 2015; Vanselow & Bourret, 2012). However, few have offered a solution to automating the phase labels, which are often utilized in behavior analytic graphical displays (Deochand et al., 2015). Despite the fact that Microsoft Excel® is extensively utilized by behavior analysts, solutions to resolve issues in our graphing practices are not always apparent or user-friendly. Considering the insertion of phase change lines and their labels constitute a repetitious and laborious endeavor, any minimization in the steps to accomplish these graphical elements could offer substantial time-savings to the field. The purpose of this report is to provide an updated way (and templates in the supplemental materials) to add phase change lines with their respective labels, which stay embedded to the graph when they are moved or updated.

Strategies for Success: An Administrator's Guide to Writing.

ERIC Educational Resources Information Center

Yerkes, Diane; Morgan, Sharon

This booklet offers practical ideas, specific examples, and realistic solutions to the most common writing problems that administrators face. The booklet's four chapters are: (1) Writing Basics (ideas on organization, reasons to write, writers' responsibilities, getting personal, and writing for a particular occasion); (2) Getting Started (getting…

Effective Recruitment of Schools for Randomized Clinical Trials: Role of School Nurses.

PubMed

Petosa, R L; Smith, L

2017-01-01

In school settings, nurses lead efforts to improve the student health and well-being to support academic success. Nurses are guided by evidenced-based practice and data to inform care decisions. The randomized controlled trial (RCT) is considered the gold standard of scientific rigor for clinical trials. RCTs are critical to the development of evidence-based health promotion programs in schools. The purpose of this article is to present practical solutions to implementing principles of randomization to RCT trials conducted in school settings. Randomization is a powerful sampling method used to build internal and external validity. The school's daily organization and educational mission provide several barriers to randomization. Based on the authors' experience in conducting school-based RCTs, they offer a host of practical solutions to working with schools to successfully implement randomization procedures. Nurses play a critical role in implementing RCTs in schools to promote rigorous science in support of evidence-based practice.

Development of Contemporary Problem-Based Learning Projects in Particle Technology

ERIC Educational Resources Information Center

Harris, Andrew T.

2009-01-01

The University of Sydney has offered an undergraduate course in particle technology using a contemporary problem based learning (PBL) methodology since 2005. Student learning is developed through the solution of complex, open-ended problems drawn from modern chemical engineering practice. Two examples are presented; i) zero emission electricity…

What's Really Wrong with Ethnography?

ERIC Educational Resources Information Center

Banfield, Grant

2004-01-01

In asking the provocative question: "What's wrong with ethnography?" Hammersley draws attention to what he sees as the conceptual and methodological confusion arising from two competing strands of practice: "naive realism" and "relativism". As a solution, he offers "subtle realism" to steer a path through and beyond the confusion. This paper…

Applied Nutrition in Dental Education; Issues and Challenges.

ERIC Educational Resources Information Center

Palmer, Carole A.

1990-01-01

The status of nutrition programs in dental education and practice is reviewed, problems are analyzed, and solutions are offered. Problems include lack of well-defined policy guidelines, confusion over the state of scientific knowledge, and the scope of nutrition counseling. Among conclusions and recommendations are the need to emphasize clinical…

Breaking the Silence: Overcoming the Problem of Principal Mistreatment of Teachers.

ERIC Educational Resources Information Center

Blase, Joseph; Blase, Jo

This book exposes the various manifestations of mistreatment of teachers by principals, offering practical solutions for its prevention and correction. Information comes from a study involving interviews with elementary and secondary teachers from rural, suburban, and urban areas across the United States and Canada. The book provides tools…

Leading through Collaboration: Guiding Groups to Productive Solutions

ERIC Educational Resources Information Center

Glaser, John P.

2004-01-01

Any group has the potential for mistrust, suspicion, and rancor, and so effective leadership involves developing attitudes that guide groups to recognize and work through conflict in order to maximize the potential for collaboration. This book offers practical guidance to leaders encountering conflict in their organizations. Based on years of…

Effective Discipline in the Home and School.

ERIC Educational Resources Information Center

Painter, Genevieve; Corsini, Raymond J.

Based originally on the work of the Austrian psychiatrist, Alfred Adler, work which was further developed by Rudolph Dreikurs, this book Dreikurs, this book offers solutions to specific child discipline problems. Part I focuses on effective discipline in the home. These topics are covered: fundamentals of practical parenting; problems of routine…

Helping Anxious Students Move Forward

ERIC Educational Resources Information Center

Minahan, Jessica

2018-01-01

Students with anxiety are prone to giving up a difficult work assignment before they even start it. So how can teachers help these students develop skills to successfully start and finish assignments and succeed in school? Behavioral analyst Jessica Minahan offers some practical solutions that teachers can implement in the classroom to motivate…

Organizational management practices for achieving software process improvement

NASA Technical Reports Server (NTRS)

Kandt, Ronald Kirk

2004-01-01

The crisis in developing software has been known for over thirty years. Problems that existed in developing software in the early days of computing still exist today. These problems include the delivery of low-quality products, actual development costs that exceed expected development costs, and actual development time that exceeds expected development time. Several solutions have been offered to overcome out inability to deliver high-quality software, on-time and within budget. One of these solutions involves software process improvement. However, such efforts often fail because of organizational management issues. This paper discusses business practices that organizations should follow to improve their chances of initiating and sustaining successful software process improvement efforts.

Sharpen your science communication skills at a Fall Meeting workshop

NASA Astrophysics Data System (ADS)

Adams, Mary Catherine

2012-10-01

Are you eager to share your research and want to help reporters get it right? Do you yearn to enter the climate science debate but are wary of saying the wrong thing? AGU is offering two separate communications skill-building events on Sunday, 2 December 2012, for Fall Meeting attendees wishing to sharpen their communications skills. For scientists interested in talking about climate science, AGU and the Union of Concerned Scientists, an organization that combines scientific research with citizen action to create practical solutions for a healthy environment and a safer world, will offer the Communicating Climate Science Workshop on Sunday morning. A panel of experienced communicators will share their success stories and offer advice on how to avoid common missteps. Then, in an interactive workshop setting, attendees will practice identifying and effectively responding to misinformation about climate science in front of a variety of audiences.

Moral dilemmas in medical school admission.

PubMed

Self, D J

1990-03-01

The wide range of complex moral and ethical issues of medical school admission committees are seldom publicly acknowledged, reflected upon, analyzed, or discussed, although they are faced regularly. Three cases are presented that illustrate some of the common and unusual moral dilemmas in the admission process. These issues and several practical strategies for ethical decision making are discussed, along with their limitations and weaknesses. These practical strategies are applied to the three cases to see what solutions might be offered.

Burnout in the Helping Professions: Mutual Aid Groups as Self-Help.

ERIC Educational Resources Information Center

Spicuzza, Frank J.; De Voe, Marianne W.

1982-01-01

Offers some insight and understanding of the stress-producing components of counseling practice. Discusses some of the physical symptoms of burnout and examines why the syndrome is prevalent in the human services. Proposes the development of mutual aid groups as one solution to prevent or minimize burnout. (Author/RC)

Evaluation of holonomic quantum computation: adiabatic versus nonadiabatic.

PubMed

Cen, LiXiang; Li, XinQi; Yan, YiJing; Zheng, HouZhi; Wang, ShunJin

2003-04-11

Based on the analytical solution to the time-dependent Schrödinger equations, we evaluate the holonomic quantum computation beyond the adiabatic limit. Besides providing rigorous confirmation of the geometrical prediction of holonomies, the present dynamical resolution offers also a practical means to study the nonadiabaticity induced effects for the universal qubit operations.

Learning from the Experts: Teacher Leaders on Solving America's Education Challenges

ERIC Educational Resources Information Center

Coggins, Celine, Ed.; Peske, Heather G., Ed.; McGovern, Kate, Ed.

2013-01-01

"Learning from the Experts" offers an intimate look at the ways education policies collide with everyday classroom practices and illustrates how thoughtful, solutions-oriented and results-driven teachers are reframing debates in education today. Early career teachers now make up a "new majority" (52 percent) of the workforce.…

Multimedia in Higher Education: A Practical Guide to New Tools for Interactive Teaching and Learning.

ERIC Educational Resources Information Center

Falk, Dennis R.; Carlson, Helen L.

This book is designed to offer an overall paradigm for designing instruction related to multimedia. Each chapter explores the paradigm through literature reviews, lists of pertinent questions, case studies, guidelines, and resource suggestions. The first two parts discuss defining an instructional problem and generating solutions via multimedia…

After the Workshop: A Case Study of Post-Workshop Implementation of Active Learning in an Electrical Engineering Course

ERIC Educational Resources Information Center

Shekhar, Prateek; Maura Borrego

2017-01-01

Engineering education research has empirically validated the effectiveness of active learning over traditional instructional methods. However, the dissemination of education research into instructional practice has been slow. Faculty workshops for current and future instructors offer a solution to promote the widespread adoption of active learning…

Increasing Career Self-Efficacy through Group Work with Culturally and Linguistically Diverse Students

ERIC Educational Resources Information Center

Mitcham, Michelle; Greenidge, Wendy-lou; Bradham-Cousar, Michelle; Figliozzi, Jennifer; Thompson, Mary Ann

2012-01-01

Group counseling is a practical way for school counselors to deliver career services. School counselors face competing demands on their time coupled with the problematic student to counselor ratios that often exist in schools, group counseling thereby offers a pragmatic solution. This article provides implications for implementing group counseling…

Family Feathers. [Videotape Series].

ERIC Educational Resources Information Center

1999

Family Feathers is a set of 18 videotapes for parents of preschool children, created by the Alaska Native Home Base Video Project of the Tlingit and Haida Head Start Program. This series offers culturally relevant solutions to the challenges of parenting, drawing on practical advice from Tlingit and Haida parents, wisdom from elders, and some of…

Creating a Global Agenda: Assessments, Solutions, and Action Plans.

ERIC Educational Resources Information Center

Didsbury, Howard F., Jr., Ed.

Designed for educational policymakers and researchers, this volume on global issues is divided into four sections. The four essays in the first section, "Reducing the Nuclear Peril," offer a brief documentary survey and then present practical suggestions and action plans to reduce the nuclear threat. The eight papers in the second…

Letting Go: A Parents' Guide to Today's College Experience.

ERIC Educational Resources Information Center

Coburn, Karen Levin; Treeger, Madge Lawrence

Acknowledging that college life has changed dramatically over the last 20 years, this book tells parents what to expect as their children leave home. Beginning with the college admissions process, practical solutions are offered for specific problems. Topics covered include: basic issues every family should discuss before the student leaves for…

Generalist solutions to overprescribing: a joint challenge for clinical and academic primary care.

PubMed

Reeve, Joanne; Bancroft, Rebecca

2014-01-01

Polypharmacy is a phenomenon of modern health care that can offer benefits in terms of patient outcomes. Known risks associated with so-called inappropriate polypharmacy can be reduced through good medicine management and appropriate use of clinical guidelines. However, we now see a growing literature highlighting additional risks to individual well-being and social functioning not recognised within these existing frameworks - the burden of polypharmacy and a problem of overprescribing. We need a new approach to defining and understanding inappropriate polypharmacy from a person-centred perspective. This paper discusses practice-based work exploring the impact of introducing generalist needs assessment for elderly patients with multiple chronic morbidities. The work suggests that generalist care offers something 'different' to current chronic disease management models, but highlights the need for formal evaluation to determine whether it is 'better'. We call for new collaborative research between clinical and academic partners to address the question as to whether generalist care offers solutions to the problems of the burden of polypharmacy.

A rational approach to the selection of useful drugs for clinical practice.

PubMed

Spector, Reynold; Vesell, Elliot S

2002-05-01

Confusion exists concerning optimal selection of drugs for clinical practice. Many reasons contribute to this confusion which derives from various sources including industry, the FDA and often less than ideal education of physicians in clinical pharmacology during medical school and thereafter. This presentation does not focus on allocating blame for the current unsatisfactory situation, but rather offers a solution to improve drug therapy. Our educational solution consists of a paradigm for rational drug therapy, specifically a checklist of eight criteria for physicians to review before prescribing drugs. Such a review would facilitate better estimation by physicians of risk/benefit ratios involving new, often expensive and, in some cases, questionably effective and safe drugs. Copyright 2002 S. Karger AG, Basel

Applying the Israeli Practice of Reconstruction Following a Terrorist Attack as a Model for Cities in the United States

DTIC Science & Technology

2013-03-01

22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY (Leave blank... innovation are offered the solutions to counter decreased resources and funding. “ Foresight tells us that the future will challenge us to be even... auditing process to identify any inappropriate practices and conduct, however, they do not sustain the system in any traditional way and would serve only

Harnessing collaborative technology to accelerate achievement of chronic disease management objectives for Canada.

PubMed

Thompson, Leslee J; Healey, Lindsay; Falk, Will

2007-01-01

Morgan and colleagues put forth a call to action for the transformation of the Canadian healthcare system through the adoption of a national chronic disease prevention and management (CDPM) strategy. They offer examples of best practices and national solutions including investment in clinical information technologies to help support improved care and outcomes. Although we acknowledge that the authors propose CDPM solutions that are headed in the right direction, more rapid deployment of solutions that harness the potential of advanced collaborative technologies is required. We provide examples of how technologies that exist today can help to accelerate the achievement of some key CDPM objectives.

Generalist solutions to complex problems: generating practice-based evidence - the example of managing multi-morbidity

PubMed Central

2013-01-01

Background A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Discussion Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a ‘complex intervention’ (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Summary Answers to the complex problem of multi-morbidity won’t come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity. PMID:23919296

Generalist solutions to complex problems: generating practice-based evidence--the example of managing multi-morbidity.

PubMed

Reeve, Joanne; Blakeman, Tom; Freeman, George K; Green, Larry A; James, Paul A; Lucassen, Peter; Martin, Carmel M; Sturmberg, Joachim P; van Weel, Chris

2013-08-07

A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a 'complex intervention' (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Answers to the complex problem of multi-morbidity won't come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity.

The Nitty-Gritty Classroom and Behavior Management Resource: Strategies, Reproducibles, and Tips for Teachers

ERIC Educational Resources Information Center

Tetteris, Belinda Christine

2006-01-01

This book will help teachers better relate to, understand, and love their job by providing a professional resource that contains innovative ideas, visuals, and reproducibles that can be referenced quickly to help make the job easier. This comprehensive resource offers practical teaching techniques, solutions, and tips on: (1) Planning and…

The Nitty-Gritty Classroom and Behavior Management Resource: Strategies, Reproducibles, and Tips for Teachers

ERIC Educational Resources Information Center

Tetteris, Belinda Christine

2006-01-01

This book will help teachers better relate to, understand, and love their job. This is a professional resource that contains innovative ideas, visuals, and reproducibles that can be referenced quickly to help make the job easier. This comprehensive resource offers practical teaching techniques, solutions, and tips on: (1) Planning and designing…

Challenges Inherent in the Design and Implementation of After-School Intervention Programs for Middle Grade Underachieving Readers

ERIC Educational Resources Information Center

Velten, Justin; Mokhtari, Kouider

2016-01-01

In this brief report, we share three challenges we encountered when designing and implementing an after school intervention program for an ethnically diverse group of middle grade underachieving readers. We also offer practical solutions to help guide middle school teams in anticipating and addressing potential problems when putting in place…

Sexual Harassment Solutions at Work. Profiles of Successful Policy and Practice.

ERIC Educational Resources Information Center

Phelan, Colleen

This publication profiles the successful efforts of eight organizations to develop programs and policies to prevent sexual harassment in their workplaces. The profiles highlight a facet of each organization's efforts. An introduction offers a blueprint for action. The first profile is a look at US West and the key elements for developing and…

Interactive Learning with Java Applets: Using Interactive, Web-Based Java Applets to Present Science in a Concrete, Meaningful Manner

ERIC Educational Resources Information Center

Corder, Greg

2005-01-01

Science teachers face challenges that affect the quality of instruction. Tight budgets, limited resources, school schedules, and other obstacles limit students' opportunities to experience science that is visual and interactive. Incorporating web-based Java applets into science instruction offers a practical solution to these challenges. The…

An Old Problem with a New Solution, Raising Classical Questions: A Commentary on Humphry

ERIC Educational Resources Information Center

Heene, Moritz

2011-01-01

Humphry (this issue) deserves credit for drawing attention to the long-neglected fact that differences in item discrimination parameters are often due to empirical factors and not the product of random error components. In doing so, Humphry offers a psychometrically elegant, coherent, and practically important new model that is more flexible while…

Single Parenting from a Father's Heart. A Back-to-Basics Guide for Both Sexes.

ERIC Educational Resources Information Center

Horner, Steve

This book addresses the void in father-oriented parenting material by offering, from a father's point of view, practical, thoughtful, and inspiring solutions to help single parents and their children be more effective, productive, and content. The book's chapters are: (1) "Dedication Comes First," covering such topics as how parents view…

The role and management implications of modeling owl populations and the habitats they occupy

Treesearch

Amy E. Kearns

1997-01-01

Modeling ecosystems is an evolving science that is both practical and theoretical. The integration of modeling, landscape ecology, management, and rapidly changing technology offers an array of possible solutions to modern environmental quandaries. In order to address these concerns, a workshop was developed to discuss the role and management implications of modeling...

Crowdfunding: an innovative way to fund your project.

PubMed

Walker, Dawn-Marie

2017-06-22

Background Getting research funded is extremely difficult, with research councils rejecting more than 70% of grant applications ( Else 2014 ). It is even more difficult if you are a junior researcher who doesn't have a track record of being awarded grant money or leading a research project. Crowdfunding may offer a solution. It is a method of raising funds from members of the public online and can offer an alternative to the more formal methods of research funding. Aim To outline how this model works and provide tips on designing a campaign. Discussion The authors provide an overview of the literature regarding this model, as well as a set of resources for future reference when designing a campaign. Conclusion Crowdfunding can provide small amounts of money for your first project. Implications for practice It is expected that clinicians practice evidence based medicine, and research in health environments is commonplace. Crowdfunding can offer you support in becoming more engaged in research.

Recruitment and retention of rural general practitioners: a marketing approach reveals new possibilities.

PubMed

Hemphill, Elizabeth; Dunn, Steve; Barich, Hayley; Infante, Rebecca

2007-12-01

This paper repositions the challenge of attracting and retaining rural GPs in a marketing context as a new focus for future research and policy development. Case study with mixed design of surveys of GPs and medical students and depth interviews with GPs, medical students, regional-division administrators and GP recruitment agents. GP recruitment and retention in the Limestone Coast region of South Australia. Twenty-seven Limestone Coast (LC) GPs; random sample of medical students from Adelaide University, Adelaide University Rural Health Society and Flinders University; snowball sampling two adjacent rural regions (20 GPs); and administrators from LC and adjacent regions and GP recruitment agencies in Adelaide. Drawing from marketing theory, creative suggestion of 'promotion of the practice and not the region' offers a means of GP recruitment and retention for structured succession planning for rural general practices. Structural attempts to broaden the GP market with overseas recruitment have done little for improving full-time equivalent GP levels. Market segmentation and market orientation offer a new emphasis on value exchange between the corporation (the practice), customer (GPs) and competition (all practices) to influence future mobility. A marketing orientation to the GP challenge emphasises individual's perceptions of value, GP expectations and practice offerings. Failure to acknowledge benefits of this marketing approach means that solutions such as those developed in the Limestone Coast region are unlikely. Research is now required to define GP satisfaction and value for long-term viability of general practices.

Reflective practice and its implications for pharmacy education.

PubMed

Tsingos, Cherie; Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-02-12

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.(1-2) Reflective practice activities encourage learning from the student's own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education.

Reflective Practice and Its Implications for Pharmacy Education

PubMed Central

Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-01-01

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.1-2 Reflective practice activities encourage learning from the student’s own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education. PMID:24558286

Activist engineering: changing engineering practice by deploying praxis.

PubMed

Karwat, Darshan M A; Eagle, Walter E; Wooldridge, Margaret S; Princen, Thomas E

2015-02-01

In this paper, we reflect on current notions of engineering practice by examining some of the motives for engineered solutions to the problem of climate change. We draw on fields such as science and technology studies, the philosophy of technology, and environmental ethics to highlight how dominant notions of apoliticism and ahistoricity are ingrained in contemporary engineering practice. We argue that a solely technological response to climate change does not question the social, political, and cultural tenet of infinite material growth, one of the root causes of climate change. In response to the contemporary engineering practice, we define an activist engineer as someone who not only can provide specific engineered solutions, but who also steps back from their work and tackles the question, What is the real problem and does this problem "require" an engineering intervention? Solving complex problems like climate change requires radical cultural change, and a significant obstacle is educating engineers about how to conceive of and create "authentic alternatives," that is, solutions that differ from the paradigm of "technologically improving" our way out of problems. As a means to realize radically new solutions, we investigate how engineers might (re)deploy the concept of praxis, which raises awareness in engineers of the inherent politics of technological design. Praxis empowers engineers with a more comprehensive understanding of problems, and thus transforms technologies, when appropriate, into more socially just and ecologically sensitive interventions. Most importantly, praxis also raises a radical alternative rarely considered-not "engineering a solution." Activist engineering offers a contrasting method to contemporary engineering practice and leads toward social justice and ecological protection through problem solving by asking not, How will we technologize our way out of the problems we face? but instead, What really needs to be done?

Finding Common Ground: Creating the Library of the Future without Diminishing the Library of the Past. The New Library Series.

ERIC Educational Resources Information Center

LaGuardia, Cheryl, Ed.; Mitchell, Barbara A., Ed.

Adapting today's libraries to better serve tomorrow's needs challenges even the most forward-thinking library staff. This book offers practical, workable solutions from several authorities in the industry. Fifty-five conference papers are included and divided into the following subject areas: "Technology and the Network: Daimons or Demons?";…

A Design-Based Research Case Study Documenting a Constructivist ID Process and Instructional Solution for a Cross-Cultural Workforce

ERIC Educational Resources Information Center

Tracey, Monica W.; Unger, Kelly L.

2012-01-01

As the need for instructing a globalized workforce increases, instructional designers must embrace the constraints and the opportunities these projects provide in order to move the field of cross-cultural instructional design (ID) forward. Cross-cultural projects offer multiple avenues for growth in ID practice, overcoming cultural barriers, and a…

Utopia: An Imaginative, Critical and Playful Dialogue on the Meaning and Practice of Contemporary Education

ERIC Educational Resources Information Center

Hayes, Michael T.; Marino, Matthew

2015-01-01

In this article the authors re-examine Sir Thomas More's classic book "Utopia" as a potential source of ideas and concepts for examining, understanding and imagining contemporary education. Too often the concept utopia is used to criticize an idea, perspective or image as offering a simplistic solution to a complex problem, or, at its…

Response Grids: Practical Ways to Display Large Data Sets with High Visual Impact

ERIC Educational Resources Information Center

Gates, Simon

2013-01-01

Spreadsheets are useful for large data sets but they may be too wide or too long to print as conventional tables. Response grids offer solutions to the challenges posed by any large data set. They have wide application throughout science and for every subject and context where visual data displays are designed, within education and elsewhere.…

Education and Community: The Collaborative Solution. Proceedings of the International Conference Linking Research and Practice (Toronto, Ontario, Canada, March 3-5, 1994).

ERIC Educational Resources Information Center

Lawton, Stephen B., Ed.; Tanenzapt, Elaine, Ed.; Townsend, Richard G., Ed.

These proceedings are divided into two sections that explore collaboration between schools and communities. In Part I, the first four papers, analytic frameworks are described that provide different perspectives on collaboration. In Part II, descriptions of concrete programs and advice for developing better school-community relations are offered.…

[Basic research in traumatology and its contribution to routine operation].

PubMed

Hausner, T; Redl, H

2017-02-01

Basic research in traumatology supports the clinical outcome of patients in trauma care and tries to find science-based solutions for clinical problems. Furthermore, institutions for basic research in traumatology usually offer training in different skills, such as how to write a scientific paper, or practice in microsurgery or intubation. Two examples of clinically significant research topics are presented.

From Performance to Passionate Utterance: Rethinking the Purpose of Restorative Conference Scripts in Schools

ERIC Educational Resources Information Center

O'Reilly, Naziya

2017-01-01

In recent years restorative practice in schools has been heralded as a new paradigm for thinking about student behaviour. Its premise is to provide solutions to indiscipline, to restore relationships where there has been conflict or harm, and to give pupils a language with which to understand wrongdoing. This article offers a critique of…

Poverty and elimination of urban health disparities: challenge and opportunity.

PubMed

Thomas, Stephen B; Quinn, Sandra Crouse

2008-01-01

The aim of this article is to examine the intersection of race and poverty, two critical factors fueling persistent racial and ethnic health disparities among urban populations. From the morass of social determinants that shape the health of racial and ethnic communities in our urban centers, we will offer promising practices and potential solutions to eliminating racial and ethnic health disparities.

Parent-Infant Skin-to-Skin Contact Following Birth: History, Benefits, and Challenges.

PubMed

Hubbard, Jessie Marie; Gattman, Kindsey Rae

2017-03-01

It is a practice with strong roots in nature and has a significant influence on health outcomes, particularly for at-risk newborns in low-resource settings. In this comprehensive review, benefits of SSC for newborns, mothers, and fathers after vaginal and cesarean births are discussed as well as the benefits of SSC observed for infants in the NICU. Barriers to SSC practice implementation are discussed, and proposed solutions and recommendations are offered. By understanding the many benefits of SSC and strategies for implementation, health care providers can best support and promote this high-quality, evidence-based practice with mothers, newborns, and their families.

Maximum-performance fiber-optic irradiation with nonimaging designs.

PubMed

Fang, Y; Feuermann, D; Gordon, J M

1997-10-01

A range of practical nonimaging designs for optical fiber applications is presented. Rays emerging from a fiber over a restricted angular range (small numerical aperture) are needed to illuminate a small near-field detector at maximum radiative efficiency. These designs range from pure reflector (all-mirror), to pure dielectric (refractive and based on total internal reflection) to lens-mirror combinations. Sample designs are shown for a specific infrared fiber-optic irradiation problem of practical interest. Optical performance is checked with computer three-dimensional ray tracing. Compared with conventional imaging solutions, nonimaging units offer considerable practical advantages in compactness and ease of alignment as well as noticeably superior radiative efficiency.

Fundamental care guided by the Careful Nursing Philosophy and Professional Practice Model©.

PubMed

Meehan, Therese Connell; Timmins, Fiona; Burke, Jacqueline

2018-02-05

To propose the Careful Nursing Philosophy and Professional Practice Model © as a conceptual and practice solution to current fundamental nursing care erosion and deficits. There is growing awareness of the crucial importance of fundamental care. Efforts are underway to heighten nurses' awareness of values that motivate fundamental care and thereby increase their attention to effective provision of fundamental care. However, there remains a need for nursing frameworks which motivate nurses to bring fundamental care values to life in their practice and strengthen their commitment to provide fundamental care. This descriptive position paper builds on the Careful Nursing Philosophy and Professional Practice Model © (Careful Nursing). Careful Nursing elaborates explicit nursing values and addresses both relational and pragmatic aspects of nursing practice, offering an ideal guide to provision of fundamental nursing care. A comparative alignment approach is used to review the capacity of Careful Nursing to address fundamentals of nursing care. Careful Nursing provides a value-based comprehensive and practical framework which can strengthen clinical nurses' ability to articulate and control their practice and, thereby, more effectively fulfil their responsibility to provide fundamental care and measure its effectiveness. This explicitly value-based nursing philosophy and professional practice model offers nurses a comprehensive, pragmatic and engaging framework designed to strengthen their control over their practice and ability to provide high-quality fundamental nursing care. © 2018 John Wiley & Sons Ltd.

Page turning solutions for musicians: a survey.

PubMed

Wolberg, George; Schipper, Irene

2012-01-01

Musicians have long been hampered by the challenge in turning sheet music while their hands are occupied playing an instrument. The sight of a human page turner assisting a pianist during a performance, for instance, is not uncommon. This need for a page turning solution is no less acute during practice sessions, which account for the vast majority of playing time. Despite widespread appreciation of the problem, there have been virtually no robust and affordable products to assist the musician. Recent progress in assistive technology and electronic reading devices offers promising solutions to this long-standing problem. The objective of this paper is to survey the technology landscape and assess the benefits and drawbacks of page turning solutions for musicians. A full range of mechanical and digital page turning products are reviewed.

Claims and Identity: On-Premise and Cloud Solutions

NASA Astrophysics Data System (ADS)

Bertocci, Vittorio

Today's identity-management practices are often a patchwork of partial solutions, which somehow accommodate but never really integrate applications and entities separated by technology and organizational boundaries. The rise of Software as a Service (SaaS) and cloud computing, however, will force organizations to cross such boundaries so often that ad hoc solutions will simply be untenable. A new approach that tears down identity silos and supports a de-perimiterized IT by design is in order.This article will walk you through the principles of claims-based identity management, a model which addresses both traditional and cloud scenarios with the same efficacy. We will explore the most common token exchange patterns, highlighting the advantages and opportunities they offer when applied on cloud computing solutions and generic distributed systems.

A colour-tunable, weavable fibre-shaped polymer light-emitting electrochemical cell

NASA Astrophysics Data System (ADS)

Zhang, Zhitao; Guo, Kunping; Li, Yiming; Li, Xueyi; Guan, Guozhen; Li, Houpu; Luo, Yongfeng; Zhao, Fangyuan; Zhang, Qi; Wei, Bin; Pei, Qibing; Peng, Huisheng

2015-04-01

The emergence of wearable electronics and optoelectronics requires the development of devices that are not only highly flexible but can also be woven into textiles to offer a truly integrated solution. Here, we report a colour-tunable, weavable fibre-shaped polymer light-emitting electrochemical cell (PLEC). The fibre-shaped PLEC is fabricated using all-solution-based processes that can be scaled up for practical applications. The design has a coaxial structure comprising a modified metal wire cathode and a conducting aligned carbon nanotube sheet anode, with an electroluminescent polymer layer sandwiched between them. The fibre shape offers unique and promising advantages. For example, the luminance is independent of viewing angle, the fibre-shaped PLEC can provide a variety of different and tunable colours, it is lightweight, flexible and wearable, and it can potentially be woven into light-emitting clothes for the creation of smart fabrics.

Stitch in the side: causes, workup, and solutions.

PubMed

Eichner, E Randy

2006-12-01

Side stitch is an acute, localized, sharp, transient pain that occurs during exercise, most often in runners or swimmers, but also in those participating in team sports, and less often in cyclists. The pain is vexing and performance-limiting, but fleeting and benign. Three theories compete to explain it: diaphragmatic ischemia, stress on peritoneal ligaments, and irritation of the parietal peritoneum. The differential diagnosis seems broad, but the classic side stitch is so unique in its features and setting that a reasonable working diagnosis can be made from a careful history and physical examination. Practical tips, although anecdotal, offer lasting solutions.

Continuous-variable quantum computing on encrypted data.

PubMed

Marshall, Kevin; Jacobsen, Christian S; Schäfermeier, Clemens; Gehring, Tobias; Weedbrook, Christian; Andersen, Ulrik L

2016-12-14

The ability to perform computations on encrypted data is a powerful tool for protecting a client's privacy, especially in today's era of cloud and distributed computing. In terms of privacy, the best solutions that classical techniques can achieve are unfortunately not unconditionally secure in the sense that they are dependent on a hacker's computational power. Here we theoretically investigate, and experimentally demonstrate with Gaussian displacement and squeezing operations, a quantum solution that achieves the security of a user's privacy using the practical technology of continuous variables. We demonstrate losses of up to 10 km both ways between the client and the server and show that security can still be achieved. Our approach offers a number of practical benefits (from a quantum perspective) that could one day allow the potential widespread adoption of this quantum technology in future cloud-based computing networks.

Continuous-variable quantum computing on encrypted data

PubMed Central

Marshall, Kevin; Jacobsen, Christian S.; Schäfermeier, Clemens; Gehring, Tobias; Weedbrook, Christian; Andersen, Ulrik L.

2016-01-01

The ability to perform computations on encrypted data is a powerful tool for protecting a client's privacy, especially in today's era of cloud and distributed computing. In terms of privacy, the best solutions that classical techniques can achieve are unfortunately not unconditionally secure in the sense that they are dependent on a hacker's computational power. Here we theoretically investigate, and experimentally demonstrate with Gaussian displacement and squeezing operations, a quantum solution that achieves the security of a user's privacy using the practical technology of continuous variables. We demonstrate losses of up to 10 km both ways between the client and the server and show that security can still be achieved. Our approach offers a number of practical benefits (from a quantum perspective) that could one day allow the potential widespread adoption of this quantum technology in future cloud-based computing networks. PMID:27966528

Continuous-variable quantum computing on encrypted data

NASA Astrophysics Data System (ADS)

Marshall, Kevin; Jacobsen, Christian S.; Schäfermeier, Clemens; Gehring, Tobias; Weedbrook, Christian; Andersen, Ulrik L.

2016-12-01

The ability to perform computations on encrypted data is a powerful tool for protecting a client's privacy, especially in today's era of cloud and distributed computing. In terms of privacy, the best solutions that classical techniques can achieve are unfortunately not unconditionally secure in the sense that they are dependent on a hacker's computational power. Here we theoretically investigate, and experimentally demonstrate with Gaussian displacement and squeezing operations, a quantum solution that achieves the security of a user's privacy using the practical technology of continuous variables. We demonstrate losses of up to 10 km both ways between the client and the server and show that security can still be achieved. Our approach offers a number of practical benefits (from a quantum perspective) that could one day allow the potential widespread adoption of this quantum technology in future cloud-based computing networks.

Numerical Solution for Navier-Stokes Equations

NASA Technical Reports Server (NTRS)

Warsi, Z. U. A.; Weed, R. A.; Thompson, J. F.

1982-01-01

Carefully selected blend of computational techniques solves complete set of equations for viscous, unsteady, hypersonic flow in general curvilinear coordinates. New algorithm has tested computation of axially directed flow about blunt body having shape similar to that of such practical bodies as wide-body aircraft or artillery shells. Method offers significant computational advantages because of conservation-law form of equations and because it reduces amount of metric data required.

Workflow for Integrating Mesoscale Heterogeneities in Materials Structure with Process Simulation of Titanium Alloys (Postprint)

DTIC Science & Technology

2014-10-01

offer a practical solution to calculating the grain -scale hetero- geneity present in the deformation field. Consequently, crystal plasticity models...process/performance simulation codes (e.g., crystal plasticity finite element method). 15. SUBJECT TERMS ICME; microstructure informatics; higher...iii) protocols for direct and efficient linking of materials models/databases into process/performance simulation codes (e.g., crystal plasticity

Fashion design solutions for environmentally conscious consumers

NASA Astrophysics Data System (ADS)

Wagner, M.; Chen, Y.; Curteza, A.; Thomassey, S.; Perwuelz, A.; Zeng, X.

2017-10-01

This paper intends to give an overview of the design solutions in fashion for environmentally conscious consumers, presenting green and ethical practices in contemporary clothing design. The results introduce the concept of slow fashion and discuss available fashion design solutions, giving most prominent examples of sustainable products and brands, these contain one or more design features. By this, the discussion extracts the main contemporary ideas. The presented examples of current offers are all envisioning less impact on the environment and society. Sustainable design solutions use more environmentally friendly materials such as organic cotton, incorporate circular design or design for recycling, e.g., replacing button closures with alternative closing possibilities or leather labels with printed versions, or ensure long product life through durability, among other methods. There are differing designs due to creators’ individuality. This overview can be beneficial for the future development of new solutions for more environmentally friendly fashion.

Digital communication between clinician and patient and the impact on marginalised groups: a realist review in general practice.

PubMed

Huxley, Caroline J; Atherton, Helen; Watkins, Jocelyn Anstey; Griffiths, Frances

2015-12-01

Increasingly, the NHS is embracing the use of digital communication technology for communication between clinicians and patients. Policymakers deem digital clinical communication as presenting a solution to the capacity issues currently faced by general practice. There is some concern that these technologies may exacerbate existing inequalities in accessing health care. It is not known what impact they may have on groups who are already marginalised in their ability to access general practice. To assess the potential impact of the availability of digital clinician-patient communication on marginalised groups' access to general practice in the UK. Realist review in general practice. A four-step realist review process was used: to define the scope of the review; to search for and scrutinise evidence; to extract and synthesise evidence; and to develop a narrative, including hypotheses. Digital communication has the potential to overcome the following barriers for marginalised groups: practical access issues, previous negative experiences with healthcare service/staff, and stigmatising reactions from staff and other patients. It may reduce patient-related barriers by offering anonymity and offers advantages to patients who require an interpreter. It does not impact on inability to communicate with healthcare professionals or on a lack of candidacy. It is likely to work best in the context of a pre-existing clinician-patient relationship. Digital communication technology offers increased opportunities for marginalised groups to access health care. However, it cannot remove all barriers to care for these groups. It is likely that they will remain disadvantaged relative to other population groups after their introduction. © British Journal of General Practice 2015.

Private sector approaches to workforce enhancement.

PubMed

Wendling, Wayne R

2010-06-01

This paper addresses the private practice model of dental care delivery in the US. The great majority of dental care services are delivered through this model and thus changes in the model represent a means to substantially change the supply and availability of dental services. The two main forces that change how private practices function are broad economic factors, which alter the demand for dental care and innovations in practice structure and function which alter the supply and cost of services. Economics has long recognized that although there are private market solutions for many issues, not all problems can be addressed through this model. The private practice of dentistry is a private market solution that works for a substantial share of the market. However, the private market may not work to resolve all issues associated with access and utilization. Solutions for some problems call for creative private - public arrangements - another form of innovation; and market-based solutions may not be feasible for each and every problem. This paper discusses these economic factors and innovation as they relate to the private practice of dentistry, with special emphasis on those elements that have increased the capacity of the dental practice to offer services to those with limited means to access fee-based care. Innovations are frequently described as new care delivery models or new workforce models. However, innovation can occur on an ongoing and regular basis as dental practices examine new ways to combine capital and human resources and to leverage the education and skill of the dentists to a greater number of patients. Innovation occurs within a market context as the current and projected economic returns reward the innovation. Innovation can also occur through private-public arrangements. There are indications of available capacity within the existing delivery system to expand service delivery. The Michigan Medicaid Healthy Kids Dental program is discussed as one example of how dental services to Medicaid insured children were effectively expanded using the private practice model.

Responsive Persistence Part II. Practices of Postmodern Therapists.

PubMed

Sutherland, Olga; Dienhart, Anna; Turner, Jean

2013-10-01

This article, a companion to Part I of this series of articles, discusses how therapists informed by social constructionist and postmodern ideas enact persistence in their work with families. Transcripts and video-recordings of therapy interaction facilitated by selected major champions for three postmodern (collaborative) therapies: Michael White (narrative therapy), Harlene Anderson (collaborative language systems approach), and Bill O'Hanlon (solution-oriented therapy) were examined for persistence practices. The article offers a range of possible ways in which postmodern therapists may enact their influence in facilitating generative and helpful conversations with families and remain responsive to clients' preferences and understandings. Implications for family therapy practice, training, and supervision are discussed. © 2013 American Association for Marriage and Family Therapy.

Regenerative Rehabilitation – a New Future?

PubMed Central

Perez-Terzic, Carmen; Childers, Martin K.

2014-01-01

Modern rehabilitation medicine is propelled by newfound knowledge aimed at offering solutions for an increasingly aging population afflicted by chronic debilitating conditions. Considered a core component of future healthcare, the roll-out of regenerative medicine underscores a paradigm shift in patient management targeted at restoring physiologic function and restituting normative impact. Nascent regenerative technologies offer unprecedented prospects in achieving repair of degenerated, diseased or damaged tissues. In this context, principles of regenerative science are increasingly integrated in rehabilitation practices as illustrated in the present Supplement. Encompassing a growing multidisciplinary domain, the emergent era of “regenerative rehabilitation” brings radical innovations at the forefront of healthcare blueprints. PMID:25310603

Analytic solution of magnetic induction distribution of ideal hollow spherical field sources

NASA Astrophysics Data System (ADS)

Xu, Xiaonong; Lu, Dingwei; Xu, Xibin; Yu, Yang; Gu, Min

2017-12-01

The Halbach type hollow spherical permanent magnet arrays (HSPMA) are volume compacted, energy efficient field sources, and capable of producing multi-Tesla field in the cavity of the array, which have attracted intense interests in many practical applications. Here, we present analytical solutions of magnetic induction to the ideal HSPMA in entire space, outside of array, within the cavity of array, and in the interior of the magnet. We obtain solutions using concept of magnetic charge to solve the Poisson's and Laplace's equations for the HSPMA. Using these analytical field expressions inside the material, a scalar demagnetization function is defined to approximately indicate the regions of magnetization reversal, partial demagnetization, and inverse magnetic saturation. The analytical field solution provides deeper insight into the nature of HSPMA and offer guidance in designing optimized one.

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

Utilization of Telehealth Technology to Develop and Implement a Comprehensive Management Initiative for Chronic Diseases

DTIC Science & Technology

2010-10-21

involving oral or injectable regimens for type 2 diabetes, alone or in various combinations . The program indicates which dose or doses of medications...educational access. Virtual diabetes education techniques that combine best educational practices with telehealth technology offer a promising solution to...patterns over time, so we combined these two groups to simplify interpretation of the results. The analyses tested for group differences in

The Genesis of Cyberscience and its Mathematical Models (CYBERSCIENCE)

DTIC Science & Technology

2005-02-01

Of course, the idea of maintaining a complete development record has other advantages , and has frequently been proposed in the past as a solution to...system development. There is no question that this offers certain advantages . For exam- ple, if systems that satisfy a standard frequently prove...some substantial practical advantages . First, providing wildly 2Unfortunately, this terminology has not been standardized. For example, in the Safety

Universal prescriptivism: traditional moral decision-making theory revisited.

PubMed

Crigger, N J

1994-09-01

Universal prescriptivism is a recently developed moral decision-making theory that combines utilitarian and Kantian theories with two levels of moral thinking. A combined approach offers a creative solution to the weaknesses inherent in traditional moral theories. The paper describes the theory and discusses important implications for nursing education, practical ethical decision-making, and research. The relationship of an ethical theory of caring to traditional moral theory is discussed.

Survival Skills for the Principalship: A Treasure Chest of Time-Savers, Short-Cuts, and Strategies to Help You Keep a Balance in Your Life

ERIC Educational Resources Information Center

Blaydes, John

2004-01-01

Today's principals face unique challenges--demands of time, knowledge, and organization which take their toll on even the most flexible leader. This compilation of resources offers practical, ready-to-use solutions to the issues and dilemmas facing principals every day. These valuable resources can be consulted for years to come as a long-term…

Branding an anatomic pathology practice to build revenue.

PubMed

Johnson, Paul

2004-01-01

Innovative Pathology Services (IPS) is an Associate Practice of Pathology Service Associates (PSA). PSA is an organization known as the "Business Solution for Pathology." IPS provides pathology services to nine hospitals, including two large tertiary-care medical centers, a progressive and renowned children's hospital, a cancer survival center, five surgery centers, and numerous physician's offices and clinics throughout east Tennessee. We accept specimen referrals from other pathology practices and providers from across the country. The center of operations is in Knoxville, a mid-sized metropolitan district. Until January 1, 2003, we were known as Knoxville Pathology Group (KPG). We renamed our practice because KPG did not reflect our service area, was limiting by perception, barely distinguished us from other groups, and did not describe our culture and philosophy. IPS is a new name for a well-established pathology group with a solid foundation and a long history of providing services at the point-of-care. As such, we offer all services that we offered through our foundation practice, and, in addition, these services were enhanced and new services were added. Our entire "team" and, in particular, the pathologists, were involved in the successful "branding" of IPS. Whether you are an independent anatomic pathology or clinical laboratory or you are hospital based, you may benefit from our experiences detailed in this article.

Digital communication between clinician and patient and the impact on marginalised groups: a realist review in general practice

PubMed Central

Huxley, Caroline J; Atherton, Helen; Watkins, Jocelyn Anstey; Griffiths, Frances

2015-01-01

Background Increasingly, the NHS is embracing the use of digital communication technology for communication between clinicians and patients. Policymakers deem digital clinical communication as presenting a solution to the capacity issues currently faced by general practice. There is some concern that these technologies may exacerbate existing inequalities in accessing health care. It is not known what impact they may have on groups who are already marginalised in their ability to access general practice. Aim To assess the potential impact of the availability of digital clinician–patient communication on marginalised groups’ access to general practice in the UK. Design and setting Realist review in general practice. Method A four-step realist review process was used: to define the scope of the review; to search for and scrutinise evidence; to extract and synthesise evidence; and to develop a narrative, including hypotheses. Results Digital communication has the potential to overcome the following barriers for marginalised groups: practical access issues, previous negative experiences with healthcare service/staff, and stigmatising reactions from staff and other patients. It may reduce patient-related barriers by offering anonymity and offers advantages to patients who require an interpreter. It does not impact on inability to communicate with healthcare professionals or on a lack of candidacy. It is likely to work best in the context of a pre-existing clinician–patient relationship. Conclusion Digital communication technology offers increased opportunities for marginalised groups to access health care. However, it cannot remove all barriers to care for these groups. It is likely that they will remain disadvantaged relative to other population groups after their introduction. PMID:26622034

Guidance for Researchers Developing and Conducting Clinical Trials in Practice-based Research Networks (PBRNs)

PubMed Central

Dolor, Rowena J.; Schmit, Kristine M.; Graham, Deborah G.; Fox, Chester H.; Baldwin, Laura Mae

2015-01-01

Background There is increased interest nationally in multicenter clinical trials to answer questions about clinical effectiveness, comparative effectiveness, and safety in real-world community settings. Primary care practice-based research networks (PBRNs), comprising community- and/or academically affiliated practices committed to improving medical care for a range of health problems, offer ideal settings for these trials, especially pragmatic clinical trials. However, many researchers are not familiar with working with PBRNs. Methods Experts in practice-based research identified solutions to challenges that researchers and PBRN personnel experience when collaborating on clinical trials in PBRNs. These were organized as frequently asked questions in a draft document presented at a 2013 Agency for Health care Research and Quality PBRN conference workshop, revised based on participant feedback, then shared with additional experts from the DARTNet Institute, Clinical Translational Science Award PBRN, and North American Primary Care Research Group PBRN workgroups for further input and modification. Results The “Toolkit for Developing and Conducting Multi-site Clinical Trials in Practice-Based Research Networks” offers guidance in the areas of recruiting and engaging practices, budgeting, project management, and communication, as well as templates and examples of tools important in developing and conducting clinical trials. Conclusion Ensuring the successful development and conduct of clinical trials in PBRNs requires a highly collaborative approach between academic research and PBRN teams. PMID:25381071

Advanced marketing: how to protect and advance your practice.

PubMed

Lexa, Frank James

2007-02-01

Radiology practices in the United States are facing mounting competitive challenges in many metropolitan areas. This competition is multifaceted and includes other traditional diagnostic imagers. However, the most severe pressures are from new entrants, such as primary and specialty physicians outside of radiology. The business science of marketing provides a set of solutions to help you fight back against this onslaught. In particular, advanced marketing techniques offer compelling strengths for raising awareness of the unique nature of our specialty among both the lay population and primary referrers. Applications of advanced marketing can be used to simultaneously hold and expand your turf. Relying on smarts rather than dollars, they also help overcome the fears that many radiology practices have about the high costs of traditional broadcasting.

Promoting the behaviorological analysis of verbal behavior

PubMed Central

Eshleman, John W.; Vargas, Ernest A.

1988-01-01

An important contribution of radical behavioral science is its analysis of verbal behavior. Slowly but surely an increasing number of efforts verify the propositions explicit or inherent in Skinner's theory of verbal behavior, or apply his analysis to clinical or educational practice. But both the theory and the effort to apply it are met with silence. Such silent neglect simply varies the calumnious attention usually given to behavioristic science. In recent years several papers have called attention to how non-behaviorists have habitually misrepresented the science of behavior and its underlying philosophy of radical behaviorism (Cooke, 1984; DellaLana, 1982; Morris, 1985; Todd, 1987a; Todd & Morris, 1981; Todd & Morris, 1983). These authors offer various solutions. Their preferred strategy stresses an increased effort to disseminate accurate information about behavioristic science to the press and to the world at large. They generally address, however, errors of commission, not omission. Further, their solutions tend to dwell on “processes” instead of “products.” This paper first reviews the problem of misrepresentation of the science. It then addresses the principal error of omission in the psychological literature, and offers a solution based on achieving new products resulting from new verbal behavior technology. PMID:22477561

Disimpaction of maxillary canines using temporary bone anchorage and cantilever springs.

PubMed

Thebault, Benoit; Dutertre, Eric

2015-03-01

Impacted canines, particularly in the maxilla, are frequently encountered in orthodontic practice. Unfortunately, depending on their position, correction can often be difficult and sometimes unsuccessful. Thorough diagnosis along with orthodontic treatment combining bone-supported anchorage and cantilever springs appears, in our view, to offer the best solution to this tricky orthodontic challenge while limiting, as far as possible, the risk of failure. Copyright © 2015. Published by Elsevier Masson SAS.

Organ donation as transition work: Policy discourse and clinical practice in The Netherlands.

PubMed

Paul, Katharina T; Avezaat, Cees J J; Ijzermans, Jan N; Friele, Roland D; Bal, Roland A

2014-07-01

An increasing number of patients become eligible for organ transplants. In the Netherlands, at the level of policy discourse, growing waiting lists are often referred to as a persistent "shortage" of organs, producing a "public health crisis." In this way, organ donation is presented as an ethical, social, and medical necessity. Likewise, policy discourse offers a range of seemingly unambiguous solutions: improving logistical infrastructure at the level of hospitals, developing organizational and legal protocols, as well as public information campaigns. Instead of taking these problem and solution definitions as given, we critically examine the relationship between policy discourse and clinical practice. Based on a historical review, first, we trace the key moments of transformation where organ donation became naturalized in Dutch policy discourse, particularly in its altruistic connotation. Second, based on in-depth interviews with medical professionals, we show how those involved in organ donation continue to struggle with the controversial nature of their clinical practice. More specifically, we highlight their use of different forms of knowledge that underlie clinicians' "transition work": from losing a patient to "gaining" a donor. © The Author(s) 2013.

Collaborative learning: A next step in the training of peer support providers.

PubMed

Cronise, Rita

2016-09-01

This column explores how peer support provider training is enhanced through collaborative learning. Collaborative learning is an approach that draws upon the "real life" experiences of individual learners and encompasses opportunities to explore varying perspectives and collectively construct solutions that enrich the practice of all participants. This description draws upon published articles and examples of collaborative learning in training and communities of practice of peer support providers. Similar to person-centered practices that enhance the recovery experience of individuals receiving services, collaborative learning enhances the experience of peer support providers as they explore relevant "real world" issues, offer unique contributions, and work together toward improving practice. Three examples of collaborative learning approaches are provided that have resulted in successful collaborative learning opportunities for peer support providers. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Developing consensus-based policy solutions for medicines adherence for Europe: a delphi study

PubMed Central

2012-01-01

Background Non-adherence to prescribed medication is a pervasive problem that can incur serious effects on patients’ health outcomes and well-being, and the availability of resources in healthcare systems. This study aimed to develop practical consensus-based policy solutions to address medicines non-adherence for Europe. Methods A four-round Delphi study was conducted. The Delphi Expert Panel comprised 50 participants from 14 countries and was representative of: patient/carers organisations; healthcare providers and professionals; commissioners and policy makers; academics; and industry representatives. Participants engaged in the study remotely, anonymously and electronically. Participants were invited to respond to open questions about the causes, consequences and solutions to medicines non-adherence. Subsequent rounds refined responses, and sought ratings of the relative importance, and operational and political feasibility of each potential solution to medicines non-adherence. Feedback of individual and group responses was provided to participants after each round. Members of the Delphi Expert Panel and members of the research group participated in a consensus meeting upon completion of the Delphi study to discuss and further refine the proposed policy solutions. Results 43 separate policy solutions to medication non-adherence were agreed by the Panel. 25 policy solutions were prioritised based on composite scores for importance, and operational and political feasibility. Prioritised policy solutions focused on interventions for patients, training for healthcare professionals, and actions to support partnership between patients and healthcare professionals. Few solutions concerned actions by governments, healthcare commissioners, or interventions at the system level. Conclusions Consensus about practical actions necessary to address non-adherence to medicines has been developed for Europe. These actions are also applicable to other regions. Prioritised policy solutions for medicines non-adherence offer a benefit to policymakers and healthcare providers seeking to address this multifaceted, complex problem. PMID:23176439

A taxonomy of accountable care organizations for policy and practice.

PubMed

Shortell, Stephen M; Wu, Frances M; Lewis, Valerie A; Colla, Carrie H; Fisher, Elliott S

2014-12-01

To develop an exploratory taxonomy of Accountable Care Organizations (ACOs) to describe and understand early ACO development and to provide a basis for technical assistance and future evaluation of performance. Data from the National Survey of Accountable Care Organizations, fielded between October 2012 and May 2013, of 173 Medicare, Medicaid, and commercial payer ACOs. Drawing on resource dependence and institutional theory, we develop measures of eight attributes of ACOs such as size, scope of services offered, and the use of performance accountability mechanisms. Data are analyzed using a two-step cluster analysis approach that accounts for both continuous and categorical data. We identified a reliable and internally valid three-cluster solution: larger, integrated systems that offer a broad scope of services and frequently include one or more postacute facilities; smaller, physician-led practices, centered in primary care, and that possess a relatively high degree of physician performance management; and moderately sized, joint hospital-physician and coalition-led groups that offer a moderately broad scope of services with some involvement of postacute facilities. ACOs can be characterized into three distinct clusters. The taxonomy provides a framework for assessing performance, for targeting technical assistance, and for diagnosing potential antitrust violations. © Health Research and Educational Trust.

Overcoming Challenges in School-Wide Survey Administration.

PubMed

Rasberry, Catherine N; Rose, India; Kroupa, Elizabeth; Hebert, Andrew; Geller, Amanda; Morris, Elana; Lesesne, Catherine A

2018-01-01

School-based surveys provide a useful method for gathering data from youth. Existing literature offers many examples of data collection through school-based surveys, and a small subset of literature describes methodological approaches or general recommendations for health promotion professionals seeking to conduct school-based data collection. Much less is available on real-life logistical challenges (e.g., minimizing disruption in the school day) and corresponding solutions. In this article, we fill that literature gap by offering practical considerations for the administration of school-based surveys. The protocol and practical considerations outlined in the article are based on a survey conducted with 11,681 students from seven large, urban public high schools in the southeast United States. We outline our protocol for implementing a school-based survey that was conducted with all students school-wide, and we describe six types of key challenges faced in conducting the survey: consent procedures, scheduling, locating students within the schools, teacher failure to administer the survey, improper administration of the survey, and minimizing disruption. For each challenge, we offer our key lessons learned and associated recommendations for successfully implementing school-based surveys, and we provide relevant tools for practitioners planning to conduct their own surveys in schools.

A biobank management model applicable to biomedical research.

PubMed

Auray-Blais, Christiane; Patenaude, Johane

2006-04-06

The work of Research Ethics Boards (REBs), especially when involving genetics research and biobanks, has become more challenging with the growth of biotechnology and biomedical research. Some REBs have even rejected research projects where the use of a biobank with coded samples was an integral part of the study, the greatest fear being the lack of participant protection and uncontrolled use of biological samples or related genetic data. The risks of discrimination and stigmatization are a recurrent issue. In light of the increasing interest in biomedical research and the resulting benefits to the health of participants, it is imperative that practical solutions be found to the problems associated with the management of biobanks: namely, protecting the integrity of the research participants, as well as guaranteeing the security and confidentiality of the participant's information. We aimed to devise a practical and efficient model for the management of biobanks in biomedical research where a medical archivist plays the pivotal role as a data-protection officer. The model had to reduce the burden placed on REBs responsible for the evaluation of genetics projects and, at the same time, maximize the protection of research participants. The proposed model includes the following: 1) a means of protecting the information in biobanks, 2) offers ways to provide follow-up information requested about the participants, 3) protects the participant's confidentiality and 4) adequately deals with the ethical issues at stake in biobanking. Until a governmental governance body is established in Quebec to guarantee the protection of research participants and establish harmonized guidelines for the management of biobanks in medical research, it is definitely up to REBs to find solutions that the present lack of guidelines poses. The model presented in this article offers a practical solution on a day-to-day basis for REBs, as well as researchers by promoting an archivist to a pivotal role in the process. It assures protection of all participants who altruistically donate their samples to generate and improve knowledge for better diagnosis and medical treatment.

A Framework to Implement IoT Network Performance Modelling Techniques for Network Solution Selection †

PubMed Central

Delaney, Declan T.; O’Hare, Gregory M. P.

2016-01-01

No single network solution for Internet of Things (IoT) networks can provide the required level of Quality of Service (QoS) for all applications in all environments. This leads to an increasing number of solutions created to fit particular scenarios. Given the increasing number and complexity of solutions available, it becomes difficult for an application developer to choose the solution which is best suited for an application. This article introduces a framework which autonomously chooses the best solution for the application given the current deployed environment. The framework utilises a performance model to predict the expected performance of a particular solution in a given environment. The framework can then choose an apt solution for the application from a set of available solutions. This article presents the framework with a set of models built using data collected from simulation. The modelling technique can determine with up to 85% accuracy the solution which performs the best for a particular performance metric given a set of solutions. The article highlights the fractured and disjointed practice currently in place for examining and comparing communication solutions and aims to open a discussion on harmonising testing procedures so that different solutions can be directly compared and offers a framework to achieve this within IoT networks. PMID:27916929

Linear adsorption of nonionic organic compounds from water onto hydrophilic minerals: Silica and alumina

USGS Publications Warehouse

Su, Y.-H.; Zhu, Y.-G.; Sheng, G.; Chiou, C.T.

2006-01-01

To characterize the linear adsorption phenomena in aqueous nonionic organic solute-mineral systems, the adsorption isotherms of some low-molecular- weightnonpolar nonionic solutes (1,2,3-trichlorobenzene, lindane, phenanthrene, and pyrene) and polar nonionic solutes (1,3-dinitrobenzene and 2,4-dinitrotoluene) from single-and binary-solute solutions on hydrophilic silica and alumina were established. Toward this objective, the influences of temperature, ionic strength, and pH on adsorption were also determined. It is found that linear adsorption exhibits low exothermic heats and practically no adsorptive competition. The solute-solid configuration and the adsorptive force consistent with these effects were hypothesized. For nonpolar solutes, the adsorption occurs presumably by London (dispersion) forces onto a water film above the mineral surface. For polar solutes, the adsorption is also assisted by polar-group interactions. The reduced adsorptive forces of solutes with hydrophilic minerals due to physical separation by the water film and the low fractions of the water-film surface covered by solutes offer a theoretical basis for linear solute adsorption, low exothermic heats, and no adsorptive competition. The postulated adsorptive forces are supported by observations that ionic strength or pH poses no effect on the adsorption of nonpolar solutes while it exhibits a significant effect on the uptake of polar solutes. ?? 2006 American Chemical Society.

A Framework to Implement IoT Network Performance Modelling Techniques for Network Solution Selection.

PubMed

Delaney, Declan T; O'Hare, Gregory M P

2016-12-01

No single network solution for Internet of Things (IoT) networks can provide the required level of Quality of Service (QoS) for all applications in all environments. This leads to an increasing number of solutions created to fit particular scenarios. Given the increasing number and complexity of solutions available, it becomes difficult for an application developer to choose the solution which is best suited for an application. This article introduces a framework which autonomously chooses the best solution for the application given the current deployed environment. The framework utilises a performance model to predict the expected performance of a particular solution in a given environment. The framework can then choose an apt solution for the application from a set of available solutions. This article presents the framework with a set of models built using data collected from simulation. The modelling technique can determine with up to 85% accuracy the solution which performs the best for a particular performance metric given a set of solutions. The article highlights the fractured and disjointed practice currently in place for examining and comparing communication solutions and aims to open a discussion on harmonising testing procedures so that different solutions can be directly compared and offers a framework to achieve this within IoT networks.

Ceiling-mounted personalized ventilation system integrated with a secondary air distribution system--a human response study in hot and humid climate.

PubMed

Yang, B; Sekhar, S C; Melikov, A K

2010-08-01

The benefits of thermal comfort and indoor air quality with personalized ventilation (PV) systems have been demonstrated in recent studies. One of the barriers for wide spread acceptance by architects and HVAC designers has been attributed to challenges and constraints faced in the integration of PV systems with the work station. A newly developed ceiling-mounted PV system addresses these challenges and provides a practical solution while retaining much of the apparent benefits of PV systems. Assessments of thermal environment, air movement, and air quality for ceiling-mounted PV system were performed with tropically acclimatized subjects in a Field Environmental Chamber. Thirty-two subjects performed normal office work and could choose to be exposed to four different PV airflow rates (4, 8, 12, and 16 L/s), thus offering themselves a reasonable degree of individual control. Ambient temperatures of 26 and 23.5 degrees C and PV air temperatures of 26, 23.5, and 21 degrees C were employed. The local and whole body thermal sensations were reduced when PV airflow rates were increased. Inhaled air temperature was perceived cooler and perceived air quality and air freshness improved when PV airflow rate was increased or temperature was reduced. The newly developed ceiling-mounted PV system offers a practical solution to the integration of PV air terminal devices (ATDs) in the vicinity of the workstation. By remotely locating the PV ATDs on the ceiling directly above the occupants and under their control, the conditioned outdoor air is now provided to the occupants through the downward momentum of the air. A secondary air-conditioning and air distribution system offers additional cooling in the room and maintains a higher ambient temperature, thus offering significant benefits in conserving energy. The results of this study provide designers and consultants with needed knowledge for design of PV systems.

Magnesium batteries: Current state of the art, issues and future perspectives.

PubMed

Mohtadi, Rana; Mizuno, Fuminori

2014-01-01

"...each metal has a certain power, which is different from metal to metal, of setting the electric fluid in motion..." Count Alessandro Volta. Inspired by the first rechargeable magnesium battery prototype at the dawn of the 21st century, several research groups have embarked on a quest to realize its full potential. Despite the technical accomplishments made thus far, challenges, on the material level, hamper the realization of a practical rechargeable magnesium battery. These are marked by the absence of practical cathodes, appropriate electrolytes and extremely sluggish reaction kinetics. Over the past few years, an increased interest in this technology has resulted in new promising materials and innovative approaches aiming to overcome the existing hurdles. Nonetheless, the current challenges call for further dedicated research efforts encompassing fundamental understanding of the core components and how they interact with each other to offering new innovative solutions. In this review, we seek to highlight the most recent developments made and offer our perspectives on how to overcome some of the remaining challenges.

Evaluation of a Digital Consultation and Self-Care Advice Tool in Primary Care: A Multi-Methods Study

PubMed Central

Bowers, Gillian; Bowers, John

2018-01-01

Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP) has the potential to alleviate some of the pressure on primary care. This paper reports on a Phase II, 6-month evaluation of eConsult, a web-based triage and consultation system that was piloted across 11 GP practices across Scotland. Through a multi-method approach the evaluation explored eConsult use across practices, exposing both barriers and facilitators to its adoption. Findings suggest that expectations that eConsult would offer an additional and alternative method of accessing GP services were largely met. However, there is less certainty that it has fulfilled expectations of promoting self-help. In addition, low uptake meant that evaluation of current effectiveness was difficult for practices to quantify. The presence of an eConsult champion(s) within the practice was seen to be a significant factor in ensuring successful integration of the tool. A lack of patient and staff engagement, insufficient support and lack of protocols around processes were seen as barriers to its success. PMID:29724040

Support for safer behaviour.

PubMed

Pujari, S

1994-01-01

Counseling persons about human immunodeficiency virus (HIV) testing and safe sex practices is performed in India at acquired immunodeficiency syndrome (AIDS) counseling centers, such as the one in Pune. The center provides counseling to clients, primarily men, before and after HIV testing. Support groups are offered for HIV-positive persons. Clients are referred by doctors, sexually transmitted disease (STD) clinics, and health care institutions. Advertising is by word of mouth. Previously, when blood banks were sending HIV-positive persons for counseling, confirmatory testing had not been performed, and 30% were actually HIV negative. Now the center, in cooperation with the blood banks, contacts all HIV-positive patients. After counseling, a confirmatory test is performed, if the patient agrees. HIV-positive persons are encouraged, but not pressured, to contact partners. Breaking confidentially is avoided. The center also counsels patients at the local government STD clinic. Again, these are mainly men. All patients have a follow up session after diagnosis to discuss sexual practices, risk reduction practices, disease prevention, and condom use. In India, culture constrains open discussion about sex. However, if counselors begin with neutral topics, such as work or children, men are more willing to speak about sexual practices and lifestyles. Counselors discuss the possible reasons for unsafe behavior and offer practical solutions. Counseling men in STD clinics also indirectly reaches their partners, the wives and sex workers who are in less of a position to protect themselves.

Printed Carbon Nanotube Electronics and Sensor Systems.

PubMed

Chen, Kevin; Gao, Wei; Emaminejad, Sam; Kiriya, Daisuke; Ota, Hiroki; Nyein, Hnin Yin Yin; Takei, Kuniharu; Javey, Ali

2016-06-01

Printing technologies offer large-area, high-throughput production capabilities for electronics and sensors on mechanically flexible substrates that can conformally cover different surfaces. These capabilities enable a wide range of new applications such as low-cost disposable electronics for health monitoring and wearables, extremely large format electronic displays, interactive wallpapers, and sensing arrays. Solution-processed carbon nanotubes have been shown to be a promising candidate for such printing processes, offering stable devices with high performance. Here, recent progress made in printed carbon nanotube electronics is discussed in terms of materials, processing, devices, and applications. Research challenges and opportunities moving forward from processing and system-level integration points of view are also discussed for enabling practical applications. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Conducting international nursing research: challenges and opportunities.

PubMed

Opollo, Jackline Gloria; Opollo, Diana Alaka; Gray, Jennifer; Spies, Lori

2014-11-01

To describe practical experiences before, during and after gaining entry into research fields in Kenya and Uganda. Planning, conducting and implementing international research can be an arduous task. Novice researchers need practical guides to accessing international fields and mitigating challenges met in the field. The researchers conducted three different studies in two developing nations. This paper reviews challenges encountered when conducting international research. Solutions used to overcome these challenges are discussed. Establishing and maintaining effective partnerships is critical to the success of international research efforts. Researchers must be tactful, flexible and creative when handling methodological, ethical and logistical challenges encountered in settings poor in resources. International research provides opportunities for increasing dedication, building cross-cultural competence and advancing health professional practice globally. This paper contributes to nursing scholarship by highlighting the practical challenges of conducting international research. Illustrations aimed at lending insight and encouraging others to expand their dedication to conducting international research are offered.

Is operational research delivering the goods? The journey to success in low-income countries.

PubMed

Zachariah, Rony; Ford, Nathan; Maher, Dermot; Bissell, Karen; Van den Bergh, Rafael; van den Boogaard, Wilma; Reid, Tony; Castro, Kenneth G; Draguez, Bertrand; von Schreeb, Johan; Chakaya, Jeremiah; Atun, Rifat; Lienhardt, Christian; Enarson, Don A; Harries, Anthony D

2012-05-01

Operational research in low-income countries has a key role in filling the gap between what we know from research and what we do with that knowledge-the so-called know-do gap, or implementation gap. Planned research that does not tangibly affect policies and practices is ineffective and wasteful, especially in settings where resources are scarce and disease burden is high. Clear parameters are urgently needed to measure and judge the success of operational research. We define operational research and its relation with policy and practice, identify why operational research might fail to affect policy and practice, and offer possible solutions to address these shortcomings. We also propose measures of success for operational research. Adoption and use of these measures could help to ensure that operational research better changes policy and practice and improves health-care delivery and disease programmes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Evidence-based medicine, the research-practice gap, and biases in medical and surgical decision making in dermatology.

PubMed

Eaglstein, William H

2010-10-01

The objectives of this article are to promote a better understanding of a group of biases that influence therapeutic decision making by physicians/dermatologists and to raise the awareness that these biases contribute to a research-practice gap that has an impact on physicians and treatment solutions. The literature included a wide range of peer-reviewed articles dealing with biases in decision making, evidence-based medicine, randomized controlled clinical trials, and the research-practice gap. Bias against new therapies, bias in favor of indirect harm or omission, and bias against change when multiple new choices are offered may unconsciously affect therapeutic decision making. Although there is no comprehensive understanding or theory as to how choices are made by physicians, recognition of certain cognition patterns and their associated biases will help narrow the research-practice gap and optimize decision making regarding therapeutic choices.

Appropriate technology for domestic wastewater management in under-resourced regions of the world

NASA Astrophysics Data System (ADS)

Oladoja, Nurudeen Abiola

2017-11-01

Centralized wastewater management system is the modern day waste management practice, but the high cost and stringent requirements for the construction and operation have made it less attractive in the under-resourced regions of the world. Considering these challenges, the use of decentralized wastewater management system, on-site treatment system, as an appropriate technology for domestic wastewater treatment is hereby advocated. Adopting this technology helps save money, protects home owners' investment, promotes better watershed management, offers an appropriate solution for low-density communities, provides suitable alternatives for varying site conditions and furnishes effective solutions for ecologically sensitive areas. In the light of this, an overview of the on-site treatment scheme, at the laboratory scale, pilot study stage, and field trials was conducted to highlight the operational principles' strength and shortcomings of the scheme. The operational requirements for the establishing and operation of the scheme and best management practice to enhance the performance and sustenance were proffered.

The p-version of the finite element method in incremental elasto-plastic analysis

NASA Technical Reports Server (NTRS)

Holzer, Stefan M.; Yosibash, Zohar

1993-01-01

Whereas the higher-order versions of the finite elements method (the p- and hp-version) are fairly well established as highly efficient methods for monitoring and controlling the discretization error in linear problems, little has been done to exploit their benefits in elasto-plastic structural analysis. Aspects of incremental elasto-plastic finite element analysis which are particularly amenable to improvements by the p-version is discussed. These theoretical considerations are supported by several numerical experiments. First, an example for which an analytical solution is available is studied. It is demonstrated that the p-version performs very well even in cycles of elasto-plastic loading and unloading, not only as compared to the traditional h-version but also in respect to the exact solution. Finally, an example of considerable practical importance - the analysis of a cold-worked lug - is presented which demonstrates how the modeling tools offered by higher-order finite element techniques can contribute to an improved approximation of practical problems.

Incentives to create and sustain healthy behaviors: technology solutions and research needs.

PubMed

Teyhen, Deydre S; Aldag, Matt; Centola, Damon; Edinborough, Elton; Ghannadian, Jason D; Haught, Andrea; Jackson, Theresa; Kinn, Julie; Kunkler, Kevin J; Levine, Betty; Martindale, Valerie E; Neal, David; Snyder, Leslie B; Styn, Mindi A; Thorndike, Frances; Trabosh, Valerie; Parramore, David J

2014-12-01

Health-related technology, its relevance, and its availability are rapidly evolving. Technology offers great potential to minimize and/or mitigate barriers associated with achieving optimal health, performance, and readiness. In support of the U.S. Army Surgeon General's vision for a "System for Health" and its Performance Triad initiative, the U.S. Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health." Members of government and academia participated to identify and define the opportunities, gain clarity in leading practices and research gaps, and articulate the characteristics of future technology solutions to create and sustain real change in the health of individuals, the Army, and the nation. The key factors discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior change intervention, and (5) the role of peer and social networks in change. This report summarizes the recommendations on how technology solutions could be employed to leverage evidence-based best practices and identifies gaps in research where further investigation is needed. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Communication in production animal medicine: modelling a complex interaction with the example of dairy herd health medicine

PubMed Central

2011-01-01

Background The importance of communication skills in veterinary medicine is increasingly recognised. Appropriate communication skills towards the client are of utmost importance in both companion animal practice and production animal field and consultancy work. The need for building a relationship with the client, alongside developing a structure for the consultation is widely recognised and applies to both types of veterinary practice. Results Veterinary advisory practice in production animal medicine is, however, characterised by a more complex communication on different levels. While the person-orientated communication is a permanent process between veterinarian and client with a rather personal perspective and defines the roles of interaction, the problem-orientated communication deals with emerging difficulties; the objective is to solve an acute health problem. The solution - orientated communication is a form of communication in which both veterinarian and client address longstanding situations or problems with the objective to improve herd health and subsequently productivity performance. All three forms of communication overlap. Conclusions Based on this model, it appears useful for a veterinary practice to offer both a curative and an advisory service, but to keep these two separated when deemed appropriate. In veterinary education, the strategies and techniques necessary for solution orientated communication should be included in the teaching of communication skills. PMID:21777495

Communication in production animal medicine: modelling a complex interaction with the example of dairy herd health medicine.

PubMed

Kleen, Joachim L; Atkinson, Owen; Noordhuizen, Jos Ptm

2011-07-20

The importance of communication skills in veterinary medicine is increasingly recognised. Appropriate communication skills towards the client are of utmost importance in both companion animal practice and production animal field and consultancy work. The need for building a relationship with the client, alongside developing a structure for the consultation is widely recognised and applies to both types of veterinary practice. Veterinary advisory practice in production animal medicine is, however, characterised by a more complex communication on different levels. While the person-orientated communication is a permanent process between veterinarian and client with a rather personal perspective and defines the roles of interaction, the problem-orientated communication deals with emerging difficulties; the objective is to solve an acute health problem. The solution - orientated communication is a form of communication in which both veterinarian and client address longstanding situations or problems with the objective to improve herd health and subsequently productivity performance. All three forms of communication overlap. Based on this model, it appears useful for a veterinary practice to offer both a curative and an advisory service, but to keep these two separated when deemed appropriate. In veterinary education, the strategies and techniques necessary for solution orientated communication should be included in the teaching of communication skills.

LOX, GOX and Pressure Relief

NASA Technical Reports Server (NTRS)

McLeod, Ken; Stoltzfus, Joel

2006-01-01

Oxygen relief systems present a serious fire hazard risk with often severe consequences. This presentation offers a risk management solution strategy which encourages minimizing ignition hazards, maximizing best materials, and utilizing good practices. Additionally, the relief system should be designed for cleanability and ballistic flow. The use of the right metals, softgoods, and lubricants, along with the best assembly techniques, is stressed. Materials should also be tested if data is not available and a full hazard analysis should be conducted in an effort to minimize risk and harm.

Device Connectivity

PubMed Central

Walsh, John; Roberts, Ruth; Morris, Richard

2015-01-01

Patients with diabetes have to take numerous factors/data into their therapeutic decisions in daily life. Connecting the devices they are using by feeding the data generated into a database/app is supposed to help patients to optimize their glycemic control. As this is not established in practice, the different roadblocks have to be discussed to open the road. That large telecommunication companies are now entering this market might be a big help in pushing this forward. Smartphones offer an ideal platform for connectivity solutions. PMID:25614015

Retrofit implementation of Zernike phase plate imaging for cryo-TEM

PubMed Central

Marko, Michael; Leith, ArDean; Hsieh, Chyongere; Danev, Radostin

2011-01-01

In-focus phase-plate imaging is particularly beneficial for cryo-TEM because it offers a substantial overall increase in image contrast, without an electron dose penalty, and it simplifies image interpretation. We show how phase-plate cryo-TEM can be implemented with an appropriate existing TEM, and provide a basic practical introduction to use of thin-film (carbon) phase plates. We point out potential pitfalls of phase-plate operation, and discuss solutions. We provide information on evaluating a particular TEM for its suitability. PMID:21272647

Promoting the nurse practitioner by using a marketing approach.

PubMed

Gallagher, S M

1996-03-01

Being good at what you do is not enough. Despite strong evidence that the nurse practitioner delivers cost-efficient and outcome-based care, few consumers really understand the nurse practitioner's scope of practice. With the current rapidly changing status of health care, the nurse practitioner is presented with many opportunities. Strategies that ensure survival and growth are critical to longevity. Marketing strategies can offer solutions to these challenges. The 4 P's of marketing are discussed as an approach to promote the role of the nurse practitioner.

Studying physician-adolescent patient communication in community-based practices: recruitment challenges and solutions.

PubMed

Bodner, Michael E; Bilheimer, Alicia; Gao, Xiaomei; Lyna, Pauline; Alexander, Stewart C; Dolor, Rowena J; Østbye, Truls; Bravender, Terrill; Tulsky, James A; Graves, Sidney; Irons, Alexis; Pollak, Kathryn I

2015-11-13

Practice-based studies are needed to assess how physicians communicate health messages about weight to overweight/obese adolescent patients, but successful recruitment to such studies is challenging. This paper describes challenges, solutions, and lessons learned to recruit physicians and adolescents to the Teen Communicating Health Analyzing Talk (CHAT) study, a randomized controlled trial of a communication skills intervention for primary care physicians to enhance communication about weight with overweight/obese adolescents. A "peer-to-peer" approach was used to recruit physicians, including the use of "clinic champions" who liaised between study leaders and physicians. Consistent rapport and cooperative working relationships with physicians and clinic staff were developed and maintained. Adolescent clinic files were reviewed (HIPAA waiver) to assess eligibility. Parents could elect to opt-out for their children. To encourage enrollment, confidentiality of audio recordings was emphasized, and financial incentives were offered to all participants. We recruited 49 physicians and audio-recorded 391 of their overweight/obese adolescents' visits. Recruitment challenges included 1) physician reticence to participate; 2) variability in clinic operating procedures; 3) variability in adolescent accrual rates; 4) clinic open access scheduling; and 5) establishing communication with parents and adolescents. Key solutions included the use of a "clinic champion" to help recruit physicians, pro-active, consistent communication with clinic staff, and adapting calling times to reach parents and adolescents. Recruiting physicians and adolescents to audio-recorded, practice-based health communication studies can be successful. Anticipated challenges to recruiting can be met with advanced planning; however, optimal solutions to challenges evolve as recruitment progresses.

The availability of diltiazem: a study on the sorption by intravenous delivery systems and on the stability of the drug.

PubMed

De Vroe, C; De Muynck, C; Remon, J P; Scheldewaert, R; Colardyn, F

1989-04-01

The stability and the sorption by intravenous delivery systems of the calcium antagonist diltiazem dissolved into either 5% dextrose or 0.9% sodium chloride solutions have been investigated, under conditions simulating current clinical practice. Static experiments showed an excellent stability and no sorption after 48 h. Dynamic experiments, at a perfusion rate of 20 mg h-1, showed no sorption of the drug by infusion fluid containers, burettes or administration sets. For end-line filters a temporary decrease of the recovered amount of diltiazem was observed but only with the 0.9% NaCl solution. It is concluded that the stability and the sorption of diltiazem offers no problem with regard to clinical efficacy.

Exact three-dimensional spectral solution to surface-groundwater interactions with arbitrary surface topography

USGS Publications Warehouse

Worman, A.; Packman, A.I.; Marklund, L.; Harvey, J.W.; Stone, S.H.

2006-01-01

It has been long known that land surface topography governs both groundwater flow patterns at the regional-to-continental scale and on smaller scales such as in the hyporheic zone of streams. Here we show that the surface topography can be separated in a Fourier-series spectrum that provides an exact solution of the underlying three-dimensional groundwater flows. The new spectral solution offers a practical tool for fast calculation of subsurface flows in different hydrological applications and provides a theoretical platform for advancing conceptual understanding of the effect of landscape topography on subsurface flows. We also show how the spectrum of surface topography influences the residence time distribution for subsurface flows. The study indicates that the subsurface head variation decays exponentially with depth faster than it would with equivalent two-dimensional features, resulting in a shallower flow interaction. Copyright 2006 by the American Geophysical Union.

MEASUREMENT ISSUES IN HOME-VISITING RESEARCH WITHIN TRIBAL COMMUNITIES: CHALLENGES AND STRATEGIES.

PubMed

Whitesell, Nancy Rumbaugh; Bolan, Marc; Chomos, Julianna C; Heath, Debra; Miles, Jon; Salvador, Melina; Whitmore, Corrie; Barlow, Allison

2018-05-04

In this article, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees share strategies they have developed and adopted to address the most common barriers to effective measurement (and thus to effective evaluation) encountered in the course of implementation and evaluation of their home-visiting programs. We identify key challenges in measuring outcomes in Tribal MIECHV Programs and provide practical examples of various strategies used to address these challenges within diverse American Indian and Alaska Native cultural and contextual settings. Notably, high-quality community engagement is a consistent thread throughout these strategies and fundamental to successful measurement in these communities. These strategies and practices reflect the experiences and innovative solutions of practitioners working on the ground to deliver and evaluate intervention programs to tribal communities. They may serve as models for getting high-quality data to inform intervention while working within the constraints and requirements of program funding. The utility of these practical solutions extends beyond the Tribal MIECHV grantees and offers the potential to inform a broad array of intervention evaluation efforts in tribal and other community contexts. © 2018 Michigan Association for Infant Mental Health.

A Taxonomy of Accountable Care Organizations for Policy and Practice

PubMed Central

Shortell, Stephen M; Wu, Frances M; Lewis, Valerie A; Colla, Carrie H; Fisher, Elliott S

2014-01-01

Objective To develop an exploratory taxonomy of Accountable Care Organizations (ACOs) to describe and understand early ACO development and to provide a basis for technical assistance and future evaluation of performance. Data Sources/Study Setting Data from the National Survey of Accountable Care Organizations, fielded between October 2012 and May 2013, of 173 Medicare, Medicaid, and commercial payer ACOs. Study Design Drawing on resource dependence and institutional theory, we develop measures of eight attributes of ACOs such as size, scope of services offered, and the use of performance accountability mechanisms. Data are analyzed using a two-step cluster analysis approach that accounts for both continuous and categorical data. Principal Findings We identified a reliable and internally valid three-cluster solution: larger, integrated systems that offer a broad scope of services and frequently include one or more postacute facilities; smaller, physician-led practices, centered in primary care, and that possess a relatively high degree of physician performance management; and moderately sized, joint hospital–physician and coalition-led groups that offer a moderately broad scope of services with some involvement of postacute facilities. Conclusions ACOs can be characterized into three distinct clusters. The taxonomy provides a framework for assessing performance, for targeting technical assistance, and for diagnosing potential antitrust violations. PMID:25251146

The IHE-Bus: a practical tool to instrument and simulate IHE deployment

NASA Astrophysics Data System (ADS)

Shani, Uri; Carmeli, Boaz; Kol, Tomer; Ram, Roni; Shabo, Amnon

2005-04-01

The IHE (Integrating the Healthcare Enterprise) initiative provides essential guidelines for the deployment of a digital health information management environment. IHE, while not inventing new standards, creates a system-level and component-level design, based on the products of the leading standards, HL7, DICOM, and more. As such, IHE can be viewed as the "Standard of Standards". The most significant value of IHE is that vendors can work on specific components of the enterprise solution, playing one or more of the IHE actor roles. IHE defines, for each actor, its external interface to the other actors in the system. Yet, the integrator of an entire IHE solution may find this job extremely difficult. The larger the number of vendors involved in the solution, the tougher the job. The complexity of coordinating all the components to work as one coherent solution multiplies and may become intractable. IHE defines very well "what" should be done, but not "how." IHE-Bus offers a practical solution for the "how" question, with many advantages. This solution is borrowed from the business integration sphere. IHE becomes a platform, and each actor can be "plugged" into it in a simple step. New actors are independent of other actors already in the system. Missing actors can be simulated (by a "stub") until replaced with the real product in the future. Moreover, the entire IHE network is managed as a single coherent system with powerful tools encapsulating the enormous amount of knowledge and expertise deemed necessary to uphold this job.

Scaffolding student learning in clinical practice.

PubMed

Spouse, J

1998-05-01

For many years the profession has acknowledged a schism between theories taught in the classroom and the practice of clinicians. This tends to arise from beliefs that knowledge which has been generalized (formalized) can be readily transferred to informal settings (practice). Whilst apprehension of formalized knowledge is crucial to professional development, a mediator is necessary to demonstrate its relevance to practice. A variety of solutions have been offered which all have value but without effective social support fail to resolve the problem. Findings from a longitudinal study investigating the professional development of pre-registration nursing students indicate the importance of sponsorship by a member of clinical staff and participation in legitimate peripheral activities. In the absence of effective sponsorship, students found it difficult to participate in clinical activities or to learn. As a result, their professional development during placements became stunted with subsequent implications for their professional future. Questions concerned with this phenomena were explored using documentary evidence supplied by research participants, observations of their practice and focused interviews throughout their programme. Sociocultural or activity theories of human learning offer some attractive explanations. One strategy is scaffolding which takes place within sponsored nursing activities and builds on the important concept of the Zone of Proximal Development (ZPD), where speech becomes a tool to mediate learning and development. As a diagnostic tool, scaffolding enables both supervisor and learner to recognize knowledge-in-waiting and knowledge-in-use and hence learning need, thus stimulating opportunities for further learning and professional development beneficial to both learner and supervisor. It provides a means for theory and practice to become integrated.

Magnesium batteries: Current state of the art, issues and future perspectives

PubMed Central

Mizuno, Fuminori

2014-01-01

Summary “...each metal has a certain power, which is different from metal to metal, of setting the electric fluid in motion...” Count Alessandro Volta. Inspired by the first rechargeable magnesium battery prototype at the dawn of the 21st century, several research groups have embarked on a quest to realize its full potential. Despite the technical accomplishments made thus far, challenges, on the material level, hamper the realization of a practical rechargeable magnesium battery. These are marked by the absence of practical cathodes, appropriate electrolytes and extremely sluggish reaction kinetics. Over the past few years, an increased interest in this technology has resulted in new promising materials and innovative approaches aiming to overcome the existing hurdles. Nonetheless, the current challenges call for further dedicated research efforts encompassing fundamental understanding of the core components and how they interact with each other to offering new innovative solutions. In this review, we seek to highlight the most recent developments made and offer our perspectives on how to overcome some of the remaining challenges. PMID:25247113

Simulated workplace neutron fields

NASA Astrophysics Data System (ADS)

Lacoste, V.; Taylor, G.; Röttger, S.

2011-12-01

The use of simulated workplace neutron fields, which aim at replicating radiation fields at practical workplaces, is an alternative solution for the calibration of neutron dosemeters. They offer more appropriate calibration coefficients when the mean fluence-to-dose equivalent conversion coefficients of the simulated and practical fields are comparable. Intensive Monte Carlo modelling work has become quite indispensable for the design and/or the characterization of the produced mixed neutron/photon fields, and the use of Bonner sphere systems and proton recoil spectrometers is also mandatory for a reliable experimental determination of the neutron fluence energy distribution over the whole energy range. The establishment of a calibration capability with a simulated workplace neutron field is not an easy task; to date only few facilities are available as standard calibration fields.

[The reform of Spanish abortion law].

PubMed

Requero Ibáñez, José Luís

2009-01-01

The article focuses on the different factors and circumstances that have led to the reform of Spanish Abortion Law (1985). Judicial investigations of several abortion clinics have demonstrated that up until today there has been a widespread tendency of the clinics to practice beyond the limits established by the law. Nonetheless, the reaction of the government has not been to protect the life of the unborn. Its reaction has been, however, to cover the irregularities committed by the abortionists through the legalization of their abusive practices. Besides, the reform of the law has been inspired by elements of radical feminism. The author points out the major reasons that make this reform unconstitutional and offers alternative solutions for the protection of the mother and the unborn child.

Review—Multifunctional Materials for Enhanced Li-Ion Batteries Durability: A Brief Review of Practical Options

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

Banerjee, Anjan; Shilina, Yuliya; Ziv, Baruch

Transition metal (TM) ions dissolution from positive electrodes, migration to and deposition on negative electrodes, followed by Mn-catalyzed reactions of solvents and anions, with loss of Li+ ions, is a major degradation (DMDCR) mechanism in Li-ion batteries (LIBs) with spinel positive electrode materials. While the details of the DMDCR mechanism are still under debate, it is clear that HF and other acid species’ attack is the main cause in solutions with LiPF6 electrolyte. We first review the work on various mitigation measures for the DMDCR mechanism, now spanning more than two decades. We then discuss recent progress on our understandingmore » of Mn species in electrolyte solutions and the extension of a mitigation measure first proposed by Tarascon and coworkers in 1999, namely chelation of TM cations, to Mn cation trapping, HF scavenging, and alkali metal ions dispensing multi-functional materials. We focus on practicable, drop-in technical solutions, based on placing such materials in the inter-electrode space, with significant benefits for LIBs performance: increased capacity retention during operation at room and above-ambient temperatures as well as robust (both maximally ionically conducting and electronically insulating) solid-electrolyte interfaces, having reduced charge transfer and film resistances at both negative and positive electrodes. We illustrate the multifunctional materials approach with both new and previously published data. We also discuss and offer our evaluation regarding the merits and drawbacks of the various mitigation measures, with an eye for practically relevant technical solutions capable to meet both the performance requirements and cost constraints for commercial LIBs, and end with recommendations for future work.« less

A new fluorescent enhanced probe based on (E)-9-(2-nitrovinyl)-anthracene for the detection of bisulfite anions and its practical application

NASA Astrophysics Data System (ADS)

Chao, Jianbin; Liu, Yuhong; Zhang, Yan; Zhang, Yongbin; Huo, Fangjun; Yin, Caixia; Wang, Yu; Qin, Liping

2015-07-01

A new fluorescent enhanced probe based on (E)-9-(2-nitrovinyl)-anthracene is developed, which shows high selectivity and sensitivity for the detection of bisulfite anions at Na2HPO4 citric acid buffer solutions (pH 5.0). When addition of HSO3-, the fluorescence intensity is significantly enhanced and the probe displays apparent fluorescence color changes from non-fluorescence to blue under a UV lamp illumination, the solution color also changes from yellow to colorless. The detection limit is determined to be as low as 6.30 μM. This offers another specific colorimetric and fluorescent probe for bisulfite anions detection, furthermore it is applied in detecting the level of bisulfite in sugar samples.

Region of validity of the finite–temperature Thomas–Fermi model with respect to quantum and exchange corrections

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

Dyachkov, Sergey, E-mail: serj.dyachkov@gmail.com; Moscow Institute of Physics and Technology, 9 Institutskiy per., Dolgoprudny, Moscow Region 141700; Levashov, Pavel, E-mail: pasha@ihed.ras.ru

We determine the region of applicability of the finite–temperature Thomas–Fermi model and its thermal part with respect to quantum and exchange corrections. Very high accuracy of computations has been achieved by using a special approach for the solution of the boundary problem and numerical integration. We show that the thermal part of the model can be applied at lower temperatures than the full model. Also we offer simple approximations of the boundaries of validity for practical applications.

An S N Algorithm for Modern Architectures

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

Baker, Randal Scott

2016-08-29

LANL discrete ordinates transport packages are required to perform large, computationally intensive time-dependent calculations on massively parallel architectures, where even a single such calculation may need many months to complete. While KBA methods scale out well to very large numbers of compute nodes, we are limited by practical constraints on the number of such nodes we can actually apply to any given calculation. Instead, we describe a modified KBA algorithm that allows realization of the reductions in solution time offered by both the current, and future, architectural changes within a compute node.

Bringing Cosmic Objects Down to Earth: An Overview of 3D Modelling and Printing in Astronomy and Astronomy Communication

NASA Astrophysics Data System (ADS)

Arcand, K.; Megan, W.; DePasquale, J.; Jubett, A.; Edmonds, P.; DiVona, K.

2017-09-01

Three-dimensional (3D) modelling is more than just good fun, it offers a new vehicle to represent and understand scientific data and gives experts and non-experts alike the ability to manipulate models and gain new perspectives on data. This article explores the use of 3D modelling and printing in astronomy and astronomy communication and looks at some of the practical challenges, and solutions, to using 3D modelling, visualisation and printing in this way.

Retrofit implementation of Zernike phase plate imaging for cryo-TEM.

PubMed

Marko, Michael; Leith, Ardean; Hsieh, Chyongere; Danev, Radostin

2011-05-01

In-focus phase-plate imaging is particularly beneficial for cryo-TEM because it offers a substantial overall increase in image contrast, without an electron dose penalty, and it simplifies image interpretation. We show how phase-plate cryo-TEM can be implemented with an appropriate existing TEM, and provide a basic practical introduction to use of thin-film (carbon) phase plates. We point out potential pitfalls of phase-plate operation, and discuss solutions. We provide information on evaluating a particular TEM for its suitability. Copyright © 2011 Elsevier Inc. All rights reserved.

Actinide management with commercial fast reactors

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

Ohki, Shigeo

The capability of plutonium-breeding and minor-actinide (MA) transmutation in the Japanese commercial sodium-cooled fast reactor offers one of practical solutions for obtaining sustainable energy resources as well as reducing radioactive toxicity and inventory. The reference core design meets the requirement of flexible breeding ratio from 1.03 to 1.2. The MA transmutation amount has been evaluated as 50-100 kg/GW{sub e}y if the MA content in fresh fuel is 3-5 wt%, where about 30-40% of initial MA can be transmuted in the discharged fuel.

Identifying Practical Solutions to Meet America’s Fiber Needs: Proceedings from the Food & Fiber Summit

PubMed Central

Mobley, Amy R.; Jones, Julie Miller; Rodriguez, Judith; Slavin, Joanne; Zelman, Kathleen M.

2014-01-01

Fiber continues to be singled out as a nutrient of public health concern. Adequate intakes of fiber are associated with reduced risk for cardiovascular disease, cancer, diabetes, certain gastrointestinal disorders and obesity. Despite ongoing efforts to promote adequate fiber through increased vegetable, fruit and whole-grain intakes, average fiber consumption has remained flat at approximately half of the recommended daily amounts. Research indicates that consumers report increasingly attempting to add fiber-containing foods, but there is confusion around fiber in whole grains. The persistent and alarmingly low intakes of fiber prompted the “Food & Fiber Summit,” which assembled nutrition researchers, educators and communicators to explore fiber’s role in public health, current fiber consumption trends and consumer awareness data with the objective of generating opportunities and solutions to help close the fiber gap. The summit outcomes highlight the need to address consumer confusion and improve the understanding of sources of fiber, to recognize the benefits of various types of fibers and to influence future dietary guidance to provide prominence and clarity around meeting daily fiber recommendations through a variety of foods and fiber types. Potential opportunities to increase fiber intake were identified, with emphasis on meal occasions and food categories that offer practical solutions for closing the fiber gap. PMID:25006857

Innovative Approach to Senior Practicum Students.

PubMed

Golightly, Melissa; Kennett, Natalie; Stout, Jacqueline A

2017-12-01

Traditional senior practicum experiences (SPEs) are microsystem based-they allow senior nursing students the opportunity to build professional nursing competencies as they transition into practice. As health care transformation continues unabated, there is a need to work toward closing the gap between nursing academia and nursing practice. A cardiovascular service line created an innovative SPE to better prepare senior nursing students for working as professional nurses in a service line model. The Senior Practicum Immersion Experience (SPIE) proved to be beneficial to senior practicum students and offered firsthand experience of the role professional nurses play in a service line model. This model increased the number of senior practicum students accepted into the cardiac service line by 50%. The SPIE creates an innovative solution to increasing the number of senior practicum students while allowing students the ability to learn and practice in a service line model. [J Nurs Educ. 2017;56(12):745-747.]. Copyright 2017, SLACK Incorporated.

Independent Community Pharmacists' Perspectives on Compounding in Contemporary Pharmacy Education

PubMed Central

McPherson, Timothy B.; Fontane, Patrick E.; Berry, Tricia; Chereson, Rasma; Bilger, Rhonda

2009-01-01

Objectives To identify compounding practices of independent community pharmacy practitioners in order to make recommendations for the development of curricular objectives for doctor of pharmacy (PharmD) programs. Methods Independent community practitioners were asked about compounding regarding their motivations, common activities, educational exposures, and recommendations for PharmD education. Results Most respondents (69%) accepted compounding as a component of pharmaceutical care and compounded dermatological preparations for local effects, oral solutions, and suspensions at least once a week. Ninety-five percent were exposed to compounding in required pharmacy school courses and most (98%) who identified compounding as a professional service offered in their pharmacy sought additional postgraduate compounding education. Regardless of the extent of compounding emphasis in the practices surveyed, 84% stated that PharmD curricula should include compounding. Conclusions Pharmacy schools should define compounding curricular objectives and develop compounding abilities in a required laboratory course to prepare graduates for pharmaceutical care practice. PMID:19564997

Tipping Points and Balancing Acts: Grand Challenges and Synergistic Opportunities of Integrating Research and Education, Science and Solutions

NASA Astrophysics Data System (ADS)

McCaffrey, M. S.; Stroeve, J. C.

2011-12-01

The "Grand Challenges" to address Global Change identified by the International Council for Science (ICSU) and its partners through the Earth System Sustainability Initiative-improving forecasting, enhancing and integrating observation systems, confining and minimizing global environmental change, responding effectively to change, as well as innovating and evaluating these efforts-require an integrative approach that engages and inspires society in general and young people in particular. What are some of the effective strategies-and stumbling blocks-in being able to make Earth System science and related sustainability efforts relevant and practical to non-technical audiences? Recent climate education projects have pioneered new strategies toward linking and infusing research with education, science with solutions. For example, the Climate Literacy and Energy Awareness Network (CLEAN), a National Science Digital Library Pathway funded by NSF, has approached this integral approach by "closing the loop" between climate and energy topics, identifying and annotating high quality online resources relating to the carbon cycle and related topics. The Inspiring Climate Education Excellence (ICEE) project, funded by NASA, offers professional development for teachers that infuses climate science with solutions as an emerging "best practice" while being sensitive to the emotional, psychological and political aspects of avoiding "gloom and doom" on one hand or advocating for particular policy solutions on another. Other examples includes NASA's climate website (http://climate.nasa.gov ), which serves as a robust, engaging portal for climate research and data, especially for educators. The recent PBS series Earth: The Operators' Manual and related book and website are other recent example of how climate science research, education and solutions can be incorporated in a way that is appealing and informative. The Alliance for Climate Education (ACE) has given assemblies in thousands of US high schools that integrate climate science and solutions in a way that inspires and informs youth, and similar programs exist internationally. Other approaches to prepare vulnerable communities, especially young people, for natural hazards and human-induced environmental change include programs such as Plan International's "Child Centered Disaster Risk Reduction- Building Resilience Through Participation," and their "Weathering the Storm" project, focusing on integrating the needs of teenage girls with climate change adaptation and risk reduction. While minimizing global environmental and climate change is crucial, these and related programs that weave research with education, science with solutions offer the potential for addressing the "Grand Challenges" by better preparing for societal and environmental tipping points through a more balanced and integrated approach to addressing change."

Clinical peripherality: development of a peripherality index for rural health services.

PubMed

Swan, Gillian M; Selvaraj, Sivasubramaniam; Godden, David J

2008-01-25

The configuration of rural health services is influenced by geography. Rural health practitioners provide a broader range of services to smaller populations scattered over wider areas or more difficult terrain than their urban counterparts. This has implications for training and quality assurance of outcomes. This exploratory study describes the development of a "clinical peripherality" indicator that has potential application to remote and rural general practice communities for planning and research purposes. Profiles of general practice communities in Scotland were created from a variety of public data sources. Four candidate variables were chosen that described demographic and geographic characteristics of each practice: population density, number of patients on the practice list, travel time to nearest specialist led hospital and travel time to Health Board administrative headquarters. A clinical peripherality index, based on these variables, was derived using factor analysis. Relationships between the clinical peripherality index and services offered by the practices and the staff profile of the practices were explored in a series of univariate analyses. Factor analysis on the four candidate variables yielded a robust one-factor solution explaining 75% variance with factor loadings ranging from 0.83 to 0.89. Rural and remote areas had higher median values and a greater scatter of clinical peripherality indices among their practices than an urban comparison area. The range of services offered and the profile of staffing of practices was associated with the peripherality index. Clinical peripherality is determined by the nature of the practice and its location relative to secondary care and administrative and educational facilities. It has features of both gravity model-based and travel time/accessibility indicators and has the potential to be applied to training of staff for rural and remote locations and to other aspects of health policy and planning. It may assist planners in conceptualising the effects on general practices of centralising specialist clinical services or administrative and educational facilities.

Clinical peripherality: development of a peripherality index for rural health services

PubMed Central

Swan, Gillian M; Selvaraj, Sivasubramaniam; Godden, David J

2008-01-01

Background The configuration of rural health services is influenced by geography. Rural health practitioners provide a broader range of services to smaller populations scattered over wider areas or more difficult terrain than their urban counterparts. This has implications for training and quality assurance of outcomes. This exploratory study describes the development of a "clinical peripherality" indicator that has potential application to remote and rural general practice communities for planning and research purposes. Methods Profiles of general practice communities in Scotland were created from a variety of public data sources. Four candidate variables were chosen that described demographic and geographic characteristics of each practice: population density, number of patients on the practice list, travel time to nearest specialist led hospital and travel time to Health Board administrative headquarters. A clinical peripherality index, based on these variables, was derived using factor analysis. Relationships between the clinical peripherality index and services offered by the practices and the staff profile of the practices were explored in a series of univariate analyses. Results Factor analysis on the four candidate variables yielded a robust one-factor solution explaining 75% variance with factor loadings ranging from 0.83 to 0.89. Rural and remote areas had higher median values and a greater scatter of clinical peripherality indices among their practices than an urban comparison area. The range of services offered and the profile of staffing of practices was associated with the peripherality index. Conclusion Clinical peripherality is determined by the nature of the practice and its location relative to secondary care and administrative and educational facilities. It has features of both gravity model-based and travel time/accessibility indicators and has the potential to be applied to training of staff for rural and remote locations and to other aspects of health policy and planning. It may assist planners in conceptualising the effects on general practices of centralising specialist clinical services or administrative and educational facilities. PMID:18221533

Social services in Sweden: an overview of policy issues, devolution, and collaboration.

PubMed

Holosko, Michael J; Holosko, Deborah Ann; Spencer, Katherine

2009-01-01

This article is the first of three related to social welfare policy in Sweden. It presents an overview of social services in Sweden highlighting its history, financing, and the various welfare programs offered in one of the more unique liberal democracies in the world. Sweden has had a long-standing historic commitment to the social welfare of its citizens. Its social services are aimed primarily in two areas: care of individuals and families and care of the elderly and disabled persons. The article then presents a generalized discussion of the global devolution revolution and how this impacts policies, best practices, and service delivery. It concludes with the solution to the worldwide devolution revolution-collaboration-and offers some of the stories behind the story of collaboration in various countries and communities of the world.

Haptic interface of web-based training system for interventional radiology procedures

NASA Astrophysics Data System (ADS)

Ma, Xin; Lu, Yiping; Loe, KiaFock; Nowinski, Wieslaw L.

2004-05-01

The existing web-based medical training systems and surgical simulators can provide affordable and accessible medical training curriculum, but they seldom offer the trainee realistic and affordable haptic feedback. Therefore, they cannot offer the trainee a suitable practicing environment. In this paper, a haptic solution for interventional radiology (IR) procedures is proposed. System architecture of a web-based training system for IR procedures is briefly presented first. Then, the mechanical structure, the working principle and the application of a haptic device are discussed in detail. The haptic device works as an interface between the training environment and the trainees and is placed at the end user side. With the system, the user can be trained on the interventional radiology procedures - navigating catheters, inflating balloons, deploying coils and placing stents on the web and get surgical haptic feedback in real time.

A robust ordering strategy for retailers facing a free shipping option.

PubMed

Meng, Qing-chun; Wan, Xiao-le; Rong, Xiao-xia

2015-01-01

Free shipping with conditions has become one of the most effective marketing tools available. An increasing number of companies, especially e-businesses, prefer to offer free shipping with some predetermined condition, such as a minimum purchase amount by the customer. However, in practice, the demands of buyers are uncertain; they are often affected by many factors, such as the weather and season. We begin by modeling the centralized ordering problem in which the supplier offers a free shipping service and retailers face stochastic demands. As these random data are considered, only partial information such as the known mean, support, and deviation is needed. The model is then analyzed via a robust optimization method, and the two types of equivalent sets of uncertainty constraints that are obtained provide good mathematical properties with consideration of the robustness of solutions. Subsequently, a numerical example is used to compare the results achieved from a robust optimization method and the linear decision rules. Additionally, the robustness of the optimal solution is discussed, as it is affected by the minimum quantity parameters. The increasing cost-threshold relationship is divided into three periods. In addition, the case study shows that the proposed method achieves better stability as well as computational complexity.

How doctors learn: the role of clinical problems across the medical school-to-practice continuum.

PubMed

Slotnick, H B

1996-01-01

The author proposes a theory of how physicians learn that uses clinical problem solving as its central feature. His theory, which integrates insights from Maslow, Schön, Norman, and others, claims that physicians-in-training and practicing physicians learn largely by deriving insights from clinical experience. These insights allow the learner to solve future problems and thereby address the learner's basic human needs for security, affiliation, and self-esteem. Ensuring that students gain such insights means that the proper roles of the teacher are (1) to select problems for students to solve and offer guidance on how to solve them, and (2) to serve as a role model of how to reflect on the problem, its solution, and the solution's effectiveness. Three principles guide instruction within its framework for learning: (1) learners, whether physicians-in-training or practicing physicians, seek to solve problems they recognize they have; (2) learners want to be involved in their own learning; and (3) instruction must both be time-efficient and also demonstrate the range of ways in which students can apply what they learn. The author concludes by applying the theory to an aspect of undergraduate education and to the general process of continuing medical education.

Tulsi - Ocimum sanctum: A herb for all reasons

PubMed Central

Cohen, Marc Maurice

2014-01-01

The predominant cause of global morbidity and mortality is lifestyle-related chronic diseases, many of which can be addressed through Ayurveda with its focus on healthy lifestyle practices and regular consumption of adaptogenic herbs. Of all the herbs used within Ayurveda, tulsi (Ocimum sanctum Linn) is preeminent, and scientific research is now confirming its beneficial effects. There is mounting evidence that tulsi can address physical, chemical, metabolic and psychological stress through a unique combination of pharmacological actions. Tulsi has been found to protect organs and tissues against chemical stress from industrial pollutants and heavy metals, and physical stress from prolonged physical exertion, ischemia, physical restraint and exposure to cold and excessive noise. Tulsi has also been shown to counter metabolic stress through normalization of blood glucose, blood pressure and lipid levels, and psychological stress through positive effects on memory and cognitive function and through its anxiolytic and anti-depressant properties. Tulsi's broad-spectrum antimicrobial activity, which includes activity against a range of human and animal pathogens, suggests it can be used as a hand sanitizer, mouthwash and water purifier as well as in animal rearing, wound healing, the preservation of food stuffs and herbal raw materials and traveler's health. Cultivation of tulsi plants has both spiritual and practical significance that connects the grower to the creative powers of nature, and organic cultivation offers solutions for food security, rural poverty, hunger, environmental degradation and climate change. The use of tulsi in daily rituals is a testament to Ayurvedic wisdom and provides an example of ancient knowledge offering solutions to modern problems. PMID:25624701

A stable solution-processed polymer semiconductor with record high-mobility for printed transistors

PubMed Central

Li, Jun; Zhao, Yan; Tan, Huei Shuan; Guo, Yunlong; Di, Chong-An; Yu, Gui; Liu, Yunqi; Lin, Ming; Lim, Suo Hon; Zhou, Yuhua; Su, Haibin; Ong, Beng S.

2012-01-01

Microelectronic circuits/arrays produced via high-speed printing instead of traditional photolithographic processes offer an appealing approach to creating the long-sought after, low-cost, large-area flexible electronics. Foremost among critical enablers to propel this paradigm shift in manufacturing is a stable, solution-processable, high-performance semiconductor for printing functionally capable thin-film transistors — fundamental building blocks of microelectronics. We report herein the processing and optimisation of solution-processable polymer semiconductors for thin-film transistors, demonstrating very high field-effect mobility, high on/off ratio, and excellent shelf-life and operating stabilities under ambient conditions. Exceptionally high-gain inverters and functional ring oscillator devices on flexible substrates have been demonstrated. This optimised polymer semiconductor represents a significant progress in semiconductor development, dispelling prevalent skepticism surrounding practical usability of organic semiconductors for high-performance microelectronic devices, opening up application opportunities hitherto functionally or economically inaccessible with silicon technologies, and providing an excellent structural framework for fundamental studies of charge transport in organic systems. PMID:23082244

Regenerative medicine blueprint.

PubMed

Terzic, Andre; Harper, C Michel; Gores, Gregory J; Pfenning, Michael A

2013-12-01

Regenerative medicine, a paragon of future healthcare, holds unprecedented potential in extending the reach of treatment modalities for individuals across diseases and lifespan. Emerging regenerative technologies, focused on structural repair and functional restoration, signal a radical transformation in medical and surgical practice. Regenerative medicine is poised to provide innovative solutions in addressing major unmet needs for patients, ranging from congenital disease and trauma to degenerative conditions. Realization of the regenerative model of care predicates a stringent interdisciplinary paradigm that will drive validated science into standardized clinical options. Designed as a catalyst in advancing rigorous new knowledge on disease causes and cures into informed delivery of quality care, the Mayo Clinic regenerative medicine blueprint offers a patient-centered, team-based strategy that optimizes the discovery-translation-application roadmap for the express purpose of science-supported practice advancement.

Green Commuting in the Health Care Sector: Obstacles and Best Practices.

PubMed

Kaplan, Susan; Ai, Ning; Orris, Peter; Sriraj, P S

2016-02-01

Fossil fuel transportation by health care providers contributes to the prevalence of diseases they treat. We conducted an exploratory study to understand obstacles to, and best practices for, greener commuting among health care providers. We surveyed staff of three hospital clinics as to how they commute and why, and interviewed key staff of five hospital leaders in green commuting about their programs. Factors that might change respondents' commuting choices from driving alone included financial incentives, convenience, and solutions to crime and safety concerns. Successful green commuting programs offer benefits including free or reduced transit passes, shuttle buses to transit stations, and free emergency rides home. Exemplary programs throughout the country demonstrate that modifying those factors within reach can impact the amount of fossil fuel energy used for health care provider transportation.

Analytic solution of field distribution and demagnetization function of ideal hollow cylindrical field source

NASA Astrophysics Data System (ADS)

Xu, Xiaonong; Lu, Dingwei; Xu, Xibin; Yu, Yang; Gu, Min

2017-09-01

The Halbach type hollow cylindrical permanent magnet array (HCPMA) is a volume compact and energy conserved field source, which have attracted intense interests in many practical applications. Here, using the complex variable integration method based on the Biot-Savart Law (including current distributions inside the body and on the surfaces of magnet), we derive analytical field solutions to an ideal multipole HCPMA in entire space including the interior of magnet. The analytic field expression inside the array material is used to construct an analytic demagnetization function, with which we can explain the origin of demagnetization phenomena in HCPMA by taking into account an ideal magnetic hysteresis loop with finite coercivity. These analytical field expressions and demagnetization functions provide deeper insight into the nature of such permanent magnet array systems and offer guidance in designing optimized array system.

Ethical dilemmas in personality assessment courses: using the classroom for in vivo training.

PubMed

Yalof, J; Brabender, V

2001-10-01

In this article, we argue that the student's first lessons in ethical decision making in personality assessment are in those assessment courses that have a practice component. In these courses, the student has an opportunity to experience in vivo how ethical problems are identified, addressed, and resolved. The faculty member's demonstration of a process wherein the ethical principles activated are highlighted and explored, will enable students to internalize a model for addressing future dilemmas. Four particular ethical situations are considered: (a) the students' procurement of personal experience with personality testing, (b) the identification of assessment participants, (c) the development of informed consent procedures for assessment participants, and (d) classroom presentations. This discussion does not provide concrete solutions to ethical problems but offers a consideration of the relevant ethical principles that any adequate solution must encompass.

Theoretical Evaluation of the Transient Response of Constant Head and Constant Flow-Rate Permeability Tests

USGS Publications Warehouse

Zhang, M.; Takahashi, M.; Morin, R.H.; Esaki, T.

1998-01-01

A theoretical analysis is presented that compares the response characteristics of the constant head and the constant flowrate (flow pump) laboratory techniques for quantifying the hydraulic properties of geologic materials having permeabilities less than 10-10 m/s. Rigorous analytical solutions that describe the transient distributions of hydraulic gradient within a specimen are developed, and equations are derived for each method. Expressions simulating the inflow and outflow rates across the specimen boundaries during a constant-head permeability test are also presented. These solutions illustrate the advantages and disadvantages of each method, including insights into measurement accuracy and the validity of using Darcy's law under certain conditions. The resulting observations offer practical considerations in the selection of an appropriate laboratory test method for the reliable measurement of permeability in low-permeability geologic materials.

Exploring incentives for RNs to return to practice: a partial solution to the nursing shortage.

PubMed

Langan, Joanne C; Tadych, Rita A; Kao, Chia-Chan

2007-01-01

Although many have suggested strategies to resolve the nursing shortage, few have considered inactive RNs. This pilot study investigated reasons why nurses leave the practice, the type of work environment and resources necessary to entice RNs to return to practice, and the specific skills required to assist RNs in feeling confident and competent to return to practice. Herzberg's Two-Factor Theory was used to study motivation and hygiene factors enticing RNs to practice. A screening questionnaire was sent to 1,004 randomly selected RNs in Missouri to determine who were licensed but not practicing. Fifty-two full questionnaires were mailed and 33 (63%) were returned. Quantitative data were analyzed using SPSS, whereas qualitative data were coded and analyzed using manifest content analysis. The lack of motivators such as recognition of one's work and achievements was one reason why RNs left the practice. The hygiene factors of money, improved working conditions, refresher courses, and health insurance would motivate RNs to return to practice. Those wishing to entice inactive nurses to practice will need to offer sign-on bonuses or make the hourly wages and benefits package very competitive. This study indicates that nurses value flexible working hours, part-time opportunities, consideration of family lives, and positive relationships with administrators.

The theoretical base of e-learning and its role in surgical education.

PubMed

Evgeniou, Evgenios; Loizou, Peter

2012-01-01

The advances in Internet and computer technology offer many solutions that can enhance surgical education and increase the effectiveness of surgical teaching. E-learning plays an important role in surgical education today, with many e-learning projects already available on the Internet. E-learning is based on a mixture of educational theories that derive from behaviorist, cognitivist, and constructivist educational theoretical frameworks. CAN EDUCATIONAL THEORY IMPROVE E-LEARNING?: Conventional educational theory can be applied to improve the quality and effectiveness of e-learning. The theory of "threshold concepts" and educational theories on reflection, motivation, and communities of practice can be applied when designing e-learning material. E-LEARNING IN SURGICAL EDUCATION: E-learning has many advantages but also has weaknesses. Studies have shown that e-learning is an effective teaching method that offers high levels of learner satisfaction. Instead of trying to compare e-learning with traditional methods of teaching, it is better to integrate in e-learning elements of traditional teaching that have been proven to be effective. E-learning can play an important role in surgical education as a blended approach, combined with more traditional methods of teaching, which offer better face-to-interaction with patients and colleagues in different circumstances and hands on practice of practical skills. National provision of e-learning can make evaluation easier. The correct utilization of Internet and computer resources combined with the application of valid conventional educational theory to design e-learning relevant to the various levels of surgical training can be effective in the training of future surgeons. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Foundation doctors and dyslexia: a qualitative study of their experiences and coping strategies.

PubMed

Newlands, Freda; Shrewsbury, Duncan; Robson, Jean

2015-03-01

Dyslexia is the most common form of specific learning difficulty affecting approximately 6% of the general UK population and believed to affect approximately 2% of UK medical students. The impact of dyslexia on early practice has not been studied. To develop an understanding of the challenges faced by doctors with dyslexia in the first year of practice and their support requirements. Semistructured telephone interviews were conducted with seven foundation year 1 doctors with dyslexia from Scottish hospitals between March 2013 and August 2013. Foundation doctors indicated that due to their dyslexia, they experience difficulty with all forms of communication, time management and anxiety. There were concerns about disclosure of their dyslexia to colleagues and supervisors. Coping strategies used frequently were safety-netting and planning; technology solutions did offer some assistance. Although technological interventions have the potential to offer benefits to foundation doctors with dyslexia, increased openness about a diagnosis of dyslexia with discussion between doctor and supervisors about the challenges and anxieties is likely to provide the most benefit. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A brief introduction to mixed effects modelling and multi-model inference in ecology

PubMed Central

Donaldson, Lynda; Correa-Cano, Maria Eugenia; Goodwin, Cecily E.D.

2018-01-01

The use of linear mixed effects models (LMMs) is increasingly common in the analysis of biological data. Whilst LMMs offer a flexible approach to modelling a broad range of data types, ecological data are often complex and require complex model structures, and the fitting and interpretation of such models is not always straightforward. The ability to achieve robust biological inference requires that practitioners know how and when to apply these tools. Here, we provide a general overview of current methods for the application of LMMs to biological data, and highlight the typical pitfalls that can be encountered in the statistical modelling process. We tackle several issues regarding methods of model selection, with particular reference to the use of information theory and multi-model inference in ecology. We offer practical solutions and direct the reader to key references that provide further technical detail for those seeking a deeper understanding. This overview should serve as a widely accessible code of best practice for applying LMMs to complex biological problems and model structures, and in doing so improve the robustness of conclusions drawn from studies investigating ecological and evolutionary questions. PMID:29844961

A brief introduction to mixed effects modelling and multi-model inference in ecology.

PubMed

Harrison, Xavier A; Donaldson, Lynda; Correa-Cano, Maria Eugenia; Evans, Julian; Fisher, David N; Goodwin, Cecily E D; Robinson, Beth S; Hodgson, David J; Inger, Richard

2018-01-01

The use of linear mixed effects models (LMMs) is increasingly common in the analysis of biological data. Whilst LMMs offer a flexible approach to modelling a broad range of data types, ecological data are often complex and require complex model structures, and the fitting and interpretation of such models is not always straightforward. The ability to achieve robust biological inference requires that practitioners know how and when to apply these tools. Here, we provide a general overview of current methods for the application of LMMs to biological data, and highlight the typical pitfalls that can be encountered in the statistical modelling process. We tackle several issues regarding methods of model selection, with particular reference to the use of information theory and multi-model inference in ecology. We offer practical solutions and direct the reader to key references that provide further technical detail for those seeking a deeper understanding. This overview should serve as a widely accessible code of best practice for applying LMMs to complex biological problems and model structures, and in doing so improve the robustness of conclusions drawn from studies investigating ecological and evolutionary questions.

Clinical decision support systems in child and adolescent psychiatry: a systematic review.

PubMed

Koposov, Roman; Fossum, Sturla; Frodl, Thomas; Nytrø, Øystein; Leventhal, Bennett; Sourander, Andre; Quaglini, Silvana; Molteni, Massimo; de la Iglesia Vayá, María; Prokosch, Hans-Ulrich; Barbarini, Nicola; Milham, Michael Peter; Castellanos, Francisco Xavier; Skokauskas, Norbert

2017-11-01

Psychiatric disorders are amongst the most prevalent and impairing conditions in childhood and adolescence. Unfortunately, it is well known that general practitioners (GPs) and other frontline health providers (i.e., child protection workers, public health nurses, and pediatricians) are not adequately trained to address these ubiquitous problems (Braddick et al. Child and Adolescent mental health in Europe: infrastructures, policy and programmes, European Communities, 2009; Levav et al. Eur Child Adolesc Psychiatry 13:395-401, 2004). Advances in technology may offer a solution to this problem with clinical decision support systems (CDSS) that are designed to help professionals make sound clinical decisions in real time. This paper offers a systematic review of currently available CDSS for child and adolescent mental health disorders prepared according to the PRISMA-Protocols (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols). Applying strict eligibility criteria, the identified studies (n = 5048) were screened. Ten studies, describing eight original clinical decision support systems for child and adolescent psychiatric disorders, fulfilled inclusion criteria. Based on this systematic review, there appears to be a need for a new, readily available CDSS for child neuropsychiatric disorder which promotes evidence-based, best practices, while enabling consideration of national variation in practices by leveraging data-reuse to generate predictions regarding treatment outcome, addressing a broader cluster of clinical disorders, and targeting frontline practice environments.

Recruitment ad analysis offers new opportunities to attract GPs to short-staffed practices.

PubMed

Hemphill, Elizabeth; Kulik, Carol T

2013-01-01

As baby-boomer practitioners exit the workforce, physician shortages present new recruitment challenges for practices seeking GPs. This article reports findings from two studies examining GP recruitment practice. GP recruitment ad content analysis (Study 1) demonstrated that both Internet and print ads emphasize job attributes but rarely present family or practice attributes. Contacts at these medical practices reported that their practices offer distinctive family and practice attributes that could be exploited in recruitment advertising (Study 2). Understaffed medical practices seeking to attract GPs may differentiate their job offerings in a crowded market by incorporating family and/or practice attributes into their ads.

Efficient Privacy-Aware Record Integration.

PubMed

Kuzu, Mehmet; Kantarcioglu, Murat; Inan, Ali; Bertino, Elisa; Durham, Elizabeth; Malin, Bradley

2013-01-01

The integration of information dispersed among multiple repositories is a crucial step for accurate data analysis in various domains. In support of this goal, it is critical to devise procedures for identifying similar records across distinct data sources. At the same time, to adhere to privacy regulations and policies, such procedures should protect the confidentiality of the individuals to whom the information corresponds. Various private record linkage (PRL) protocols have been proposed to achieve this goal, involving secure multi-party computation (SMC) and similarity preserving data transformation techniques. SMC methods provide secure and accurate solutions to the PRL problem, but are prohibitively expensive in practice, mainly due to excessive computational requirements. Data transformation techniques offer more practical solutions, but incur the cost of information leakage and false matches. In this paper, we introduce a novel model for practical PRL, which 1) affords controlled and limited information leakage, 2) avoids false matches resulting from data transformation. Initially, we partition the data sources into blocks to eliminate comparisons for records that are unlikely to match. Then, to identify matches, we apply an efficient SMC technique between the candidate record pairs. To enable efficiency and privacy, our model leaks a controlled amount of obfuscated data prior to the secure computations. Applied obfuscation relies on differential privacy which provides strong privacy guarantees against adversaries with arbitrary background knowledge. In addition, we illustrate the practical nature of our approach through an empirical analysis with data derived from public voter records.

Prevention and treatment of low back pain: evidence, challenges, and promising directions.

PubMed

Foster, Nadine E; Anema, Johannes R; Cherkin, Dan; Chou, Roger; Cohen, Steven P; Gross, Douglas P; Ferreira, Paulo H; Fritz, Julie M; Koes, Bart W; Peul, Wilco; Turner, Judith A; Maher, Chris G

2018-06-09

Many clinical practice guidelines recommend similar approaches for the assessment and management of low back pain. Recommendations include use of a biopsychosocial framework to guide management with initial non-pharmacological treatment, including education that supports self-management and resumption of normal activities and exercise, and psychological programmes for those with persistent symptoms. Guidelines recommend prudent use of medication, imaging, and surgery. The recommendations are based on trials almost exclusively from high-income countries, focused mainly on treatments rather than on prevention, with limited data for cost-effectiveness. However, globally, gaps between evidence and practice exist, with limited use of recommended first-line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related disability or its long-term consequences. The advances with the greatest potential are arguably those that align practice with the evidence, reduce the focus on spinal abnormalities, and ensure promotion of activity and function, including work participation. We have identified effective, promising, or emerging solutions that could offer new directions, but that need greater attention and further research to determine if they are appropriate for large-scale implementation. These potential solutions include focused strategies to implement best practice, the redesign of clinical pathways, integrated health and occupational interventions to reduce work disability, changes in compensation and disability claims policies, and public health and prevention strategies. Copyright © 2018 Elsevier Ltd. All rights reserved.

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.

Generating high Reynolds-number flows.

NASA Technical Reports Server (NTRS)

Russell, D. A.

1972-01-01

Present test facilities are seriously limited regarding investigations involving high Reynolds numbers due to financial considerations. Quasi-steady testing facilities offer a practical immediate solution to the problem of high-Re testing. A familiar example is the blowdown wind tunnel, but even more flexibility and economy may be provided by using shock-tube devices. The Ludwieg tube is the shock-tube device most often proposed as a means of generating high-Re flows. Two-stage nozzles may be used with a Ludwieg tube. Quasi-steady facilities will be useful only if the available test time exceeds that required to establish steady flow.

Fusion splicing small-core photonic crystal fibers and single-mode fibers by repeated arc discharges.

PubMed

Xiao, Limin; Jin, Wei; Demokan, M S

2007-01-15

We demonstrate a novel method for low-loss splicing small-core photonic crystal fibers (PCFs) and single-mode fibers (SMFs) by repeated arc discharges using a conventional fusion splicer. An optimum mode field match at the interface of PCF-SMF and an adiabatic mode field variation in the longitudinal direction of the small-core PCF can be achieved by repeated arc discharges applied over the splicing joint to gradually collapse the air holes of the small-core PCF. This method is simple and offers a practical solution for light coupling between small-core PCFs and SMFs.

Fusion splicing small-core photonic crystal fibers and single-mode fibers by repeated arc discharges

NASA Astrophysics Data System (ADS)

Xiao, Limin; Jin, Wei; Demokan, M. S.

2007-01-01

We demonstrate a novel method for low-loss splicing small-core photonic crystal fibers (PCFs) and single-mode fibers (SMFs) by repeated arc discharges using a conventional fusion splicer. An optimum mode field match at the interface of PCF-SMF and an adiabatic mode field variation in the longitudinal direction of the small-core PCF can be achieved by repeated arc discharges applied over the splicing joint to gradually collapse the air holes of the small-core PCF. This method is simple and offers a practical solution for light coupling between small-core PCFs and SMFs.

16 CFR 453.3 - Misrepresentations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Misrepresentations. (a) Embalming provisions—(1) Deceptive acts or practices. In selling or offering to sell funeral... practices. In selling or offering to sell funeral goods or funeral services to the public, it is a deceptive... practices. In selling or offering to sell funeral goods and funeral services to the public, it is a...

Gaming of performance measurement in health care: parallels with tax compliance.

PubMed

Mears, Alex; Webley, Paul

2010-10-01

Gaming of performance measurement in health care distorts performance, making it appear better than it is. This can conceal potentially hazardous practice and endanger patients and staff. Research has investigated and categorized this behaviour but as yet has offered little in the way of potential solutions as the drivers are still not well understood. Studies of the psychology of tax behaviour, specifically tax avoidance and evasion, reveal some insights into what the underlying causes are. Looking at health care and tax compliance, seven similarities in response can be detected: negative view of those subject to it; not salient except for specific classes of people; general understanding of the need versus resentment of actuality; cognitive dissonance; moral versus legal grey areas; two levels of objective non-compliance; and four categories of subjective behaviour and attitude. We suggest a model of reaction and compliance for gaming and offer some suggestions as to how this phenomenon might be minimized.

The complex system of environmental monitoring (CSEM). An analysis of concept

NASA Astrophysics Data System (ADS)

Kazatsev, Yury I.; Mitchenkov, Igor G.

2018-01-01

Researches of ecological processes in Russia testify to rather difficult and adverse situation. It is quite obviously that we need a reasonable concept of an exit from the situation. It could become the strategic program for the solution of ecological tasks at the same time. In this regard, it is obviously necessary not just to develop new scientific and technological mechanisms to overcome of critical situations, but to offer a new research platform which will be able to give ideas to predict tendencies of ecological development and to analyses the consequences of their embodiment. Our offer for it is “the composite system of environmental monitoring” (CSEM) of the territory or region. We use a method of the conceptual analysis. Also, we will try to show how definition of the term influences to contents of social practicing, namely, environmental monitoring of the region.

Biological Small Angle Scattering: Techniques, Strategies and Tips

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

Chaudhuri, Barnali; Muñoz, Inés G.; Urban, Volker S.

This book provides a clear, comprehensible and up-to-date description of how Small Angle Scattering (SAS) can help structural biology researchers. SAS is an efficient technique that offers structural information on how biological macromolecules behave in solution. SAS provides distinct and complementary data for integrative structural biology approaches in combination with other widely used probes, such as X-ray crystallography, Nuclear magnetic resonance, Mass spectrometry and Cryo-electron Microscopy. The development of brilliant synchrotron small-angle X-ray scattering (SAXS) beam lines has increased the number of researchers interested in solution scattering. SAS is especially useful for studying conformational changes in proteins, highly flexible proteins,more » and intrinsically disordered proteins. Small-angle neutron scattering (SANS) with neutron contrast variation is ideally suited for studying multi-component assemblies as well as membrane proteins that are stabilized in surfactant micelles or vesicles. SAS is also used for studying dynamic processes of protein fibrillation in amyloid diseases, and pharmaceutical drug delivery. The combination with size-exclusion chromatography further increases the range of SAS applications.The book is written by leading experts in solution SAS methodologies. The principles and theoretical background of various SAS techniques are included, along with practical aspects that range from sample preparation to data presentation for publication. Topics covered include techniques for improving data quality and analysis, as well as different scientific applications of SAS. With abundant illustrations and practical tips, we hope the clear explanations of the principles and the reviews on the latest progresses will serve as a guide through all aspects of biological solution SAS.The scope of this book is particularly relevant for structural biology researchers who are new to SAS. Advanced users of the technique will find it helpful for exploring the diversity of solution SAS methods and applications.« less

Secure quantum private information retrieval using phase-encoded queries

NASA Astrophysics Data System (ADS)

Olejnik, Lukasz

2011-08-01

We propose a quantum solution to the classical private information retrieval (PIR) problem, which allows one to query a database in a private manner. The protocol offers privacy thresholds and allows the user to obtain information from a database in a way that offers the potential adversary, in this model the database owner, no possibility of deterministically establishing the query contents. This protocol may also be viewed as a solution to the symmetrically private information retrieval problem in that it can offer database security (inability for a querying user to steal its contents). Compared to classical solutions, the protocol offers substantial improvement in terms of communication complexity. In comparison with the recent quantum private queries [Phys. Rev. Lett.PRLTAO0031-900710.1103/PhysRevLett.100.230502 100, 230502 (2008)] protocol, it is more efficient in terms of communication complexity and the number of rounds, while offering a clear privacy parameter. We discuss the security of the protocol and analyze its strengths and conclude that using this technique makes it challenging to obtain the unconditional (in the information-theoretic sense) privacy degree; nevertheless, in addition to being simple, the protocol still offers a privacy level. The oracle used in the protocol is inspired both by the classical computational PIR solutions as well as the Deutsch-Jozsa oracle.

[Opinion of the primary care veterinarians of Andalusia concerning the management of their professional practice].

PubMed

Conti Cuesta, F; Baena Parejo, M I; Pinzón Pulido, S A

1999-01-01

This study describes the opinion of the veterinarians in Andalusia regarding the organization and management of their professional practice and pinpoints solutions to the problems found for the purpose of providing planning and management aspects in view of the reforms undertaken in the Andalusian Health Service Strategy Plan. Descriptive opinion poll employing a questionnaire filled out by each individual among all of the Primary Care (PC) veterinarians in Andalusia (including those who have been currently employed who possess at least one year's experience, except substitutes). A description was provided of their personal traits, their opinion of the management-related factors involved in their professional practice. A description was also provided of the suggestions for improving the problems found to exist. Over 70% said they were aware of the objectives, although only the coordinators found them to be clearly motivating the practice. Their opinion was that the indicators of activity neither include any quality-related criteria nor afford the possibility of evaluating the activity they are carrying out. They believed that the contributions from other members of the multidisciplinary team improve their work and are in favor of continuing their involvement therein. They were satisfied with doing their work (the coordinators to a greater degree). They found the productivity pay to be too low and not useful as regards providing them with any incentive. They were not satisfied with the training with which they are provided and thought that what they are offered is far less than their other colleagues in the health care field. Most were of the opinion that they should remain under the authority of the Andalusian Health Service. This group prefers to continue working for the same organization, but improving the following management aspects: training offer, practice incentives and activity indicators.

Feasibility and impact of a computer-guided consultation on guideline-based management of COPD in general practice.

PubMed

Angus, Robert M; Thompson, Elizabeth B; Davies, Lisa; Trusdale, Ann; Hodgson, Chris; McKnight, Eddie; Davies, Andrew; Pearson, Mike G

2012-12-01

Applying guidelines is a universal challenge that is often not met. Intelligent software systems that facilitate real-time management during a clinical interaction may offer a solution. To determine if the use of a computer-guided consultation that facilitates the National Institute for Health and Clinical Excellence-based chronic obstructive pulmonary disease (COPD) guidance and prompts clinical decision-making is feasible in primary care and to assess its impact on diagnosis and management in reviews of COPD patients. Practice nurses, one-third of whom had no specific respiratory training, undertook a computer-guided review in the usual consulting room setting using a laptop computer with the screen visible to them and to the patient. A total of 293 patients (mean (SD) age 69.7 (10.1) years, 163 (55.6%) male) with a diagnosis of COPD were randomly selected from GP databases in 16 practices and assessed. Of 236 patients who had spirometry, 45 (19%) did not have airflow obstruction and the guided clinical history changed the primary diagnosis from COPD in a further 24 patients. In the 191 patients with confirmed COPD, the consultations prompted management changes including 169 recommendations for altered prescribing of inhalers (addition or discontinuation, inhaler dose or device). In addition, 47% of the 55 current smokers were referred for smoking cessation support, 12 (6%) for oxygen assessment, and 47 (24%) for pulmonary rehabilitation. Computer-guided consultations are practicable in general practice. Primary care COPD databases were confirmed to contain a significant proportion of incorrectly assigned patients. They resulted in interventions and the rationalisation of prescribing in line with recommendations. Only in 22 (12%) of those fully assessed was no management change suggested. The introduction of a computer-guided consultation offers the prospect of comprehensive guideline quality management.

Strategies for Information Retrieval and Virtual Teaming to Mitigate Risk on NASA's Missions

NASA Technical Reports Server (NTRS)

Topousis, Daria; Williams, Gregory; Murphy, Keri

2007-01-01

Following the loss of NASA's Space Shuttle Columbia in 2003, it was determined that problems in the agency's organization created an environment that led to the accident. One component of the proposed solution resulted in the formation of the NASA Engineering Network (NEN), a suite of information retrieval and knowledge sharing tools. This paper describes the implementation of this set of search, portal, content management, and semantic technologies, including a unique meta search capability for data from distributed engineering resources. NEN's communities of practice are formed along engineering disciplines where users leverage their knowledge and best practices to collaborate and take informal learning back to their personal jobs and embed it into the procedures of the agency. These results offer insight into using traditional engineering disciplines for virtual teaming and problem solving.

Building a sustainable Academic Health Department: the South Carolina model.

PubMed

Smith, Lillian Upton; Waddell, Lisa; Kyle, Joseph; Hand, Gregory A

2014-01-01

Given the limited resources available to public health, it is critical that university programs complement the development needs of agencies. Unfortunately, academic and practice public health entities have long been challenged in building sustainable collaborations that support practice-based research, teaching, and service. The academic health department concept offers a promising solution. In South Carolina, the partners started their academic health department program with a small grant that expanded into a dynamic infrastructure that supports innovative professional exchange and development programs. This article provides a background and describes the key elements of the South Carolina model: joint leadership, a multicomponent memorandum of agreement, and a shared professional development mission. The combination of these elements allows the partners to leverage resources and deftly respond to challenges and opportunities, ultimately fostering the sustainability of the collaboration.

"I am a trained nurse": the nursing identity of anarchist and radical Emma Goldman.

PubMed

Connolly, Cynthia Anne

2010-01-01

For more than a century, scholars have analyzed the many dimensions of Emma Goldman. Remembered as an agent of revolution, feminism, sexual freedom, anarchy, and atheism, Goldman's motives, personality, and actions have generated an entire subgenre of historical scholarship. But although Goldman practiced nursing in New York City for ten years, one facet of her life that has been neglected is her nursing identity. Goldman's autobiography, Living My Life, reveals the way her nursing experiences informed her evolving anarchist political philosophy and international activism. She valued nursing for many reasons--for the economic independence it offered, identity it provided, and sense of community and connectivity she believed it encouraged. Finally, for Goldman, nursing represented was a vehicle to understand people's struggles and as a way of translating political philosophy into meaningful, practical solutions.

Practical Designs of Brain-Computer Interfaces Based on the Modulation of EEG Rhythms

NASA Astrophysics Data System (ADS)

Wang, Yijun; Gao, Xiaorong; Hong, Bo; Gao, Shangkai

A brain-computer interface (BCI) is a communication channel which does not depend on the brain's normal output pathways of peripheral nerves and muscles [1-3]. It supplies paralyzed patients with a new approach to communicate with the environment. Among various brain monitoring methods employed in current BCI research, electroencephalogram (EEG) is the main interest due to its advantages of low cost, convenient operation and non-invasiveness. In present-day EEG-based BCIs, the following signals have been paid much attention: visual evoked potential (VEP), sensorimotor mu/beta rhythms, P300 evoked potential, slow cortical potential (SCP), and movement-related cortical potential (MRCP). Details about these signals can be found in chapter "Brain Signals for Brain-Computer Interfaces". These systems offer some practical solutions (e.g., cursor movement and word processing) for patients with motor disabilities.

Two Wrongs Do Not Make a Right: Flaws in Alternatives to Fee-for-Service Payment Plans Do Not Mean Fee-for-Service Is a Good Solution to Rising Prices Comment on "Fee-for-Service Payment - An Evil Practice That Must Be Stamped Out?".

PubMed

Koppel, Ross

2015-05-11

Professor Naoki Ikegami's "Fee-for-service payment - an evil practice that must be stamped out" summarizes many of the failings of alternatives to fee-for-service (FFS) payment systems. His article also offers several suggestions for improving FFS systems. However, even powerful arguments against many of the alternatives to FFS, does not make a convincing argument for FFS systems. In addition, there are significant misunderstandings in Professor Ikegami's presentation of and use of United States payment methods, the role of private vs. public insurance systems, and the increasing role of "accountable care organizations. © 2015 by Kerman University of Medical Sciences.

Introduction to special section of the Journal of Family Psychology, advances in mixed methods in family psychology: integrative and applied solutions for family science.

PubMed

Weisner, Thomas S; Fiese, Barbara H

2011-12-01

Mixed methods in family psychology refer to the systematic integration of qualitative and quantitative techniques to represent family processes and settings. Over the past decade, significant advances have been made in study design, analytic strategies, and technological support (such as software) that allow for the integration of quantitative and qualitative methods and for making appropriate inferences from mixed methods. This special section of the Journal of Family Psychology illustrates how mixed methods may be used to advance knowledge in family science through identifying important cultural differences in family structure, beliefs, and practices, and revealing patterns of family relationships to generate new measurement paradigms and inform clinical practice. Guidance is offered to advance mixed methods research in family psychology through sound principles of peer review.

The semantic web in translational medicine: current applications and future directions

PubMed Central

Machado, Catia M.; Rebholz-Schuhmann, Dietrich; Freitas, Ana T.; Couto, Francisco M.

2015-01-01

Semantic web technologies offer an approach to data integration and sharing, even for resources developed independently or broadly distributed across the web. This approach is particularly suitable for scientific domains that profit from large amounts of data that reside in the public domain and that have to be exploited in combination. Translational medicine is such a domain, which in addition has to integrate private data from the clinical domain with proprietary data from the pharmaceutical domain. In this survey, we present the results of our analysis of translational medicine solutions that follow a semantic web approach. We assessed these solutions in terms of their target medical use case; the resources covered to achieve their objectives; and their use of existing semantic web resources for the purposes of data sharing, data interoperability and knowledge discovery. The semantic web technologies seem to fulfill their role in facilitating the integration and exploration of data from disparate sources, but it is also clear that simply using them is not enough. It is fundamental to reuse resources, to define mappings between resources, to share data and knowledge. All these aspects allow the instantiation of translational medicine at the semantic web-scale, thus resulting in a network of solutions that can share resources for a faster transfer of new scientific results into the clinical practice. The envisioned network of translational medicine solutions is on its way, but it still requires resolving the challenges of sharing protected data and of integrating semantic-driven technologies into the clinical practice. PMID:24197933

The semantic web in translational medicine: current applications and future directions.

PubMed

Machado, Catia M; Rebholz-Schuhmann, Dietrich; Freitas, Ana T; Couto, Francisco M

2015-01-01

Semantic web technologies offer an approach to data integration and sharing, even for resources developed independently or broadly distributed across the web. This approach is particularly suitable for scientific domains that profit from large amounts of data that reside in the public domain and that have to be exploited in combination. Translational medicine is such a domain, which in addition has to integrate private data from the clinical domain with proprietary data from the pharmaceutical domain. In this survey, we present the results of our analysis of translational medicine solutions that follow a semantic web approach. We assessed these solutions in terms of their target medical use case; the resources covered to achieve their objectives; and their use of existing semantic web resources for the purposes of data sharing, data interoperability and knowledge discovery. The semantic web technologies seem to fulfill their role in facilitating the integration and exploration of data from disparate sources, but it is also clear that simply using them is not enough. It is fundamental to reuse resources, to define mappings between resources, to share data and knowledge. All these aspects allow the instantiation of translational medicine at the semantic web-scale, thus resulting in a network of solutions that can share resources for a faster transfer of new scientific results into the clinical practice. The envisioned network of translational medicine solutions is on its way, but it still requires resolving the challenges of sharing protected data and of integrating semantic-driven technologies into the clinical practice. © The Author 2013. Published by Oxford University Press.

Contemporary disease management in Quebec.

PubMed

Gogovor, Amédé; Savoie, Michelle; Moride, Yola; Krelenbaum, Marilyn; Montague, Terrence

2008-01-01

Health or disease management (DM) has emerged as a promising solution to improve the quality of healthcare and patient outcomes in a cost-efficient way. This solution is particularly relevant in the care of our increasing, and aging, patient populations with multiple chronic diseases. This article reviews the recent history and current status of DM in the province of Quebec and summarizes its evolving perspectives and future prospects. Most DM projects in Quebec have developed from a public-private partnership, and they have addressed several disease states. The results of completed programs confirmed the presence of care gaps--the differences between best and usual care in several disease states. They also identified process changes leading to improved practices and enhanced professional satisfaction among stakeholders. Priorities identified for further research include increased knowledge of the underlying causes of care gaps and greater concentration on the measurement of clinical, humanistic and fiscal outcomes and their causal links to DM structures and processes. Although still embryonic in Quebec and Canada, the available evidence suggests that DM partnerships are practical and functional vehicles to expedite knowledge creation and transfer in the care of whole populations of patients. Future projects offer the promise of updated knowledge and continuously improved care and outcomes.

An image-based approach to understanding the physics of MR artifacts.

PubMed

Morelli, John N; Runge, Val M; Ai, Fei; Attenberger, Ulrike; Vu, Lan; Schmeets, Stuart H; Nitz, Wolfgang R; Kirsch, John E

2011-01-01

As clinical magnetic resonance (MR) imaging becomes more versatile and more complex, it is increasingly difficult to develop and maintain a thorough understanding of the physical principles that govern the changing technology. This is particularly true for practicing radiologists, whose primary obligation is to interpret clinical images and not necessarily to understand complex equations describing the underlying physics. Nevertheless, the physics of MR imaging plays an important role in clinical practice because it determines image quality, and suboptimal image quality may hinder accurate diagnosis. This article provides an image-based explanation of the physics underlying common MR imaging artifacts, offering simple solutions for remedying each type of artifact. Solutions that have emerged from recent technologic advances with which radiologists may not yet be familiar are described in detail. Types of artifacts discussed include those resulting from voluntary and involuntary patient motion, magnetic susceptibility, magnetic field inhomogeneities, gradient nonlinearity, standing waves, aliasing, chemical shift, and signal truncation. With an improved awareness and understanding of these artifacts, radiologists will be better able to modify MR imaging protocols so as to optimize clinical image quality, allowing greater confidence in diagnosis. Copyright © RSNA, 2011.

Understanding dental CAD/CAM for restorations--accuracy from a mechanical engineering viewpoint.

PubMed

Tapie, Laurent; Lebon, Nicolas; Mawussi, Bernardin; Fron-Chabouis, Hélène; Duret, Francois; Attal, Jean-Pierre

2015-01-01

As is the case in the field of medicine, as well as in most areas of daily life, digital technology is increasingly being introduced into dental practice. Computer-aided design/ computer-aided manufacturing (CAD/CAM) solutions are available not only for chairside practice but also for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental practice can be considered as the handling of devices and software processing for the almost automatic design and creation of dental restorations. However, dentists who want to use dental CAD/CAM systems often do not have enough information to understand the variations offered by such technology practice. Knowledge of the random and systematic errors in accuracy with CAD/CAM systems can help to achieve successful restorations with this technology, and help with the purchasing of a CAD/CAM system that meets the clinical needs of restoration. This article provides a mechanical engineering viewpoint of the accuracy of CAD/ CAM systems, to help dentists understand the impact of this technology on restoration accuracy.

A Robust Ordering Strategy for Retailers Facing a Free Shipping Option

PubMed Central

Meng, Qing-chun; Wan, Xiao-le; Rong, Xiao-xia

2015-01-01

Free shipping with conditions has become one of the most effective marketing tools available. An increasing number of companies, especially e-businesses, prefer to offer free shipping with some predetermined condition, such as a minimum purchase amount by the customer. However, in practice, the demands of buyers are uncertain; they are often affected by many factors, such as the weather and season. We begin by modeling the centralized ordering problem in which the supplier offers a free shipping service and retailers face stochastic demands. As these random data are considered, only partial information such as the known mean, support, and deviation is needed. The model is then analyzed via a robust optimization method, and the two types of equivalent sets of uncertainty constraints that are obtained provide good mathematical properties with consideration of the robustness of solutions. Subsequently, a numerical example is used to compare the results achieved from a robust optimization method and the linear decision rules. Additionally, the robustness of the optimal solution is discussed, as it is affected by the minimum quantity parameters. The increasing cost-threshold relationship is divided into three periods. In addition, the case study shows that the proposed method achieves better stability as well as computational complexity. PMID:25993533

Metal–Air Batteries: Will They Be the Future Electrochemical Energy Storage Device of Choice? [Metal-Air Batteries: Future Electrochemical Energy Storage of Choice?

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

Li, Yanguang; Lu, Jun

Metal-air batteries have much higher theoretical energy density than lithium-ion batteries, and are frequently advocated as the solution toward next-generation electrochemical energy storage for applications including electric vehicles or grid energy storage. Yet they have not fulfilled their full potentials as limited by challenges associated with the metal anode, air cathode and electrolyte. These challenges would have to be properly resolved before metal-air batteries can become a practical reality and be deployed on a large scale. Here we survey the current status and latest advances in metal-air battery research for both aqueous (e.g. Zn-air) and non-aqueous (e.g. Li-air) systems. Themore » general technical issues confronting their developments are overviewed, and our perspective on possible solutions is offered.« less

Metal–Air Batteries: Will They Be the Future Electrochemical Energy Storage Device of Choice? [Metal-Air Batteries: Future Electrochemical Energy Storage of Choice?

DOE PAGES

Li, Yanguang; Lu, Jun

2017-05-05

Metal-air batteries have much higher theoretical energy density than lithium-ion batteries, and are frequently advocated as the solution toward next-generation electrochemical energy storage for applications including electric vehicles or grid energy storage. Yet they have not fulfilled their full potentials as limited by challenges associated with the metal anode, air cathode and electrolyte. These challenges would have to be properly resolved before metal-air batteries can become a practical reality and be deployed on a large scale. Here we survey the current status and latest advances in metal-air battery research for both aqueous (e.g. Zn-air) and non-aqueous (e.g. Li-air) systems. Themore » general technical issues confronting their developments are overviewed, and our perspective on possible solutions is offered.« less

An investigation into the use of the car as a mobile office.

PubMed

Eost, C; Flyte, M G

1998-10-01

In today's business environment people can no longer afford to be 'out of touch' when they are away from the office, with the result, the car has become a mobile office for many workers. The aims of this study were * to review current technology in the mobile office, * to determine problems of office working in the car, * to offer design solutions. Case studies gained an insight into working practices and problems in the car. Diaries quantified the types and amounts of work done in the car and an interview survey measured the extent of mobile office technology implemented into cars, problems relating to working in the car and some potential solutions. People do experience problems trying to do office work in their car. These problems include lack of space, lack of storage, nowhere flat to rest work on, inadequate temperature control in the car and poor communication facilities.

Friction-term response to boundary-condition type in flow models

USGS Publications Warehouse

Schaffranek, R.W.; Lai, C.

1996-01-01

The friction-slope term in the unsteady open-channel flow equations is examined using two numerical models based on different formulations of the governing equations and employing different solution methods. The purposes of the study are to analyze, evaluate, and demonstrate the behavior of the term in a set of controlled numerical experiments using varied types and combinations of boundary conditions. Results of numerical experiments illustrate that a given model can respond inconsistently for the identical resistance-coefficient value under different types and combinations of boundary conditions. Findings also demonstrate that two models employing different dependent variables and solution methods can respond similarly for the identical resistance-coefficient value under similar types and combinations of boundary conditions. Discussion of qualitative considerations and quantitative experimental results provides insight into the proper treatment, evaluation, and significance of the friction-slope term, thereby offering practical guidelines for model implementation and calibration.

Ver-i-Fus: an integrated access control and information monitoring and management system

NASA Astrophysics Data System (ADS)

Thomopoulos, Stelios C.; Reisman, James G.; Papelis, Yiannis E.

1997-01-01

This paper describes the Ver-i-Fus Integrated Access Control and Information Monitoring and Management (IAC-I2M) system that INTELNET Inc. has developed. The Ver-i-Fus IAC-I2M system has been designed to meet the most stringent security and information monitoring requirements while allowing two- way communication between the user and the system. The systems offers a flexible interface that permits to integrate practically any sensing device, or combination of sensing devices, including a live-scan fingerprint reader, thus providing biometrics verification for enhanced security. Different configurations of the system provide solutions to different sets of access control problems. The re-configurable hardware interface, tied together with biometrics verification and a flexible interface that allows to integrate Ver-i-Fus with an MIS, provide an integrated solution to security, time and attendance, labor monitoring, production monitoring, and payroll applications.

Osteoarthritis guidelines: Barriers to implementation and solutions.

PubMed

Ferreira de Meneses, Sarah; Rannou, Francois; Hunter, David J

2016-06-01

Osteoarthritis (OA) is a leading cause of disability worldwide. Clinical practice guidelines (CPGs) have been developed to facilitate improved OA management. Scientific communities worldwide have proposed CPGs for OA treatment. Despite the number of highly prominent guidelines available and their remarkable consistency, their uptake has been suboptimal. Possibly because of the multitude of barriers related to the implementation of CPGs. For example, different guidelines show contradictions, some lack evidence, and they lack a hierarchy or tools to facilitate their translation and application. Also, the guidelines do not acknowledge the effect of comorbidities on choosing the treatments. Finally, poor integration of multidisciplinary services within and across healthcare settings is a major barrier to the effective implementation of management guidelines. Here we describe the main problems related to the OA guidelines and some solutions so as to offer some guidance on the elaboration of future CPGs and their implementation in primary care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Challenges and controversies of complex interventions in osteoarthritis management: recognizing inappropriate and discordant care

PubMed Central

Dziedzic, Krysia S; Allen, Kelli D

2018-01-01

Abstract A number of controversies and challenges exist for the management of OA in health care. This paper describes the challenges and gaps in OA care, particularly in relation to population health management, complex interventions and outcomes. It sets this in the context of competing health priorities and multimorbidity, access to high quality conservative care, non-pharmacological therapies, resource limitations and models of care. The overuse of some therapies and neglect of others are discussed, as well as the potential for self-management. The roles of patient and public involvement and the healthcare team are highlighted in enhancing best care for OA and providing solutions for closing the evidence-to-practice gap. Implementation of models of care offer one solution to the challenges and progress of such implementation is described. Areas for further research are highlighted. PMID:29684219

Millimetre-Wave Backhaul for 5G Networks: Challenges and Solutions.

PubMed

Feng, Wei; Li, Yong; Jin, Depeng; Su, Li; Chen, Sheng

2016-06-16

The trend for dense deployment in future 5G mobile communication networks makes current wired backhaul infeasible owing to the high cost. Millimetre-wave (mm-wave) communication, a promising technique with the capability of providing a multi-gigabit transmission rate, offers a flexible and cost-effective candidate for 5G backhauling. By exploiting highly directional antennas, it becomes practical to cope with explosive traffic demands and to deal with interference problems. Several advancements in physical layer technology, such as hybrid beamforming and full duplexing, bring new challenges and opportunities for mm-wave backhaul. This article introduces a design framework for 5G mm-wave backhaul, including routing, spatial reuse scheduling and physical layer techniques. The associated optimization model, open problems and potential solutions are discussed to fully exploit the throughput gain of the backhaul network. Extensive simulations are conducted to verify the potential benefits of the proposed method for the 5G mm-wave backhaul design.

High-Capacity Hydrogen-Based Green-Energy Storage Solutions For The Grid Balancing

NASA Astrophysics Data System (ADS)

D'Errico, F.; Screnci, A.

One of the current main challenges in green-power storage and smart grids is the lack of effective solutions for accommodating the unbalance between renewable energy sources, that offer intermittent electricity supply, and a variable electricity demand. Energy management systems have to be foreseen for the near future, while they still represent a major challenge. Integrating intermittent renewable energy sources, by safe and cost-effective energy storage systems based on solid state hydrogen is today achievable thanks to recently some technology breakthroughs. Optimized solid storage method made of magnesium-based hydrides guarantees a very rapid absorption and desorption kinetics. Coupled with electrolyzer technology, high-capacity storage of green-hydrogen is therefore practicable. Besides these aspects, magnesium has been emerging as environmentally friend energy storage method to sustain integration, monitoring and control of large quantity of GWh from high capacity renewable generation in the EU.

High-Capacity Hydrogen-Based Green-Energy Storage Solutions for the Grid Balancing

NASA Astrophysics Data System (ADS)

D'Errico, F.; Screnci, A.

One of the current main challenges in green-power storage and smart grids is the lack of effective solutions for accommodating the unbalance between renewable energy sources, that offer intermittent electricity supply, and a variable electricity demand. Energy management systems have to be foreseen for the near future, while they still represent a major challenge. Integrating intermittent renewable energy sources, by safe and cost-effective energy storage systems based on solid state hydrogen is today achievable thanks to recently some technology breakthroughs. Optimized solid storage method made of magnesium-based hydrides guarantees a very rapid absorption and desorption kinetics. Coupled with electrolyzer technology, high-capacity storage of green-hydrogen is therefore practicable. Besides these aspects, magnesium has been emerging as environmentally friend energy storage method to sustain integration, monitoring and control of large quantity of GWh from high capacity renewable generation in the EU.

Comprehending the multiple 'values' of green infrastructure - Valuing nature-based solutions for urban water management from multiple perspectives.

PubMed

Wild, T C; Henneberry, J; Gill, L

2017-10-01

The valuation of urban water management practices and associated nature-based solutions (NBS) is highly contested, and is becoming increasingly important to cities seeking to increase their resilience to climate change whilst at the same time facing budgetary pressures. Different conceptions of 'values' exist, each being accompanied by a set of potential measures ranging from calculative practices (closely linked to established market valuation techniques) - through to holistic assessments that seek to address wider concerns of sustainability. Each has the potential to offer important insights that often go well beyond questions of balancing the costs and benefits of the schemes concerned. However, the need to address - and go beyond - economic considerations presents policy-makers, practitioners and researchers with difficult methodological, ethical and practical challenges, especially when considered without the benefit of a broader theoretical framework or in the absence of well-established tools (as might apply within more traditional infrastructural planning contexts, such as the analysis of transport interventions). Drawing on empirical studies undertaken in Sheffield over a period of 10 years, and delivered in partnership with several other European cities and regions, we compare and examine different attempts to evaluate the benefits of urban greening options and future development scenarios. Comparing these different approaches to the valuation of nature-based solutions alongside other, more conventional forms of infrastructure - and indeed integrating both 'green and grey' interventions within a broader framework of infrastructures - throws up some surprising results and conclusions, as well as providing important sign-posts for future research in this rapidly emerging field. Copyright © 2017 Elsevier Inc. All rights reserved.

The WHO 2016 verbal autopsy instrument: An international standard suitable for automated analysis by InterVA, InSilicoVA, and Tariff 2.0

PubMed Central

Chandramohan, Daniel; Clark, Samuel J.; Jakob, Robert; Leitao, Jordana; Rao, Chalapati; Riley, Ian; Setel, Philip W.

2018-01-01

Background Verbal autopsy (VA) is a practical method for determining probable causes of death at the population level in places where systems for medical certification of cause of death are weak. VA methods suitable for use in routine settings, such as civil registration and vital statistics (CRVS) systems, have developed rapidly in the last decade. These developments have been part of a growing global momentum to strengthen CRVS systems in low-income countries. With this momentum have come pressure for continued research and development of VA methods and the need for a single standard VA instrument on which multiple automated diagnostic methods can be developed. Methods and findings In 2016, partners harmonized a WHO VA standard instrument that fully incorporates the indicators necessary to run currently available automated diagnostic algorithms. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality. This VA instrument offers the opportunity to harmonize the automated diagnostic algorithms in the future. Conclusions Despite all improvements in design and technology, VA is only recommended where medical certification of cause of death is not possible. The method can nevertheless provide sufficient information to guide public health priorities in communities in which physician certification of deaths is largely unavailable. The WHO 2016 VA instrument, together with validated approaches to analyzing VA data, offers countries solutions to improving information about patterns of cause-specific mortality. PMID:29320495

Chlamydia and HIV testing, contraception advice, and free condoms offered in general practice: a qualitative interview study of young adults' perceptions of this initiative.

PubMed

Jones, Leah Ffion; Ricketts, Ellie; Town, Katy; Rugman, Claire; Lecky, Donna; Folkard, Kate; Nardone, Anthony; Hartney, Thomas Nathan; McNulty, Cliodna

2017-07-01

Opportunistic chlamydia screening is actively encouraged in English general practices. Based on recent policy changes, Public Health England piloted 3Cs and HIV in 2013-2014, integrating the offer of chlamydia testing with providing condoms, contraceptive information, and HIV testing (referred to as 3Cs and HIV) according to national guidelines. To determine young adults' opinions of receiving a broader sexual health offer of 3Cs and HIV at their GP practice. Qualitative interviews were conducted in a general practice setting in England between March and June 2013. Thirty interviews were conducted with nine male and 21 female patients aged 16-24 years, immediately before or after a routine practice attendance. Data were transcribed verbatim and analysed using a thematic framework. Participants indicated that the method of testing, timing, and the way the staff member approached the topic were important aspects to patients being offered 3Cs and HIV. Participants displayed a clear preference for 3Cs and HIV to be offered at the GP practice over other sexual health service providers. Participants highlighted convenience of the practice, assurance of confidentiality, and that the sexual health discussion was appropriate and routine. Barriers identified for patients were embarrassment, unease, lack of time, religion, and patients believing that certain patients could take offence. Suggested facilitators include raising awareness, reassuring confidentiality, and ensuring the offer is made in a professional and non-judgemental way at the end of the consultation. General practice staff should facilitate patients' preferences by ensuring that 3Cs and HIV testing services are made available at their surgery and offered to appropriate patients in a non-judgemental way. © British Journal of General Practice 2017.

Digital devices: big challenge in color management

NASA Astrophysics Data System (ADS)

Vauderwange, Oliver; Curticapean, Dan; Dreβler, Paul; Wozniak, Peter

2014-09-01

The paper will present how the students learn to find technical solutions in color management by using adequate digital devices and recognize the specific upcoming tasks in this area. Several issues, problems and their solutions will be discussed. The scientific background offer specific didactical solutions in this area of optics. Color management is the major item of this paper. Color management is a crucial responsibility for media engineers and designers. Print, screen and mobile applications must independently display the same colors. Predictability and consistency in the color representation are the aims of a color management system. This is only possible in a standardized and audited production workflow. Nowadays digital media have a fast-paced development process. An increasing number of different digital devices with different display sizes and display technologies are a great challenge for every color management system. The authors will present their experience in the field of color management. The design and development of a suitable learning environment with the required infrastructure is in the focus. The combination of theoretical and practical lectures creates a deeper understanding in the area of the digital color representation.

A Qualitative Assessment of the Practice Experiences of Certified Diabetes Educator Pharmacists.

PubMed

Alzahrani, Fahad; Taylor, Jeff; Perepelkin, Jason; Mansell, Kerry

2015-08-01

To describe the practice experiences of Certified Diabetes Educator (CDE) pharmacists in Saskatchewan and determine what impact the CDE designation has had on their personal practices. A qualitative research approach was used. All pharmacists in Saskatchewan were e-mailed about the study, and eventually, a purposive sampling method was used to select a range of CDE pharmacists. Semistructured, in-person interviews were performed. An interview guide was developed to assess the work activities performed, the benefits of becoming a CDE and the challenges and resultant solutions that optimize their CDE designations. All interviews were transcribed verbatim and coded using deductive thematic analysis to identify the main themes that described the experiences of respondents, with the aid of QSR NVivo. A total of 14 CDE pharmacists from various communities and work settings chose to participate. All of the participants indicated they were engaging in increased diabetes-related activities since becoming CDEs. All participants indicated they were happy with their decisions to become CDEs and described numerous benefits as a direct result of achieving this designation. Although some solutions were offered, participants still face challenges in optimizing their role as CDEs, such as devoting enough time to diabetes management and remuneration for providing diabetes services. CDE pharmacists in Saskatchewan report performing enhanced diabetes-related activities subsequent to becoming CDEs and that obtaining this designation has had a positive impact on their personal practices. A larger, cross-country study is necessary to determine whether these results are consistent amongst all pharmacists in Canada. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

16 CFR 233.4 - Bargain offers based upon the purchase of other merchandise.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Bargain offers based upon the purchase of... PRACTICE RULES GUIDES AGAINST DECEPTIVE PRICING § 233.4 Bargain offers based upon the purchase of other... given a customer on the condition that he purchase a particular article at the price usually offered by...

AAFP and ISFM Guidelines for diagnosing and solving house-soiling behavior in cats.

PubMed

Carney, Hazel C; Sadek, Tammy P; Curtis, Terry M; Halls, Vicky; Heath, Sarah; Hutchison, Pippa; Mundschenk, Kari; Westropp, Jodi L

2014-07-01

These Guidelines have been developed by the American Association of Feline Practitioners (AAFP) and the International Society of Feline Medicine (ISFM) as a resource for veterinary practitioners who want to better understand and manage the important clinical condition of house-soiling in their feline patients. The Guidelines offer straightforward, practical solutions that, in most cases, will help veterinarians and cat owners prevent, manage or entirely remediate feline house-soiling behavior. The Guidelines include scientifically documented information when it is available. However, because research is often lacking, some recommendations reflect the accumulated clinical experience of the authors. © ISFM and AAFP 2014.

The SDGs Will Require Integrated Agriculture, Nutrition, and Health at the Community Level.

PubMed

Canavan, Chelsey R; Graybill, Lauren; Fawzi, Wafaie; Kinabo, Joyce

2016-03-01

Child malnutrition is an urgent and complex issue and requires integrated approaches across agriculture, nutrition, and health. This issue has gained prominence at the global level. While national-level efforts are underway in many countries, there is little information on how to integrate at the community level. Here, we offer a community-based approach using cadres of agricultural and community health workers, drawing on qualitative work we have conducted in Tanzania. Agriculture is an important driver of nutritional and health outcomes, and improving child health will require practical solutions for integration that can add to the evidence base. © The Author(s) 2016.

[Priest-doctors in Russia].

PubMed

Berlan, Hélène; Triaire, Dominique

2012-01-01

Jean Pierre Frank offers in the early nineteenth century a revolution in medical Russian Empire. Indeed, Russia is in an emergency situation where the lack of practitioners is obvious. The imperial project is inspired by past practices in some European countries. Frank fits these transfers and implements a unique model where the priest-doctor stands out as the solution to overcome the lack of medicalization of the Empire. Even if the attempt was a failure, it remains that the proposals were part of Frank in both an ancient tradition that priests and physicians providing care for souls and bodies, but also showed that called his wishes the advent of "public health" in this country disinherited.

Converting an intranet site to the cloud: using CampusGuides to refresh a library portal.

PubMed

Osterhaus Trzasko, Leah C; Farrell, Ann M; Rethlefsen, Melissa L

2012-01-01

After a major redesign project in 2002, Mayo Clinic Libraries' heavily used intranet portal remained largely static. Library staff were unable to make substantive design changes or introduce tools that would make the content more dynamic. CampusGuides offered a practical, user-friendly, web-based solution to add dynamic content to the library site. A task force was formed both to establish design and style guidelines that would integrate with the library site and to plan the conversion of content to CampusGuides. Converting intranet site content to CampusGuides gave the task force the opportunity to examine, re-imagine, and revitalize site content.

Proceedings of the 7th Annual Precise Time and Time Interval (PTTI) Applications and Planning Meeting

NASA Technical Reports Server (NTRS)

1975-01-01

The Proceedings contain the papers presented at the Seventh Annual Precise Time and Time Interval (PTTI) Applications and Planning Meeting and the edited record of the discussion period following each paper. This meeting provided a forum to promote more effective, efficient, economical and skillful applications of PTTI technology to the many problem areas to which PTTI offers solutions. Specifically the purpose of the meeting is to: disseminate, coordinate, and exchange practical information associated with precise time and frequency; acquaint systems engineers, technicians and managers with precise time and frequency technology and its applications; and review present and future requirements for PTTI.

The application of remote sensing technology to the solution of problems in the management of resources in Indiana

NASA Technical Reports Server (NTRS)

Weismiller, R. A.; Mroczynski, R. P. (Principal Investigator)

1978-01-01

The author has identified the following significant results. Of the sampling techniques considered, a combination soil mapping and area sampling offered the most practical method for gathering soils data. Using the dot grid count, a relative percentage composition of soils can be calculated for each spectral class. From these percentages, a legend describing the dominant soils and inclusions can be developed. Interval drainage class seemed to be correlated with magnitude. For every parent material area, the more poorly drained soils had a lower magnitude of reflectance. Soil spectral classes seemed to be predominantly one internal drainage class.

Securing Wireless Communications of the Internet of Things from the Physical Layer, An Overview

NASA Astrophysics Data System (ADS)

Zhang, Junqing; Duong, Trung; Woods, Roger; Marshall, Alan

2017-08-01

The security of the Internet of Things (IoT) is receiving considerable interest as the low power constraints and complexity features of many IoT devices are limiting the use of conventional cryptographic techniques. This article provides an overview of recent research efforts on alternative approaches for securing IoT wireless communications at the physical layer, specifically the key topics of key generation and physical layer encryption. These schemes can be implemented and are lightweight, and thus offer practical solutions for providing effective IoT wireless security. Future research to make IoT-based physical layer security more robust and pervasive is also covered.

Peer coaching: the next step in staff development.

PubMed

Waddell, Donna L; Dunn, Nancy

2005-01-01

A common problem in continuing nursing education and staff development is the transfer of learning to clinical practice. Peer coaching offers a solution to this problem. Initiated by educators, peer coaching has been researched in educational settings and found to be effective in facilitating the transfer of newly acquired knowledge and skill into classroom teaching strategies. This article describes the background, components, process, characteristics, and benefits of peer coaching. A specific example of using peer coaching to teach clinical breast examination skills is used to illustrate the application of peer coaching to the staff development of healthcare professionals. Peer coaching is the next step in nursing staff development.

Technology for nature conservation: an industry perspective.

PubMed

Joppa, Lucas N

2015-11-01

Information age technology has the potential to change the game for conservation by continuously monitoring the pulse of the natural world. Whether or not it will depends on the ability of the conservation sector to build a community of practice, come together to define key technology challenges and work with a wide variety of partners to create, implement, and sustain solutions. I describe why these steps are necessary, outline the latest developments in the field and offer actionable ways forward for conservation agencies, universities, funding bodies, professional societies, and technology corporations to come together to realize the revolution that computational technologies can bring for biodiversity conservation.

Arts-based palliative care training, education and staff development: A scoping review.

PubMed

Turton, Benjamin Mark; Williams, Sion; Burton, Christopher R; Williams, Lynne

2018-02-01

The experience of art offers an emerging field in healthcare staff development, much of which is appropriate to the practice of palliative care. The workings of aesthetic learning interventions such as interactive theatre in relation to palliative and end-of-life care staff development programmes are widely uncharted. To investigate the use of aesthetic learning interventions used in palliative and end-of-life care staff development programmes. Scoping review. Published literature from 1997 to 2015, MEDLINE, CINAHL and Applied Social Sciences Index and Abstracts, key journals and citation tracking. The review included 138 studies containing 60 types of art. Studies explored palliative care scenarios from a safe distance. Learning from art as experience involved the amalgamation of action, emotion and meaning. Art forms were used to transport healthcare professionals into an aesthetic learning experience that could be reflected in the lived experience of healthcare practice. The proposed learning included the development of practical and technical skills; empathy and compassion; awareness of self; awareness of others and the wider narrative of illness; and personal development. Aesthetic learning interventions might be helpful in the delivery of palliative care staff development programmes by offering another dimension to the learning experience. As researchers continue to find solutions to understanding the efficacy of such interventions, we argue that evaluating the contextual factors, including the interplay between the experience of the programme and its impact on the healthcare professional, will help identify how the programmes work and thus how they can contribute to improvements in palliative care.

Managing pets with behavior problems: realistic expectations.

PubMed

Horwitz, Debra F

2008-09-01

Management solutions offer a useful tool for owners faced with behavior issues in their pets. In some cases management will improve the behavior and allow control. In other situations it may be only the first step in treatment. By offering management solutions, veterinarians can help owners with problem pets and begin the road to recovery.

Challenges in conducting qualitative research in health: A conceptual paper.

PubMed

Khankeh, Hamidreza; Ranjbar, Maryam; Khorasani-Zavareh, Davoud; Zargham-Boroujeni, Ali; Johansson, Eva

2015-01-01

Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues. The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others.

St. Louis Initiative for Integrated Care Excellence (SLI(2)CE): integrated-collaborative care on a large scale model.

PubMed

Brawer, Peter A; Martielli, Richard; Pye, Patrice L; Manwaring, Jamie; Tierney, Anna

2010-06-01

The primary care health setting is in crisis. Increasing demand for services, with dwindling numbers of providers, has resulted in decreased access and decreased satisfaction for both patients and providers. Moreover, the overwhelming majority of primary care visits are for behavioral and mental health concerns rather than issues of a purely medical etiology. Integrated-collaborative models of health care delivery offer possible solutions to this crisis. The purpose of this article is to review the existing data available after 2 years of the St. Louis Initiative for Integrated Care Excellence; an example of integrated-collaborative care on a large scale model within a regional Veterans Affairs Health Care System. There is clear evidence that the SLI(2)CE initiative rather dramatically increased access to health care, and modified primary care practitioners' willingness to address mental health issues within the primary care setting. In addition, data suggests strong fidelity to a model of integrated-collaborative care which has been successful in the past. Integrated-collaborative care offers unique advantages to the traditional view and practice of medical care. Through careful implementation and practice, success is possible on a large scale model. PsycINFO Database Record (c) 2010 APA, all rights reserved.

Transforming State-of-the-Art into Best Practice: A Guide for High-Performance Energy Efficient Buildings in India

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

Singh, Reshma; Ravache, Baptiste; Sartor, Dale

India launched the Energy Conservation Building Code (ECBC) in 2007, and a revised version in 2017 as ambitious first steps towards promoting energy efficiency in the building sector. Pioneering early adopters—building owners, A&E firms, and energy consultants—have taken the lead to design customized solutions for their energy-efficient buildings. This Guide offers a synthesizing framework, critical lessons, and guidance to meet and exceed ECBC. Its whole-building lifecycle assurance framework provides a user-friendly methodology to achieve high performance in terms of energy, environmental, and societal impact. Class A offices are selected as a target typology, being a high-growth sector, with significant opportunitiesmore » for energy savings. The practices may be extrapolated to other commercial building sectors, as well as extended to other regions with similar cultural, climatic, construction, and developmental contexts« less

Theory-led confirmation bias and experimental persona

NASA Astrophysics Data System (ADS)

Allen, Michael

2011-04-01

Questionnaire and interview findings from a survey of three Year 8 (ages 12-13 years) science practical lessons (n = 52) demonstrate how pupils' data collection and inference making were sometimes biased by desires to confirm a personal theory. A variety of behaviours are described where learners knowingly rejected anomalies, manipulated apparatus, invented results or carried out other improper operations to either collect data which they believed were scientifically correct, or achieve social conformity. It is proposed that confirmation bias was a consequence of the degree to which individuals were laden by theory, and driven by this, experimenters assumed one of three different personas: becoming right answer confirmers; good scientists; or indifferent spectators. These personas have parallels with historical instances of scientific behaviour. Implications of a continued teacher-tolerance of pupil confirmation bias include the promotion of unscientific experimenting, and the persistence of unchallenged science misconceptions. Solutions are offered in the way of practical strategies that might reduce experimenters' theory-ladeness.

Organizational safety culture/climate and worker compliance with hazardous drug guidelines: lessons from the blood-borne pathogen experience.

PubMed

McDiarmid, Melissa A; Condon, Marian

2005-07-01

The health risks posed to health care workers (HCW) handling antineoplastic and other hazardous drugs (HDs) are well established. However, despite nearly 20 years of professional practice standards, compliance with safe handling procedures is poor. We present documentation of undercompliance with recommended safety procedures for HDs. Then, we examine a similar problem, HCW compliance with blood-borne pathogen universal precautions (UP) and its partial solution tied to the strength of a facility's safety culture. Lessons learned here may be applicable to the HD issue. It is proposed that analyzing a facility's safety culture may enlarge our understanding of the barriers contributing to HD under-compliance and suggest strategies to improve it. The Safety Culture paradigm offers many targets for intervention to enhance and promote worker compliance with safe HD handling practices thus mitigating internal exposure.

Hypnosis in the Treatment of Depression: Considerations in Research Design and Methods

PubMed Central

McCann, Barbara S.; Landes, Sara J.

2010-01-01

Depressive disorders constitute a serious problem in the United States. The appearance of practice guidelines and lists of evidenced based therapies suggests that adequate treatments for depression exist. However, a careful consideration of what we do and do not know about the treatment of depression leaves plenty of room for improved approaches to addressing this condition. Although there has been a dearth of research on the treatment of depression using hypnosis, there are several compelling arguments for the inclusion of hypnotic approaches in the array of strategies for dealing with depression. However, traditional “gold standard” research methods, namely randomized controlled trials (RCTs) have many potential shortcomings for identifying the potential impact of hypnosis on depression. Other strategies, notably single-case design and benchmarking approaches, may offer a more practical solution to the problem of determining “what works for depression.” PMID:20390688

Secure quantum private information retrieval using phase-encoded queries

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

Olejnik, Lukasz

We propose a quantum solution to the classical private information retrieval (PIR) problem, which allows one to query a database in a private manner. The protocol offers privacy thresholds and allows the user to obtain information from a database in a way that offers the potential adversary, in this model the database owner, no possibility of deterministically establishing the query contents. This protocol may also be viewed as a solution to the symmetrically private information retrieval problem in that it can offer database security (inability for a querying user to steal its contents). Compared to classical solutions, the protocol offersmore » substantial improvement in terms of communication complexity. In comparison with the recent quantum private queries [Phys. Rev. Lett. 100, 230502 (2008)] protocol, it is more efficient in terms of communication complexity and the number of rounds, while offering a clear privacy parameter. We discuss the security of the protocol and analyze its strengths and conclude that using this technique makes it challenging to obtain the unconditional (in the information-theoretic sense) privacy degree; nevertheless, in addition to being simple, the protocol still offers a privacy level. The oracle used in the protocol is inspired both by the classical computational PIR solutions as well as the Deutsch-Jozsa oracle.« less

You and your manager: reducing workplace stress by creating and maintaining a good relationship.

PubMed

Hills, Laura Sachs

2007-01-01

The relationship a medical practice employee has with his or her practice manager is probably the most important relationship the employee will have at work. No matter what position an employee has in the medical practice, it's to his or her advantage to get along well with the practice manager. This article offers concrete suggestions to medical practice employees to help them establish and cultivate a positive working relationship with their practice managers. It examines different working styles of practice managers and suggests strategies for medical practice employees who want or need different amounts and styles of supervision. It describes five personal characteristics a practice manager expects in employees and two basic rules of thumb for using the practice manager's time efficiently. This article also emphasizes the importance of good communication with the practice manager and offers 12 practical and specific tips for building the employee-practice manager relationship. Finally, this article offers advice to medical practice employees about what to do when they disagree with their practice managers.

Residentialization of Public Spaces: Bratislava Example

NASA Astrophysics Data System (ADS)

Bacová, Andrea; Puškár, Branislav; Vráblová, Edita

2017-10-01

The housing estates in Bratislava saturated the housing needs of a large number of inhabitants who come after World War II to the city. Design of public spaces often did not have priority in the process of designing. The solutions for mentioned exterior spaces had been planned after blocks of flat realization, but many of them are not realized to this day. The article analyzes the example of the unrealized public spaces in existing housing estates Devinska Nova Ves and Petržalka (city districts of Bratislava) and offer practical solutions in relation to residencialization method. Residencialization of missing public places is an effective method of adding identities to settlements. It improves the quality of residential environment and public spaces. The main aim is to create better conditions for social activities in public areas, which are missing on the present. The research will be focused on the examination of the urban, cultural and construction potential of the existing residential enviroment in Bratislava. The main aim of residentialization is not only to enhance the quality of spatial and building structures in the selected residential area and maintain long-term sustainability in the pertinent programme area, but mainly to improve the quality of living for the residents. The outputs of the project are proposals and practical procedures developed with regard to planning documents for local municipal authorities and regional organizations. The solutions will have a positive impact on the enhancement of the quality of public spaces, attractive social activities and of a conceptual link - residentialization.

Associations among school characteristics and foodservice practices in a nationally representative sample of United States schools.

PubMed

Thomson, Jessica L; Tussing-Humphreys, Lisa M; Martin, Corby K; LeBlanc, Monique M; Onufrak, Stephen J

2012-01-01

Determine school characteristics associated with healthy/unhealthy food service offerings or healthy food preparation practices. Secondary analysis of cross-sectional data. Nationally representative sample of public and private elementary, middle, and high schools. Data from the 2006 School Health Policies and Practices Study Food Service School Questionnaire, n = 526 for Healthy and Unhealthy Offerings analysis; n = 520 for Healthy Preparation analysis. Scores for healthy/unhealthy foodservice offerings and healthy food preparation practices. Multivariable regression to determine significant associations among school characteristics and offerings/preparation practices. Public schools and schools participating in the United States Department of Agriculture (USDA) Team Nutrition reported more healthy offerings and preparation than private or nonparticipating schools, respectively. Elementary schools reported fewer unhealthy offerings than middle or high schools; middle schools reported fewer unhealthy offerings than high schools. Schools requiring foodservice managers to have a college education reported more healthy preparation, whereas those requiring completion of a foodservice training program reported fewer unhealthy offerings and more healthy preparation than schools without these requirements. Results suggest the school nutrition environment may be improved by requiring foodservice managers to hold a nutrition-related college degree and/or successfully pass a foodservice training program, and by participating in a school-based nutrition program, such as USDA Team Nutrition. Copyright © 2012 Society for Nutrition Education and Behavior. All rights reserved.

Knowledge and practices of mothers on childhood diarrhoea and its management attended at a tertiary hospital in bangladesh.

PubMed

Akhtaruzzaman, M; Hossain, M A; Khan, R H; Karim, M R; Choudhury, A M; Islam, M S; Ahamed, F; Khan, N; Ahammed, S U; Dhar, S K; Mahmud, A A; Khan, A K; Alam, M S; Nahar, S

2015-04-01

This descriptive cross sectional study was conducted in Pediatric out Patient Department (OPD) of Mymensingh Medical College Hospital (MMCH) from March 2014 to August 2014 to assess the knowledge and practices of the mothers in acute diarrhoeal diseases in children under-five years of age regarding use of oral rehydration solution (ORS), zinc, other drugs and feeding practices. Four hundred children under-five years of age having acute diarrhoea were included in the study by systematic random sampling. A structured, pretested, interviewer-administered questionnaire was used to collect data from mothers of children having diarrhoeal diseases. ORS was offered by 360(90.00%) of the mothers. Out of which 279(77.50%) used it by their own knowledge. One hundred and ninety-one (53.06%) mothers prepared it correctly, while 169(46.94%) prepared it incorrectly. Of 169, 129(35.83%) mothers used less amount of water, while 40(11.11%) mothers used much amount of water to prepare ORS. Of 360 mothers, 89(24.72%) mixed part of the content of ORS sachet at a time. Of 360 mothers, only 55(15.28%) offered correct amount of ORS after each purging. Zinc was offered in 142(35.50%) children. Of 400, only 13(3.25%) mothers used recommended home-based fluid, while 70(17.50%) mothers offered increased amount of fluid to their child. Drugs other than zinc and ORS were used in 247(61.75%) children. Among drugs, other than zinc and ORS, antibiotics was used in 109(44.13%) cases, whereas antiprotozoal in 97(39.27%) cases. Amount of liquid given was more than usual in 70(17.50%) children, same as usual in 57(14.25%) children and less than usual in 273(68.25%) children. Amount of food given was same as usual in 59(14.75%) children, while less than usual in 341(85.25%) children. Control of diarrhoeal diseases programme is successful in introducing ORS at mass level. Great emphasis is needed to educate mothers about preparation and quantity of ORS to be given to children with diarrhoeal diseases.

Associations among School Characteristics and Foodservice Practices in a Nationally Representative Sample of U.S. Schools

PubMed Central

Thomson, Jessica L.; Tussing-Humphreys, Lisa M.; Martin, Corby K.; LeBlanc, Monique M.; Onufrak, Stephen J.

2012-01-01

Objective Determine school characteristics associated with healthy/unhealthy foodservice offerings or healthy food preparation practices. Design Retrospective analysis of cross-sectional data. Setting Nationally representative sample of public and private elementary, middle and high schools. Participants 526 and 520 schools with valid data from the 2006 School Health Policies and Practices Study (SHPPS) Food Service School Questionnaire. Main Outcome Measure(s) Scores for healthy/unhealthy foodservice offerings and healthy food preparation practices. Analysis Multivariable regression to determine significant associations among school characteristics and offerings/preparation practices. Results Public schools and schools participating in USDA Team Nutrition reported more healthy offerings and preparation than private or non-participating schools, respectively. Elementary schools reported less unhealthy offerings than middle or high schools; middle schools reported less unhealthy offerings than high schools. Schools requiring foodservice managers to have a college education reported more healthy preparation while those requiring completion of a foodservice training program reported less unhealthy offerings and more healthy preparation than schools without these requirements. Conclusions and Implications Results suggest the school nutrition environment may be improved by requiring foodservice managers to hold a nutrition-related college degree and/or successfully pass a foodservice training program, and by participating in a school-based nutrition program, such as USDA Team Nutrition. PMID:22963956

Parallel-vector computation for structural analysis and nonlinear unconstrained optimization problems

NASA Technical Reports Server (NTRS)

Nguyen, Duc T.

1990-01-01

Practical engineering application can often be formulated in the form of a constrained optimization problem. There are several solution algorithms for solving a constrained optimization problem. One approach is to convert a constrained problem into a series of unconstrained problems. Furthermore, unconstrained solution algorithms can be used as part of the constrained solution algorithms. Structural optimization is an iterative process where one starts with an initial design, a finite element structure analysis is then performed to calculate the response of the system (such as displacements, stresses, eigenvalues, etc.). Based upon the sensitivity information on the objective and constraint functions, an optimizer such as ADS or IDESIGN, can be used to find the new, improved design. For the structural analysis phase, the equation solver for the system of simultaneous, linear equations plays a key role since it is needed for either static, or eigenvalue, or dynamic analysis. For practical, large-scale structural analysis-synthesis applications, computational time can be excessively large. Thus, it is necessary to have a new structural analysis-synthesis code which employs new solution algorithms to exploit both parallel and vector capabilities offered by modern, high performance computers such as the Convex, Cray-2 and Cray-YMP computers. The objective of this research project is, therefore, to incorporate the latest development in the parallel-vector equation solver, PVSOLVE into the widely popular finite-element production code, such as the SAP-4. Furthermore, several nonlinear unconstrained optimization subroutines have also been developed and tested under a parallel computer environment. The unconstrained optimization subroutines are not only useful in their own right, but they can also be incorporated into a more popular constrained optimization code, such as ADS.

The stability of freak waves with regard to external impact and perturbation of initial data

NASA Astrophysics Data System (ADS)

Smirnova, Anna; Shamin, Roman

2014-05-01

We investigate solutions of the equations, describing freak waves, in perspective of stability with regard to external impact and perturbation of initial data. The modeling of freak waves is based on numerical solution of equations describing a non-stationary potential flow of the ideal fluid with a free surface. We consider the two-dimensional infinitely deep flow. For waves modeling we use the equations in conformal variables. The variant of these equations is offered in [1]. Mathematical correctness of these equations was discussed in [2]. These works establish the uniqueness of solutions, offer the effective numerical solution calculation methods, prove the numerical convergence of these methods. The important aspect of numerical modeling of freak waves is the stability of solutions, describing these waves. In this work we study the questions of stability with regards to external impact and perturbation of initial data. We showed the stability of freak waves numerical model, corresponding to the external impact. We performed series of computational experiments with various freak wave initial data and random external impact. This impact means the power density on free surface. In each experiment examine two waves: the wave that was formed by external impact and without one. In all the experiments we see the stability of equation`s solutions. The random external impact practically does not change the time of freak wave formation and its form. Later our work progresses to the investigation of solution's stability under perturbations of initial data. We take the initial data that provide a freak wave and get the numerical solution. In common we take the numerical solution of equation with perturbation of initial data. The computing experiments showed that the freak waves equations solutions are stable under perturbations of initial data.So we can make a conclusion that freak waves are stable relatively external perturbation and perturbation of initial data both. 1. Zakharov V.E., Dyachenko A.I., Vasilyev O.A. New method for numerical simulation of a nonstationary potential flow of incompressible fluid with a free surface// Eur. J.~Mech. B Fluids. 2002. V. 21. P. 283-291. 2. R.V. Shamin. Dynamics of an Ideal Liquid with a Free Surface in Conformal Variables // Journal of Mathematical Sciences, Vol. 160, No. 5, 2009. P. 537-678. 3. R.V. Shamin, V.E. Zakharov, A.I. Dyachenko. How probability for freak wave formation can be found // THE EUROPEAN PHYSICAL JOURNAL - SPECIAL TOPICS Volume 185, Number 1, 113-124, DOI: 10.1140/epjst/e2010-01242-y

48 CFR 13.104 - Promoting competition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost of the purchase. (a) The contracting officer must not— (1) Solicit quotations based on personal... practicable competition ordinarily can be obtained by soliciting quotations or offers from sources within the... the maximum extent practicable. Whenever practicable, request quotations or offers from two sources...

Observation Care: Ethical and Legal Considerations for the Emergency Physician.

PubMed

Ali, Nissa J; Jesus, John; Smulowitz, Peter B

2016-03-01

The Medicare observation rules remain controversial despite Centers for Medicare and Medicaid Services revisions and the new 2-midnight rule. The increased financial risks for patients and heightened awareness of the rule have placed emergency physicians (EPs) at the center of the controversy. This article reviews the primary ethical and legal (particularly with respect to the Emergency Medical Treatment and Active Labor Act) implications of the existing observation rule for EPs and offers practical solutions for EPs faced with counseling patients on the meaning and ramifications of the observation rule. We conclude that while we believe it does not violate the intent of the Emergency Medical Treatment and Active Labor Act to respond to patient questions about their admission status, the observation rules challenge the ethical principles of transparency related to the physician-patient relationship and justice as fairness. Guidance for physicians is offered to improve transparency and patient fairness. Copyright © 2016 Elsevier Inc. All rights reserved.

When Science is Not Enough: A Framework Towards More Customer-Focused Drug Development.

PubMed

Oraiopoulos, Nektarios; Dunlop, William C N

2017-07-01

The purpose of this study was to identify the key barriers to a customer-focused drug development process and develop a comprehensive framework to overcome them. The paper draws on existing literature, both academic and practitioner, across a range of disciplines (innovation management, marketing, organizational behavior, behavioral economics, health economics, industry reports). On the basis of this extensive review, a conceptual framework is developed that offers concrete suggestions on how organizations can overcome the barriers and enable a more customer-focused development process. The barriers to collaboration are organized into three distinct categories (economic, behavioral, organizational), and within each category, a one-to-one mapping between barriers and solutions is developed. The framework is specifically designed with the objective of offering actionable and practical advice to executives who face these challenges in their organizations. The paper provides a unique theoretical contribution by synthesizing findings from several academic disciplines with concrete examples from the pharmaceutical industry. Mundipharma International Limited.

Using a student-faculty collaborative learning model to teach grant development in graduate nursing education.

PubMed

Falk, Nancy L; Phillips, Kathleen M; Hymer, Regina; Acquaviva, Kimberly D; Schumann, Mary Jean

2014-05-01

Graduate nurses are employed in clinical, research, educational, and policy roles. As leaders, they are expected to develop and sustain projects that support translating research to practice and policy. Funding to support initiatives is tight and requires innovative solutions to cover salaries, benefits, equipment purchases, and other program expenses. In an effort to teach grant writing while developing skilled leaders who are effective and competitive in securing funds, the George Washington University School of Nursing offers a graduate-level grant writing course. In the summer of 2011, a collaborative learning model was developed within the course. The joint approach was foundational to securing an Agency for Healthcare Research and Quality grant to support development and implementation of a patient engagement project by the Nursing Alliance for Quality Care. This article describes the project and offers hints for those seeking to develop a collaborative educational experience that affords new leadership skills for RNs from all backgrounds. Copyright 2014, SLACK Incorporated.

Software Piracy in Research: A Moral Analysis.

PubMed

Santillanes, Gary; Felder, Ryan Marshall

2015-08-01

Researchers in virtually every discipline rely on sophisticated proprietary software for their work. However, some researchers are unable to afford the licenses and instead procure the software illegally. We discuss the prohibition of software piracy by intellectual property laws, and argue that the moral basis for the copyright law offers the possibility of cases where software piracy may be morally justified. The ethics codes that scientific institutions abide by are informed by a rule-consequentialist logic: by preserving personal rights to authored works, people able to do so will be incentivized to create. By showing that the law has this rule-consequentialist grounding, we suggest that scientists who blindly adopt their institutional ethics codes will commit themselves to accepting that software piracy could be morally justified, in some cases. We hope that this conclusion will spark debate over important tensions between ethics codes, copyright law, and the underlying moral basis for these regulations. We conclude by offering practical solutions (other than piracy) for researchers.

Telemedicine: legal and licensure issues

NASA Astrophysics Data System (ADS)

Wood, Michael B.; Whelan, Leo J.

1995-10-01

The National Information Infrastructure program offers a great opportunity for the United States to capitalize on remarkable technological advancements over a broad range of applications benefiting society. One such application, telemedicine, has the potential to offer widespread access to sophisticated medical care, curtailed health care delivery costs, and homogeneous health and health-related educational opportunities. However, there are a variety of barriers to widespread application of telemedicine once the technical infrastructure of the information highway is well established and ubiquitous. These barriers include technical limitations, reimbursement issues, equipment and networking costs, and appropriate scientific studies to document efficacy and cost effectiveness. These issues may prove to be only transient disincentives which can be surmounted. Additional barriers exist, however, that may not be as readily resolved by traditional methods of analysis and more widespread practice applications. These political and regulatory obstacles will require clarification of the issues and solutions based on national consensus. It is the purpose of this discussion to amplify on these particular barriers which include licensure and tort jurisdiction.

A DISCUSSION ON UTILIZATION OF HEAT PIPE AND VAPOUR CHAMBER TECHNOLOGY AS A PRIMARY DEVICE FOR HEAT EXTRACTION FROM PHOTON ABSORBER SURFACES

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

Suthar, K. J.; Lurie, Alexander M.; Den Hartog, P.

Heat pipes and vapour chambers work on heat exchange phenomena of two-phase flow and are widely used for in-dustrial and commercial applications. These devices offer very high effective thermal conductivities (5,000-200,000 W/m/K) and are adaptable to various sizes, shapes, and ori-entations. Although they have been found to be an excel-lent thermal management solution for laptops, satellites, and many things in-between, heat pipes and vapour cham-bers have yet to be adopted for use at particle accelerator facilities where they offer the possibility of more compact and more efficient means to remove heat from unwanted synchrotron radiation. As with all technologies, theremore » are inherent limitations. Foremost, they are limited by practi-cality to serve as local heat transfer devices; heat transfer over long distances is likely best provided by other means. Heat pipes also introduce unique failure modes which must be considered.« less

Application of NASA's Advanced Life Support Technologies in Polar Regions

NASA Technical Reports Server (NTRS)

Bubenheim, David L.

1997-01-01

The problems of obtaining adequate pure drinking water and disposing of liquid and solid waste in the U.S Arctic, a region where virtually all water is frozen solid for much of the year, has led to unsanitary solutions. Sanitation and a safe water supply are particularly problems in rural villages. These villages are without running water and use plastic buckets for toilets. The outbreak of diseases is believed to be partially attributable to exposure to human waste and lack of sanitation. Villages with the most frequent outbreaks of disease are those in which running water is difficult to obtain. Waste is emptied into open lagoons, rivers, or onto the sea coast. It does not degrade rapidly and in addition to affecting human health, can be harmful to the fragile ecology of the Arctic and the indigenous wildlife and fish populations. Current practices for waste management and sanitation pose serious human hazards as well as threaten the environment. NASA's unique knowledge of water/wastewater treatment systems for extreme environments, identified in the Congressional Office of Technology Assessment report entitled An Alaskan Challenge: Native Villagt Sanitation, may offer practical solutions addressing the issues of safe drinking water and effective sanitation practices in rural villages. NASA's advanced life support technologies are being combined with Arctic science and engineering knowledge to address the unique needs of the remote communities of Alaska through the Advanced Life Systems for Extreme Environments (ALSEE) project. ALSEE is a collaborative effort involving the NASA, the State of Alaska, the University of Alaska, the North Slope Borough of Alaska, Ilisagvik College in Barrow and the National Science Foundation (NSF). The focus is a major issue in the State of Alaska and other areas of the Circumpolar North; the health and welfare of its people, their lives and the subsistence lifestyle in remote communities, economic opportunity, and care for the environment. As advanced technologies are transferred to the commercial sector the ALSEE project Offers the potential for development of new industries in Alaska to supply the products to support remote communities of the globe.

Pathologic Analysis of Control Plans for Air Pollution Management in Tehran Metropolis: A Cross-Sectional Study

PubMed Central

Salehi Shahrabi, Narges; Pourezzat, Aliasghar; Mobaraki, Hossein; Mafimoradi, Shiva

2013-01-01

Abstract Background The centralization of human activities is associated with different pollutants which enter into environment easily and cause the urban environment more vulnerable. Regarding the importance of air pollution issue for Tehran metropolis, many plans and regulations have been developed. However, most of them failed to decline the pollution. The purpose of this study was to pathologically analyze air-pollution control plans to offer effective solutions for Tehran metropolis. Methods A Qualitative content analysis in addition to a semi-structured interview with 14 practicing professional were used to identify 1) key sources of Tehran’s air pollution, 2) recognize challenges towards effective performance of pertinent plans and 3), offer effective solutions. Results Related challenges to air-pollution control plans can be divided into two major categories including lack of integrated and organized stewardship and PEST challenges. Conclusion For controlling the air pollution of Tehran effectively, various controlling alternatives were identified as systematization of plan preparation process, standardization and utilization of new technologies & experts, infrastructural development, realization of social justice, developing coordination mechanisms, improving citizens’ participatory capacity and focusing on effective management of fuel and energy. Controlling air pollution in Tehran needs a serious attention of policymakers to make enforcements through applying a systemic cycle of preparation comprehensive plans. Further, implement the enforcements and evaluate the environmental impact of the plans through involving all stakeholders. PMID:26171340

Leveraging electronic health records for clinical research.

PubMed

Raman, Sudha R; Curtis, Lesley H; Temple, Robert; Andersson, Tomas; Ezekowitz, Justin; Ford, Ian; James, Stefan; Marsolo, Keith; Mirhaji, Parsa; Rocca, Mitra; Rothman, Russell L; Sethuraman, Barathi; Stockbridge, Norman; Terry, Sharon; Wasserman, Scott M; Peterson, Eric D; Hernandez, Adrian F

2018-04-30

Electronic health records (EHRs) can be a major tool in the quest to decrease costs and timelines of clinical trial research, generate better evidence for clinical decision making, and advance health care. Over the past decade, EHRs have increasingly offered opportunities to speed up, streamline, and enhance clinical research. EHRs offer a wide range of possible uses in clinical trials, including assisting with prestudy feasibility assessment, patient recruitment, and data capture in care delivery. To fully appreciate these opportunities, health care stakeholders must come together to face critical challenges in leveraging EHR data, including data quality/completeness, information security, stakeholder engagement, and increasing the scale of research infrastructure and related governance. Leaders from academia, government, industry, and professional societies representing patient, provider, researcher, industry, and regulator perspectives convened the Leveraging EHR for Clinical Research Now! Think Tank in Washington, DC (February 18-19, 2016), to identify barriers to using EHRs in clinical research and to generate potential solutions. Think tank members identified a broad range of issues surrounding the use of EHRs in research and proposed a variety of solutions. Recognizing the challenges, the participants identified the urgent need to look more deeply at previous efforts to use these data, share lessons learned, and develop a multidisciplinary agenda for best practices for using EHRs in clinical research. We report the proceedings from this think tank meeting in the following paper. Copyright © 2018 Elsevier, Inc. All rights reserved.

Laser Remediation of Threats Posed by Small Orbital Debris

NASA Technical Reports Server (NTRS)

Fork, Richard L.; Rogers, Jan R.; Hovater, Mary A.

2012-01-01

The continually increasing amount of orbital debris in near Earth space poses an increasing challenge to space situational awareness. Recent collisions of spacecraft caused abrupt increases in the density of both large and small debris in near Earth space. An especially challenging class of threats is that due to the increasing density of small (1 mm to 10 cm dimension) orbital debris. This small debris poses a serious threat since: (1) The high velocity enables even millimeter dimension debris to cause serious damage to vulnerable areas of space assets, e.g., detector windows; (2) The small size and large number of debris elements prevent adequate detection and cataloguing. We have identified solutions to this threat in the form of novel laser systems and novel ways of using these laser systems. While implementation of the solutions we identify is challenging we find approaches offering threat mitigation within time frames and at costs of practical interest. We base our analysis on the unique combination of coherent light specifically structured in both space and time and applied in novel ways entirely within the vacuum of space to deorbiting small debris. We compare and contrast laser based small debris removal strategies using ground based laser systems with strategies using space based laser systems. We find laser systems located and used entirely within space offer essential and decisive advantages over groundbased laser systems.

The long-term financial impact of electronic health record implementation.

PubMed

Howley, Michael J; Chou, Edgar Y; Hansen, Nancy; Dalrymple, Prudence W

2015-03-01

To examine the financial impact of electronic health record (EHR) implementation on ambulatory practices. We tracked the practice productivity (ie, number of patient visits) and reimbursement of 30 ambulatory practices for 2 years after EHR implementation and compared each practice to their pre-EHR implementation baseline. Reimbursements significantly increased after EHR implementation even though practice productivity (ie, the number of patient visits) decreased over the 2-year observation period. We saw no evidence of upcoding or increased reimbursement rates to explain the increased revenues. Instead, they were associated with an increase in ancillary office procedures (eg, drawing blood, immunizations, wound care, ultrasounds). The bottom line result-that EHR implementation is associated with increased revenues-is reassuring and offers a basis for further EHR investment. While the productivity losses are consistent with field reports, they also reflect a type of efficiency-the practices are receiving more reimbursement for fewer seeing patients. For the practices still seeing fewer patients after 2 years, the solution likely involves advancing their EHR functionality to include analytics. Although they may still see fewer patients, with EHR analytics, they can focus on seeing the right patients. Practice reimbursements increased after EHR implementation, but there was a long-term decrease in the number of patient visits seen in this ambulatory practice context. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

AT on Buried LPG Tanks Over 13 m3: An Innovative and Practical Solution

NASA Astrophysics Data System (ADS)

Di Fratta, Crescenzo; Ferraro, Antonio; Tscheliesnig, Peter; Lackner, Gerald; Correggia, Vincenzo; Altamura, Nicola

In Italy, since 2005, techniques based on Acoustic Emission have been introduced for testing of underground LPG tanks up to 13 m3, according to the European standard EN 12818:2004. The testing procedure for these tanks plans to install one or more pairs of sensors inside the "dome" suited for the access to the valves and fittings of the tank, directly on the accessible metal shell. This methodology is not applicable for the underground LPG buried tanks, where it is necessary to install a larger number of AE sensors, in order to cover at 100% the whole tank shell, even at very deep positions. Already in 2004, the European standard EN 12820 (Appendix C - Informative)give the possibility to use Acoustic Emission testing of LPG underground or buried tanks with a capacity exceeding 13 m3, but no technique was specified for the application. In 2008, TÜV AUSTRIA ITALIA - BLU SOLUTIONS srl - Italian company of TÜV AUSTRIA Group - has developed a technique to get access at tank shell, where tank capacity is greater than 13 m3 and its' diameter greater than 3,5 m. This methodology was fully in comply with the provisions of the European Standard EN 12819:2010, becoming an innovative solution widely appreciated and is used in Italy since this time. Currently, large companies and petrochemical plants, at the occurrence of the tank's requalification, have engaged TÜV AUSTRIA ITALIA - BLU SOLUTIONS to install such permanent predispositions, which allow access to the tank shell - test object - with diameters from 4 to 8 m. Through this access, you can install the AE sensors needed to cover at 100% the tank surface and then to perform AE test. In an economic crisis period, this technique is proving a valid and practically applicable answer, in order to reduce inspection costs and downtime by offering a technically advanced solution (AT), increasing the safety of the involved operators, protecting natural resources and the environment.

Protecting the privacy of individual general practice patient electronic records for geospatial epidemiology research.

PubMed

Mazumdar, Soumya; Konings, Paul; Hewett, Michael; Bagheri, Nasser; McRae, Ian; Del Fante, Peter

2014-12-01

General practitioner (GP) practices in Australia are increasingly storing patient information in electronic databases. These practice databases can be accessed by clinical audit software to generate reports that inform clinical or population health decision making and public health surveillance. Many audit software applications also have the capacity to generate de-identified patient unit record data. However, the de-identified nature of the extracted data means that these records often lack geographic information. Without spatial references, it is impossible to build maps reflecting the spatial distribution of patients with particular conditions and needs. Links to socioeconomic, demographic, environmental or other geographically based information are also not possible. In some cases, relatively coarse geographies such as postcode are available, but these are of limited use and researchers cannot undertake precision spatial analyses such as calculating travel times. We describe a method that allows researchers to implement meaningful mapping and spatial epidemiological analyses of practice level patient data while preserving privacy. This solution has been piloted in a diabetes risk research project in the patient population of a practice in Adelaide. The method offers researchers a powerful means of analysing geographic clinic data in a privacy-protected manner. © 2014 Public Health Association of Australia.

A service brokering and recommendation mechanism for better selecting cloud services.

PubMed

Gui, Zhipeng; Yang, Chaowei; Xia, Jizhe; Huang, Qunying; Liu, Kai; Li, Zhenlong; Yu, Manzhu; Sun, Min; Zhou, Nanyin; Jin, Baoxuan

2014-01-01

Cloud computing is becoming the new generation computing infrastructure, and many cloud vendors provide different types of cloud services. How to choose the best cloud services for specific applications is very challenging. Addressing this challenge requires balancing multiple factors, such as business demands, technologies, policies and preferences in addition to the computing requirements. This paper recommends a mechanism for selecting the best public cloud service at the levels of Infrastructure as a Service (IaaS) and Platform as a Service (PaaS). A systematic framework and associated workflow include cloud service filtration, solution generation, evaluation, and selection of public cloud services. Specifically, we propose the following: a hierarchical information model for integrating heterogeneous cloud information from different providers and a corresponding cloud information collecting mechanism; a cloud service classification model for categorizing and filtering cloud services and an application requirement schema for providing rules for creating application-specific configuration solutions; and a preference-aware solution evaluation mode for evaluating and recommending solutions according to the preferences of application providers. To test the proposed framework and methodologies, a cloud service advisory tool prototype was developed after which relevant experiments were conducted. The results show that the proposed system collects/updates/records the cloud information from multiple mainstream public cloud services in real-time, generates feasible cloud configuration solutions according to user specifications and acceptable cost predication, assesses solutions from multiple aspects (e.g., computing capability, potential cost and Service Level Agreement, SLA) and offers rational recommendations based on user preferences and practical cloud provisioning; and visually presents and compares solutions through an interactive web Graphical User Interface (GUI).

Methods for Computationally Efficient Structured CFD Simulations of Complex Turbomachinery Flows

NASA Technical Reports Server (NTRS)

Herrick, Gregory P.; Chen, Jen-Ping

2012-01-01

This research presents more efficient computational methods by which to perform multi-block structured Computational Fluid Dynamics (CFD) simulations of turbomachinery, thus facilitating higher-fidelity solutions of complicated geometries and their associated flows. This computational framework offers flexibility in allocating resources to balance process count and wall-clock computation time, while facilitating research interests of simulating axial compressor stall inception with more complete gridding of the flow passages and rotor tip clearance regions than is typically practiced with structured codes. The paradigm presented herein facilitates CFD simulation of previously impractical geometries and flows. These methods are validated and demonstrate improved computational efficiency when applied to complicated geometries and flows.

Low-power chip-level optical interconnects based on bulk-silicon single-chip photonic transceivers

NASA Astrophysics Data System (ADS)

Kim, Gyungock; Park, Hyundai; Joo, Jiho; Jang, Ki-Seok; Kwack, Myung-Joon; Kim, Sanghoon; Kim, In Gyoo; Kim, Sun Ae; Oh, Jin Hyuk; Park, Jaegyu; Kim, Sanggi

2016-03-01

We present new scheme for chip-level photonic I/Os, based on monolithically integrated vertical photonic devices on bulk silicon, which increases the integration level of PICs to a complete photonic transceiver (TRx) including chip-level light source. A prototype of the single-chip photonic TRx based on a bulk silicon substrate demonstrated 20 Gb/s low power chip-level optical interconnects between fabricated chips, proving that this scheme can offer compact low-cost chip-level I/O solutions and have a significant impact on practical electronic-photonic integration in high performance computers (HPC), cpu-memory interface, 3D-IC, and LAN/SAN/data-center and network applications.

Developments in cognitive neuroscience: I. Conflict, compromise, and connectionism.

PubMed

Westen, Drew; Gabbard, Glen O

2002-01-01

The strength of psychoanalysis has always been its understanding of affect and motivation. Contemporary developments in cognitive neuroscience offer possibilities of integrating sophisticated, experimentally informed models of thought and memory with an understanding of dynamically and clinically meaningful processes. Aspects of contemporary theory and research in cognitive neuroscience are integrated with psychoanalytic theory and technique, particularly theories of conflict and compromise. After a description of evolving models of the mind in cognitive neuroscience, several issues relevant to psychoanalytic theory and practice are addressed. These include the nature of representations, the interaction of cognition and affect, and the mechanisms by which the mind unconsciously forges compromise solutions that best fit multiple cognitive and affective-motivational constraints.

Optics and communication technology major of physics undergraduate degree at King Mongkut's Institute of Technology Ladkrabang

NASA Astrophysics Data System (ADS)

Buranasiri, Prathan

2014-09-01

A physics undergraduate degree major in optics and communication technology has been offered at King Mongkut's Institute of Technology Ladkrabang (KMITL), Bangkok, Thailand. There are nine required three credit hour courses including two laboratory courses plus a number of selections in optics and communication based technology courses. For independent thinking and industrial working skills, nine credit hours of research project, practical training or overseas studies are included for selection in the final semester. Students are encouraged to participate in international conferences and professional organizations. Recently the program, with support from SPIE and OSA, has organized its first international conference on photonic solutions 2013 (ICPS 2013).

Value of Vintage Observatories and Historic Telescopes in Communicating Astronomy with the Public

NASA Astrophysics Data System (ADS)

Bell, T. E.

2010-10-01

The Antique Telescope Society convened a thematic workshop, The Vintage Observatory: Thriving in the 21st Century, on 2-4 May 2008. The workshop's purpose was to bring together those charged with the care of observatories and telescopes built before World War II, to examine common issues and share practical solutions, specifically in preparation for the International Year of Astronomy in 2009. Although much of the workshop concerned issues of preservation and restoration, several sessions focused on the uses of historical artefacts as a means for public education and outreach on astronomy and the history of astronomy, including discussion of the unique opportunities vintage observatories and telescopes offer in intriguing the public about astronomy.

Using ecotechnology to address water quality and wetland habitat loss problems in the Mississippi basin: a hierarchical approach.

PubMed

Day, John W; Yañéz Arancibia, Alejandro; Mitsch, William J; Lara-Dominguez, Ana Laura; Day, Jason N; Ko, Jae-Young; Lane, Robert; Lindsey, Joel; Lomeli, David Zarate

2003-12-01

Human activities are affecting the environment at continental and global scales. An example of this is the Mississippi basin where there has been a large scale loss of wetlands and water quality deterioration over the past century. Wetland and riparian ecosystems have been isolated from rivers and streams. Wetland loss is due both to drainage and reclamation, mainly for agriculture, and to isolation from the river by levees, as in the Mississippi delta. There has been a decline in water quality due to increasing use of fertilizers, enhanced drainage and the loss of wetlands for cleaning water. Water quality has deteriorated throughout the basin and high nitrogen in the Mississippi river is causing a large area of hypoxia in the Gulf of Mexico adjacent to the Mississippi delta. Since the causes of these problems are distributed over the basin, the solution also needs to be distributed over the basin. Ecotechnology and ecological engineering offer the only ecologically sound and cost-effective method of solving these problems. Wetlands to promote nitrogen removal, mainly through denitrification but also through burial and plant uptake, offer a sound ecotechnological solution. At the level of the Mississippi basin, changes in farming practices and use of wetlands for nitrogen assimilation can reduce nitrogen levels in the River. There are additional benefits of restoration of wetland and riverine ecosystems, flood control, reduction in public health threats, and enhanced wildlife and fisheries. At the local drainage basin level, the use of river diversions in the Mississippi delta can address both problems of coastal land loss and water quality deterioration. Nitrate levels in diverted river water are rapidly reduced as water flows through coastal watersheds. At the local level, wetlands are being used to treat municipal wastewater. This is a cost-effective method, which results in improved water quality, enhanced wetland productivity and increased accretion. The problems in the Mississippi basin serves as an example for other watersheds in the Gulf of Mexico. This is especially important in Mexico, where there is a strong need for economical solutions to ecological problems. The Usumacinta delta-Laguna de Terminos regional ecosystem is an example where ecotechnological approaches offer realistic solutions to environmental problems.

Answering the call to accessible quality health care for all using a new model of local community not-for-profit charity clinics: A return to Christ-centered care of the past

PubMed Central

Cuellar De la Cruz, Yuri

2017-01-01

This article uses studies and organizational trends to understand available solutions to the lack of quality health care access, especially for the poor and needy of local U.S. communities. The U.S. healthcare system seems to be moving toward the World Health Organization's recommendation for universal health coverage for healthcare sustainability. Healthcare trends and offered solutions are varied. Christian healthcare traditionally implements works of mercy guided by a Christian ethos embracing the teachings of human dignity, solidarity, the common good, and subsidiarity. Culture of Life Ministries is one of many new sustainable U.S. healthcare models which implements Christ-centered health care to meet the need of quality and accessible health care for the local community. Culture of Life Ministries employs a model of charity care through volunteerism. Volunteer workers not only improve but also transform the local healthcare system into a personal healing ministry of the highest quality for every person. Summary: The lack of access to quality health care is a common problem in the U.S. despite various solutions offered through legislative and socioeconomic works: universal healthcare models, insurance models, and other business models. U.S. health care would be best transformed by returning to the implementation of a traditional system founded on the Christian principles of human dignity, solidarity, subsidiarity, and the common good. Culture of Life Ministries is an example of such a local ministry in Texas, which has found success in practically applying these Christ-centered, healthcare principles into an emerging not-for-profit, economically sustainable, healthcare model. PMID:28392598

Bird Diversity, Birdwatching Tourism and Conservation in Peru: A Geographic Analysis

PubMed Central

Puhakka, Liisa; Salo, Matti; Sääksjärvi, Ilari E.

2011-01-01

In the face of the continuing global biodiversity loss, it is important not only to assess the need for conservation, through e.g. gap analyses, but also to seek practical solutions for protecting biodiversity. Environmentally and socially sustainable tourism can be one such solution. We present a method to spatially link data on conservation needs and tourism-based economic opportunities, using bird-related tourism in Peru as an example. Our analysis highlighted areas in Peru where potential for such projects could be particularly high. Several areas within the central and northern Andean regions, as well as within the lowland Amazonian regions of Madre de Dios and Loreto emerge as promising for this type of activity. Mechanisms to implement conservation in these areas include e.g. conservation and ecotourism concessions, private conservation areas, and conservation easements. Some of these mechanisms also offer opportunities for local communities seeking to secure their traditional land ownership and use rights. (Spanish language abstract, Abstract S1). PMID:22132078

Bird diversity, birdwatching tourism and conservation in Peru: a geographic analysis.

PubMed

Puhakka, Liisa; Salo, Matti; Sääksjärvi, Ilari E

2011-01-01

In the face of the continuing global biodiversity loss, it is important not only to assess the need for conservation, through e.g. gap analyses, but also to seek practical solutions for protecting biodiversity. Environmentally and socially sustainable tourism can be one such solution. We present a method to spatially link data on conservation needs and tourism-based economic opportunities, using bird-related tourism in Peru as an example. Our analysis highlighted areas in Peru where potential for such projects could be particularly high. Several areas within the central and northern Andean regions, as well as within the lowland Amazonian regions of Madre de Dios and Loreto emerge as promising for this type of activity. Mechanisms to implement conservation in these areas include e.g. conservation and ecotourism concessions, private conservation areas, and conservation easements. Some of these mechanisms also offer opportunities for local communities seeking to secure their traditional land ownership and use rights. (Spanish language abstract, Abstract S1).

Scalable Architecture for Federated Translational Inquiries Network (SAFTINet) Technology Infrastructure for a Distributed Data Network

PubMed Central

Schilling, Lisa M.; Kwan, Bethany M.; Drolshagen, Charles T.; Hosokawa, Patrick W.; Brandt, Elias; Pace, Wilson D.; Uhrich, Christopher; Kamerick, Michael; Bunting, Aidan; Payne, Philip R.O.; Stephens, William E.; George, Joseph M.; Vance, Mark; Giacomini, Kelli; Braddy, Jason; Green, Mika K.; Kahn, Michael G.

2013-01-01

Introduction: Distributed Data Networks (DDNs) offer infrastructure solutions for sharing electronic health data from across disparate data sources to support comparative effectiveness research. Data sharing mechanisms must address technical and governance concerns stemming from network security and data disclosure laws and best practices, such as HIPAA. Methods: The Scalable Architecture for Federated Translational Inquiries Network (SAFTINet) deploys TRIAD grid technology, a common data model, detailed technical documentation, and custom software for data harmonization to facilitate data sharing in collaboration with stakeholders in the care of safety net populations. Data sharing partners host TRIAD grid nodes containing harmonized clinical data within their internal or hosted network environments. Authorized users can use a central web-based query system to request analytic data sets. Discussion: SAFTINet DDN infrastructure achieved a number of data sharing objectives, including scalable and sustainable systems for ensuring harmonized data structures and terminologies and secure distributed queries. Initial implementation challenges were resolved through iterative discussions, development and implementation of technical documentation, governance, and technology solutions. PMID:25848567

Scalable Architecture for Federated Translational Inquiries Network (SAFTINet) Technology Infrastructure for a Distributed Data Network.

PubMed

Schilling, Lisa M; Kwan, Bethany M; Drolshagen, Charles T; Hosokawa, Patrick W; Brandt, Elias; Pace, Wilson D; Uhrich, Christopher; Kamerick, Michael; Bunting, Aidan; Payne, Philip R O; Stephens, William E; George, Joseph M; Vance, Mark; Giacomini, Kelli; Braddy, Jason; Green, Mika K; Kahn, Michael G

2013-01-01

Distributed Data Networks (DDNs) offer infrastructure solutions for sharing electronic health data from across disparate data sources to support comparative effectiveness research. Data sharing mechanisms must address technical and governance concerns stemming from network security and data disclosure laws and best practices, such as HIPAA. The Scalable Architecture for Federated Translational Inquiries Network (SAFTINet) deploys TRIAD grid technology, a common data model, detailed technical documentation, and custom software for data harmonization to facilitate data sharing in collaboration with stakeholders in the care of safety net populations. Data sharing partners host TRIAD grid nodes containing harmonized clinical data within their internal or hosted network environments. Authorized users can use a central web-based query system to request analytic data sets. SAFTINet DDN infrastructure achieved a number of data sharing objectives, including scalable and sustainable systems for ensuring harmonized data structures and terminologies and secure distributed queries. Initial implementation challenges were resolved through iterative discussions, development and implementation of technical documentation, governance, and technology solutions.

Water-evaporation-induced electricity with nanostructured carbon materials.

PubMed

Xue, Guobin; Xu, Ying; Ding, Tianpeng; Li, Jia; Yin, Jun; Fei, Wenwen; Cao, Yuanzhi; Yu, Jin; Yuan, Longyan; Gong, Li; Chen, Jian; Deng, Shaozhi; Zhou, Jun; Guo, Wanlin

2017-05-01

Water evaporation is a ubiquitous natural process that harvests thermal energy from the ambient environment. It has previously been utilized in a number of applications including the synthesis of nanostructures and the creation of energy-harvesting devices. Here, we show that water evaporation from the surface of a variety of nanostructured carbon materials can be used to generate electricity. We find that evaporation from centimetre-sized carbon black sheets can reliably generate sustained voltages of up to 1 V under ambient conditions. The interaction between the water molecules and the carbon layers and moreover evaporation-induced water flow within the porous carbon sheets are thought to be key to the voltage generation. This approach to electricity generation is related to the traditional streaming potential, which relies on driving ionic solutions through narrow gaps, and the recently reported method of moving ionic solutions across graphene surfaces, but as it exploits the natural process of evaporation and uses cheap carbon black it could offer advantages in the development of practical devices.

Millimetre-Wave Backhaul for 5G Networks: Challenges and Solutions

PubMed Central

Feng, Wei; Li, Yong; Jin, Depeng; Su, Li; Chen, Sheng

2016-01-01

The trend for dense deployment in future 5G mobile communication networks makes current wired backhaul infeasible owing to the high cost. Millimetre-wave (mm-wave) communication, a promising technique with the capability of providing a multi-gigabit transmission rate, offers a flexible and cost-effective candidate for 5G backhauling. By exploiting highly directional antennas, it becomes practical to cope with explosive traffic demands and to deal with interference problems. Several advancements in physical layer technology, such as hybrid beamforming and full duplexing, bring new challenges and opportunities for mm-wave backhaul. This article introduces a design framework for 5G mm-wave backhaul, including routing, spatial reuse scheduling and physical layer techniques. The associated optimization model, open problems and potential solutions are discussed to fully exploit the throughput gain of the backhaul network. Extensive simulations are conducted to verify the potential benefits of the proposed method for the 5G mm-wave backhaul design. PMID:27322265

Addressing the Math-Practice Gap in Elementary School: Are Tablets a Feasible Tool for Informal Math Practice?

PubMed Central

Stacy, Sara T.; Cartwright, Macey; Arwood, Zjanya; Canfield, James P.; Kloos, Heidi

2017-01-01

Students rarely practice math outside of school requirements, which we refer to as the “math-practice gap”. This gap might be the reason why students struggle with math, making it urgent to develop means by which to address it. In the current paper, we propose that math apps offer a viable solution to the math-practice gap: Online apps can provide access to a large number of problems, tied to immediate feedback, and delivered in an engaging way. To substantiate this conversation, we looked at whether tablets are sufficiently engaging to motivate children’s informal math practice. Our approach was to partner with education agencies via a community-based participatory research design. The three participating education agencies serve elementary-school students from low-SES communities, allowing us to look at tablet use by children who are unlikely to have extensive access to online math enrichment programs. At the same time, the agencies differed in several structural details, including whether our intervention took place during school time, after school, or during the summer. This allowed us to shed light on tablet feasibility under different organizational constraints. Our findings show that tablet-based math practice is engaging for young children, independent of the setting, the student’s age, or the math concept that was tackled. At the same time, we found that student engagement was a function of the presence of caring adults to facilitate their online math practice. PMID:28270780

Addressing the Math-Practice Gap in Elementary School: Are Tablets a Feasible Tool for Informal Math Practice?

PubMed

Stacy, Sara T; Cartwright, Macey; Arwood, Zjanya; Canfield, James P; Kloos, Heidi

2017-01-01

Students rarely practice math outside of school requirements, which we refer to as the "math-practice gap". This gap might be the reason why students struggle with math, making it urgent to develop means by which to address it. In the current paper, we propose that math apps offer a viable solution to the math-practice gap: Online apps can provide access to a large number of problems, tied to immediate feedback, and delivered in an engaging way. To substantiate this conversation, we looked at whether tablets are sufficiently engaging to motivate children's informal math practice. Our approach was to partner with education agencies via a community-based participatory research design. The three participating education agencies serve elementary-school students from low-SES communities, allowing us to look at tablet use by children who are unlikely to have extensive access to online math enrichment programs. At the same time, the agencies differed in several structural details, including whether our intervention took place during school time, after school, or during the summer. This allowed us to shed light on tablet feasibility under different organizational constraints. Our findings show that tablet-based math practice is engaging for young children, independent of the setting, the student's age, or the math concept that was tackled. At the same time, we found that student engagement was a function of the presence of caring adults to facilitate their online math practice.

Connecting the Space between Design and Research: Explorations in Participatory Research Supervision

ERIC Educational Resources Information Center

Caldwell, Glenda Amayo; Osborne, Lindy; Mewburn, Inger; Nottingham, Anitra

2016-01-01

In this article we offer a single case study using an action research method for gathering and analysing data offering insights valuable to both design and research supervision practice. We do not attempt to generalise from this single case, but offer it as an instance that can improve our understanding of research supervision practice. We…

Mineral induced formation of sugar phosphates

NASA Technical Reports Server (NTRS)

Pitsch, S.; Eschenmoser, A.; Gedulin, B.; Hui, S.; Arrhenius, G.

1995-01-01

Glycolaldehyde phosphate, sorbed from highly dilute, weakly alkaline solution into the interlayer of common expanding sheet structure metal hydroxide minerals, condenses extensively to racemic aldotetrose-2, 4-diphophates, and aldohexose-2, 4, 6-triphosphates. The reaction proceeds mainly through racemic erythrose-2, 4-phosphate, and terminates with a large fraction of racemic altrose-2, 4, 6-phosphate. In the absence of an inductive mineral phase, no detectable homogeneous reaction takes place in the concentration- and pH range used. The reactant glycolaldehyde phosphate is practically completely sorbed within an hour from solutions with concentrations as low as 50 micron; the half-time for conversion to hexose phosphates is of the order of two days at room temperature and pH 9.5. Total production of sugar phosphates in the mineral interlayer is largely independent of the glycolaldehyde phosphate concentration in the external solution, but is determined by the total amount of GAP offered for sorption up to the capacity of the mineral. In the presence of equimolar amounts of rac-glyceraldehyde-2-phosphate, but under otherwise similar conditions, aldopentose-2, 4, -diphosphates also form, but only as a small fraction of the hexose-2, 4, 6-phosphates.

The Propagation and Scattering of EM Waves in Electrically Large Ducts

NASA Astrophysics Data System (ADS)

Khan, Saeed Mahmood

The electromagnetic scattering from large arbitrarily shaped ducts with complex termination is studied here by a hybrid technique. The propagation of electromagnetic waves in the duct is analyzed in terms of an approximate modal solution. A finite difference technique is employed for computing the reflection characteristics of the complex terminations. Both solutions are combined using the unimoment method. The analysis here is carried out for monostatic RCS and considers only fields backscattered from inside the cavity. Rim-diffraction has been left out. The procedure offers such advantages as in that it is not necessary to find complicated Green's functions, which may not be readily available, when compared with the integral equation method. Hybridization performed by combining an approximate modal technique with a finite difference one makes the scheme numerically efficient. From a computational EM point of view, it brings together a whole spectrum of techniques associated with high frequency modal analysis, Fourier Methods, Radar Cross Section and Scattering, finite difference solution and the Unimoment Method. The practical application of this technique may range from the study of RCS scattered from jet inlets of radar evasive aircraft to submarine communication waveguides.

Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers: A "Positive Deviance" Approach.

PubMed

Toscos, Tammy; Carpenter, Maria; Flanagan, Mindy; Kunjan, Kislaya; Doebbeling, Bradley N

2018-01-01

Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These "positive deviant" practices translate into organizational policies to improve health care access and patient experience. To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient-provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access.

A reliable, low-cost picture archiving and communications system for small and medium veterinary practices built using open-source technology.

PubMed

Iotti, Bryan; Valazza, Alberto

2014-10-01

Picture Archiving and Communications Systems (PACS) are the most needed system in a modern hospital. As an integral part of the Digital Imaging and Communications in Medicine (DICOM) standard, they are charged with the responsibility for secure storage and accessibility of the diagnostic imaging data. These machines need to offer high performance, stability, and security while proving reliable and ergonomic in the day-to-day and long-term storage and retrieval of the data they safeguard. This paper reports the experience of the authors in developing and installing a compact and low-cost solution based on open-source technologies in the Veterinary Teaching Hospital for the University of Torino, Italy, during the course of the summer of 2012. The PACS server was built on low-cost x86-based hardware and uses an open source operating system derived from Oracle OpenSolaris (Oracle Corporation, Redwood City, CA, USA) to host the DCM4CHEE PACS DICOM server (DCM4CHEE, http://www.dcm4che.org ). This solution features very high data security and an ergonomic interface to provide easy access to a large amount of imaging data. The system has been in active use for almost 2 years now and has proven to be a scalable, cost-effective solution for practices ranging from small to very large, where the use of different hardware combinations allows scaling to the different deployments, while the use of paravirtualization allows increased security and easy migrations and upgrades.

Developing Effective Collaboration Between Primary Care and Mental Health Providers

PubMed Central

Felker, Bradford L.; Chaney, Edmund; Rubenstein, Lisa V.; Bonner, Laura M.; Yano, Elizabeth M.; Parker, Louise E.; Worley, Linda L. M.; Sherman, Scott E.; Ober, Scott

2006-01-01

Objective: Improving care for depressed primary care (PC) patients requires system-level interventions based on chronic illness management with collaboration among primary care providers (PCPs) and mental health providers (MHPs). We describe the development of an effective collaboration system for an ongoing multisite Department of Veterans Affairs (VA) study evaluating a multifaceted program to improve management of major depression in PC practices. Method: Translating Initiatives for Depression into Effective Solutions (TIDES) is a research project that helps VA facilities adopt depression care improvements for PC patients with depression. A regional telephone-based depression care management program used Depression Case Managers (DCMs) supervised by MHPs to assist PCPs with patient management. The Collaborative Care Workgroup (CWG) was created to facilitate collaboration between PCPs, MHPs, and DCMs. The CWG used a 3-phase process: (1) identify barriers to better depression treatment, (2) identify target problems and solutions, and (3) institutionalize ongoing problem detection and solution through new policies and procedures. Results: The CWG overcame barriers that exist between PCPs and MHPs, leading to high rates of the following: patients with depression being followed by PCPs (82%), referred PC patients with depression keeping their appointments with MHPs (88%), and PC patients with depression receiving antidepressants (76%). The CWG helped sites implement site-specific protocols for addressing patients with suicidal ideation. Conclusion: By applying these steps in PC practices, collaboration between PCPs and MHPs has been improved and maintained. These steps offer a guide to improving collaborative care to manage depression or other chronic disorders within PC clinics. PMID:16862248

Is innovative workforce planning software the solution to NHS staffing and cost crisis? An exploration of the locum industry.

PubMed

Theodoulou, Iakovos; Reddy, Akshaya Mohan; Wong, Jeremy

2018-03-20

Workforce planning in the British healthcare system (NHS) is associated with significant costs of agency staff employment. The introduction of a novel software (ABG) as a 'people to people economy' (P2PE) platform for temporary staff recruitment offers a potential solution to this problem. Consequently, the focus of this study was twofold - primarily to explore the locum doctor landscape, and secondarily to evaluate the implementation of P2PE in the healthcare industry. Documentary analysis was conducted alongside thirteen semi structured interviews across five informant groups: two industry experts, two healthcare consultants, an executive director, two speciality managers and six doctors. We found that locum doctors are indispensable to covering workforce shortages, yet existing planning and recruitment practices were found to be inefficient, inconsistent and lacking transparency. Contrarily, mobile-first solutions such as ABG seem to secure higher convenience, better transparency, cost and time efficiency. We also identified factors facilitating the successful diffusion of ABG; these were in line with classically cited characteristics of innovation such as trialability, observability, and scope for local reinvention. Drawing upon the concept of value-based healthcare coupled with the analysis of our findings led to the development of Information Exchange System (IES) model, a comprehensive framework allowing a thorough comparison of recruitment practices in healthcare. IES was used to evaluate ABG and its diffusion against other recruitment methods and ABG was found to outperform its alternatives, thus suggesting its potential to solve the staffing and cost crisis at the chosen hospital.

Student Credit Card Debt in the 21st Century: Options for Financial Aid Administrators.

ERIC Educational Resources Information Center

Oleson, Mark

2001-01-01

Provides multiple workable solutions financial aid offices can offer students throughout their college experience to deal with debt: preventive solutions for avoiding problems with credit card debt, holistic solutions for other related problems, and remedial solutions for existing problems. (EV)

Lessons learned from the Apple stores.

PubMed

Pinkney, Henry; Baum, Neil

2012-01-01

Medical practices have an opportunity to improve the services that they offer their patients. Practices can look at other businesses and industries for examples of outstanding customer service. This article will discuss the services provided by Apple, Inc., and how medical practices can learn from this industry giant and improve the services that they offer patients.

Challenges in conducting qualitative research in health: A conceptual paper

PubMed Central

Khankeh, Hamidreza; Ranjbar, Maryam; Khorasani-Zavareh, Davoud; Zargham-Boroujeni, Ali; Johansson, Eva

2015-01-01

Background: Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. Materials and Methods: This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. Results: One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues. Conclusions: The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others. PMID:26793245

Cattle and sheep develop preference for drinking water containing grape seed tannin.

PubMed

Kronberg, S L; Schauer, C S

2013-10-01

Ingestion of small amounts of some types of condensed tannins (CTs) by ruminant livestock can provide nutritional, environmental and economic benefits. However, practical methods are needed to make these tannins more available to ruminant livestock. Results from previous trials with crude quebracho and black wattle tannin indicated that cattle and/or sheep would not preferentially drink water containing these tannins. Therefore, we conducted preference trials to determine if cattle and sheep would learn to prefer water containing purified grape seed tannin (GST) that provided up to 2% of their daily dry matter (DM) intake. After gradual exposure to increasing amounts of this tannin in water during a pre-trial period, five adult ewes and five yearling heifers fed lucerne (Medicago sativa) pellets (19% CP) were offered water and several concentrations of GST solutions for either 15 (sheep trial) or 20 days (cattle trial). We measured intake of all liquids daily. Concentrations of blood urea were also measured for heifers when they drank only tannin solutions or water. Both sheep and cattle developed preferences for water with GST in it over water alone (P < 0.01) although this preference appeared earlier in the trial for sheep than for cattle. For the sheep, mean daily intake of water alone and all tannin solutions (in total) was 0.6 and 6.1 l, respectively. For the cattle, mean daily intake of water and all tannin solutions in total was 21.8 and 20.6 l, respectively, in the first half of the trial and 10.8 and 26.1 l, respectively, in the second half of the trial. Compared with the other tannin solutions, both sheep and cattle drank more of the solution with the highest tannin concentration (2% of daily DM intake as GST) than of water on more trial days (P < 0.05). Ingestion of water with the highest concentration of GST reduced blood plasma urea concentration in the cattle by 9% to 14% (P ≤ 0.10) compared with ingestion of water alone. Results from the trials suggest that providing grape seed and perhaps other CTs via drinking water may be a practical way to introduce CTs into sheep and cattle diets.

Energetics of drug-DNA interactions.

PubMed

Chaires, J B

1997-01-01

Understanding the thermodynamics of drug binding to DNA is of both practical and fundamental interest. The practical interest lies in the contribution that thermodynamics can make to the rational design process for the development of new DNA targeted drugs. Thermodynamics offer key insights into the molecular forces that drive complex formation that cannot be obtained by structural or computational studies alone. The fundamental interest in these interactions lies in what they can reveal about the general problems of parsing and predicting ligand binding free energies. For these problems, drug-DNA interactions offer several distinct advantages, among them being that the structures of many drug-DNA complexes are known at high resolution and that such structures reveal that in many cases the drug acts as a rigid body, with little conformational change upon binding. Complete thermodynamic profiles (delta G, delta H, delta S, delta Cp) for numerous drug-DNA interactions have been obtained, with the help of high-sensitivity microcalorimetry. The purpose of this article is to offer a perspective on the interpretation of these thermodynamics parameters, and in particular how they might be correlated with known structural features. Obligatory conformational changes in the DNA to accommodate intercalators and the loss of translational and rotational freedom upon complex formation both present unfavorable free energy barriers for binding. Such barriers must be overcome by favorable free energy contributions from the hydrophobic transfer of ligand from solution into the binding site, polyelectrolyte contributions from coupled ion release, and molecular interactions (hydrogen and ionic bonds, van der Waals interactions) that form within the binding site. Theoretical and semiempirical tools that allow estimates of these contributions to be made will be discussed, and their use in dissecting experimental data illustrated. This process, even at the current level of approximation, can shed considerable light on the drug-DNA binding process.

Healthcare leadership's diversity paradox.

PubMed

Silver, Reginald

2017-02-06

Purpose The purpose of this research study was to obtain healthcare executives' perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color. Design/methodology/approach A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified. Findings The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles. Research limitations/implications This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics. Practical implications The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of color in leadership roles that guide healthcare policy and access. This study connects contemporary literature to perspectives of executives in the field and offers practical solutions to improving the representation of people of color in executive healthcare leadership roles. Social implications The recommendations offered as a result of this research effort serve to create awareness of the challenges that people of color face in career attainment. Although the process of increasing the representation of people of color in executive healthcare leadership will be a complex task that will involve a number of players over the course of several years, this study serves to provide a practical roadmap with actionable tactics that can be deployed. Originality/value This paper is an extension of the work that was done by the author during the course of completing the program requirements for the author's doctoral program. The findings were previously discussed in the author's dissertation. The value of these findings is significant because they validate some of the topics in contemporary literature with the perspectives of practicing healthcare executives. This study is also unique from other studies in that it offers a long-term plan to increase the representation of people of color in executive roles by creating an early disposition toward executive level roles and identifies a number of practical steps toward that end.

A Novel Hypercomplex Solution to Kepler's Problem

NASA Astrophysics Data System (ADS)

Condurache, C.; Martinuşi, V.

2007-05-01

By using a Sundman like regularization, we offer a unified solution to Kepler's problem by using hypercomplex numbers. The fundamental role in this paper is played by the Laplace-Runge-Lenz prime integral and by the hypercomplex numbers algebra. The procedure unifies and generalizes the regularizations offered by Levi-Civita and Kustaanheimo-Stiefel. Closed form hypercomplex expressions for the law of motion and velocity are deduced, together with inedite hypercomplex prime integrals.

The Difficulties Experienced by Teachers in the Process of Primary Reading and Writing Instruction and Their Solution Offers for Eliminating These Difficulties

ERIC Educational Resources Information Center

Gündogmus, Hatice Degirmenci

2018-01-01

The purpose of the current research is to identify the difficulties that primary school teachers experience in the primary reading and writing instruction, and to find out their solution offers for eliminating these difficulties. The study group of the research is composed of 51 primary school teachers selected by criterion sampling as a type of…

Centering Pregnancy: practical tips for your practice.

PubMed

DeCesare, Julie Z; Jackson, Jessica R

2015-03-01

With increased access to care, current health delivery systems will need expansion to meet higher demands and needs. To define Centering Pregnancy and practical tips for implementation into both private and academic practices. Evidence was gathered through literature reviews. It was found that Centering Pregnancy offers a patient-centered, evidence-based approach to helping with access issues, as well as improving outcomes. This article describes the benefits of Centering Pregnancy to the practice, the provider, and the patient. Practical implementation tips will be offered, with suggestions for negating common implementation barriers.

16 CFR 238.1 - Bait advertisement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Bait advertisement. 238.1 Section 238.1 Commercial Practices FEDERAL TRADE COMMISSION GUIDES AND TRADE PRACTICE RULES GUIDES AGAINST BAIT ADVERTISING § 238.1 Bait advertisement. No advertisement containing an offer to sell a product should be published when the offer is not a bona fide effort...

12 CFR 563b.340 - What sales practices are prohibited?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false What sales practices are prohibited? 563b.340... FROM MUTUAL TO STOCK FORM Standard Conversions Offers and Sales of Stock § 563b.340 What sales practices are prohibited? (a) In connection with offers, sales, or purchases of conversion shares under this...

Methodical approaches in town-planning design of street circuits in the conditions of sustainable development of the city

NASA Astrophysics Data System (ADS)

Ivanova, Nina; Ganzha, Olga

2017-10-01

In article the technique of adoption of the design decision on placement of eco-friendly routes for the purpose of use is proved by steady transport, the technique of the choice of the optimal solution of development of local bicycle network of routes is offered and developed structural model of the choice of options of placement of cycle routes in system of street road system and recreational zones in the conditions of sustainable development of the city. The theoretical and practical experience of construction of cycle routes in Russia and abroad is generalized; the method of the analysis of hierarchies which allows to carry out the choice of the design decision taking into account different groups of factors is used; the structural model at the choice of options of placement of bicycle tracks on the example of linear structure of the coastal city is developed; experimental design in the territory of streets of Volgograd is executed. The offered structural model is used in development of design offers of construction of bicycle tracks for the streets of Volgograd providing to inhabitants and city visitors more attractive, healthy and cheap option of movement to place of work, training, rest and entertainments.

Internet-mediated psychotherapy: Are we ready for the ethical challenges?

PubMed

Satalkar, Priya; Shrivastava, Shivanshu; Desousa, Avinash

2015-01-01

Advances in information and communication technology have facilitated the development of online psychotherapy. This form of psychotherapy would provide the developing world with better access to professional mental healthcare services. At the same time, it is prudent to carefully consider the various ethical, legal and regulatory issues involved in online psychotherapy. This paper highlights the major ethical issues involved in the use of online psychotherapy, whether conducted via e-mail, chat rooms or interactive video, and identifies practical solutions for the ethical dilemmas that exist. Many authors and organisations have expressed their opinions on the subject, but no consensus has evolved. The advice offered to psychologists is mostly skewed and the scarcity of literature available to those considering expanding their practice to include online psychotherapy is certainly a source of vexation. While reviewing the existing literature, this paper seeks to describe and discuss the major ethical issues in this area, particularly in India, but many of these issues will be equally applicable to any developing world settings.

The social implications of using drones for biodiversity conservation.

PubMed

Sandbrook, Chris

2015-11-01

Unmanned aerial vehicles, or 'drones', appear to offer a flexible, accurate and affordable solution to some of the technical challenges of nature conservation monitoring and law enforcement. However, little attention has been given to their possible social impacts. In this paper, I review the possible social impacts of using drones for conservation, including on safety, privacy, psychological wellbeing, data security and the wider understanding of conservation problems. I argue that negative social impacts are probable under some circumstances and should be of concern for conservation for two reasons: (1) because conservation should follow good ethical practice; and (2) because negative social impacts could undermine conservation effectiveness in the long term. The paper concludes with a call for empirical research to establish whether the identified social risks of drones occur in reality and how they could be mitigated, and for self-regulation of drone use by the conservation sector to ensure good ethical practice and minimise the risk of unintended consequences.

Fortuitous phenomena: on complexity, pragmatic randomised controlled trials, and knowledge for evidence-based practice.

PubMed

Thompson, Carl

2004-01-01

Many of the interventions that nurses develop and implement are in themselves complex and have to operate in situations of irreducible complexity and uncertainty. This article argues that the primary means of generating knowledge for the evidence-based deployment of complex interventions should be the pragmatic randomised controlled trial. Randomised controlled trials represent the only research design to adequately deal with that which we know and (far more importantly) that which we do not. Using the example of practice development as an exemplar for complexity, and drawing on the objections often voiced as a response to calls to make use of randomised controlled trials in nursing and nursing research, the article presents a developmental framework and some methodological solutions to problems often encountered. Randomised controlled trials, whilst undoubtedly methodologically and strategically challenging, offer the most robust basis for developing primary research knowledge on the effects of complex interventions in nursing and their active components.

Understanding your supply chain to reduce the risk of supply chain disruption.

PubMed

Wildgoose, Nick; Brennan, Patrick; Thompson, Simon

2012-01-01

Supply chains are at the heart of the way in which organisations operate and compete today; they also play a critical role in overall organisation performance. In the context of increasingly complex and global supply chains, the actions taken to drive down costs are likely to drive risk into the supply chain. The frequency of supply chain disruptions is high and this paper offers practical advice to help reduce the frequency and cost associated with these. There is advice to help with the understanding of how to identify critical suppliers. The reader is guided through comprehensive risk assessment and mitigation approaches and a selection of practical risk solutions and tools that you can use is described. There is a section on the 'dos and don'ts' relating to supplier due diligence. For those organisations facing the challenge of drawing up a business case relating to investment in improving supply chain resiliency, there is also a section outlining some of the business benefits of improving supply chain resiliency.

Damage Based Analysis (DBA) - Theory, Derivation and Practical Application Using Both an Acceleration and Pseudo Velocity Approach

NASA Technical Reports Server (NTRS)

Grillo, Vince

2017-01-01

The objective of this presentation is to give a brief overview of the theory behind the (DBA) method, an overview of the derivation and a practical application of the theory using the Python computer language. The Theory and Derivation will use both Acceleration and Pseudo Velocity methods to derive a series of equations for processing by Python. We will take the results and compare both Acceleration and Pseudo Velocity methods and discuss implementation of the Python functions. Also, we will discuss the efficiency of the methods and the amount of computer time required for the solution. In conclusion, (DBA) offers a powerful method to evaluate the amount of energy imparted into a system in the form of both Amplitude and Duration during qualification testing and flight environments. Many forms of steady state and transient vibratory motion can be characterized using this technique. (DBA) provides a more robust alternative to traditional methods such Power Spectral Density (PSD) using a maximax approach.

Damage Based Analysis (DBA): Theory, Derivation and Practical Application - Using Both an Acceleration and Pseudo-Velocity Approach

NASA Technical Reports Server (NTRS)

Grillo, Vince

2016-01-01

The objective of this presentation is to give a brief overview of the theory behind the (DBA) method, an overview of the derivation and a practical application of the theory using the Python computer language. The Theory and Derivation will use both Acceleration and Pseudo Velocity methods to derive a series of equations for processing by Python. We will take the results and compare both Acceleration and Pseudo Velocity methods and discuss implementation of the Python functions. Also, we will discuss the efficiency of the methods and the amount of computer time required for the solution. In conclusion, (DBA) offers a powerful method to evaluate the amount of energy imparted into a system in the form of both Amplitude and Duration during qualification testing and flight environments. Many forms of steady state and transient vibratory motion can be characterized using this technique. (DBA) provides a more robust alternative to traditional methods such Power Spectral Density (PSD) using a Maximax approach.

High-Resolution Sequence-Function Mapping of Full-Length Proteins

PubMed Central

Kowalsky, Caitlin A.; Klesmith, Justin R.; Stapleton, James A.; Kelly, Vince; Reichkitzer, Nolan; Whitehead, Timothy A.

2015-01-01

Comprehensive sequence-function mapping involves detailing the fitness contribution of every possible single mutation to a gene by comparing the abundance of each library variant before and after selection for the phenotype of interest. Deep sequencing of library DNA allows frequency reconstruction for tens of thousands of variants in a single experiment, yet short read lengths of current sequencers makes it challenging to probe genes encoding full-length proteins. Here we extend the scope of sequence-function maps to entire protein sequences with a modular, universal sequence tiling method. We demonstrate the approach with both growth-based selections and FACS screening, offer parameters and best practices that simplify design of experiments, and present analytical solutions to normalize data across independent selections. Using this protocol, sequence-function maps covering full sequences can be obtained in four to six weeks. Best practices introduced in this manuscript are fully compatible with, and complementary to, other recently published sequence-function mapping protocols. PMID:25790064

Standardization of quantum key distribution and the ETSI standardization initiative ISG-QKD

NASA Astrophysics Data System (ADS)

Länger, Thomas; Lenhart, Gaby

2009-05-01

In recent years, quantum key distribution (QKD) has been the object of intensive research activities and of rapid progress, and it is now developing into a competitive industry with commercial products. Once QKD systems are transferred from the controlled environment of physical laboratories into a real-world environment for practical use, a number of practical security, compatibility and connectivity issues need to be resolved. In particular, comprehensive security evaluation and watertight security proofs need to be addressed to increase trust in QKD. System interoperability with existing infrastructures and applications as well as conformance with specific user requirements have to be assured. Finding common solutions to these problems involving all actors can provide an advantage for the commercialization of QKD as well as for further technological development. The ETSI industry specification group for QKD (ISG-QKD) offers a forum for creating such universally accepted standards and will promote significant leverage effects on coordination, cooperation and convergence in research, technical development and business application of QKD.

Assessment of existing local houses condition as analysis tools for shore housing improvement program in Weriagar district, Bintuni Bay

NASA Astrophysics Data System (ADS)

Firmansyah, F.; Fernando, A.; Allo, I. P. R.

2018-01-01

The housing assessment is a part of the pre-feasibility study inThe Shore Housing Improvement Program in Weriagar District, West Papua. The housing assessment was conducted to identify the physical condition of existing houses. The parameters of assessment formulated from local references, practices and also national building regulation that covers each building system components, such as building structure/frame, building floor, building cover, and building roof. This study aims to explains lessons from local practices and references, used as the formula to generate assessment parameter, elaborate with Indonesia building regulation. The result of housing assessment were used as a basis to develop the house improvement strategy, the design alternative for housing improvement and further planning recommendations. The local knowledges involved in housing improvement program expected that the local-based approach could respect to the local build culture, respect the local environment, and the most important can offer best suitable solutions for functional utility and livability.

Situating the Debate on "Geometrical Algebra" within the Framework of Premodern Algebra.

PubMed

Sialaros, Michalis; Christianidis, Jean

2016-06-01

Argument The aim of this paper is to employ the newly contextualized historiographical category of "premodern algebra" in order to revisit the arguably most controversial topic of the last decades in the field of Greek mathematics, namely the debate on "geometrical algebra." Within this framework, we shift focus from the discrepancy among the views expressed in the debate to some of the historiographical assumptions and methodological approaches that the opposing sides shared. Moreover, by using a series of propositions related to Elem. II.5 as a case study, we discuss Euclid's geometrical proofs, the so-called "semi-algebraic" alternative demonstrations attributed to Heron of Alexandria, as well as the solutions given by Diophantus, al-Sulamī, and al-Khwārizmī to the corresponding numerical problem. This comparative analysis offers a new reading of Heron's practice, highlights the significance of contextualizing "premodern algebra," and indicates that the origins of algebraic reasoning should be sought in the problem-solving practice, rather than in the theorem-proving tradition.

Barriers and Strategies to Engaging Our Community-Based Preceptors.

PubMed

Graziano, Scott C; McKenzie, Margaret L; Abbott, Jodi F; Buery-Joyner, Samantha D; Craig, LaTasha B; Dalrymple, John L; Forstein, David A; Hampton, Brittany S; Page-Ramsey, Sarah M; Pradhan, Archana; Wolf, Abigail; Hopkins, Laura

2018-03-26

This article, from the "To the Point" series that is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a review of commonly cited barriers to recruiting and retaining community-based preceptors in undergraduate medical education and potential strategies to overcome them. Community-based preceptors have traditionally served as volunteer, nonsalaried faculty, with academic institutions relying on intrinsic teaching rewards to sustain this model. However, increasing numbers of learners, the burdens of incorporating the electronic medical record in practice, and increasing demands for clinical productivity are making recruitment and retention of community-based preceptors more challenging. General challenges to engaging preceptors, as well as those unique to women's health, are discussed. Potential solutions are reviewed, including alternative recruitment strategies, faculty development to emphasize efficient teaching practices in the ambulatory setting, offers of online educational resources, and opportunities to incorporate students in value-added roles. Through examples cited in this review, clerkship directors and medical school administrators should have a solid foundation to actively engage their community-based preceptors.

The Implementation of Novel Collaborative Structures for the Identification and Resolution of Barriers to Pluripotent Stem Cell Translation

PubMed Central

Brindley, David A.; French, Anna; Suh, Jane; Roberts, MacKenna; Davies, Benjamin; Pinedo-Villanueva, Rafael; Wartolowska, Karolina; Rooke, Kelly; Kramm, Anneke; Judge, Andrew; Morrey, Mark; Chandra, Amit; Hurley, Hannah; Grover, Liam; Bingham, Ian; Siegel, Bernard; Rattley, Matt S.; Buckler, R. Lee; McKeon, David; Krumholz, Katie; Hook, Lilian; May, Michael; Rikabi, Sarah; Pigott, Rosie; Morys, Megan; Sabokbar, Afsie; Titus, Emily; Laabi, Yacine; Lemaitre, Gilles; Zahkia, Raymond; Sipp, Doug; Horne, Robert; Bravery, Christopher; Williams, David; Wall, Ivan; Snyder, Evan Y.; Karp, Jeffrey M.; Barker, Richard W.; Bure, Kim; Carr, Andrew J.; Reeve, Brock

2013-01-01

Abstract Increased global connectivity has catalyzed technological development in almost all industries, in part through the facilitation of novel collaborative structures. Notably, open innovation and crowd-sourcing—of expertise and/or funding—has tremendous potential to increase the efficiency with which biomedical ecosystems interact to deliver safe, efficacious and affordable therapies to patients. Consequently, such practices offer tremendous potential in advancing development of cellular therapies. In this vein, the CASMI Translational Stem Cell Consortium (CTSCC) was formed to unite global thought-leaders, producing academically rigorous and commercially practicable solutions to a range of challenges in pluripotent stem cell translation. Critically, the CTSCC research agenda is defined through continuous consultation with its international funding and research partners. Herein, initial findings for all research focus areas are presented to inform global product development strategies, and to stimulate continued industry interaction around biomanufacturing, strategic partnerships, standards, regulation and intellectual property and clinical adoption. PMID:24304079

Modification of Encapsulation Pressure of Reverse Micelles in Liquid Ethane

PubMed Central

Peterson, Ronald W.; Nucci, Nathaniel V.; Wand, A. Joshua

2011-01-01

Encapsulation of within reverse micelles dissolved in low viscosity fluids offers a potential solution to the slow tumbling problem presented by large soluble macromolecules to solution NMR spectroscopy. The reduction in effective macromolecular tumbling is directly dependent upon the viscosity of the solvent. Liquid ethane is of sufficiently low viscosity at pressures below 5,000 p.s.i. to offer a significant advantage. Unfortunately, the viscosity of liquid ethane shows appreciable pressure dependence. Reverse micelle encapsulation in liquid ethane often requires significantly higher pressures, which obviates the potential advantages offered by liquid ethane over liquid propane. Addition of co-surfactants or co-solvents can be used to manipulate the minimum pressure required to obtain stable, well-behaved solutions of reverse micelles prepared in liquid ethane. A library of potential additives is examined and several candidates suitable for use with encapsulated proteins are described. PMID:21764613

Modification of encapsulation pressure of reverse micelles in liquid ethane.

PubMed

Peterson, Ronald W; Nucci, Nathaniel V; Wand, A Joshua

2011-09-01

Encapsulation within reverse micelles dissolved in low viscosity fluids offers a potential solution to the slow tumbling problem presented by large soluble macromolecules to solution NMR spectroscopy. The reduction in effective macromolecular tumbling is directly dependent upon the viscosity of the solvent. Liquid ethane is of sufficiently low viscosity at pressures below 5000 psi to offer a significant advantage. Unfortunately, the viscosity of liquid ethane shows appreciable pressure dependence. Reverse micelle encapsulation in liquid ethane often requires significantly higher pressures, which obviates the potential advantages offered by liquid ethane over liquid propane. Addition of co-surfactants or co-solvents can be used to manipulate the minimum pressure required to obtain stable, well-behaved solutions of reverse micelles prepared in liquid ethane. A library of potential additives is examined and several candidates suitable for use with encapsulated proteins are described. Copyright © 2011 Elsevier Inc. All rights reserved.

Ultrasmooth Quantum Dot Micropatterns by a Facile Controllable Liquid-Transfer Approach: Low-Cost Fabrication of High-Performance QLED.

PubMed

Zhang, Min; Hu, Binbin; Meng, Lili; Bian, Ruixin; Wang, Siyuan; Wang, Yunjun; Liu, Huan; Jiang, Lei

2018-06-26

Fabrication of a high quality quantum dot (QD) film is essentially important for a high-performance QD light emitting diode display (QLED) device. It is normally a high-cost and multiple-step solution-transfer process where large amounts of QDs were needed but with only limited usefulness. Thus, developing a simple, efficient, and low-cost approach to fabricate high-quality micropatterned QD film is urgently needed. Here, we proposed that the Chinese brush enables the controllable transfer of a QD solution directly onto a homogeneous and ultrasmooth micropatterned film in one step. It is proposed that the dynamic balance of QDs was enabled during the entire solution transfer process under the cooperative effect of Marangoni flow aroused by the asymmetric solvent evaporation and the Laplace pressure different by conical fibers. By this approach, QD nanoparticles were homogeneously transferred onto the desired area on the substrate. The as-prepared QLED devices show rather high performances with the current efficiencies of 72.38, 26.03, and 4.26 cd/A and external quantum efficiencies of 17.40, 18.96, and 6.20% for the green, red, and blue QLED devices, respectively. We envision that the result offers a low-cost, facile, and practically applicable solution-processing approach that works even in air for fabricating high-performance QLED devices.

Optimisation of maintenance concept choice using risk-decision factor - a case study

NASA Astrophysics Data System (ADS)

Popovic, Vladimir M.; Vasic, Branko M.; Rakicevic, Branislav B.; Vorotovic, Goran S.

2012-10-01

The design of maintenance system and the corresponding logistic support is a very complex process, during which the aim is to find the compromise solutions regarding the relations among different maintenance procedures and the ways of their implementation. As a result of this, various solutions can be adopted, since this is conditioned by a series of important factors and criteria, which can be contradictory sometimes. There are different perspectives on ways of solving practical maintenance problems, that is dilemmas when it comes to the choice of maintenance concept. The principal dilemma is how and when to decide on carrying out maintenance procedures. Should the decision be based on theoretical grounds or experience, how does one reconcile those two extremes, who is to decide upon this? In this article we have offered one, basically new solution as a possibility for maintenance concept choice, based on a significant modification of the widely used failure modes and effects analysis (FMEA) method. This solution is risk-decision factor (RDF). This is a result of seven parameters (of different importance and weight) that have the key impact on the process of production and logistic support. The application of this factor is illustrated by the example of planning, organisation and functioning of the maintenance system applied in The Institute for Manufacturing Banknotes and Coins (ZIN) in Belgrade.

A Service Brokering and Recommendation Mechanism for Better Selecting Cloud Services

PubMed Central

Gui, Zhipeng; Yang, Chaowei; Xia, Jizhe; Huang, Qunying; Liu, Kai; Li, Zhenlong; Yu, Manzhu; Sun, Min; Zhou, Nanyin; Jin, Baoxuan

2014-01-01

Cloud computing is becoming the new generation computing infrastructure, and many cloud vendors provide different types of cloud services. How to choose the best cloud services for specific applications is very challenging. Addressing this challenge requires balancing multiple factors, such as business demands, technologies, policies and preferences in addition to the computing requirements. This paper recommends a mechanism for selecting the best public cloud service at the levels of Infrastructure as a Service (IaaS) and Platform as a Service (PaaS). A systematic framework and associated workflow include cloud service filtration, solution generation, evaluation, and selection of public cloud services. Specifically, we propose the following: a hierarchical information model for integrating heterogeneous cloud information from different providers and a corresponding cloud information collecting mechanism; a cloud service classification model for categorizing and filtering cloud services and an application requirement schema for providing rules for creating application-specific configuration solutions; and a preference-aware solution evaluation mode for evaluating and recommending solutions according to the preferences of application providers. To test the proposed framework and methodologies, a cloud service advisory tool prototype was developed after which relevant experiments were conducted. The results show that the proposed system collects/updates/records the cloud information from multiple mainstream public cloud services in real-time, generates feasible cloud configuration solutions according to user specifications and acceptable cost predication, assesses solutions from multiple aspects (e.g., computing capability, potential cost and Service Level Agreement, SLA) and offers rational recommendations based on user preferences and practical cloud provisioning; and visually presents and compares solutions through an interactive web Graphical User Interface (GUI). PMID:25170937

Evidence-based surgery: barriers, solutions, and the role of evidence synthesis.

PubMed

Garas, George; Ibrahim, Amel; Ashrafian, Hutan; Ahmed, Kamran; Patel, Vanash; Okabayashi, Koji; Skapinakis, Petros; Darzi, Ara; Athanasiou, Thanos

2012-08-01

Surgery is a rapidly evolving field, making the rigorous testing of emerging innovations vital. However, most surgical research fails to employ randomized controlled trials (RCTs) and has particularly been based on low-quality study designs. Subsequently, the analysis of data through meta-analysis and evidence synthesis is particularly difficult. Through a systematic review of the literature, this article explores the barriers to achieving a strong evidence base in surgery and offers potential solutions to overcome the barriers. Many barriers exist to evidence-based surgical research. They include enabling factors, such as funding, time, infrastructure, patient preference, ethical issues, and additionally barriers associated with specific attributes related to researchers, methodologies, or interventions. Novel evidence synthesis techniques in surgery are discussed, including graphics synthesis, treatment networks, and network meta-analyses that help overcome many of the limitations associated with existing techniques. They offer the opportunity to assess gaps and quantitatively present inconsistencies within the existing evidence of RCTs. Poorly or inadequately performed RCTs and meta-analyses can give rise to incorrect results and thus fail to inform clinical practice or revise policy. The above barriers can be overcome by providing academic leadership and good organizational support to ensure that adequate personnel, resources, and funding are allocated to the researcher. Training in research methodology and data interpretation can ensure that trials are conducted correctly and evidence is adequately synthesized and disseminated. The ultimate goal of overcoming the barriers to evidence-based surgery includes the improved quality of patient care in addition to enhanced patient outcomes.

More Reliable Lithium-Sulfur Batteries: Status, Solutions and Prospects.

PubMed

Fang, Ruopian; Zhao, Shiyong; Sun, Zhenhua; Wang, Da-Wei; Cheng, Hui-Ming; Li, Feng

2017-12-01

Lithium-sulfur (Li-S) batteries have attracted tremendous interest because of their high theoretical energy density and cost effectiveness. The target of Li-S battery research is to produce batteries with a high useful energy density that at least outperforms state-of-the-art lithium-ion batteries. However, due to an intrinsic gap between fundamental research and practical applications, the outstanding electrochemical results obtained in most Li-S battery studies indeed correspond to low useful energy densities and are not really suitable for practical requirements. The Li-S battery is a complex device and its useful energy density is determined by a number of design parameters, most of which are often ignored, leading to the failure to meet commercial requirements. The purpose of this review is to discuss how to pave the way for reliable Li-S batteries. First, the current research status of Li-S batteries is briefly reviewed based on statistical information obtained from literature. This includes an analysis of how the various parameters influence the useful energy density and a summary of existing problems in the current Li-S battery research. Possible solutions and some concerns regarding the construction of reliable Li-S batteries are comprehensively discussed. Finally, insights are offered on the future directions and prospects in Li-S battery field. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

An enhanced reliability-oriented workforce planning model for process industry using combined fuzzy goal programming and differential evolution approach

NASA Astrophysics Data System (ADS)

Ighravwe, D. E.; Oke, S. A.; Adebiyi, K. A.

2018-03-01

This paper draws on the "human reliability" concept as a structure for gaining insight into the maintenance workforce assessment in a process industry. Human reliability hinges on developing the reliability of humans to a threshold that guides the maintenance workforce to execute accurate decisions within the limits of resources and time allocations. This concept offers a worthwhile point of deviation to encompass three elegant adjustments to literature model in terms of maintenance time, workforce performance and return-on-workforce investments. These fully explain the results of our influence. The presented structure breaks new grounds in maintenance workforce theory and practice from a number of perspectives. First, we have successfully implemented fuzzy goal programming (FGP) and differential evolution (DE) techniques for the solution of optimisation problem in maintenance of a process plant for the first time. The results obtained in this work showed better quality of solution from the DE algorithm compared with those of genetic algorithm and particle swarm optimisation algorithm, thus expressing superiority of the proposed procedure over them. Second, the analytical discourse, which was framed on stochastic theory, focusing on specific application to a process plant in Nigeria is a novelty. The work provides more insights into maintenance workforce planning during overhaul rework and overtime maintenance activities in manufacturing systems and demonstrated capacity in generating substantially helpful information for practice.

Measuring the impact of the advanced practitioner role: a practical approach.

PubMed

Neville, Lillian; Swift, Juliette

2012-04-01

This paper aims to illuminate difficulties in evaluating the advanced practitioner role and to offer a practical solution. The advanced practice role has been part of the workforce strategy in the Northwest of England since 2005. However capturing hard evidence of the impact of this role has been problematic. Current restrictions on resources require the provision of evidence of the value of roles and services. Critical analysis of literature has identified challenges in evaluating the advanced practice role. The case study design takes account of current policy initiatives, notably QIPP. There is no common approach to evaluating the role of advanced practitioners. The case study has the potential to be a useful tool to organise evidence of the impact of advanced practitioner roles. Advanced practitioners need to have appropriate knowledge and skills to provide evidence of the impact of their role. There is potential for this work to be applied to other roles across the NHS. Managers need to work in partnership with workforce planners and educationalists to support advanced practitioners to utilise their skills in methods of providing evidence that they do work of value. Clear strategic direction for advanced practitioners is advised as part of the workforce strategy. © 2012 Blackwell Publishing Ltd.

Twelve tips for a successful workplace-based masters programme in geriatric for specialist registrars and specialty trainees.

PubMed

Bhat, Sarita; Baker, Paul; Eyres, Renata

2008-01-01

Postgraduate medical training is undergoing major change, shortening and disrupting traditional practices. Scholarship remains highly valued, but increasingly difficult to fit in. Workplace-based Masters study offers a solution. We want consultants who are driven by enquiry, good teachers and team workers. Academic qualifications demonstrate trainees' commitment and expertise in competitive employment markets. Most Deaneries allow two sessions weekly for research/personal development, so this resource demands effective use. The good will, talent and commitment of colleagues are vital. A credible structured curriculum combines real-life consultant-level generic practice, with technical medical skills. Academic writing and practical assignments are assessed. Linking with a far-sighted academic institution brings vast expertise in education administration and delivery of accredited learning. The course is more cost-effective than traditional study leave activities. Running part-time over 4 years fits with Higher Specialist Training. Structured programmes, over 9 month 'terms', fit with clinical rotations. Module leaders run yearly clinical modules alongside continuous generic modules. Clinical units are signed up to releasing trainees to attend. Evaluation is external to faculty, with highly favourable feedback. We believe training in academic disciplines underpins practice. With strong partnership working, planning and especially hard work, such a course is deliverable.

Camera processing with chromatic aberration.

PubMed

Korneliussen, Jan Tore; Hirakawa, Keigo

2014-10-01

Since the refractive index of materials commonly used for lens depends on the wavelengths of light, practical camera optics fail to converge light to a single point on an image plane. Known as chromatic aberration, this phenomenon distorts image details by introducing magnification error, defocus blur, and color fringes. Though achromatic and apochromatic lens designs reduce chromatic aberration to a degree, they are complex and expensive and they do not offer a perfect correction. In this paper, we propose a new postcapture processing scheme designed to overcome these problems computationally. Specifically, the proposed solution is comprised of chromatic aberration-tolerant demosaicking algorithm and post-demosaicking chromatic aberration correction. Experiments with simulated and real sensor data verify that the chromatic aberration is effectively corrected.

A novel approach for separating bacteriophages from other bacteriophages using affinity chromatography and phage display.

PubMed

Ceglarek, Izabela; Piotrowicz, Agnieszka; Lecion, Dorota; Miernikiewicz, Paulina; Owczarek, Barbara; Hodyra, Katarzyna; Harhala, Marek; Górski, Andrzej; Dąbrowska, Krystyna

2013-11-14

Practical applications of bacteriophages in medicine and biotechnology induce a great need for technologies of phage purification. None of the popular methods offer solutions for separation of a phage from another similar phage. We used affinity chromatography combined with competitive phage display (i) to purify T4 bacteriophage from bacterial debris and (ii) to separate T4 from other contaminating bacteriophages. In 'competitive phage display' bacterial cells produced both wild types of the proteins (expression from the phage genome) and the protein fusions with affinity tags (expression from the expression vectors). Fusion proteins were competitively incorporated into the phage capsid. It allowed effective separation of T4 from a contaminating phage on standard affinity resins.

A novel approach for separating bacteriophages from other bacteriophages using affinity chromatography and phage display

PubMed Central

Ceglarek, Izabela; Piotrowicz, Agnieszka; Lecion, Dorota; Miernikiewicz, Paulina; Owczarek, Barbara; Hodyra, Katarzyna; Harhala, Marek; Górski, Andrzej; Dąbrowska, Krystyna

2013-01-01

Practical applications of bacteriophages in medicine and biotechnology induce a great need for technologies of phage purification. None of the popular methods offer solutions for separation of a phage from another similar phage. We used affinity chromatography combined with competitive phage display (i) to purify T4 bacteriophage from bacterial debris and (ii) to separate T4 from other contaminating bacteriophages. In ‘competitive phage display’ bacterial cells produced both wild types of the proteins (expression from the phage genome) and the protein fusions with affinity tags (expression from the expression vectors). Fusion proteins were competitively incorporated into the phage capsid. It allowed effective separation of T4 from a contaminating phage on standard affinity resins. PMID:24225840

Feminist-informed participatory action research: a methodology of choice for examining critical nursing issues.

PubMed

Corbett, Andrea M; Francis, Karen; Chapman, Ysanne

2007-04-01

Identifying a methodology to guide a study that aims to enhance service delivery can be challenging. Participatory action research offers a solution to this challenge as it both informs and is informed by critical social theory. In addition, using a feminist lens helps acquiesce this approach as a suitable methodology for changing practice. This methodology embraces empowerment self-determination and the facilitation of agreed change as central tenets that guide the research process. Encouraged by the work of Foucault, Friere, Habermas, and Maguire, this paper explicates the philosophical assumptions underpinning critical social theory and outlines how feminist influences are complimentary in exploring the processes and applications of nursing research that seeks to embrace change.

Social Entrepreneurship for Obesity Prevention: What Are the Opportunities?

PubMed

Smith, Tosha Woods; Calancie, Larissa; Ammerman, Alice

2015-09-01

In recent years, social entrepreneurship has emerged as a new field to address social and public health challenges. Social entrepreneurship, which harnesses traditional business practices and market forces to address social challenges, may produce solutions that are more cost-effective and sustainable than those produced by governmental and nonprofit sectors. In this paper, we discuss whether and how social entrepreneurship can be harnessed for obesity prevention by defining and briefly reviewing the rise of social entrepreneurship in the USA, outlining the threat that obesity poses to US society and offering some examples of how social ventures are addressing the problem of obesity. Additional untapped opportunities are also discussed and recommendations given for how social entrepreneurship might impact obesity prevention in the future.

A speciation solver for cement paste modeling and the semismooth Newton method

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

Georget, Fabien, E-mail: fabieng@princeton.edu; Prévost, Jean H., E-mail: prevost@princeton.edu; Vanderbei, Robert J., E-mail: rvdb@princeton.edu

2015-02-15

The mineral assemblage of a cement paste may vary considerably with its environment. In addition, the water content of a cement paste is relatively low and the ionic strength of the interstitial solution is often high. These conditions are extreme conditions with respect to the common assumptions made in speciation problem. Furthermore the common trial and error algorithm to find the phase assemblage does not provide any guarantee of convergence. We propose a speciation solver based on a semismooth Newton method adapted to the thermodynamic modeling of cement paste. The strong theoretical properties associated with these methods offer practical advantages.more » Results of numerical experiments indicate that the algorithm is reliable, robust, and efficient.« less

Designing a combined casting mold for manufacture of a gasoline centrifugal pump body using CAD/CAM-systems

NASA Astrophysics Data System (ADS)

Galin, N. E.; Ogol, I. I.; Chervach, Yu B.; Dammer, V. Kh; Ru, Jia Hong

2017-02-01

The present paper examines designing of a combined casting mold for manufacture of a gasoline centrifugal pump body. The paper offers technological solutions for obtaining high quality castings at the testing stage of the finished mold. The paper is intended for practical use and prepared by order of JSC ‘Tomsk Electrical Engineering Plant’ using software and equipment of the department ‘Technologies of Computer-Aided Machinery Manufacturing’ of the Tomsk Polytechnic University (TPU) under the economic contract within state import substitution program. In preparing the paper, CAD/CAM-systems KOMPAS-3D and PowerMILL were used. In 2015, the designed casting mold was introduced into the production process at JSC ‘Tomsk Electrical Engineering Plant’.

Electrocatalysts by atomic layer deposition for fuel cell applications

DOE PAGES

Cheng, Niancai; Shao, Yuyan; Liu, Jun; ...

2016-01-22

Here, fuel cells are a promising technology solution for reliable and clean energy because they offer high energy conversion efficiency and low emission of pollutants. However, high cost and insufficient durability are considerable challenges for widespread adoption of polymer electrolyte membrane fuel cells (PEMFCs) in practical applications. Current PEMFCs catalysts have been identified as major contributors to both the high cost and limited durability. Atomic layer deposition (ALD) is emerging as a powerful technique for solving these problems due to its exclusive advantages over other methods. In this review, we summarize recent developments of ALD in PEMFCs with a focusmore » on design of materials for improved catalyst activity and durability. New research directions and future trends have also been discussed.« less

Cultural Translation of Interventions: Diabetes Care in American Samoa

PubMed Central

Rosen, Rochelle K.; Batts-Turner, Marian; Bereolos, Nicole; House, Meaghan; Held, Rachel Forster; Nu'usolia, Ofeira; Tuitele, John; Goldstein, Michael G.; McGarvey, Stephen T.

2010-01-01

Translation of research advances into clinical practice for at-risk communities is important to eliminate disease disparities. Adult type 2 diabetes prevalence in the US territory of American Samoa is 21.5%, but little intervention research has been carried out there. We discuss our experience with cultural translation, drawing on an emerging implementation science, which aims to build a knowledge base on adapting interventions to real-world settings. We offer examples from our behavioral intervention study, Diabetes Care in American Samoa, which was adapted from Project Sugar 2, a nurse and community health worker intervention to support diabetes self-management among urban African Americans. The challenges we experienced and solutions we used may inform adaptations of interventions in other settings. PMID:20864729

Optimal plane search method in blood flow measurements by magnetic resonance imaging

NASA Astrophysics Data System (ADS)

Bargiel, Pawel; Orkisz, Maciej; Przelaskowski, Artur; Piatkowska-Janko, Ewa; Bogorodzki, Piotr; Wolak, Tomasz

2004-07-01

This paper offers an algorithm for determining the blood flow parameters in the neck vessel segments using a single (optimal) measurement plane instead of the usual approach involving four planes orthogonal to the artery axis. This new approach aims at significantly shortening the time required to complete measurements using Nuclear Magnetic Resonance techniques. Based on a defined error function, the algorithm scans the solution space to find the minimum of the error function, and thus to determine a single plane characterized by a minimum measurement error, which allows for an accurate measurement of blood flow in the four carotid arteries. The paper also comprises a practical implementation of this method (as a module of a larger imaging-measuring system), including preliminary research results.

The Impact of a Staff Development Offering on Nursing Practice.

ERIC Educational Resources Information Center

Foglesong, Dianne H.

1983-01-01

Describes a problem-focused audit used to measure the impact of a staff development offering on pain relief. Concludes that the audit provided concrete evidence that the class on pain did influence nursing practice and affected patients directly. (NRJ)

Managing your practice's first impression: the process of front-desk reengineering.

PubMed

Walsh, Alison L

2004-01-01

Patients must be regarded as consumers. As such, they are increasingly informed, questioning, cost-conscious, technologically savvy, and demanding. Just as health plans have developed defined contribution products that offer consumers more control over how and where their health-care dollars are spent, practice success is linked to reengineering office operations to offer consumers and patients greater choice, control, autonomy, and service. Patients and consumers want practices that deliver clinical and business services that meet the criteria of reliability, effciency, service offerings, patient focus, enthusiasm, customization, and trust. Physician practices must also take care to avoid destructive and disruptive behaviors and conditions such as noise, interference, excessive repetition, long waits, appointment delays, and staff rudeness. A successful patient-focused practice emerges when physicians and office staff begin to look at the clinical and service experience through the patient's eyes.

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision.

PubMed

Biggs, M Antonia; Harper, Cynthia C; Brindis, Claire D

2015-08-01

To assess the extent to which practices offering family planning services are able to offer intrauterine devices (IUDs) and implants in one visit and to identify the reasons why multiple visits may be required. In the fall of 2011, 1,000 California family planning providers were asked about their long-acting reversible contraception delivery practices in a probability survey. We used multivariable logistic regression to examine practice characteristics associated with same-day provision of IUDs and implants. Among the 636 responding practices, 67% offered an IUD and 40% offered a contraceptive implant onsite. Among those with onsite provision, the majority required two or more visits to place an IUD (58%); almost half required two visits to place an implant (47%). Nearly all Planned Parenthood practices could place an IUD (95%) or implant (95%) at the initial visit, whereas the majority of all other practice types could not. The main reasons for delaying IUD and contraceptive implant provision included the need to screen and wait for test results (68% and 24%, respectively) and clinic flow and scheduling issues (50% and 64%, respectively). Multivariable analyses indicated that Planned Parenthood practices were significantly more likely than private practices to have same-day insertion protocols. Most of the family planning providers surveyed have not adopted same-day long-acting reversible contraception insertion protocols and face barriers to same-day provision. III.

A universal data access and protocol integration mechanism for smart home

NASA Astrophysics Data System (ADS)

Shao, Pengfei; Yang, Qi; Zhang, Xuan

2013-03-01

With the lack of standardized or completely missing communication interfaces in home electronics, there is no perfect solution to address every aspect in smart homes based on existing protocols and technologies. In addition, the central control unit (CCU) of smart home system working point-to-point between the multiple application interfaces and the underlying hardware interfaces leads to its complicated architecture and unpleasant performance. A flexible data access and protocol integration mechanism is required. The current paper offers a universal, comprehensive data access and protocol integration mechanism for a smart home. The universal mechanism works as a middleware adapter with unified agreements of the communication interfaces and protocols, offers an abstraction of the application level from the hardware specific and decoupling the hardware interface modules from the application level. Further abstraction for the application interfaces and the underlying hardware interfaces are executed based on adaption layer to provide unified interfaces for more flexible user applications and hardware protocol integration. This new universal mechanism fundamentally changes the architecture of the smart home and in some way meets the practical requirement of smart homes more flexible and desirable.

Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System.

PubMed

East, Marlene Lynette; Havard, Byron C

2015-01-01

The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations, continuing education providers, and app developers.

EDITORIAL Wireless sensor networks: design for real-life deployment and deployment experiences Wireless sensor networks: design for real-life deployment and deployment experiences

NASA Astrophysics Data System (ADS)

Gaura, Elena; Roedig, Utz; Brusey, James

2010-12-01

Wireless sensor networks (WSNs) are among the most promising technologies of the new millennium. The opportunities afforded by being able to program networks of small, lightweight, low-power, computation- and bandwidth-limited nodes have attracted a large community of researchers and developers. However, the unique set of capabilities offered by the technology produces an exciting but complex design space, which is often difficult to negotiate in an application context. Deploying sensing physical environments produces its own set of challenges, and can push systems into failure modes, thus revealing problems that can be difficult to discover or reproduce in simulation or the laboratory. Sustained efforts in the area of wireless networked sensing over the last 15 years have resulted in a large number of theoretical developments, substantial practical achievements, and a wealth of lessons for the future. It is clear that in order to bridge the gap between (on the one hand) visions of very large scale, autonomous, randomly deployed networks and (on the other) the actual performance of fielded systems, we need to view deployment as an essential component in the process of developing sensor networks: a process that includes hardware and software solutions that serve specific applications and end-user needs. Incorporating deployment into the design process reveals a new and different set of requirements and considerations, whose solutions require innovative thinking, multidisciplinary teams and strong involvement from end-user communities. This special feature uncovers and documents some of the hurdles encountered and solutions offered by experimental scientists when deploying and evaluating wireless sensor networks in situ, in a variety of well specified application scenarios. The papers specifically address issues of generic importance for WSN system designers: (i) data quality, (ii) communications availability and quality, (iii) alternative, low-energy sensing modalities and (iv) system solutions with high end-user added value and cost benefits. The common thread is deployment and deployment evaluation. In particular, satisfaction of application requirements, involvement of the end-user in the design and deployment process, satisfactory system performance and user acceptance are concerns addressed in many of the contributions. The contributions form a valuable set, which help to identify the priorities for research in this burgeoning area: Robust, reliable and efficient data collection in embedded wireless multi-hop networks are essential elements in creating a true deploy-and-forget user experience. Maintaining full connectivity within a WSN, in a real world environment populated by other WSNs, WiFi networks or Bluetooth devices that constitute sources of interference is a key element in any application, but more so for those that are safety-critical, such as disaster response. Awareness of the effects of wireless channel, physical position and line-of-sight on received signal strength in real-world, outdoor environments will shape the design of many outdoor applications. Thus, the quantification of such effects is valuable knowledge for designers. Sensors' failure detection, scalability and commercialization are common challenges in many long-term monitoring applications; transferable solutions are evidenced here in the context of pollutant detection and water quality. Innovative, alternative thinking is often needed to achieve the desired long-lived networks when power-hungry sensors are foreseen components; in some instances, the very problems of wireless technology, such as RF irregularity, can be transformed into advantages. The importance of an iterative design and evaluation methodology—from analysis to simulation to real-life deployment—should be well understood by all WSN developers. The value of this is highlighted in the context of a challenging WPAN video-surveillance application based on a novel Nomadic Access Mechanism. Cost benefits to be drawn from devising a WSN based solution to classic application areas such as surveillance are often a prime motivator for WSN designers; an example is offered here based on the use of intelligent agents for intrusion monitoring. Last but not least, the practicality and usability of the WSN solutions found for novel applications is key to their adoption. This is particularly true when the end-users of the developed technology are medical patients. The importance of feedback, elegant hardware encapsulation and extraction of meaning from data is presented in the context of novel orthopedic rehabilitation aids. Overall, this feature offers wide coverage of most issues encountered in the process of design, implementation and evaluation of deployable WSN systems. We trust that designers and developers of WSN systems will find much work of value, ranging from lessons learned, through solutions to known hurdles, to novel developments that enhance applications. Finally, we would like to thank all authors for their valuable contributions!

Sleep health education in pediatric community settings: rationale and practical suggestions for incorporating healthy sleep education into pediatric practice.

PubMed

Gruber, Reut; Cassoff, Jamie; Knäuper, Bärbel

2011-06-01

This article offers practical ways to incorporate healthy sleep education into pediatric practice and discusses key questions, barriers, and strategies associated with such efforts. The rationale for incorporating healthy sleep education in pediatric practice settings is presented, and desirable features of sleep education programs that may be implemented in pediatric practice are identified. Potential barriers are reviewed and strategies offered to overcome these barriers, such as developing resources applicable to healthy sleep education and practical information for pediatricians. Key factors regarding effectiveness of such interventional programs and key points relevant to successful healthy sleep education in pediatric practice are highlighted. Copyright © 2011. Published by Elsevier Inc.

e-Government Readiness, Strategy and Two Different User Groups - in Austria

NASA Astrophysics Data System (ADS)

Edelmann, Noella; Hoechtl, Johann; Parycek, Peter

This paper offers a description of the e-Government Strategy in Austria and its e-Government readiness, and looks at how two different user groups are experiencing e-Government in Austria. Studies conducted show that adolescent citizens are more optimistic and enthusiastic about the possibilities offered whilst the municipalities are more skeptical. The Austrian e-Government strategy, the decisionmakers and IT solution providers must understand the needs of all stakeholders and provide viable solutions accordingly.

Behavioural informatics for improving water hygiene practice based on IoT environment.

PubMed

Fu, Yang; Wu, Wenyan

2018-02-01

The development of Internet of Things (IoT) and latest Information and Communication Technologies (ICT) have changed the nature of healthcare monitoring and health behaviour intervention in many applications. Water hygiene and water conservation behaviour intervention as important influence factors to human health are gaining much attentions for improving sustained sanitation practice. Based on face-to-face delivery, typical behaviour intervention method is costly and hardly to provide all day access to personalised intervention guidance and feedbacks. In this study, we presented a behavioural information system and water use behaviour model using IoT platform. Using Expanded Theory of Planned Behaviour (ETPB) and adopted structure equation model, this study offers a solution for understanding the behaviour intervention mechanism and methodology for developing empirical model. A case study of behaviour intervention model is presented by utilising residential water conservation behaviour data collected in China. Results suggested that cultural differences have significant influences on the understanding of intervention drivers, promoting projects and increasing awareness, which could improve the behaviour intervention efficiency and further facilitate the improvement of water hygiene practice. The performance evaluation of water saving dimension is discussed as well in the paper. Copyright © 2017 Elsevier Inc. All rights reserved.

Inernational research in health care management: its need in the 21st century, methodological challenges, ethical issues, pitfalls, and practicalities.

PubMed

Buttigieg, Sandra C; Rathert, Cheryl; D'Aunno, Thomas A; Savage, Grant T

2015-01-01

This commentary argues in favor of international research in the 21st century. Advances in technology, science, communication, transport, and infrastructure have transformed the world into a global village. Industries have increasingly adopted globalization strategies. Likewise, the health sector is more internationalized whereby comparisons between diverse health systems, international best practices, international benchmarking, cross-border health care, and cross-cultural issues have become important subjects in the health care literature. The focus has now turned to international, collaborative, cross-national, and cross-cultural research, which is by far more demanding than domestic studies. In this commentary, we explore the methodological challenges, ethical issues, pitfalls, and practicalities within international research and offer possible solutions to address them. The commentary synthesizes contributions from four scholars in the field of health care management, who came together during the annual meeting of the Academy of Management to discuss with members of the Health Care Management Division the challenges of international research. International research is worth pursuing; however, it calls for scholarly attention to key methodological and ethical issues for its success. This commentary addresses salient issues pertaining to international research in one comprehensive account.

Connecting narrative with mental health learning through discussion and analysis of selected contemporary films.

PubMed

McAllister, Margaret

2015-08-01

In a recently completed qualitative study of nursing leaders' views of requirements for practice, seven aspects of recovery practice were revealed as central for graduates to learn. It is challenging to provide an in-depth understanding of recovery in a nursing curriculum because there are so many competing content areas and, as a result, time is constrained. However, because it is so vital to understand, educators would benefit from developing and sharing teaching strategies that explore recovery deeply, memorably, and engagingly, in order to encourage theory to be put into practice. Recent research into narrative pedagogy suggests that better use of stories, especially those that have strong emotional pull, such as well-made films and memoirs, may offer solutions to creative educators. Stories can have transformative potential, because once heard and heeded, the person can never go back to exactly how they were before. Recovery learned in this way becomes a threshold concept for the mental health curriculum. This paper outlines an engaging and time-efficient teaching strategy to develop these skills, drawing on the concept of narrative pedagogy. © 2015 Australian College of Mental Health Nurses Inc.

Youth Mental Health, Family Practice, and Knowledge Translation Video Games about Psychosis: Family Physicians' Perspectives.

PubMed

Ferrari, Manuela; Suzanne, Archie

2017-01-01

Family practitioners face many challenges providing mental healthcare to youth. Digital technology may offer solutions, but the products often need to be adapted for primary care. This study reports on family physicians' perspectives on the relevance and feasibility of a digital knowledge translation (KT) tool, a set of video games, designed to raise awareness about psychosis, marijuana use, and facilitate access to mental health services among youth. As part of an integrated knowledge translation project, five family physicians from a family health team participated in a focus group. The focus group delved into their perspectives on treating youth with mental health concerns while exploring their views on implementing the digital KT tool in their practice. Qualitative data was analyzed using thematic analysis to identify patterns, concepts, and themes in the transcripts. Three themes were identified: (a) challenges in assessing youth with mental health concerns related to training, time constraints, and navigating the system; (b) feedback on the KT tool; and, (c) ideas on how to integrate it into a primary care practice. Family practitioners felt that the proposed video game KT tool could be used to address youth's mental health and addictions issues in primary care settings.

Inherent Limitations of Hydraulic Tomography

USGS Publications Warehouse

Bohling, Geoffrey C.; Butler, J.J.

2010-01-01

We offer a cautionary note in response to an increasing level of enthusiasm regarding high-resolution aquifer characterization with hydraulic tomography. We use synthetic examples based on two recent field experiments to demonstrate that a high degree of nonuniqueness remains in estimates of hydraulic parameter fields even when those estimates are based on simultaneous analysis of a number of carefully controlled hydraulic tests. We must, therefore, be careful not to oversell the technique to the community of practicing hydrogeologists, promising a degree of accuracy and resolution that, in many settings, will remain unattainable, regardless of the amount of effort invested in the field investigation. No practically feasible amount of hydraulic tomography data will ever remove the need to regularize or bias the inverse problem in some fashion in order to obtain a unique solution. Thus, along with improving the resolution of hydraulic tomography techniques, we must also strive to couple those techniques with procedures for experimental design and uncertainty assessment and with other more cost-effective field methods, such as geophysical surveying and, in unconsolidated formations, direct-push profiling, in order to develop methods for subsurface characterization with the resolution and accuracy needed for practical field applications. Copyright ?? 2010 The Author(s). Journal compilation ?? 2010 National Ground Water Association.

Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions.

PubMed

Keefe, Francis J; Main, Chris J; George, Steven Z

2018-05-01

There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical and pathology-based approaches that have been traditionally used to manage musculoskeletal pain. A major focus of PIP is addressing the behavioral aspects of pain (ie, peoples' responses to pain) by identifying individual expectations, beliefs, and feelings as prognostic factors for clinical and occupational outcomes indicating progression to chronicity. Since 2011, the interest in PIP seems to be growing, as evidenced by its use in large trials, inclusion in scientific conferences, increasing evidence base, and expansion to other musculoskeletal pain conditions. Primary care physicians and physical therapists have delivered PIP as part of a stratified care approach involving screening and targeting of treatment for people at high risk for continued pain-associated disability. Furthermore, PIP is consistent with recent national priorities emphasizing nonpharmacological pain management options. In this perspective, PIP techniques that range in complexity are described, considerations for implementation in clinical practice are offered, and future directions that will advance the understanding of PIP are outlined.

Risk management in obstetric care for family physicians: results of a 10-year project.

PubMed

Nesbitt, Thomas S; Hixon, Allen; Tanji, Jeffrey L; Scherger, Joseph E; Abbott, Dana

2003-01-01

Malpractice issues within the United States remain a critical factor for family physicians providing obstetric care. Although tort reform is being widely discussed, little has been written regarding the malpractice crisis from a risk management perspective. Between 1989 and 1998, a 10-year risk management study at the UC Davis Health System provided a unique collaboration between researchers, a mutual insurance carrier and family physicians practicing obstetrics. Physicians were asked to comply with standardized clinical guidelines, attend continuing medical education (CME) seminars, and submit obstetric medical records for review. Feedback analysis was provided to each physician on their records, and the insurance carrier tracked interim malpractice claims. One hundred and ninety-four physicians participated, attending to 32,831 births. Compliance with project guidelines was 91%. Five closed obstetric cases were reported with only one settlement reported to the National Provider Data Bank. Physicians believed the project was beneficial to their practices. Family physicians practicing obstetrics are willing to participate in a collaborative risk management program and are compliant with standardized clinical guidelines. The monetary award for successful malpractice claims was relatively low. This collaborative risk management model may offer a potential solution to the current malpractice crisis.

Barriers to Expanding Advanced Pharmacy Practice Experience Site Availability in an Experiential Education Consortium

PubMed Central

Byrd, Debbie C.; Duke, Lori J.; Fetterman, James W.; Unterwagner, Whitney L.; Staton, April G.; Miller, Mindi S.; Sheffield, Melody C.; Kennedy, William K.; McDuffie, Charles H.; Stevenson, T. Lynn; Thompson, Paula A.; McCullough, Elizabeth S.

2009-01-01

Objectives To compare 2006-2007 and projected 2010-2011 advanced pharmacy practice experience (APPE) availability and needs for 4 colleges and schools of pharmacy in Georgia and Alabama and to examine barriers and offer potential solutions to increase APPE site and preceptor availability. Methods Data on APPE needs and availability were gathered prospectively and evaluated relative to current and projected enrollment and planned programmatic changes. Results Combined 2006-2007 non-community APPE needs and availabilities were 3,590 and 4,427, respectively, with a surplus availability of 837. Combined projected 2010-2011 non-community APPEs were estimated at 4,309. Assuming 2006-2007 non-community availability remained unchanged, the surplus availability declined to 118. Conclusions The need for quality experiential education represents a significant barrier and rate-limiting step to the matriculation of the increased numbers of pharmacists. Barriers to expanding APPE availability include: introductory pharmacy practice experience (IPPE) and APPE expansion, growth of new and existing pharmacy programs, financial instability of acute care facilities, and lack of preceptor development resources. Regional experiential education consortiums can provide a constructive approach to improve access to quality sites and preceptors through standardizing processes and leveraging resources. PMID:19777097

Geometric Series: A New Solution to the Dog Problem

ERIC Educational Resources Information Center

Dion, Peter; Ho, Anthony

2013-01-01

This article describes what is often referred to as the dog, beetle, mice, ant, or turtle problem. Solutions to this problem exist, some being variations of each other, which involve mathematics of a wide range of complexity. Herein, the authors describe the intuitive solution and the calculus solution and then offer a completely new solution…

DOE Voluntary Partnership Program with Utilities and Local Governments Supports the Design of New Data Access Solutions

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

Shah, Monisha; Burr, Andrew; Schulte, Andrew

2016-08-26

The Better Buildings Energy Data Accelerator (BBEDA) is a unique effort that has supported 22 pairs of local governments and their utility companies to help building owners gain access to their whole-building energy data. Municipal and Utility BBEDA Partners committed to develop streamlined and easy-to-use solutions to provide whole-building energy data, especially for multitenant commercial buildings, by the end of 2015. As a result, building owners would be able to make data-driven decisions about their buildings by utilizing readily available energy consumption data for entire buildings. Traditionally, data access was difficult to implement due to technical barriers and the lackmore » of clear value propositions for the utilities. During the past two years, BBEDA has taken a hands-on approach to overcome these barriers by offering a platform for the partners to discuss their challenges and solutions. Customized support was also provided to Partners building their local strategies. Based on the lessons learned from the partners, BBEDA developed a final toolkit with guiding documents that addressed key barriers and served as a resource for the other cities and utilities attempting to establish whole-building data access, including an exploration of opportunities to apply the whole-building data to various aspects of utility demand-side management (DSM) programs. BBEDA has been a catalyst for market transformation by addressing the upstream (to efficiency implementation) barrier of data access, demonstrated through the success of the BBEDA partners to address policy, engagement, and technical hurdles and arrive at replicable solutions to make data access a standard practice nationwide. As a result of best practices identified by the BBEDA, 18 utilities serving more than 2.6 million commercial customers nationwide will provide whole-building energy data access to building owners by 2017. This historic expansion of data accessibility will increase building energy benchmarking, the first step many building owners take to improve the energy efficiency of their buildings.« less

Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers

PubMed Central

Toscos, Tammy; Carpenter, Maria; Flanagan, Mindy; Kunjan, Kislaya; Doebbeling, Bradley N.

2018-01-01

Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These “positive deviant” practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Participants: Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Methods: Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Results: Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient–provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. Conclusion: We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access. PMID:29552599

The Woman Athlete and Alternative Approaches to Explaining Sport Participation.

ERIC Educational Resources Information Center

DeSensi, Joy T.

This study explored the model of feminist frameworks offered by Jagger and Struhl (1978) in the women's sport setting. The framework offers a classification of models of feminism (Liberalism, Marxism, Radicalism, and Socialism) describing the forms of women's oppression and offers a solution for eliminating such oppression. The Jaggen and Struhl's…

"Maybe we should talk about it anyway": a qualitative study of understanding expectations and use of an established technology innovation in caring practices.

PubMed

Stokke, Randi

2017-09-15

Technological innovations are strongly promoted to meet the demands posed by increased pressure on home care services and to assist ageing in place in western societies. Although heavily advocated as plug and play solutions, technologies have proven difficult and unpredictable when integrated into home care services. We need greater insight into what happens when technologies are integrated into caring practices. All technologies come with expectations as to their function. This study explores how actors who are involved with the social alarm, which is an established technology innovation, relate to, perceive and articulate these expectations of the technology in everyday living. The article presents results from a two-case study, using a triangulation of qualitative methods in order to gain an in-depth understanding of technology in use in home care services through "thick descriptions". The study was conducted in Norway and data were analysed using a stepwise deductive-inductive analysis. The empirical findings demonstrate that expectations regarding the social alarm, even though it represents a simple and well-established technology, are complex and multidimensional. The notion of script and domestication provided relevant tools for exploring these expectations and for understanding how actors interpret and adapt their practices of using the technology. This enabled a more comprehensive understanding of how technology opens up for different interpretations and puts values in play. This article suggests exploring technology in use as scripted in multidimensional script, and offers a frame for doing so. It also reveals how technology scripts and articulation prove important for understanding the complex reality when integrated into home care practices, thus identifying how using the technology leads to the taming and unleashing of both technology and actors. The study offers an increased understanding of how and why technology is unpredictable and works differently in different contexts. Moreover, it stresses the importance of avoiding expectations of plug-and-play in a reality of complex interactions between different actors.

Eight worst advertising mistakes.

PubMed

Maley, Catherine

2010-11-01

This article presents strategies for advertising the medical practice. The emphasis is on breaking out of the old rules of how one should advertise and delves into asking questions that lead to a true strategy unique to one's medical practice and offerings. The article discusses the myriad ways to think about and create a patient-centered approach, turning from "here is what we offer" to instead "what you want we offer." Copyright © 2010 Elsevier Inc. All rights reserved.

Clean Energy Solutions Center Services (Chinese Translation)

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

2016-03-01

This is a Mandarin translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

Clean Energy Solutions Center Services (Vietnamese Translation)

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

2016-03-01

This is a Vietnamese translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

Clean Energy Solutions Center Services (French Translation)

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

This is a French translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

Clean Energy Solutions Center Services (Arabic Translation)

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

2016-03-01

This is an Arabic translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

Clean Energy Solutions Center Services (Portuguese Translation)

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

This is a Portuguese translation of the Clean Energy Solutions Center Services fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

The Pursuit of K: Reflections on the Current State-of-the-Art in Stress Intensity Factor Solutions for Practical Aerospace Applications

NASA Technical Reports Server (NTRS)

CraigMcClung, R.; Lee, Yi-Der; Cardinal, Joseph W.; Guo, Yajun

2012-01-01

The elastic stress intensity factor (SIF, commonly denoted as K) is the foundation of practical fracture mechanics (FM) analysis for aircraft structures. This single parameter describes the first-order effects of stress magnitude and distribution as well as the geometry of both structure/component and crack. Hence, the calculation of K is often the most significant step in fatigue analysis based on FM. This presentation will provide several reflections on the current state-of-the-art in SIF solution methods used for practical aerospace applications, including a brief historical perspective, descriptions of some recent and ongoing advances, and comments on some remaining challenges. Newman and Raju made significant early contributions to practical structural analysis by developing closed-form SIF equations for surface and corner cracks in simplified geometries, often based on empirical fits of finite element (FE) solutions. Those solutions (and others like them) were sometimes revised as new analyses were conducted or limitations discovered. The foundational solutions have exhibited striking longevity, despite the relatively "coarse" FE models employed many decades ago. However, in recent years, the accumulation of different generations of solutions for the same nominal geometry has led to some confusion (which solution is correct?), and steady increases in computational capabilities have facilitated the discovery of inaccuracies in some (not all!) of the legacy solutions. Some examples of problems and solutions are presented and discussed, including the challenge of maintaining consistency with legacy design applications. As computational power has increased, the prospect of calculating large numbers of SIF solutions for specific complex geometries with advanced numerical methods has grown more attractive. Fawaz and Andersson, for example, have been generating literally millions of new SIF solutions for different combinations of multiple cracks under simplified loading schemes using p-version FE methods. These data are invaluable, but questions remain about their practical use, because the tabular databases of key results needed to support practical life analysis can occupy gigabytes of storage for only a few classes of geometries. The prospect of using such advanced numerical methods to calculate in real time only those K solutions actually needed to support a specific crack growth analysis is also tempting, but the stark reality is that the computational cost is still so high that the approach is not practical except for specific, critical application problems. Some thoughts are offered about alternative paradigms. Compounding approaches are some of the earliest building blocks of SIF development for more complex geometries. These approaches are especially attractive because of their very low computational cost and their conceptual robustness; they are, in some ways, an intriguing contrast and complement to the brute-force numerical methods. In recent years, researchers at NRC-Canada have published remarkable results showing how compounding approaches can be used to generate accurate solutions for very difficult problems. Examples are provided of some successes--and some limitations--using this approach. These closed-form, tabulated numerical, and compounding approaches have typically been used for simple remote loading with simple load paths to the crack. However, many significant cracks occur in complex stress gradient fields. This is a job for weight function (WF) methods, where the arbitrary stress distribution on the crack plane in the corresponding uncracked body (typically determined using FE methods) is used to determine K. Several significant recent advances in WF methods and solutions are highlighted here. Fueled by advanced 3D numerical methods, many new solutions have been generated for classic geometries such as surface and corner cracks with wide ranges of geometrical validity. A new WF formulation has also be developed for part-through cracks considering the arbitrary stress gradients in all directions in the crack plane (so-called bivariant solutions). Basic WF methods have recently been combined with analytical expressions for crack plane stresses to develop a large family of accurate SIF solutions for corner, surface, and through cracks at internal or external notches with very wide ranges of shapes, sizes, acuities, and offsets. Finally, WF solutions are much faster than FE or boundary element solutions, but can still be much slower than simple closed-form solutions, especially for bivariant solutions that can require 2D numerical integration. Novel pre-integration and dynamic tabular methods have been developed that substantially increase the speed of these advanced WF solutions. The practical utility of advanced SIF methods, including both WF and direct numerical methods, is greatly enhanced if the FM life analysis can be directly and efficiently linked with digital models of the actual structure or component (e.g., FE models for stress analysis). Two recent advances of this type will be described. One approach directly interfaces the FM life analysis with the FE model of the uncracked component (including stress results). Through a powerful graphical user interface, simplified FM life models can be constructed (and visualized) directly on the component model, with the computer collecting the geometry and stress gradient information needed for the life calculation. An even more powerful paradigm uses expert logic to automatically build an optimum simple fracture model at any and every desired location in the component model, perform the life calculation, and even generate fatigue crack growth life contour maps, all with minimal user intervention. This paradigm has also been extended to the automatic calculation of fracture risk, considering uncertainty or variability in key input parameters such as initial crack size or location. Another new integrated approach links the engineering life analysis, the component model, and a 3D numerical fracture analysis built with the same component model to generate a table of SIF values at a specific location that can then be employed efficiently to perform the life calculation. Some attention must be given to verification and validation (V&V) issues and challenges: how good are these SIF solutions, how good is good enough, and does anyone believe the life answer? It is important to think critically about the different sources of error or uncertainty and to perform V&V in a hierarchal, building-block manner. Some accuracy issues for SIF solutions, for example, may actually involve independent material behavior issues, such as constraint loss effects for crack fronts near component surfaces, and can be a source of confusion. Recommendations are proposed for improved V&V approaches. This presentation will briefly but critically survey the range of issues and advances mentioned above, with a particular view towards assembling an integrated approach that combines different methods to create practical tools for real-world design and analysis problems. Examples will be selectively drawn from the recent literature, from recent enhancements in the NASGRO and DARWIN computer codes, and from previously unpublished research

Practical Solutions for Pesticide Safety: A Farm and Research Team Participatory Model

PubMed Central

Galvin, Kit; Krenz, Jen; Harrington, Marcy; Palmández, Pablo; Fenske, Richard A.

2018-01-01

Development of the Practical Solutions for Pesticide Safety guide used participatory research strategies to identify and evaluate solutions that reduce pesticide exposures for workers and their families and to disseminate these solutions. Project principles were (1) workplace chemicals belong in the workplace, and (2) pesticide handlers and farm managers are experts, with direct knowledge of production practices. The project’s participatory methods were grounded in self-determination theory. Practical solutions were identified and evaluated based on five criteria: practicality, adaptability, health and safety, novelty, and regulatory compliance. Research activities that had more personal contact provided better outcomes. The Expert Working Group, composed of farm managers and pesticide handlers, was key to the identification of solutions, as were farm site visits. Audience participation, hands-on testing, and orchard field trials were particularly effective in the evaluation of potential solutions. Small work groups in a Regional Advisory Committee provided the best direction and guidance for a “user-friendly” translational document that provided evidence-based practical solutions. The “farmer to farmer” format of the guide was endorsed by both the Expert Working Group and the Regional Advisory Committee. Managers and pesticide handlers wanted to share their solutions in order to “help others stay safe,” and they appreciated attribution in the guide. The guide is now being used in educational programs across the region. The fundamental concept that farmers and farmworkers are innovators and experts in agricultural production was affirmed by this study. The success of this process demonstrates the value of participatory industrial hygiene in agriculture. PMID:26488540

Practical Solutions for Pesticide Safety: A Farm and Research Team Participatory Model.

PubMed

Galvin, Kit; Krenz, Jen; Harrington, Marcy; Palmández, Pablo; Fenske, Richard A

2016-01-01

Development of the Practical Solutions for Pesticide Safety guide used participatory research strategies to identify and evaluate solutions that reduce pesticide exposures for workers and their families and to disseminate these solutions. Project principles were (1) workplace chemicals belong in the workplace, and (2) pesticide handlers and farm managers are experts, with direct knowledge of production practices. The project's participatory methods were grounded in self-determination theory. Practical solutions were identified and evaluated based on five criteria: practicality, adaptability, health and safety, novelty, and regulatory compliance. Research activities that had more personal contact provided better outcomes. The Expert Working Group, composed of farm managers and pesticide handlers, was key to the identification of solutions, as were farm site visits. Audience participation, hands-on testing, and orchard field trials were particularly effective in the evaluation of potential solutions. Small work groups in a Regional Advisory Committee provided the best direction and guidance for a "user-friendly" translational document that provided evidence-based practical solutions. The "farmer to farmer" format of the guide was endorsed by both the Expert Working Group and the Regional Advisory Committee. Managers and pesticide handlers wanted to share their solutions in order to "help others stay safe," and they appreciated attribution in the guide. The guide is now being used in educational programs across the region. The fundamental concept that farmers and farmworkers are innovators and experts in agricultural production was affirmed by this study. The success of this process demonstrates the value of participatory industrial hygiene in agriculture.

Preventing employee theft: 15 techniques for preventing bookkeeping embezzlement.

PubMed

Hills, Laura Sachs

2004-01-01

Medical practices are unfortunately the target of embezzlement more often than you might think. This article offers practical suggestions for keeping your employees honest and thwarting a would-be embezzler. It describes the common symptoms of an embezzler at work and offers 15 practical techniques for preventing bookkeeping embezzlement. This article also suggests a simple method for conducting mini-audits from time to time and precautions to take to ensure the reliability of computer passwords. The article advocates keeping tighter control of office supplies and a method for spotting telephone abuse. Finally, it offers suggestions for dealing with employees who steal time on the job.

A novel harmony search-K means hybrid algorithm for clustering gene expression data

PubMed Central

Nazeer, KA Abdul; Sebastian, MP; Kumar, SD Madhu

2013-01-01

Recent progress in bioinformatics research has led to the accumulation of huge quantities of biological data at various data sources. The DNA microarray technology makes it possible to simultaneously analyze large number of genes across different samples. Clustering of microarray data can reveal the hidden gene expression patterns from large quantities of expression data that in turn offers tremendous possibilities in functional genomics, comparative genomics, disease diagnosis and drug development. The k- ¬means clustering algorithm is widely used for many practical applications. But the original k-¬means algorithm has several drawbacks. It is computationally expensive and generates locally optimal solutions based on the random choice of the initial centroids. Several methods have been proposed in the literature for improving the performance of the k-¬means algorithm. A meta-heuristic optimization algorithm named harmony search helps find out near-global optimal solutions by searching the entire solution space. Low clustering accuracy of the existing algorithms limits their use in many crucial applications of life sciences. In this paper we propose a novel Harmony Search-K means Hybrid (HSKH) algorithm for clustering the gene expression data. Experimental results show that the proposed algorithm produces clusters with better accuracy in comparison with the existing algorithms. PMID:23390351

A novel harmony search-K means hybrid algorithm for clustering gene expression data.

PubMed

Nazeer, Ka Abdul; Sebastian, Mp; Kumar, Sd Madhu

2013-01-01

Recent progress in bioinformatics research has led to the accumulation of huge quantities of biological data at various data sources. The DNA microarray technology makes it possible to simultaneously analyze large number of genes across different samples. Clustering of microarray data can reveal the hidden gene expression patterns from large quantities of expression data that in turn offers tremendous possibilities in functional genomics, comparative genomics, disease diagnosis and drug development. The k- ¬means clustering algorithm is widely used for many practical applications. But the original k-¬means algorithm has several drawbacks. It is computationally expensive and generates locally optimal solutions based on the random choice of the initial centroids. Several methods have been proposed in the literature for improving the performance of the k-¬means algorithm. A meta-heuristic optimization algorithm named harmony search helps find out near-global optimal solutions by searching the entire solution space. Low clustering accuracy of the existing algorithms limits their use in many crucial applications of life sciences. In this paper we propose a novel Harmony Search-K means Hybrid (HSKH) algorithm for clustering the gene expression data. Experimental results show that the proposed algorithm produces clusters with better accuracy in comparison with the existing algorithms.

Direct Retrieval of Exterior Orientation Parameters Using A 2-D Projective Transformation

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

Seedahmed, Gamal H.

2006-09-01

Direct solutions are very attractive because they obviate the need for initial approximations associated with non-linear solutions. The Direct Linear Transformation (DLT) establishes itself as a method of choice for direct solutions in photogrammetry and other fields. The use of the DLT with coplanar object space points leads to a rank deficient model. This rank deficient model leaves the DLT defined up to a 2-D projective transformation, which makes the direct retrieval of the exterior orientation parameters (EOPs) a non-trivial task. This paper presents a novel direct algorithm to retrieve the EOPs from the 2-D projective transformation. It is basedmore » on a direct relationship between the 2-D projective transformation and the collinearity model using homogeneous coordinates representation. This representation offers a direct matrix correspondence between the 2-D projective transformation parameters and the collinearity model parameters. This correspondence lends itself to a direct matrix factorization to retrieve the EOPs. An important step in the proposed algorithm is a normalization process that provides the actual link between the 2-D projective transformation and the collinearity model. This paper explains the theoretical basis of the proposed algorithm as well as the necessary steps for its practical implementation. In addition, numerical examples are provided to demonstrate its validity.« less

What to do when trust has been breached in your practice.

PubMed

Hills, Laura

2013-01-01

We've all experienced gossiping, missed deadlines, someone taking credit for another's work, and little white lies. These and other breaches of trust are commonplace. However, they do more damage in the medical practice than many practice managers realize. This article argues that medical practice employees need to trust their managers, patients, doctors, one another, and even the security of their jobs so they are able to focus on their daily tasks and perform well. It defines trust as both a logical and emotional act and describes common breaches of workplace trust. It defines three characteristics of high-trust organizations and illustrates through examples how practice managers can demonstrate their trustworthiness through their actions, not only through their words. This article also offers seven steps for rebuilding trust that has been breached. It offers readers two instruments: a survey tool practice managers can use to assess the trust in their practices and a self-quiz practice managers can take to assess their own trustworthiness. Finally, this article offers research about the impact of trust on the bottom line and 10 truths about trust that medical practice managers can share with their employees.

The ELPA library: scalable parallel eigenvalue solutions for electronic structure theory and computational science.

PubMed

Marek, A; Blum, V; Johanni, R; Havu, V; Lang, B; Auckenthaler, T; Heinecke, A; Bungartz, H-J; Lederer, H

2014-05-28

Obtaining the eigenvalues and eigenvectors of large matrices is a key problem in electronic structure theory and many other areas of computational science. The computational effort formally scales as O(N(3)) with the size of the investigated problem, N (e.g. the electron count in electronic structure theory), and thus often defines the system size limit that practical calculations cannot overcome. In many cases, more than just a small fraction of the possible eigenvalue/eigenvector pairs is needed, so that iterative solution strategies that focus only on a few eigenvalues become ineffective. Likewise, it is not always desirable or practical to circumvent the eigenvalue solution entirely. We here review some current developments regarding dense eigenvalue solvers and then focus on the Eigenvalue soLvers for Petascale Applications (ELPA) library, which facilitates the efficient algebraic solution of symmetric and Hermitian eigenvalue problems for dense matrices that have real-valued and complex-valued matrix entries, respectively, on parallel computer platforms. ELPA addresses standard as well as generalized eigenvalue problems, relying on the well documented matrix layout of the Scalable Linear Algebra PACKage (ScaLAPACK) library but replacing all actual parallel solution steps with subroutines of its own. For these steps, ELPA significantly outperforms the corresponding ScaLAPACK routines and proprietary libraries that implement the ScaLAPACK interface (e.g. Intel's MKL). The most time-critical step is the reduction of the matrix to tridiagonal form and the corresponding backtransformation of the eigenvectors. ELPA offers both a one-step tridiagonalization (successive Householder transformations) and a two-step transformation that is more efficient especially towards larger matrices and larger numbers of CPU cores. ELPA is based on the MPI standard, with an early hybrid MPI-OpenMPI implementation available as well. Scalability beyond 10,000 CPU cores for problem sizes arising in the field of electronic structure theory is demonstrated for current high-performance computer architectures such as Cray or Intel/Infiniband. For a matrix of dimension 260,000, scalability up to 295,000 CPU cores has been shown on BlueGene/P.

From Dyadic Ties to Information Infrastructures: Care-Coordination between Patients, Providers, Students and Researchers

PubMed Central

Purkayastha, S.; Biswas, R.; Jai Ganesh, A.U.; Otero, P.

2015-01-01

Summary Objective To share how an effectual merging of local and online networks in low resource regions can supplement and strengthen the local practice of patient centered care through the use of an online digital infrastructure powered by all stakeholders in healthcare. User Driven Health Care offers the dynamic integration of patient values and evidence based solutions for improved medical communication in medical care. Introduction This paper conceptualizes patient care-coordination through the lens of engaged stakeholders using digital infrastructures tools to integrate information technology. We distinguish this lens from the prevalent conceptualization of dyadic ties between clinician-patient, patient-nurse, clinician-nurse, and offer the holistic integration of all stakeholder inputs, in the clinic and augmented by online communication in a multi-national setting. Methods We analyze an instance of the user-driven health care (UDHC), a network of providers, patients, students and researchers working together to help manage patient care. The network currently focuses on patients from LMICs, but the provider network is global in reach. We describe UDHC and its opportunities and challenges in care-coordination to reduce costs, bring equity, and improve care quality and share evidence. Conclusion UDHC has resulted in coordinated global based local care, affecting multiple facets of medical practice. Shared information resources between providers with disparate knowledge, results in better understanding by patients, unique and challenging cases for students, innovative community based research and discovery learning for all. PMID:26123908

From Dyadic Ties to Information Infrastructures: Care-Coordination between Patients, Providers, Students and Researchers. Contribution of the Health Informatics Education Working Group.

PubMed

Purkayastha, S; Price, A; Biswas, R; Jai Ganesh, A U; Otero, P

2015-08-13

To share how an effectual merging of local and online networks in low resource regions can supplement and strengthen the local practice of patient centered care through the use of an online digital infrastructure powered by all stakeholders in healthcare. User Driven Health Care offers the dynamic integration of patient values and evidence based solutions for improved medical communication in medical care. This paper conceptualizes patient care-coordination through the lens of engaged stakeholders using digital infrastructures tools to integrate information technology. We distinguish this lens from the prevalent conceptualization of dyadic ties between clinician-patient, patient-nurse, clinician-nurse, and offer the holistic integration of all stakeholder inputs, in the clinic and augmented by online communication in a multi-national setting. We analyze an instance of the user-driven health care (UDHC), a network of providers, patients, students and researchers working together to help manage patient care. The network currently focuses on patients from LMICs, but the provider network is global in reach. We describe UDHC and its opportunities and challenges in care-coordination to reduce costs, bring equity, and improve care quality and share evidence. UDHC has resulted in coordinated global based local care, affecting multiple facets of medical practice. Shared information resources between providers with disparate knowledge, results in better understanding by patients, unique and challenging cases for students, innovative community based research and discovery learning for all.

Integrating palliative care into comprehensive cancer care.

PubMed

Abrahm, Janet L

2012-10-01

While there are operational, financial, and workforce barriers to integrating oncology with palliative care, part of the problem lies in ourselves, not in our systems. First, there is oncologists' "learned helplessness" from years of practice without effective medications to manage symptoms or training in how to handle the tough communication challenges every oncologist faces. Unless they and the fellows they train have had the opportunity to work with a palliative care team, they are unlikely to be fully aware of what palliative care has to offer to their patients at the time of diagnosis, during active therapy, or after developing advanced disease, or may believe that, "I already do that." The second barrier to better integration is the compassion fatigue many oncologists develop from caring for so many years for patients who, despite the oncologists' best efforts, suffer and die. The cumulative grief oncologists experience may go unnamed and unacknowledged, contributing to this compassion fatigue and burnout, both of which inhibit the integration of oncology and palliative care. Solutions include training fellows and practicing oncologists in palliative care skills (eg, in symptom management, psychological disorders, communication), preventing and treating compassion fatigue, and enhancing collaboration with palliative care specialists in caring for patients with refractory distress at any stage of disease. As more oncologists develop these skills, process their grief, and recognize the breadth of additional expertise offered by their palliative care colleagues, palliative care will become integrated into comprehensive cancer care.

Critique of a practice-based pilot study in chiropractic practices in Western Australia.

PubMed

Amorin-Woods, Lyndon G; Parkin-Smith, Gregory F; Nedkoff, Lee; Fisher, Colleen

2016-01-01

Practice-based data collection can offer insight into the nature of chiropractic practice and contribute to resolving the conundrum of the chiropractic profession's role in contemporary healthcare, subsequently informing care service policy. However, there is little formal data available about chiropractic practice to inform decision-makers about the nature and role of chiropractic within the context of a modern multidisciplinary healthcare context in Australia, particularly at a local and regional level. This was a mixed-methods data transformation model (qualitative to quantitative) pilot study the purpose of which was to provide a critique of the research design and collect data from a selected sample of chiropractic practices in Western Australia, with a view to offer recommendations related to the design, feasibility and implementation of a future confirmatory study. A narrative critique of the research methods of this pilot study is offered in this paper covering: (a) practice and patient recruitment, (b) enrollment of patients, (c) data collection methods, (d) acceptability of the study methods, (e) sample size calculations, and (f) design critique. The result of this critique provides a sensible sample size estimate and recommendations as to the design and implementation of a future confirmatory study. Furthermore, we believe that a confirmatory study is not only feasible, but indeed necessary, with a view to offer meaningful insight into chiropractic practice in Western Australia. ACTRN12616000434493 Australian New Zealand Clinical Trials Registry (ANZCTR). Registered 5 April 2016. First participant enrolled 01 July 2014, retrospectively registered.

Applying Bayesian statistics to the study of psychological trauma: A suggestion for future research.

PubMed

Yalch, Matthew M

2016-03-01

Several contemporary researchers have noted the virtues of Bayesian methods of data analysis. Although debates continue about whether conventional or Bayesian statistics is the "better" approach for researchers in general, there are reasons why Bayesian methods may be well suited to the study of psychological trauma in particular. This article describes how Bayesian statistics offers practical solutions to the problems of data non-normality, small sample size, and missing data common in research on psychological trauma. After a discussion of these problems and the effects they have on trauma research, this article explains the basic philosophical and statistical foundations of Bayesian statistics and how it provides solutions to these problems using an applied example. Results of the literature review and the accompanying example indicates the utility of Bayesian statistics in addressing problems common in trauma research. Bayesian statistics provides a set of methodological tools and a broader philosophical framework that is useful for trauma researchers. Methodological resources are also provided so that interested readers can learn more. (c) 2016 APA, all rights reserved).

Robust Stability of Scaled-Four-Channel Teleoperation with Internet Time-Varying Delays

PubMed Central

Delgado, Emma; Barreiro, Antonio; Falcón, Pablo; Díaz-Cacho, Miguel

2016-01-01

We describe the application of a generic stability framework for a teleoperation system under time-varying delay conditions, as addressed in a previous work, to a scaled-four-channel (γ-4C) control scheme. Described is how varying delays are dealt with by means of dynamic encapsulation, giving rise to mu-test conditions for robust stability and offering an appealing frequency technique to deal with the stability robustness of the architecture. We discuss ideal transparency problems and we adapt classical solutions so that controllers are proper, without single or double differentiators, and thus avoid the negative effects of noise. The control scheme was fine-tuned and tested for complete stability to zero of the whole state, while seeking a practical solution to the trade-off between stability and transparency in the Internet-based teleoperation. These ideas were tested on an Internet-based application with two Omni devices at remote laboratory locations via simulations and real remote experiments that achieved robust stability, while performing well in terms of position synchronization and force transparency. PMID:27128914

Deterring Violent Extremism in America by Utilizing Good Counter-Radicalization Practices from Abroad: A Policy Perspective

DTIC Science & Technology

2017-03-01

offering rehabilitation programs to former extremists. This thesis provides a way ahead for American policy makers by sharing good practices in each of...and offering training to prevent terrorism from when individuals are young. Understanding that humans are fallible, American policy makers and...in the United Kingdom that provided trained Islamic scholars to offer advice about the true teaching of Islam.102 The hotline “El-Hatef el- Islami’s

Beyond 'faith-based medicine' and EBM.

PubMed

De Simone, John

2006-08-01

Longstanding debate on evidence-based medicine (EBM) may have reached a critical saturation point. I briefly report on systematic reviews on the recurring themes in the critical literature. In this context, some criticisms to EBM are substantial and enduring, although convincing arguments to contrast unresolved issues have yet to be produced. Nonetheless, few changes have been adopted and conservative attitudes persist in EBM. Despite its 'success', implementation in practice has been inexorably overshadowed leading to paradoxical shortcomings. This controversial scenario offers a formidable occasion to gain needed insight. The aim of this paper is to attempt a comprehensive analysis by reframing a number of key concerns, while furnishing pragmatic, interdisciplinary solutions for these deep-rooted dilemmas. In the interests of all stakeholders, I seek to promote a concerted effort to resolve conflict and build consensus. This paper explores a strategically unifying vision of primary care, based on current understanding of practice patterns, having a research-friendly 'common ground' where practitioners' information needs may be met. In addition, an analysis of existing problems identifies underlying 'root causes'. Moreover, I expediently reframe crucial matters by focusing on EBM, more than as a paradigm, as an organisation, hence amenable to a variety of cross-disciplinary analyses and solutions. Finally, recent state-of-the-art reviews on implementation and dissemination research are cited for the pertinent implications for study design and practice. Present policies and influential testimonials on behalf of EBM encounter the pitfalls of hindering learning and progress through defensive attitudes and mechanisms. Current study designs and evaluation criteria must strive to adapt to real-world settings, rather than vice versa. The arguments exposed herein alter the terms of the debate on EBM and may outline a basis for initiatives with conflict-resolution and consensus-building scopes.

Chemical Strips Anodic Film From Aluminum

NASA Technical Reports Server (NTRS)

Eichinger, Eric C.

1993-01-01

Phosphoric acid solution offers advantages over other stripping solutions. More effective than other strippers and safer to use. Relatively environmentally benign, phosphoric acid stripper ceases its chemical attack so less process control is needed in its use.

How Near is a Near-Optimal Solution: Confidence Limits for the Global Optimum.

DTIC Science & Technology

1980-05-01

or near-optimal solutions are the only practical solutions available. This paper identifies and compares some procedures which use independent near...approximate or near-optimal solutions are the only practical solutions available. This paper identifies and compares some procedures which use inde- pendent...The objective of this paper is to indicate some relatively new statistical procedures for obtaining an upper confidence limit on G Each of these

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

Lakshminarayan, Raghuram, E-mail: raghuram.lakshminarayan@hey.nhs.u; Simpson, James O.; Ettles, Duncan F., E-mail: Duncan.Ettles@hey.nhs.u

Magnetic resonance angiography (MRA) has become an established imaging modality in the management of lower-limb arterial disease, with emerging roles in treatment planning and follow-up. Contrast-enhanced MRA is now the most widely used technique with clinically acceptable results in the majority of patients. Difficulties in imaging and image interpretation are recognised in certain subgroups, including patients with critical limb ischaemia as well as patients with stents. Although newer contrast agents and refined imaging protocols may offer some solutions to these problems, this optimism is balanced by concerns about the toxicity of certain gadolinium chelates. Further development of interventional MRA remainsmore » one of the most significant challenges in the development of magnetic resonance imaging-guided peripheral vascular intervention. The status of MRA in managing patients with lower-limb arterial disease in current clinical practice is reviewed.« less

Prevention concept in industry: improvement in occupational safety and health protection--an empirical study.

PubMed

Ramsauer, F

2001-12-01

This prevention concept offers a contribution to the expansion of the set of instruments for occupational safety and health protection within workplace prevention. The concept involves the multilateral analysis of work conditions. The utilized instruments include a strategy group, a survey, a health issue round table, and an analysis of work demands, and lead to synergy effects at the results level. Employees are drawn into the analysis of work conditions and workplace design solutions for the improvement of the work situation. The prevention concept was tested in a large company and its application established in practice. It was accepted by all participants, and the comparison with the previous situation (defined only through the analysis of work demands) demonstrated a significant improvement in health protection.

Improving the Product Documentation Process of a Small Software Company

NASA Astrophysics Data System (ADS)

Valtanen, Anu; Ahonen, Jarmo J.; Savolainen, Paula

Documentation is an important part of the software process, even though it is often neglected in software companies. The eternal question is how much documentation is enough. In this article, we present a practical implementation of lightweight product documentation process resulting from SPI efforts in a small company. Small companies’ financial and human resources are often limited. The documentation process described here, offers a template for creating adequate documentation consuming minimal amount of resources. The key element of the documentation process is an open source web-based bugtracking system that was customized to be used as a documentation tool. The use of the tool enables iterative and well structured documentation. The solution best serves the needs of a small company with off-the-shelf software products and striving for SPI.

Analyzing clinical phonological data using Phon

PubMed Central

McAllister Byun, Tara

2016-01-01

In this paper, we describe how Phon, a software program for the transcription and analysis of phonological data, can be applied to facilitate clinical phonological analyses. We begin with a summary of the types of analyses that are frequently used in the assessment and management of speech sound disorders. We then discuss challenges inherent to the transcription and analysis of clinical phonological data. For each challenge, we discuss solutions currently available within Phon, and offer an outlook on future methodological and technical developments in the area of clinical phonology. This paper includes a step-by-step introduction to Phon suitable for readers who lack previous experience with the software. We conclude with a discussion of data sharing and its vital role in advancing research and intervention practices in the area of speech development and disorders. PMID:27111269

Ohm's Law, Batteries, and the Clean Energy Landscape

NASA Astrophysics Data System (ADS)

Balsara, Nitash

The need for creating safe electrolytes for lithium batteries is significant given the continued safety problems associated with current lithium-ion batteries. Nonflammable polymer electrolytes offer a possible solution but the rate of lithium ion transport is too low for practical applications. In this talk, I will discuss some of the fundamental factors that limit ion transport in polymers. Polymer electrolytes obey Ohm's Law, i.e. in the limit of small applied potentials, the current generated at steady state is proportional to the applied potential. Factors that determine the current generated will be determined using the continuum theory of Newman. Independent measurements of ion diffusion by pulsed-field gradient NMR will also be presented. The talk will end with a discussion of the possibility of commercializing all-solid batteries with polymer electrolytes.

Translating evidence from systematic reviews for policy makers.

PubMed

Nannini, Angela; Houde, Susan Crocker

2010-06-01

Gerontological nurses who have received education and have experience in conducting systematic reviews may assume a key role in interpreting systematic reviews for policy makers. Systematic reviews offer evidence to determine the best policy and program solutions to a problem. To be successful in translating evidence from systematic reviews, gerontological nurses need to (a) understand the steps of the policy making process and where different kinds of reviews may be used, (b) assess the "technical" literacy and level of interest in gerontological issues of the intended policy maker, and (c) develop and practice skills in policy writing that distill information in policy briefs as well as shorter formats. Gerontological nurses can be powerful advocates for older adults using the systematic review of the literature as an instrument to educate policy makers. Copyright 2010, SLACK Incorporated.

How to Allow Conscientious Objection in Medicine While Protecting Patient Rights.

PubMed

Ancell, Aaron; Sinnott-Armstrong, Walter

2017-01-01

Paradigmatic cases of conscientious objection in medicine are those in which a physician refuses to provide a medical service or good because doing so would conflict with that physician's personal moral or religious beliefs. Should such refusals be allowed in medicine? We argue that (1) many conscientious objections to providing certain services must be allowed because they fall within the range of freedom that physicians have to determine which services to offer in their practices; (2) at least some conscientious objections to serving particular groups of patients should be allowed because they are not invidiously discriminatory; and (3) even in cases of invidiously discriminatory conscientious objections, legally prohibiting individual physicians from refusing to serve patients on the basis of such objections is not always the best solution.

Outcomes measurement in hospitals: can the system change the organization?

PubMed

Linder, J C

1992-01-01

The U.S. health care industry is in crisis--a crisis of accountability. Many believe that improved information, especially outcomes information, is at least part of the solution. If this assessment is accurate, outcomes measurement could offer a powerful opportunity to help mold our dysfunctional health care machinery into an effective infrastructure. This article explores whether implementing an outcomes measurement system in a hospital compels this kind of change. It examines the experiences of 31 hospitals that implemented a market-leading outcomes measurement system. Despite its potential, MedisGroups did not compel important improvements in hospitals' quality of care or their internal practices. Hospitals found it particularly difficult to maintain momentum throughout implementation and to structure the system as a supporting tool, rather than a driving influence, in their pursuit of operating improvements.

Towards Improved Finite Element Modelling of the Interaction of Elastic Waves with Complex Defect Geometries

NASA Astrophysics Data System (ADS)

Rajagopal, P.; Drozdz, M.; Lowe, M. J. S.

2009-03-01

A solution to the problem of improving the finite element (FE) modeling of elastic wave-defect interaction is sought by reconsidering the conventional opinion on meshing strategy. The standard approach using uniform square elements imposes severe limitations in representing complex defect outlines but this is thought to improve when the mesh is made finer. Free meshing algorithms available widely in commercial packages of late can cope with difficult features well but they are thought to cause scattering by the irregular mesh itself. This paper examines whether the benefits offered by free meshing in representing defects better outweigh the inaccuracies due to mesh scattering. If using the standard mesh, the questions whether mesh refinement leads to improved results and whether a practical strategy can be constructed are considered.

Cryptanalysis of SFLASH with Slightly Modified Parameters

NASA Astrophysics Data System (ADS)

Dubois, Vivien; Fouque, Pierre-Alain; Stern, Jacques

SFLASH is a signature scheme which belongs to a family of multivariate schemes proposed by Patarin et al. in 1998 [9]. The SFLASH scheme itself has been designed in 2001 [8] and has been selected in 2003 by the NESSIE European Consortium [6] as the best known solution for implementation on low cost smart cards. In this paper, we show that slight modifications of the parameters of SFLASH within the general family initially proposed renders the scheme insecure. The attack uses simple linear algebra, and allows to forge a signature for an arbitrary message in a question of minutes for practical parameters, using only the public key. Although SFLASH itself is not amenable to our attack, it is worrying to observe that no rationale was ever offered for this "lucky" choice of parameters.

Robust adaptive uniform exact tracking control for uncertain Euler-Lagrange system

NASA Astrophysics Data System (ADS)

Yang, Yana; Hua, Changchun; Li, Junpeng; Guan, Xinping

2017-12-01

This paper offers a solution to the robust adaptive uniform exact tracking control for uncertain nonlinear Euler-Lagrange (EL) system. An adaptive finite-time tracking control algorithm is designed by proposing a novel nonsingular integral terminal sliding-mode surface. Moreover, a new adaptive parameter tuning law is also developed by making good use of the system tracking errors and the adaptive parameter estimation errors. Thus, both the trajectory tracking and the parameter estimation can be achieved in a guaranteed time adjusted arbitrarily based on practical demands, simultaneously. Additionally, the control result for the EL system proposed in this paper can be extended to high-order nonlinear systems easily. Finally, a test-bed 2-DOF robot arm is set-up to demonstrate the performance of the new control algorithm.

Long-acting injectable hormonal dosage forms for contraception.

PubMed

Wu, Linfeng; Janagam, Dileep R; Mandrell, Timothy D; Johnson, James R; Lowe, Tao L

2015-07-01

Although great efforts have been made to develop long-acting injectable hormonal contraceptives for more than four decades, few long-acting injectable contraceptives have reached the pharmaceutical market or even entered clinical trials. On the other hand, in clinical practice there is an urgent need for injectable long-acting reversible contraceptives which can provide contraceptive protection for more than 3 months after one single injection. Availability of such products will offer great flexibility to women and resolve certain continuation issues currently occurring in clinics. Herein, we reviewed the strategies exploited in the past to develop injectable hormonal contraceptive dosages including drug microcrystal suspensions, drug-loaded microsphere suspensions and in situ forming depot systems for long-term contraception and discussed the potential solutions for remaining issues met in the previous development.

Stylization levels of industrial design objects

NASA Astrophysics Data System (ADS)

Kukhta, M. S.; Sokolov, A. P.; Krauinsh, D. P.; Bouchard, C.

2017-01-01

The urgency of the research of form making problem in design is associated with the necessity of new understanding of visual culture and new approaches to design engineering representing the integration of artistic and designed problems. The aim of this research is to study the levels of stylization of design objects and dependance (relation) on the specific project objectives and existing technologies. On the ground of quantitative evaluation, the stylization measures are emphasized: figurative image, stylized image and abstract image. Theoretic conclusions are complemented by practical problem solution over creating openwork metal lantern. Variants of both the traditional mains supply of the lantern and the autonomic supply system based on solar energy were offered. The role of semantic factor, affecting the depth of perception of design objects semantic space, is represented in this paper.

Private health insurance: a role model for European health systems.

PubMed

Arentz, Christine; Eekhoff, Johann; Kochskämper, Susanna

2012-10-01

European health care systems will face major challenges in the near future. Demographic change and technological progress induce rising costs. In order to deal with these developments and to preserve the current level of health care provision, health care systems need to be highly efficient. Yet existing health care systems show a lot of inefficiencies that result in waste of scarce resources. Therefore, improvements in performance are necessary. In this article, we argue that a change in financing health care accompanied by the liberalisation of the market for health care service providers offers a promising solution. We develop a market-based model for financing health care and show how it can be put into practice without generating additional costs for society while meeting social equity criteria.

Socializing health services in Greece.

PubMed

Kent, G D

1989-01-01

Greece's first socialist government has established the legal framework for a national health system. The Government would not have been able to initiate such an action if the previous health delivery system had not had significant imperfections. In addressing these deficiencies, none of the solutions offered by the government has proved more controversial than the proposal to bring the practice of medicine under its control. To meet this objective, the Greek Government is employing strategies that maintain the growth in the total number of physicians; expand the ranks of its own physician corps; eliminate private ownership of most hospitals and clinics; and increase physicians' accountability to the public sector. It may be that the ultimate success of the Government's attempt to establish a national health system will depend on its ability to control physicians as a group.

Bis(carbazol-9-ylphenyl)aniline end-capped oligoarylenes as solution-processed nondoped emitters for full-emission color tuning organic light-emitting diodes.

PubMed

Khanasa, Tanika; Prachumrak, Narid; Rattanawan, Rattanawaree; Jungsuttiwong, Siriporn; Keawin, Tinnagon; Sudyoadsuk, Taweesak; Tuntulani, Thawatchai; Promarak, Vinich

2013-07-05

A series of bis(3,6-di-tert-butylcarbazol-9-ylphenyl)aniline end-capped oligoarylenes, BCPA-Ars, are synthesized by double palladium-catalyzed cross-coupling reactions. By using this bis(carbazol-9-yl)triphenylamine moiety as an end-cap, we are able to reduce the crystallization and retain the high-emission ability of these planar fluorescent oligoarylene cores in the solid state, as well as improve the amorphous stability and solubility of the materials. The results of optical and electrochemical studies show that their HOMOs, LUMOs, and energy gaps can be easily modified or fine-tuned by either varying the degree of π-conjugation or using electron affinities of the aryl cores which include fluorene, oligothiophenes, 2,1,3-benzothiadiazole, 4,7-diphenyl-4-yl-2,1,3-benzothiadiazole, and 4,7-dithien-2-yl-2,1,3-benzothiadiazole. As a result, their emission spectra measured in solution and thin films can cover the full UV-vis spectrum (426-644 nm). Remarkably, solution-processed nondoped BCPA-Ars-based OLEDs could show moderate to excellent device performance with emission colors spanning the whole visible spectrum (deep blue to red). Particularly, the RGB (red, green, blue) OLEDs exhibit good color purity close to the pure RGB colors. This report offers a practical approach for both decorating the highly efficient but planar fluorophores and tuning their emission colors to be suitable for applications in nondoped and solution-processable full-color emission OLEDs.

Privacy-preserving genome-wide association studies on cloud environment using fully homomorphic encryption.

PubMed

Lu, Wen-Jie; Yamada, Yoshiji; Sakuma, Jun

2015-01-01

Developed sequencing techniques are yielding large-scale genomic data at low cost. A genome-wide association study (GWAS) targeting genetic variations that are significantly associated with a particular disease offers great potential for medical improvement. However, subjects who volunteer their genomic data expose themselves to the risk of privacy invasion; these privacy concerns prevent efficient genomic data sharing. Our goal is to presents a cryptographic solution to this problem. To maintain the privacy of subjects, we propose encryption of all genotype and phenotype data. To allow the cloud to perform meaningful computation in relation to the encrypted data, we use a fully homomorphic encryption scheme. Noting that we can evaluate typical statistics for GWAS from a frequency table, our solution evaluates frequency tables with encrypted genomic and clinical data as input. We propose to use a packing technique for efficient evaluation of these frequency tables. Our solution supports evaluation of the D' measure of linkage disequilibrium, the Hardy-Weinberg Equilibrium, the χ2 test, etc. In this paper, we take χ2 test and linkage disequilibrium as examples and demonstrate how we can conduct these algorithms securely and efficiently in an outsourcing setting. We demonstrate with experimentation that secure outsourcing computation of one χ2 test with 10, 000 subjects requires about 35 ms and evaluation of one linkage disequilibrium with 10, 000 subjects requires about 80 ms. With appropriate encoding and packing technique, cryptographic solutions based on fully homomorphic encryption for secure computations of GWAS can be practical.

Course Corrections. Experts Offer Solutions to the College Cost Crisis

ERIC Educational Resources Information Center

Lumina Foundation for Education, 2005

2005-01-01

This paper discusses outsourcing as one solution to the college cost crisis. It is not presented as the solution; rather, it is put forth as an attractive strategy characterized by minimal financial and programmatic risk. To explore the basic policy considerations associated with outsourcing, this paper briefly reviews why institutions consider…

NREL, LiquidCool Solutions Partner on Energy-Efficient Cooling for

Science.gov Websites

denser and generate more heat. Liquid cooling, including the LiquidCool Solutions technology, offers a more energy-efficient solution that also allows for effective reuse of the heat rejected by the water, depending on the coolant temperature and heat exchanger specifications. These water temperatures

Refusing analgesics: using continuous improvement to improve pain management on a surgical ward.

PubMed

Carr, Eloise C J

2002-11-01

Despite advances in pain control many patients experience moderate to severe pain whilst in hospital. Contributory factors include inadequate assessment and documentation of pain, as well as patient and professional misconceptions. A 28-bedded surgical ward in a District General Hospital in the South of England was the setting for the project. A small preliminary audit of pain on this ward indicated that some patients experienced postoperative pain, which was not effectively controlled. A 'continuous improvement' framework was used to increase understanding of the problem and identify an aim for the project, which was to reduce the number of patients refusing analgesics when offered by nurses. An audit to ascertain how many patients refused analgesia revealed that, of 133 patients offered, 93 (70%) refused. Using the 'Model for Improvement' (Langley et al., 1996) a number of changes were introduced, including a patient information sheet, regular documented pain assessment and an innovative staff education programme. To evaluate if the changes in practice had been successful, further audit data were collected from 167 patients. Sixty-three (44%) accepted analgesics, indicating a significant decrease in the number refusing (P = 0.005). This small project demonstrated that continuous improvement methodology can improve the management of pain and quality of care for patients. Such an approach brings practitioner and patient into meaningful understanding and offers solutions which are realistic, achievable and sustainable over time. Despite finite resources and increased pressure on staff it is possible to motivate people when they feel they have ownership and change is meaningful. Continuous improvement methods offer an exciting, feasible, patient-centred approach to improving care.

What Is the Optimal Target Convective Volume in On-Line Hemodiafiltration Therapy?

PubMed

Canaud, Bernard; Koehler, Katrin; Bowry, Sudhir; Stuard, Stefano

2017-01-01

Conventional diffusion-based dialysis modalities including high-flux hemodialysis are limited in their capacity to effectively remove large uremic toxins and to improve outcomes for end-stage chronic kidney disease (ESKD) patients. By increasing convective solute transport, hemodiafiltration (HDF) enhances solute removal capacity over a broad range of middle- and large-size uremic toxins implicated in the pathophysiology of chronic kidney disease. Furthermore, by offering flexible convection volume, on-line HDF permits customizing the treatment dose to the patient's needs. In addition, convective-based modalities have been shown to improve hemodynamic stability and to reduce patients' inflammation profile - both of which are implicated in CKD morbidity and mortality. Growing clinical evidence indicates that HDF-based modalities provide ESKD patients with a number of clinical and biological benefits, including improved outcomes. Interestingly, it has recently emerged that the clinical benefits associated with HDF are positively associated with the total ultrafiltered volume per session (and per week), namely convective dose. In this chapter, we revisit the concept of convective dose and discuss the threshold value above which an improvement in ESKD patient outcome can be expected. This particular point will be addressed by stratifying the level of efficacy of convective volumes, schematically defined as minimal, optimal, personalized, and maximal. In addition, factors and best clinical practices implicated in the achievement of an optimal convective dose are reviewed. To conclude, we show how HDF differs from standard hemodialysis and why HDF offers a paradigm shift in renal replacement therapy. © 2017 S. Karger AG, Basel.

Analysis of in vitro release through reconstructed human epidermis and synthetic membranes of multi-vitamins from cosmetic formulations.

PubMed

Gabbanini, Simone; Matera, Riccardo; Beltramini, Claudia; Minghetti, Andrea; Valgimigli, Luca

2010-08-01

A convenient method for in vitro investigation of the release of lipid- and water-soluble vitamins from cosmetic formulations was developed. The permeation of (d)-alpha-tocopherol (vitamin E), retinyl acetate (pro-vitamin A), ascorbic acid (vitamin C) and pyridoxine (vitamin B6) through SkinEthic reconstructed human epidermis (RHE), and synthetic polyethersulfone and polycarbonate membranes was studied in vitro using a Franz-type diffusion apparatus, coupled either to a spectrophotometer for continuous reading (dynamic setting) or to HPLC-DAD analysis of the receptor medium (static setting). O/W and W/O emulsions were compared with simple aqueous solutions for their kinetic of vitamins release, to evaluate the influence of the cosmetic formulation on the bioavailability of active ingredients. Results indicate that synthetic membranes offer a limited barrier to the diffusion of vitamins, but may provide information on the release ability of the formulation. Penetration was more effective when water was the external phase of the formulation, i.e. W/O emulsions were less effective in the release of vitamins than O/W emulsion or aqueous solutions. RHE (17 days old) offered a significantly higher barrier to penetration of vitamins, as expected for native human epidermis. The relative ranking in coefficient of permeability (Ps (cm/h)) was: ascorbic acid>pyridoxine>retinyl acetate>alpha-tocopherol approximately 0, the absolute values depending on the formulation. The method herein described showed to be a practical and convenient tool for the quality-control and efficacy evaluation of cosmetic formulations. Copyright (c) 2010 Elsevier B.V. All rights reserved.

Prescriptive Statements and Educational Practice: What Can Structural Equation Modeling (SEM) Offer?

ERIC Educational Resources Information Center

Martin, Andrew J.

2011-01-01

Longitudinal structural equation modeling (SEM) can be a basis for making prescriptive statements on educational practice and offers yields over "traditional" statistical techniques under the general linear model. The extent to which prescriptive statements can be made will rely on the appropriate accommodation of key elements of research design,…

Narrative Inquiry: Theory and Practice

ERIC Educational Resources Information Center

Savin-Baden, Maggi; Van Niekerk, Lana

2007-01-01

This article offers an overview of the method of narrative inquiry and explores competing trends in the use of the approach. It not only examines the theories relating to the method but also offers practical guidance on using narrative inquiry, including an exploration of what might count as a narrative and ways of analysing narrative data. The…

Principles and Practices of the Circle of Trust[R] Approach

ERIC Educational Resources Information Center

Chadsey, Terry; Jackson, Marcy

2012-01-01

Through the Center for Courage & Renewal, the authors offer personal and professional retreats and programs designed to explore vocational and life questions, offer renewal and encouragement, and deepen engagement in professional practice. Using what they call the Circle of Trust[R] approach, they invite groups into a communal process based upon a…

Use of Selected Dental School Courses for Continuing Education.

ERIC Educational Resources Information Center

Sanger, Roger G.

1981-01-01

In an effort to market current predoctoral dental courses offered at the University of Colorado Health Sciences Center School of Dentistry to the practicing dentist, a 10-hour forensic odontology course was offered to both predoctoral dental students and practicing dentists and their staffs. Positive reactions and cost effectiveness of this pilot…

Observations

ERIC Educational Resources Information Center

Joosten, Albert Max

2016-01-01

Joosten begins his article by telling us that love and knowledge together are the foundation for our work with children. This combination is at the heart of our observation. With this as the foundation, he goes on to offer practical advice to aid our practice of observation. He offers a "List of Objects of Observation" to help guide our…

Professional Development in Teaching and Learning for Early Career Academic Geographers: Contexts, Practices and Tensions

ERIC Educational Resources Information Center

Vajoczki, Susan; Biegas, Tamara C.; Crenshaw, Melody; Healey, Ruth L.; Osayomi, Tolulope; Bradford, Michael; Monk, Janice

2011-01-01

This paper provides a review of the practices and tensions informing approaches to professional development for early career academic geographers who are teaching in higher education. We offer examples from Britain, Canada, Nigeria and the USA. The tensions include: institutional and departmental cultures; models that offer generic and…

Learning through Artful Knowing

ERIC Educational Resources Information Center

van Meer, Pleuntje

2016-01-01

In this paper, van Meer offers an exploration in the context of action learning doctoral research in which she explores leadership consultancy practice. The purpose is to grow insight on learning as a lived experience. Artful knowing offers a way to learn about life and practice, through a deeply personal, reflective and sense-making process. The…

Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.

PubMed

Ong, Toan C; Kahn, Michael G; Kwan, Bethany M; Yamashita, Traci; Brandt, Elias; Hosokawa, Patrick; Uhrich, Chris; Schilling, Lisa M

2017-09-13

Electronic health records (EHRs) contain detailed clinical data stored in proprietary formats with non-standard codes and structures. Participating in multi-site clinical research networks requires EHR data to be restructured and transformed into a common format and standard terminologies, and optimally linked to other data sources. The expertise and scalable solutions needed to transform data to conform to network requirements are beyond the scope of many health care organizations and there is a need for practical tools that lower the barriers of data contribution to clinical research networks. We designed and implemented a health data transformation and loading approach, which we refer to as Dynamic ETL (Extraction, Transformation and Loading) (D-ETL), that automates part of the process through use of scalable, reusable and customizable code, while retaining manual aspects of the process that requires knowledge of complex coding syntax. This approach provides the flexibility required for the ETL of heterogeneous data, variations in semantic expertise, and transparency of transformation logic that are essential to implement ETL conventions across clinical research sharing networks. Processing workflows are directed by the ETL specifications guideline, developed by ETL designers with extensive knowledge of the structure and semantics of health data (i.e., "health data domain experts") and target common data model. D-ETL was implemented to perform ETL operations that load data from various sources with different database schema structures into the Observational Medical Outcome Partnership (OMOP) common data model. The results showed that ETL rule composition methods and the D-ETL engine offer a scalable solution for health data transformation via automatic query generation to harmonize source datasets. D-ETL supports a flexible and transparent process to transform and load health data into a target data model. This approach offers a solution that lowers technical barriers that prevent data partners from participating in research data networks, and therefore, promotes the advancement of comparative effectiveness research using secondary electronic health data.

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2014 CFR

2014-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2012 CFR

2012-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2013 CFR

2013-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2011 CFR

2011-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

21 CFR 310.534 - Drug products containing active ingredients offered over-the-counter (OTC) for human use as oral...

Code of Federal Regulations, 2010 CFR

2010-04-01

... offered over-the-counter (OTC) for human use as oral wound healing agents. 310.534 Section 310.534 Food... active ingredients offered over-the-counter (OTC) for human use as oral wound healing agents. (a... aqueous solution have been present in oral mucosal injury drug products for use as oral wound healing...

Communities of practice in support of collaborative multi-disciplinary learning and action in response to climate change

NASA Astrophysics Data System (ADS)

Heimlich, J. E.; Stylinski, C.; Palmquist, S.; Wasserman, D.

2017-12-01

Collaborative efforts reaching across interdisciplinary boundaries to address controversial issues such as climate change present significant complexities, including developing shared language, agreeing on common outcomes, and even establishing habits of regular dialogue. Such collaborative efforts should include museums, aquariums, zoos, parks, and youth groups as each of these informal education institutions provides a critical avenue for supporting learning about and responding to climate change. The community of practice framework offers a potential effective approach to support learning and action of diverse groups with a shared interest. Our study applied this framework to the NSF-funded Maryland and Delaware Climate Change Assessment and Education (MADE-CLEAR) project, facilitating informal educators across these two states to advance their climate change education practices, and could provide insight for a building a citywide multi-sector collaborative effort. We found strategies that center on the process of group evolution; support different perspectives, levels of participation, and community spaces; focus on value as defined by members; and balance familiarity and fun produced a dynamic and functional community with a shared practice where none had existed before. Also important was expanding the community-of-practice focus on relationship building to include structured professional development and spin-off opportunities for small-group team-based endeavors. Our findings suggest that this collaborative professional learning approach is well suited to diverse groups seeking creative solutions to complex and even divisive challenges.

Advanced practice physiotherapy in paediatric orthopaedics: innovation and collaboration to improve service delivery.

PubMed

Ó Mír, M; O'Sullivan, C

2018-02-01

One in eight paediatric primary care presentations is for a musculoskeletal (MSK) disorder. These patients are frequently referred to paediatric orthopaedic surgeons; however, up to 50% of referrals are for normal variants. This results in excessive wait-times and impedes access for urgent surgical cases. Adult MSK medicine has successfully utilised advanced practice physiotherapists (APP) managing non-surgical candidates, with documented benefits both to patients and services. There is a gap in the literature with regard to APP in paediatric orthopaedics. In this review, we investigate demands on paediatric orthopaedic services, examine the literature regarding APP in paediatric orthopaedics and explore the value the role has to offer current outpatient services. Paediatric orthopaedic services are under-resourced with concurrent long wait times. Approximately 50% of referrals are for normal variants, which do not require specialist intervention. Poor musculoskeletal examination skills and low diagnostic confidence amongst primary care physicians have been identified as a cause of inappropriate referrals. APP clinics for normal variants have reported independent management rate and discharge rates of 95% and marked reduction in patient wait times. There is limited evidence to support the APP in paediatric orthopaedics. Further studies are needed investigating diagnostic agreement, patient/stakeholder satisfaction, patient outcomes and economic evaluation. Paediatric orthopaedics is in crisis as to how to effectively manage the overwhelming volume of referrals. Innovative multidisciplinary solutions are required so that the onus is not solely on physicians to provide all services. The APP in paediatric orthopaedics may be part of the solution.

Application of core-shell-structured CdTe@SiO2 quantum dots synthesized via a facile solution method for improving latent fingerprint detection

NASA Astrophysics Data System (ADS)

Gao, Feng; Han, Jiaxing; Lv, Caifeng; Wang, Qin; Zhang, Jun; Li, Qun; Bao, Liru; Li, Xin

2012-10-01

Fingerprint detection is important in criminal investigation. This paper reports a facile powder brushing technique for improving latent fingerprint detection using core-shell-structured CdTe@SiO2 quantum dots (QDs) as fluorescent labeling marks. Core-shell-structured CdTe@SiO2 QDs are prepared via a simple solution-based approach using NH2NH2·H2O as pH adjustor and stabilizer, and their application for improving latent fingerprint detection is explored. The obtained CdTe@SiO2 QDs show spherical shapes with well-defined core-shell structures encapsulating different amounts of QDs depending on the type of the pH adjustor and stabilizer. Moreover, the fluorescence of CdTe@SiO2 QDs is largely enhanced by surface modification of the SiO2 shell. The CdTe@SiO2 QDs overcome the oxidation problem of pure CdTe QDs in air, thus affording better variability with strong adhesive ability, better resolution, and bright emission colors for practical application in latent fingerprint detection. In comparison with the conventional fluorescence powders, silver powders, and others, the effectiveness of CdTe@SiO2 QD powders for detection of latent fingerprints present on a large variety of object surfaces is greatly improved. The synthesis method for CdTe@SiO2 QDs is simple, cheap, and easy for large-scale production, and thus offers many advantages in the practical application of fingerprint detection.

Web GIS in practice VII: stereoscopic 3-D solutions for online maps and virtual globes

PubMed Central

Boulos, Maged N Kamel; Robinson, Larry R

2009-01-01

Because our pupils are about 6.5 cm apart, each eye views a scene from a different angle and sends a unique image to the visual cortex, which then merges the images from both eyes into a single picture. The slight difference between the right and left images allows the brain to properly perceive the 'third dimension' or depth in a scene (stereopsis). However, when a person views a conventional 2-D (two-dimensional) image representation of a 3-D (three-dimensional) scene on a conventional computer screen, each eye receives essentially the same information. Depth in such cases can only be approximately inferred from visual clues in the image, such as perspective, as only one image is offered to both eyes. The goal of stereoscopic 3-D displays is to project a slightly different image into each eye to achieve a much truer and realistic perception of depth, of different scene planes, and of object relief. This paper presents a brief review of a number of stereoscopic 3-D hardware and software solutions for creating and displaying online maps and virtual globes (such as Google Earth) in "true 3D", with costs ranging from almost free to multi-thousand pounds sterling. A practical account is also given of the experience of the USGS BRD UMESC (United States Geological Survey's Biological Resources Division, Upper Midwest Environmental Sciences Center) in setting up a low-cost, full-colour stereoscopic 3-D system. PMID:19849837

Web GIS in practice VII: stereoscopic 3-D solutions for online maps and virtual globes.

PubMed

Boulos, Maged N Kamel; Robinson, Larry R

2009-10-22

Because our pupils are about 6.5 cm apart, each eye views a scene from a different angle and sends a unique image to the visual cortex, which then merges the images from both eyes into a single picture. The slight difference between the right and left images allows the brain to properly perceive the 'third dimension' or depth in a scene (stereopsis). However, when a person views a conventional 2-D (two-dimensional) image representation of a 3-D (three-dimensional) scene on a conventional computer screen, each eye receives essentially the same information. Depth in such cases can only be approximately inferred from visual clues in the image, such as perspective, as only one image is offered to both eyes. The goal of stereoscopic 3-D displays is to project a slightly different image into each eye to achieve a much truer and realistic perception of depth, of different scene planes, and of object relief. This paper presents a brief review of a number of stereoscopic 3-D hardware and software solutions for creating and displaying online maps and virtual globes (such as Google Earth) in "true 3D", with costs ranging from almost free to multi-thousand pounds sterling. A practical account is also given of the experience of the USGS BRD UMESC (United States Geological Survey's Biological Resources Division, Upper Midwest Environmental Sciences Center) in setting up a low-cost, full-colour stereoscopic 3-D system.

Web GIS in practice VII: stereoscopic 3-D solutions for online maps and virtual globes

USGS Publications Warehouse

Boulos, Maged N.K.; Robinson, Larry R.

2009-01-01

Because our pupils are about 6.5 cm apart, each eye views a scene from a different angle and sends a unique image to the visual cortex, which then merges the images from both eyes into a single picture. The slight difference between the right and left images allows the brain to properly perceive the 'third dimension' or depth in a scene (stereopsis). However, when a person views a conventional 2-D (two-dimensional) image representation of a 3-D (three-dimensional) scene on a conventional computer screen, each eye receives essentially the same information. Depth in such cases can only be approximately inferred from visual clues in the image, such as perspective, as only one image is offered to both eyes. The goal of stereoscopic 3-D displays is to project a slightly different image into each eye to achieve a much truer and realistic perception of depth, of different scene planes, and of object relief. This paper presents a brief review of a number of stereoscopic 3-D hardware and software solutions for creating and displaying online maps and virtual globes (such as Google Earth) in "true 3D", with costs ranging from almost free to multi-thousand pounds sterling. A practical account is also given of the experience of the USGS BRD UMESC (United States Geological Survey's Biological Resources Division, Upper Midwest Environmental Sciences Center) in setting up a low-cost, full-colour stereoscopic 3-D system.

Empathy in general practice-the gap between wishes and reality: comparing the views of patients and physicians.

PubMed

Derksen, F A W M; Olde Hartman, Tim; Bensing, Jozien; Lagro-Janssen, Antoine

2018-03-27

Empathy is regarded by patients and general practitioners (GPs) as fundamental in patient-GP communication. Patients do not always experience empathy and GPs encounter circumstances which hamper applying it. To explore why receiving and offering empathy during the encounter in general practice does not always meet the wishes of both patients and GPs. A qualitative research method, based on focus group interviews with patients and in-depth interviews with GPs, was carried out. Within the research process, iterative data collection and analysis were applied. Both patients and GPs perceive a gap between what they wish for with regard to empathy, and what they actually encounter in general practice. Patients report on circumstances which hamper receiving empathy and GPs on circumstances offering it. Various obstacles were mentioned: (i) circumstances related to practice organization, (ii) circumstances related to patient-GP communication or connectedness, (iii) differences between the patient's and the GP's expectations, (iv) time pressure and its causes and (v) the GP's individual capability to offer empathy. When patients do not receive empathy from their GP or practice staff, they feel frustrated. This causes a gap between their expectations on the one hand and their actual experiences on the other. GPs generally want to incorporate empathy; the GP's private, professional and psychological well-being appears to be an important contributing factor in practicing empathy in daily practice. But they encounter various obstacles to offer this. It is up to GPs to take responsibility for showing practice members the importance of an appropriate empathical behaviour towards patients.

Towards a framework for the elicitation of dilemmas.

PubMed

Burger, Marc J C

2008-08-01

This paper covers the main findings of the doctoral research that was concerned with seeking to extend aspects of dilemma theory. In professional practice, the Trompenaars Hampden-Turner Dilemma Reconciliation Process(TM) is a vehicle delivering dilemma theory in application. It informs a manager or leader on how to explore the dilemmas they face, how to reconcile the tensions that result, and how to structure the action steps for implementing the reconciled solutions. This vehicle forms the professional practice of the author who seeks to bring more rigor to consulting practice and thereby also contribute to theory development in the domain. The critical review of dilemma theory reveals that previous authors are inconsistent and variously invalid in their use of the terms 'dilemma theory,' 'dilemma methodology,' 'dilemma process,' 'dilemma reconciliation,' etc., and therefore an attempt is made to resolve these inconsistencies by considering whether 'dilemmaism' at the meta-level might be positioned as a new paradigm of inquiry for (management) research that embodies ontological, epistemological, and methodical premises that frame an approach to the resolution of real world business problems in (multi) disciplinary; (multi) functional and (multi) cultural business environments. This research offers contributions to knowledge, professional practice and theory development from the exploration of the SPID model as a way to make the elicitation of dilemmas more rigorous and structured and in the broader context of exploring 'dilemmaism' as a new paradigm of inquiry.

Knowledge Retrieval Solutions.

ERIC Educational Resources Information Center

Khan, Kamran

1998-01-01

Excalibur RetrievalWare offers true knowledge retrieval solutions. Its fundamental technologies, Adaptive Pattern Recognition Processing and Semantic Networks, have capabilities for knowledge discovery and knowledge management of full-text, structured and visual information. The software delivers a combination of accuracy, extensibility,…

Practices participating in a dental PBRN have substantial and advantageous diversity even though as a group they have much in common with dentists at large

PubMed Central

Makhija, Sonia K; Gilbert, Gregg H; Rindal, D Brad; Benjamin, Paul; Richman, Joshua S; Pihlstrom, Daniel J; Qvist, Vibeke

2009-01-01

Background Practice-based research networks offer important opportunities to move recent advances into routine clinical practice. If their findings are not only generalizable to dental practices at large, but can also elucidate how practice characteristics are related to treatment outcome, their importance is even further elevated. Our objective was to determine whether we met a key objective for The Dental Practice-Based Research Network (DPBRN): to recruit a diverse range of practitioner-investigators interested in doing DPBRN studies. Methods DPBRN participants completed an enrollment questionnaire about their practices and themselves. To date, more than 1100 practitioners from the five participating regions have completed the questionnaire. The regions consist of: Alabama/Mississippi, Florida/Georgia, Minnesota, Permanente Dental Associates, and Scandinavia (Denmark, Norway, and Sweden). We tested the hypothesis that there are statistically significant differences in key characteristics among DPBRN practices, based on responses from dentists who participated in DPBRN's first network-wide study (n = 546). Results There were statistically significant, substantive regional differences among DPBRN-participating dentists, their practices, and their patient populations. Conclusion Although as a group, participants have much in common with practices at large; their substantial diversity offers important advantages, such as being able to evaluate how practice differences may affect treatment outcomes, while simultaneously offering generalizability to dentists at large. This should help foster knowledge transfer in both the research-to-practice and practice-to-research directions. PMID:19832991

How the medical practice employee can get more from continuing education programs.

PubMed

Hills, Laura Sachs

2007-01-01

Continuing education can be a win-win situation for the medical practice employee and for the practice. However, in order education programs must become informed consumers of such programs. They must know how to select the right educational programs for their needs and maximize their own participation. Employees who attend continuing education programs without preparation may not get the full benefit from their experiences. This article suggests benchmarks to help determine whether a continuing education program is worthwhile and offers advice for calculating the actual cost of any continuing education program. It provides a how-to checklist for medical practice employees so they know how to get the most out of their continuing education experience before, during, and after the program. This article also suggests using a study partner system to double educational efforts among employees and offers 10 practical tips for taking and using notes at a continuing education program. Finally, this article outlines the benefits of becoming a regular student and offers three practical tips for maximizing the employee's exhibit hall experience.

Sex selection for non-medical indications: a survey of current pre-implantation genetic screening practices among U.S. ART clinics.

PubMed

Capelouto, Sarah M; Archer, Sydney R; Morris, Jerrine R; Kawwass, Jennifer F; Hipp, Heather S

2018-03-01

This study aimed to determine the current percentage of United States (U.S.) assisted reproductive technology (ART) clinics offering sex selection via pre-implantation genetic screening (PGS) for non-medical purposes. The authors conducted website review and telephone interview survey of 493 U.S. ART clinics performing in vitro fertilization (IVF) in 2017. Main outcome measures were pre-implantation genetic screening (PGS)/pre-implantation genetic diagnosis (PGD) practices and non-medical sex selection practices including family balancing. Of the 493 ART clinics in the USA, 482 clinics (97.8%) responded to our telephone interview survey. Among all U.S. ART clinics, 91.9% (n = 449) reported offering PGS and/or PGD. Furthermore, 476 clinics responded to survey questions about sex selection practices. Of those ART clinics, 72.7% (n = 346) reported offering sex selection. More specifically among those clinics offering sex selection, 93.6% (n = 324) reported performing sex selection for family balancing, and 81.2% (n = 281) reported performing for elective purposes (patient preference, regardless of rationale for the request). For couples without infertility, 83.5% (n = 289) of clinics offer sex selection for family balancing and 74.6% (n = 258) for non-specific elective reasons. The majority of U.S. ART clinics offer non-medical sex selection, a percentage that has increased substantially since last reported in 2006.

Current opinion on auricular reconstruction.

PubMed

Sivayoham, Eason; Woolford, Tim J

2012-08-01

To review the current practice in the field of auricular reconstruction and to highlight the recent advances reported in the medical literature. The majority of surgeons who perform auricular reconstruction continue to employ the well-established techniques developed by Brent and Nagata. Surgery takes between two and four stages, with the initial stage being construction of a framework of autogenous rib cartilage which is implanted into a subcutaneous pocket. Several modifications of these techniques have been reported. More recently, synthetic frameworks have been employed instead of autogenous rib cartilage. For this procedure, the implant is generally covered with a temporoparietal flap and a skin graft at the first stage of surgery. Tissue engineering is a rapidly developing field, and there have been several articles related to the field of auricular reconstruction. These show great potential to offer a solution to the challenge associated with construction of a viable autogenous cartilage framework, whilst avoiding donor-site morbidity. This article gives an overview of the current practice in the field of auricular reconstruction and summarizes the recent surgical developments and relevant tissue engineering research.

The void in using urine concentration to assess population fluid intake adequacy or hydration status.

PubMed

Cheuvront, Samuel N; Muñoz, Colleen X; Kenefick, Robert W

2016-09-01

Urine concentration can be used to assess fluid intake adequacy or to diagnose dehydration. However, too often urine concentration is used inappropriately to draw dubious conclusions that could have harmful health and economic consequences. Inappropriate uses of urine concentration relate primarily to convenience sampling (timing) and problems related to convenience sampling (misapplication of thresholds), but a conceptual problem also exists with using urine concentration in isolation. The purpose of this Perspective article is to briefly explain the problematic nature of current practices and to offer a possible solution to improve practice with minimal added complication. When urine is used exclusively to assess fluid intake adequacy and hydration status in adults, we propose that only when urine concentration is high (>850 mmol/kg) and urine excretion rate is low (<850 mL/24 h) should suspicion of inadequate drinking or impending dehydration be considered. Prospective tests of the 850 × 850 thresholds will provide supporting evidence and/or help refine the best thresholds for men and women, young and old. © 2016 American Society for Nutrition.

Practical low-cost visual communication using binary images for deaf sign language.

PubMed

Manoranjan, M D; Robinson, J A

2000-03-01

Deaf sign language transmitted by video requires a temporal resolution of 8 to 10 frames/s for effective communication. Conventional videoconferencing applications, when operated over low bandwidth telephone lines, provide very low temporal resolution of pictures, of the order of less than a frame per second, resulting in jerky movement of objects. This paper presents a practical solution for sign language communication, offering adequate temporal resolution of images using moving binary sketches or cartoons, implemented on standard personal computer hardware with low-cost cameras and communicating over telephone lines. To extract cartoon points an efficient feature extraction algorithm adaptive to the global statistics of the image is proposed. To improve the subjective quality of the binary images, irreversible preprocessing techniques, such as isolated point removal and predictive filtering, are used. A simple, efficient and fast recursive temporal prefiltering scheme, using histograms of successive frames, reduces the additive and multiplicative noise from low-cost cameras. An efficient three-dimensional (3-D) compression scheme codes the binary sketches. Subjective tests performed on the system confirm that it can be used for sign language communication over telephone lines.

Competencies in Training at the Graduate Student Level: Example of a Pediatric Psychology Seminar Course

PubMed Central

Ievers-Landis, Carolyn E.; Hazen, Rebecca A.; Fehr, Karla K.

2015-01-01

The recently developed competencies in pediatric psychology from the Society of Pediatric Psychology (SPP) Task Force on Competencies and Best Training Practices in Pediatric Psychology provide a benchmark to evaluate training program practices and student progress toward training in level-specific competency goals. Graduate-level training presents a unique challenge for addressing the breadth of competencies required in pediatric psychology while maintaining development of broader clinical psychology training goals. We describe a recurring graduate-level pediatric psychology seminar course that addresses training in a number of the competency cluster areas. The structure of the seminar, examples of classroom topics that correspond with competency cluster areas as well as benchmarks used to evaluate each student’s development in the competency area are provided. Specific challenges in developing and maintaining the seminar in this format are identified, and possible solutions are offered. This training format could serve as a model for established pediatric psychology programs to expand their didactic training goals or for programs without formal pediatric psychology training to address competencies outside of clinical placements. PMID:26900536

A cross Canada survey of sperm banking practices in pediatric oncology centers.

PubMed

Chong, Amy Lee; Gupta, Abha; Punnett, Angela; Nathan, Paul C

2010-12-15

Childhood cancer survivors have identified fertility preservation as a major concern. Sperm banking is an established fertility preservation option in pubertal males. We sought to describe current practices in Canadian pediatric oncology programs, and to identify perceived barriers to sperm banking for male adolescents. A questionnaire was developed to (1) describe current sperm banking practices and facilities; (2) report on the utilization of sperm banking; and (3) identify barriers to sperm banking and possible solutions to improve current practices. A healthcare professional with an interest in fertility preservation within each institution was approached to participate in the study. Fifteen of 16 institutions participated, 2 have fertility preservation teams. Only one has written guidelines or adolescent focused educational material. Over 2 years, 50/262 (19%) adolescents in 12 institutions successfully banked a specimen. In 11 of these, additional information was available: of 85/172 (49%) adolescents offered the option to bank, 38/85 (45%) subsequently attempted. Reported barriers to sperm banking included the pressure to start therapy and restricted banking hours. Formal education of healthcare providers in fertility preservation practices, provision of financial support for families, and an adolescent focused approach were identified as important initiatives to improve sperm banking. There is a disparity in current sperm banking practices in Canada and at present, <25% of eligible male adolescents attempt to bank sperm. The development of a fertility preservation team, adolescent-specific guidelines, adolescent friendly sperm banking units, financial support, and improving knowledge translation among professionals and patients may improve the rates of banking. Copyright © 2010 Wiley-Liss, Inc.

Interprofessional Education and Practice Guide No. 6: Developing practice-based interprofessional learning using a short placement model.

PubMed

Anderson, Elizabeth Susan; Ford, Jenny; Kinnair, Daniel James

2016-07-01

Offering undergraduate and post-qualified learners opportunities to take part in, and reflect on, the nature of interprofessional working when in practice remains an important goal for interprofessional educators. There are a plethora of opportunities within hospital and community care for learners to actively participate in health and social care delivery where collaborative practice prevails. However, it remains challenging to know how to establish and sustain meaningful interprofessional practice-based learning. This is because profession-specific teaching is prioritised and many teams are under-resourced, leaving little time for additional teaching activities. In some instances, practitioners lack the knowledge concerning how to design meaningful interprofessional learning and often feel unprepared for this teaching because of limited interprofessional faculty development. Others are simply unaware of the presence of the different students within their practice area. This guide offers key lessons developed over many years for setting up practice-based interprofessional education. The learning model has been adapted and adopted in different settings and countries and offers a method for engaging clinical front-line practitioners in learning with, and from learners who can help support and in some instances advance care delivery.

The effect of explanations on mathematical reasoning tasks

NASA Astrophysics Data System (ADS)

Norqvist, Mathias

2018-01-01

Studies in mathematics education often point to the necessity for students to engage in more cognitively demanding activities than just solving tasks by applying given solution methods. Previous studies have shown that students that engage in creative mathematically founded reasoning to construct a solution method, perform significantly better in follow up tests than students that are given a solution method and engage in algorithmic reasoning. However, teachers and textbooks, at least occasionally, provide explanations together with an algorithmic method, and this could possibly be more efficient than creative reasoning. In this study, three matched groups practiced with either creative, algorithmic, or explained algorithmic tasks. The main finding was that students that practiced with creative tasks did, outperform the students that practiced with explained algorithmic tasks in a post-test, despite a much lower practice score. The two groups that got a solution method presented, performed similarly in both practice and post-test, even though one group got an explanation to the given solution method. Additionally, there were some differences between the groups in which variables predicted the post-test score.

Graphing as a Problem-Solving Strategy.

ERIC Educational Resources Information Center

Cohen, Donald

1984-01-01

The focus is on how line graphs can be used to approximate solutions to rate problems and to suggest equations that offer exact algebraic solutions to the problem. Four problems requiring progressively greater graphing sophistication are presented plus four exercises. (MNS)

Re-defining nursing expertise in the United kingdom.

PubMed

Hardy, Sally; Titchen, Angie; Manley, Kim; McCormack, Brendan

2006-07-01

There is now international recognition of the importance of practice expertise in modern and effective health services. The Expertise in Practice Project in the United Kingdom began in May 1998 and continued to 2004. It included nurses working in all four countries of the United Kingdom, and it covered clinical specialists from pediatrics to palliative care. The project added to the current understanding of what nursing practice expertise is, through the identification and verification of attributes and factors which enable expert practice. The proposed framework offers a language for sharing what constitutes practice expertise and offers insight into what occurs between the expert practitioner and the people that experience their care. The Expertise in Practice Project demonstrates that nurses affect change and facilitate performance and organizational development.

Learner Centered Teaching: Putting the Research on Learning into Practice

ERIC Educational Resources Information Center

Doyle, Terry

2011-01-01

This book presents the research-based case that Learner Centered Teaching (LCT) offers the best means to optimize student learning in college, and offers examples and ideas for putting it into practice, as well the underlying rationale. It also starts from the premise that many faculty are much closer to being learner centered teachers than they…

12 CFR 16.32 - Fraudulent transactions and unsafe and unsound practices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... operates as a fraud or deceit upon any person, in connection with the purchase or sale of any security of a... SECURITIES OFFERING DISCLOSURE RULES § 16.32 Fraudulent transactions and unsafe and unsound practices. (a) No person in the offer or sale of bank securities shall directly or indirectly: (1) Employ any device...

The Practice of Academic Administration: Internships in Higher Education Programs. ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Foster, Lenoar; Ward, Kelly

Existing research reveals little about the availability of internships for graduate students in higher education, and also fails to explain the utilization of these internship offerings. The findings from this study suggest that while a majority of programs in higher education have some type of practice-based offerings in their curricula,…

16 CFR Appendix A to Part 436 - Sample Item 10 Table-Summary of Financing Offered

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Sample Item 10 Table-Summary of Financing Offered A Appendix A to Part 436 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES DISCLOSURE REQUIREMENTS AND PROHIBITIONS CONCERNING FRANCHISING Pt. 436, App. A Appendix A to Part 436—Sample...

Evaluation of community pharmacy service mix: evidence from the 2004 National Pharmacist Workforce Study.

PubMed

Doucette, William R; Kreling, David H; Schommer, Jon C; Gaither, Caroline A; Mott, David A; Pedersen, Craig A

2006-01-01

To describe the mix of pharmacy services being offered in different types of community pharmacy practices and to identify factors associated with a community pharmacy offering pharmacy services. Cross-sectional study. Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies). Pharmacists practicing full-time or part-time who worked in community pharmacies and responded to the 2004 National Pharmacist Workforce Survey. Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled pharmacists and supplemental surveys that included workplace questions for a selected subsample of pharmacists. Type and frequency of pharmacy services being offered in a community pharmacy, including dispensing and product-related services (e.g., specialty compounding), and pharmacist care services (e.g., immunizations, smoking cessation, health screening, medication therapy management, wellness screening, nutritional support, and disease management services). Four pharmacist care services were reported as being offered at more than 10% of community pharmacy practices: immunizations, smoking cessation, health screening, and diabetes management. The number of pharmacist care services offered at a community pharmacy was positively associated with having at least three pharmacists on duty, innovativeness of the pharmacy, status as an independent pharmacy, and status as a supermarket pharmacy. More than one half of the community pharmacy practices did not offer any of the eight pharmacist care services included in a pharmacy service index. Pharmacy services were reported at relatively few community pharmacies, and were associated with pharmacy innovativeness, pharmacist staffing levels, and pharmacy setting. Some community pharmacies are offering pharmacy services as part of their business strategy, while others are dedicated to dispensing services. Continued study of pharmacy service availability in community pharmacies is needed to improve our understanding of our capacity to deliver such services, including medication therapy management services.

Reducing social inequities in health through settings-related interventions -- a conceptual framework.

PubMed

Shareck, Martine; Frohlich, Katherine L; Poland, Blake

2013-06-01

The creation of supportive environments for health is a basic action principle of health promotion, and equity is a core value. A settings approach offers an opportunity to bridge these two, with its focus on the interplay between individual, environmental and social determinants of health. We conducted a scoping review of the literature on theoretical bases and practical applications of the settings approach. Interventions targeting social inequities in health through action on various settings were analyzed to establish what is done in health equity research and action as it relates to settings. Four elements emerged as central to an equity-focused settings approach: a focus on social determinants of health, addressing the needs of marginalized groups, effecting change in a setting's structure, and involving stakeholders. Each came with related challenges. To offer potential solutions to these challenges we developed a conceptual framework that integrates theoretical and methodological approaches, along with six core guiding principles, into a 'settings praxis'. Reducing social inequities in health through the creation of supportive environments requires the application of the settings approach in an innovative way. The proposed conceptual framework can serve as a guide to do so, and help develop, implement and evaluate equity-focused settings-related interventions.

[Application of fluid mechanics and simulation: urinary tract and ureteral catheters.

PubMed

Gómez-Blanco, J C; Martínez-Reina, J; Cruz, D; Blas Pagador, J; Sánchez-Margallo, F M; Soria, F

2016-10-01

The mechanics of urine during its transport from the renal pelvis to the bladder is of great interest for urologists. The knowledge of the different physical variables and their interrelationship, both in physiologic movements and pathologies, will help a better diagnosis and treatment. The objective of this chapter is to show the physics principles and their most relevant basic relations in urine transport, and to bring them over the clinical world. For that, we explain the movement of urine during peristalsis, ureteral obstruction and in a ureter with a stent. This explanation is based in two tools used in bioengineering: the theoretical analysis through the Theory of concontinuous media and Ffluid mechanics and computational simulation that offers a practical solution for each scenario. Moreover, we review other contributions of bioengineering to the field of Urology, such as physical simulation or additive and subtractive manufacturing techniques. Finally, we list the current limitations for these tools and the technological development lines with more future projection. In this chapter we aim to help urologists to understand some important concepts of bioengineering, promoting multidisciplinary cooperation to offer complementary tools that help in diagnosis and treatment of diseases.

It's not maths; it's science: exploring thinking dispositions, learning thresholds and mindfulness in science learning

NASA Astrophysics Data System (ADS)

Quinnell, R.; Thompson, R.; LeBard, R. J.

2013-09-01

Developing quantitative skills, or being academically numerate, is part of the curriculum agenda in science teaching and learning. For many of our students, being asked to 'do maths' as part of 'doing science' leads to disengagement from learning. Notions of 'I can't do maths' speak of a rigidity of mind, a 'standoff', forming a barrier to learning in science that needs to be addressed if we, as science educators, are to offer solutions to the so-called 'maths problem' and to support students as they move from being novice to expert. Moving from novice to expert is complex and we lean on several theoretical frameworks (thinking dispositions, threshold concepts and mindfulness in learning) to characterize this pathway in science, with a focus on quantitative skills. Fluid thinking and application of numeracy skills are required to manipulate experimental data sets and are integral to our science practice; we need to stop students from seeing them as optional 'maths' or 'statistics' tasks within our discipline. Being explicit about the ways those in the discipline think, how quantitative data is processed, and allowing places for students to address their skills (including their confidence) offer some ways forward.

Proceedings of the Hydrokinetic and Wave Energy Technologies Technical and Environmental Issues Workshop

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

None

2006-03-01

Renewable energy technologies offer the promise of non-polluting alternatives to fossil and nuclear-fueled power plants to meet growing demand for electrical energy. Two emerging categories of renewable energy technologies, hydrokinetic and wave energy conversion devices, offer ways to tap the energy of moving water without impoundment (dams) or diversion required by many conventional hydroelectric facilities. These technologies include devices designed for deployment in natural streams, tidal estuaries, ocean currents, and constructed waterways, as well as devices designed to capture the energy of ocean waves. On October 26-28, 2005, 54 representatives from government, non-governmental organizations, and private business met to (1)more » identify the varieties of hydrokinetic energy and wave technology devices, their stages of development, and the projected cost to bring each to market; (2) identify where these technologies can best operate; (3) identify the potential environmental issues associated with these technologies and possible mitigation measures; (4) develop a list of research needs and/or practical solutions to address unresolved environmental issues. These workshop proceedings include detailed summaries of the 24 presentations made and the discussions that followed.« less

The Role for Virtual Patients in the Future of Medical Education.

PubMed

Berman, Norman B; Durning, Steven J; Fischer, Martin R; Huwendiek, Soren; Triola, Marc M

2016-09-01

The medical education community is working-across disciplines and across the continuum-to address the current challenges facing the medical education system and to implement strategies to improve educational outcomes. Educational technology offers the promise of addressing these important challenges in ways not previously possible. The authors propose a role for virtual patients (VPs), which they define as multimedia, screen-based interactive patient scenarios. They believe VPs offer capabilities and benefits particularly well suited to addressing the challenges facing medical education. Well-designed, interactive VP-based learning activities can promote the deep learning that is needed to handle the rapid growth in medical knowledge. Clinically oriented learning from VPs can capture intrinsic motivation and promote mastery learning. VPs can also enhance trainees' application of foundational knowledge to promote the development of clinical reasoning, the foundation of medical practice. Although not the entire solution, VPs can support competency-based education. The data created by the use of VPs can serve as the basis for multi-institutional research that will enable the medical education community both to better understand the effectiveness of educational interventions and to measure progress toward an improved system of medical education.

Blended E-learning in a Web-based virtual hospital: a useful tool for undergraduate education in urology.

PubMed

Horstmann, M; Renninger, M; Hennenlotter, J; Horstmann, C C; Stenzl, A

2009-08-01

E-learning is a teaching tool used successfully in many medical subspecialties. Experience with its use in urology, however, is scarce. We present our teaching experience with the INMEDEA simulator to teach urological care to medical students. The INMEDEA simulator is an interactive e-learning system built around a virtual hospital which includes a department of urology. It allows students to solve virtual patient cases online. In this study, students were asked to prepare two urological cases prior to discussion of the cases in small groups. This blended teaching approach was evaluated by students through anonymous questionnaires. Of 70 4th year medical students 76% judged this teaching method as good or very good. Eighty-seven percent felt that it offered a good way to understand urological diseases better and 72% felt that learning with this method was fun. Nevertheless, 30 out of 70 free text statements revealed that further improvements of the program, including an easier and more comfortable navigation and a faster supply of information are necessary. Virtual patient cases offer a practicable solution for teaching based on problem solving in urology with a high acceptance rate by students.

17 CFR 240.14e-1 - Unlawful tender offer practices.

Code of Federal Regulations, 2010 CFR

2010-04-01

... holders; provided, however, that if the tender offer involves a roll-up transaction as defined in Item 901... section. (d) Extend the length of a tender offer without issuing a notice of such extension by press...

17 CFR 240.14e-1 - Unlawful tender offer practices.

Code of Federal Regulations, 2011 CFR

2011-04-01

... holders; provided, however, that if the tender offer involves a roll-up transaction as defined in Item 901... section. (d) Extend the length of a tender offer without issuing a notice of such extension by press...

Youth Mental Health, Family Practice, and Knowledge Translation Video Games about Psychosis: Family Physicians’ Perspectives

PubMed Central

Ferrari, Manuela; Suzanne, Archie

2017-01-01

Objective Family practitioners face many challenges providing mental healthcare to youth. Digital technology may offer solutions, but the products often need to be adapted for primary care. This study reports on family physicians’ perspectives on the relevance and feasibility of a digital knowledge translation (KT) tool, a set of video games, designed to raise awareness about psychosis, marijuana use, and facilitate access to mental health services among youth. Method As part of an integrated knowledge translation project, five family physicians from a family health team participated in a focus group. The focus group delved into their perspectives on treating youth with mental health concerns while exploring their views on implementing the digital KT tool in their practice. Qualitative data was analyzed using thematic analysis to identify patterns, concepts, and themes in the transcripts. Results Three themes were identified: (a) challenges in assessing youth with mental health concerns related to training, time constraints, and navigating the system; (b) feedback on the KT tool; and, (c) ideas on how to integrate it into a primary care practice. Conclusions Family practitioners felt that the proposed video game KT tool could be used to address youth’s mental health and addictions issues in primary care settings. PMID:29056980

Real-time distributed video coding for 1K-pixel visual sensor networks

NASA Astrophysics Data System (ADS)

Hanca, Jan; Deligiannis, Nikos; Munteanu, Adrian

2016-07-01

Many applications in visual sensor networks (VSNs) demand the low-cost wireless transmission of video data. In this context, distributed video coding (DVC) has proven its potential to achieve state-of-the-art compression performance while maintaining low computational complexity of the encoder. Despite their proven capabilities, current DVC solutions overlook hardware constraints, and this renders them unsuitable for practical implementations. This paper introduces a DVC architecture that offers highly efficient wireless communication in real-world VSNs. The design takes into account the severe computational and memory constraints imposed by practical implementations on low-resolution visual sensors. We study performance-complexity trade-offs for feedback-channel removal, propose learning-based techniques for rate allocation, and investigate various simplifications of side information generation yielding real-time decoding. The proposed system is evaluated against H.264/AVC intra, Motion-JPEG, and our previously designed DVC prototype for low-resolution visual sensors. Extensive experimental results on various data show significant improvements in multiple configurations. The proposed encoder achieves real-time performance on a 1k-pixel visual sensor mote. Real-time decoding is performed on a Raspberry Pi single-board computer or a low-end notebook PC. To the best of our knowledge, the proposed codec is the first practical DVC deployment on low-resolution VSNs.

Polarimetry With Phased Array Antennas: Theoretical Framework and Definitions

NASA Astrophysics Data System (ADS)

Warnick, Karl F.; Ivashina, Marianna V.; Wijnholds, Stefan J.; Maaskant, Rob

2012-01-01

For phased array receivers, the accuracy with which the polarization state of a received signal can be measured depends on the antenna configuration, array calibration process, and beamforming algorithms. A signal and noise model for a dual-polarized array is developed and related to standard polarimetric antenna figures of merit, and the ideal polarimetrically calibrated, maximum-sensitivity beamforming solution for a dual-polarized phased array feed is derived. A practical polarimetric beamformer solution that does not require exact knowledge of the array polarimetric response is shown to be equivalent to the optimal solution in the sense that when the practical beamformers are calibrated, the optimal solution is obtained. To provide a rough initial polarimetric calibration for the practical beamformer solution, an approximate single-source polarimetric calibration method is developed. The modeled instrumental polarization error for a dipole phased array feed with the practical beamformer solution and single-source polarimetric calibration was -10 dB or lower over the array field of view for elements with alignments perturbed by random rotations with 5 degree standard deviation.

What is professionalism? A training tool for the medical practice staff.

PubMed

Hills, Laura Sachs

2007-01-01

We all recognize and appreciate professionalism when we see it. However, it is not crystal clear to everyone what makes an individual's behavior professional. This article explores professionalism specifically for medical practice employees. It suggests that acting professionally is much more than simply being paid to do a job. It defines professionalism by offering 15 core competencies and character traits for medical practice employee professionalism. This article also describes the tangible and intangible benefits of professionalism for medical practice employees and offers guidelines for increasing one's own professionalism. Finally, this article includes a self-quiz for medical practice employees to evaluate their own professionalism and pinpoint areas for improvement and growth.

45 CFR 81.85 - Offer of proof.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Offer of proof. 81.85 Section 81.85 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PRACTICE AND PROCEDURE FOR HEARINGS UNDER PART 80 OF THIS TITLE Hearing Procedures § 81.85 Offer of proof. An offer of proof made in connection with...

45 CFR 81.85 - Offer of proof.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Offer of proof. 81.85 Section 81.85 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PRACTICE AND PROCEDURE FOR HEARINGS UNDER PART 80 OF THIS TITLE Hearing Procedures § 81.85 Offer of proof. An offer of proof made in connection with...

Sociomateriality in medical practice and learning: attuning to what matters.

PubMed

Fenwick, Tara

2014-01-01

In current debates about professional practice and education, increasing emphasis is placed on understanding learning as a process of ongoing participation rather than one of acquiring knowledge and skills. However, although this socio-cultural view is important and useful, issues have emerged in studies of practice-based learning that point to certain oversights. Three issues are described here: (i) the limited attention paid to the importance of materiality - objects, technologies, nature, etc.-- in questions of learning; (ii) the human-centric view of practice that fails to note the relations among social and material forces, and (iii) the conflicts between ideals of evidence-based standardised models and the sociomaterial contingencies of clinical practice. It is argued here that a socio-material approach to practice and learning offers important insights for medical education. This view is in line with a growing field of research in the materiality of everyday life, which embraces wide-ranging families of theory that can be only briefly mentioned in this short paper. The main premise they share is that social and material forces, culture, nature and technology, are enmeshed in everyday practice. Objects and humans act upon one another in ways that mutually transform their characteristics and activity. Examples from research in medical practice show how materials actively influence clinical practice, how learning itself is a material matter, how protocols are in fact temporary sociomaterial achievements, and how practices form unique and sometimes conflicting sociomaterial worlds, with diverse diagnostic and treatment approaches for the same thing. This discussion concludes with implications for learning in practice. What is required is a shift from an emphasis on acquiring knowledge to participating more wisely in particular situations. This focus is on learning how to attune to minor material fluctuations and surprises, how to track one's own and others' effects on 'intra-actions' and emerging effects, and how to improvise solutions. © 2013 John Wiley & Sons Ltd.

Logical gaps in the approximate solutions of the social learning game and an exact solution.

PubMed

Dai, Wenjie; Wang, Xin; Di, Zengru; Wu, Jinshan

2014-01-01

After the social learning models were proposed, finding solutions to the games becomes a well-defined mathematical question. However, almost all papers on the games and their applications are based on solutions built either upon an ad-hoc argument or a twisted Bayesian analysis of the games. Here, we present logical gaps in those solutions and offer an exact solution of our own. We also introduce a minor extension to the original game so that not only logical differences but also differences in action outcomes among those solutions become visible.

The block adaptive multigrid method applied to the solution of the Euler equations

NASA Technical Reports Server (NTRS)

Pantelelis, Nikos

1993-01-01

In the present study, a scheme capable of solving very fast and robust complex nonlinear systems of equations is presented. The Block Adaptive Multigrid (BAM) solution method offers multigrid acceleration and adaptive grid refinement based on the prediction of the solution error. The proposed solution method was used with an implicit upwind Euler solver for the solution of complex transonic flows around airfoils. Very fast results were obtained (18-fold acceleration of the solution) using one fourth of the volumes of a global grid with the same solution accuracy for two test cases.

Understanding facilitators and barriers to reengineering the clinical research enterprise in community-based practice settings.

PubMed

Kukafka, Rita; Allegrante, John P; Khan, Sharib; Bigger, J Thomas; Johnson, Stephen B

2013-09-01

Solutions are employed to support clinical research trial tasks in community-based practice settings. Using the IT Implementation Framework (ITIF), an integrative framework intended to guide the synthesis of theoretical perspectives for planning multi-level interventions to enhance IT use, we sought to understand the barriers and facilitators to clinical research in community-based practice settings preliminary to implementing new informatics solutions for improving clinical research infrastructure. The studies were conducted in practices within the Columbia University Clinical Trials Network. A mixed-method approach, including surveys, interviews, time-motion studies, and observations was used. The data collected, which incorporates predisposing, enabling, and reinforcing factors in IT use, were analyzed according to each phase of ITIF. Themes identified in the first phase of ITIF were 1) processes and tools to support clinical trial research and 2) clinical research peripheral to patient care processes. Not all of the problems under these themes were found to be amenable to IT solutions. Using the multi-level orientation of the ITIF, we set forth strategies beyond IT solutions that can have an impact on reengineering clinical research tasks in practice-based settings. Developing strategies to target enabling and reinforcing factors, which focus on organizational factors, and the motivation of the practice at large to use IT solutions to integrate clinical research tasks with patient care processes, is most challenging. The ITIF should be used to consider both IT and non-IT solutions concurrently for reengineering of clinical research in community-based practice settings. © 2013.

Dynamics as a 'Red Flag' in Exoplanetary Science

NASA Astrophysics Data System (ADS)

Horner, Jonathan; Wittenmyer, Robert

2018-01-01

The great majority of exoplanets are discovered indirectly - by observing a star doing something unusual, and inferring the presence of planets from that behaviour. The nature of those planets - their mass and their orbital parameters - is typically somewhat unclear, with a variety of different scenarios offering equally good fits to the observational data.Typically, authors publish the solution that offers the best fit to the data, without considering the degree to which the planets propsed would interact with one another. This has led to the 'discovery' of planetary systems that are clearly unfeasible - and it is likely that a number of such systems are buried in the catalogue of 'confirmed' exoplanets.Fortunately, there is a solution to this problem. By carrying out suites of n-body integrations of proposed planetary systems, we can find solutions that both offer a good fit to the observational data and the long-term dynamical stability required to give confidence that the planets proposed are truly all they seem.Here, we present the results from a number of such dynamical studies, showing the importance of such simulations to the process of exoplanet discovery and characterisation.

Clinical and Translational Science Awards: can they increase the efficiency and speed of clinical and translational research?

PubMed

Heller, Caren; de Melo-Martín, Inmaculada

2009-04-01

Most agree that the recent decades-long boom in biomedical research discoveries has not had a sufficient effect on the public's health. To overcome some of the barriers to speeding clinical and translational (C/T) research, the National Institutes of Health has established the Institutional Clinical and Translational Science Award (CTSA). To explore whether the CTSA proposal addresses major C/T barriers and whether funded institutions offer adequate solutions, the authors reviewed the obstacles to C/T research described in the literature and examined the completeness of the solutions offered by the 12 initial CTSA awardees. Through an analysis of the literature, the authors categorized C/T barriers into three categories (research workforce, research operations, and organizational silos). They then analyzed each CTSA proposal regarding the types of programs offered to address these barriers. They found that, in general, institutions developed detailed programs to address research workforce and research operations barriers but had limited to no solutions for organizational silos. The authors suggest that differences in how barriers are addressed are consistent with the degree of control that CTSA centers have over these obstacles and solutions. They argue that although CTSA centers might have an important role in successfully addressing some of the barriers to C/T research, CTSA centers might ultimately have difficulties achieving their purported goal of facilitating and increasing the efficiency and speed of C/T research because of a lack of control over solutions to some important obstacles facing such research.

Nature-based agricultural solutions: Scaling perennial grains across Africa.

PubMed

Peter, Brad G; Mungai, Leah M; Messina, Joseph P; Snapp, Sieglinde S

2017-11-01

Modern plant breeding tends to focus on maximizing yield, with one of the most ubiquitous implementations being shorter-duration crop varieties. It is indisputable that these breeding efforts have resulted in greater yields in ideal circumstances; however, many farmed locations across Africa suffer from one or more conditions that limit the efficacy of modern short-duration hybrids. In view of global change and increased necessity for intensification, perennial grains and long-duration varieties offer a nature-based solution for improving farm productivity and smallholder livelihoods in suboptimal agricultural areas. Specific conditions where perennial grains should be considered include locations where biophysical and social constraints reduce agricultural system efficiency, and where conditions are optimal for crop growth. Using a time-series of remotely-sensed data, we locate the marginal agricultural lands of Africa, identifying suboptimal temperature and precipitation conditions for the dominant crop, i.e., maize, as well as optimal climate conditions for two perennial grains, pigeonpea and sorghum. We propose that perennial grains offer a lower impact, sustainable nature-based solution to this subset of climatic drivers of marginality. Using spatial analytic methods and satellite-derived climate information, we demonstrate the scalability of perennial pigeonpea and sorghum across Africa. As a nature-based solution, we argue that perennial grains offer smallholder farmers of marginal lands a sustainable solution for enhancing resilience and minimizing risk in confronting global change, while mitigating social and edaphic drivers of low and variable production. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Voluntary community service in medical school: a qualitative study on obstacles faced by student leaders and potential solutions

PubMed Central

Loh, Alvona Zi Hui; Tan, Julia Shi Yu; Lee, Jeannette Jen-Mai; Koh, Gerald Choon-Huat

2015-01-01

Purpose In medical school, students may participate in various community involvement projects (CIP), which serve disadvantaged communities. However, several obstacles may arise during these projects. The authors conducted a qualitative study with the primary aim of understanding the obstacles and corresponding potential solutions when medical students in Singapore participate in local CIP (LCIP) and overseas CIP (OCIP). Design The authors recruited medical students from Yong Loo Lin School of Medicine, National University of Singapore, who were also leaders of a specific community service project done in medical school. Twelve one-to-one interviews were held for the participants from 6 to 8 January 2013. Participants were led in a discussion based on an interview guide. The interviews were audio-recorded and transcribed into free-flow text. Subsequently, content and thematic analyses of the transcripts were performed independently by three researchers. Results The medical students faced many common obstacles during their community service projects. These obstacles include difficulties in recruiting and managing volunteers, attaining recognition or credibility for the project to acquire funding and resources, adjusting to a different culture or language, setting goals, and facing project-specific obstacles. Potential solutions were offered for some obstacles, such as building a strong executive committee for the project, grooming successive batches of leaders, and improving the project's public image, mentorship, reflections, and sustainability plans. Conclusions Mentorship, reflections, and sustainability are potential solutions that have been proposed to tackle the obstacles faced during community service participation in medical school. However, there may still be difficulty in solving some of the problems even after these measures are put into practice. Future research may focus on evaluating the effectiveness of these suggested solutions. PMID:26490690

Voluntary community service in medical school: a qualitative study on obstacles faced by student leaders and potential solutions.

PubMed

Loh, Alvona Zi Hui; Tan, Julia Shi Yu; Lee, Jeannette Jen-Mai; Koh, Gerald Choon-Huat

2015-01-01

In medical school, students may participate in various community involvement projects (CIP), which serve disadvantaged communities. However, several obstacles may arise during these projects. The authors conducted a qualitative study with the primary aim of understanding the obstacles and corresponding potential solutions when medical students in Singapore participate in local CIP (LCIP) and overseas CIP (OCIP). The authors recruited medical students from Yong Loo Lin School of Medicine, National University of Singapore, who were also leaders of a specific community service project done in medical school. Twelve one-to-one interviews were held for the participants from 6 to 8 January 2013. Participants were led in a discussion based on an interview guide. The interviews were audio-recorded and transcribed into free-flow text. Subsequently, content and thematic analyses of the transcripts were performed independently by three researchers. The medical students faced many common obstacles during their community service projects. These obstacles include difficulties in recruiting and managing volunteers, attaining recognition or credibility for the project to acquire funding and resources, adjusting to a different culture or language, setting goals, and facing project-specific obstacles. Potential solutions were offered for some obstacles, such as building a strong executive committee for the project, grooming successive batches of leaders, and improving the project's public image, mentorship, reflections, and sustainability plans. Mentorship, reflections, and sustainability are potential solutions that have been proposed to tackle the obstacles faced during community service participation in medical school. However, there may still be difficulty in solving some of the problems even after these measures are put into practice. Future research may focus on evaluating the effectiveness of these suggested solutions.

Quantum Heterogeneous Computing for Satellite Positioning Optimization

NASA Astrophysics Data System (ADS)

Bass, G.; Kumar, V.; Dulny, J., III

2016-12-01

Hard optimization problems occur in many fields of academic study and practical situations. We present results in which quantum heterogeneous computing is used to solve a real-world optimization problem: satellite positioning. Optimization problems like this can scale very rapidly with problem size, and become unsolvable with traditional brute-force methods. Typically, such problems have been approximately solved with heuristic approaches; however, these methods can take a long time to calculate and are not guaranteed to find optimal solutions. Quantum computing offers the possibility of producing significant speed-up and improved solution quality. There are now commercially available quantum annealing (QA) devices that are designed to solve difficult optimization problems. These devices have 1000+ quantum bits, but they have significant hardware size and connectivity limitations. We present a novel heterogeneous computing stack that combines QA and classical machine learning and allows the use of QA on problems larger than the quantum hardware could solve in isolation. We begin by analyzing the satellite positioning problem with a heuristic solver, the genetic algorithm. The classical computer's comparatively large available memory can explore the full problem space and converge to a solution relatively close to the true optimum. The QA device can then evolve directly to the optimal solution within this more limited space. Preliminary experiments, using the Quantum Monte Carlo (QMC) algorithm to simulate QA hardware, have produced promising results. Working with problem instances with known global minima, we find a solution within 8% in a matter of seconds, and within 5% in a few minutes. Future studies include replacing QMC with commercially available quantum hardware and exploring more problem sets and model parameters. Our results have important implications for how heterogeneous quantum computing can be used to solve difficult optimization problems in any field.

Integrated primary health care: Finnish solutions and experiences

PubMed Central

Kokko, Simo

2009-01-01

Background Finland has since 1972 had a primary health care system based on health centres run and funded by the local public authorities called ‘municipalities’. On the world map of primary health care systems, the Finnish solution claims to be the most health centre oriented and also the widest, both in terms of the numbers of staff and also of different professions employed. Offering integrated care through multi-professional health centres has been overshadowed by exceptional difficulties in guaranteeing a reasonable access to the population at times when they need primary medical or dental services. Solutions to the problems of access have been found, but they do not seem durable. Description of policy practice During the past 10 years, the health centres have become a ground of active development structural change, for which no end is in sight. Broader issues of municipal and public administration structures are being solved through rearranging primary health services. In these rearrangements, integration with specialist services and with social services together with mergers of health centres and municipalities are occurring at an accelerated pace. This leads into fundamental questions of the benefits of integration, especially if extensive integration leads into the threat of the loss of identity for primary health care. Discussion This article ends with some lessons to be learned from the situation in Finland for other countries. PMID:19590612

Dynamic Consent: a potential solution to some of the challenges of modern biomedical research.

PubMed

Budin-Ljøsne, Isabelle; Teare, Harriet J A; Kaye, Jane; Beck, Stephan; Bentzen, Heidi Beate; Caenazzo, Luciana; Collett, Clive; D'Abramo, Flavio; Felzmann, Heike; Finlay, Teresa; Javaid, Muhammad Kassim; Jones, Erica; Katić, Višnja; Simpson, Amy; Mascalzoni, Deborah

2017-01-25

Innovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment. An interdisciplinary workshop jointly organised by the University of Oxford and the COST Action CHIP ME gathered clinicians, researchers, ethicists, lawyers, research participants and patient representatives to discuss experiences of using Dynamic Consent, and how such use may facilitate the conduct of specific research tasks. The data collected during the workshop were analysed using a content analysis approach. Dynamic Consent can provide practical, sustainable and future-proof solutions to challenges related to participant recruitment, the attainment of informed consent, participant retention and consent management, and may bring economic efficiencies. Dynamic Consent offers opportunities for ongoing communication between researchers and research participants that can positively impact research. Dynamic Consent supports inter-sector, cross-border approaches and large scale data-sharing. Whilst it is relatively easy to set up and maintain, its implementation will require that researchers re-consider their relationship with research participants and adopt new procedures.

Male Cross-Dressers in Therapy: A Solution-Focused Perspective for Marriage and Family Therapists.

ERIC Educational Resources Information Center

Dzelme, Kristina; Jones, Rene A.

2001-01-01

Offers techniques on how to work with male cross-dressers using solution focused therapy. Solution focused therapy is discussed as a way to work with male cross dressers and their partners. A case study of a male cross dresser and his wife is presented and possible directions are suggested for marriage and family therapists. (BF)

Behavioral medicine as a part of a comprehensive small animal medical program.

PubMed

Burghardt, W F

1991-03-01

The rationale of incorporating behavioral medicine into veterinary practice is that it can expand the range of medical services offered, help obtain happier, more acceptable pets, and lead to longer pet ownership. In doing so, veterinarians should be able to increase their business both through an actual increase in pet ownership and retention and through increased services for individual pets. The range of services offered can differ from practice to practice but may include preventive, interventive, and ancillary services, as with other areas in contemporary veterinary medical practice. Each area of behavioral practice can be an economically feasible addition to veterinary practice from the perspective of medical services rendered, as a method of practice promotion, or as an area of public service. The choice depends on the level of competence of the practitioner, the practice philosophy, and the need for the services in a given service area.

Obstetrician-gynecologist physicians’ beliefs about emergency contraception: A national survey

PubMed Central

Lawrence, Ryan E; Rasinski, Kenneth A; Yoon, John D; Curlin, Farr A

2010-01-01

Background Although emergency contraception (EC) is available without a prescription, women still rely on doctors’ advice about its safety and effectiveness. Yet little is known about doctors’ beliefs and practices in this area. Study Design We surveyed 1800 US obstetrician-gynecologists. Criterion variables were doctors’ beliefs about EC’s effects on pregnancy rates, and patients’ sexual practices. We also asked which women are offered EC. Predictors were demographic, clinical, and religious characteristics. Results Response rate 66% (1154/1760). Most (89%) believe EC access lowers unintended pregnancy rates. Some believe women use other contraceptives less (27%), initiate sex at younger ages (12%), and have more sexual partners (15%). Half of physicians offer EC to all women (51%), while others offer it never (6%) or only after sexual assault (6%). Physicians critical of EC, males, and religious physicians were more likely to offer it never or only after sexual assault (odds ratios 2.1–12). Conclusion Gender, religion, and divergent beliefs about EC’s effects shape physicians’ beliefs and practices. PMID:20851225

Creating environments that foster academic integrity.

PubMed

Tippitt, Michelle Pixley; Ard, Nell; Kline, Juanita Reese; Tilghman, Joan; Chamberlain, Barbara; Meagher, P Gail

2009-01-01

A number of studies related to academic dishonesty within the nursing student population have been published; however, little has been written in the nursing literature regarding academic integrity and means of promoting this value. In addition to the many short-term solutions to prevent cheating and dissuade academic misconduct that are offered, solutions that promote long-term affective changes underlying the acquisition of academic integrity are needed. This article provides a context for discussions related to academic integrity, explores issues facing faculty when dealing with this challenge, and offers short-term and long-term strategies for creating environments that foster academic integrity.

Choosing a CD-ROM Network Solution.

ERIC Educational Resources Information Center

Doering, David

1996-01-01

Discusses issues to consider in selecting a CD-ROM network solution, including throughput (speed of data delivery), security, access, servers, key features, training, jukebox support, documentation, and licenses. Reviews software products offered by Novell, Around Technology, Micro Design, Smart Storage, Microtest, Meridian, CD-Connection,…

Symmetry restoration and quantumness reestablishment.

PubMed

Zeng, Guo-Mo; Wu, Lian-Ao; Xing, Hai-Jun

2014-09-18

A realistic quantum many-body system, characterized by a generic microscopic Hamiltonian, is accessible only through approximation methods. The mean field theories, as the simplest practices of approximation methods, commonly serve as a powerful tool, but unfortunately often violate the symmetry of the Hamiltonian. The conventional BCS theory, as an excellent mean field approach, violates the particle number conservation and completely erases quantumness characterized by concurrence and quantum discord between different modes. We restore the symmetry by using the projected BCS theory and the exact numerical solution and find that the lost quantumness is synchronously reestablished. We show that while entanglement remains unchanged with the particle numbers, quantum discord behaves as an extensive quantity with respect to the system size. Surprisingly, discord is hardly dependent on the interaction strengths. The new feature of discord offers promising applications in modern quantum technologies.

Gradient Calculation Methods on Arbitrary Polyhedral Unstructured Meshes for Cell-Centered CFD Solvers

NASA Technical Reports Server (NTRS)

Sozer, Emre; Brehm, Christoph; Kiris, Cetin C.

2014-01-01

A survey of gradient reconstruction methods for cell-centered data on unstructured meshes is conducted within the scope of accuracy assessment. Formal order of accuracy, as well as error magnitudes for each of the studied methods, are evaluated on a complex mesh of various cell types through consecutive local scaling of an analytical test function. The tests highlighted several gradient operator choices that can consistently achieve 1st order accuracy regardless of cell type and shape. The tests further offered error comparisons for given cell types, leading to the observation that the "ideal" gradient operator choice is not universal. Practical implications of the results are explored via CFD solutions of a 2D inviscid standing vortex, portraying the discretization error properties. A relatively naive, yet largely unexplored, approach of local curvilinear stencil transformation exhibited surprisingly favorable properties

Development of a database system for operational use in the selection of titanium alloys

NASA Astrophysics Data System (ADS)

Han, Yuan-Fei; Zeng, Wei-Dong; Sun, Yu; Zhao, Yong-Qing

2011-08-01

The selection of titanium alloys has become a complex decision-making task due to the growing number of creation and utilization for titanium alloys, with each having its own characteristics, advantages, and limitations. In choosing the most appropriate titanium alloys, it is very essential to offer a reasonable and intelligent service for technical engineers. One possible solution of this problem is to develop a database system (DS) to help retrieve rational proposals from different databases and information sources and analyze them to provide useful and explicit information. For this purpose, a design strategy of the fuzzy set theory is proposed, and a distributed database system is developed. Through ranking of the candidate titanium alloys, the most suitable material is determined. It is found that the selection results are in good agreement with the practical situation.

Ionic liquid-functionalized carbon nanoparticles-modified cathode for efficiency enhancement in polymer solar cells

NASA Astrophysics Data System (ADS)

Chen, Xiaohong; Yang, Jiaxiang; Lu, Jiong; Manga, Kiran Kumar; Loh, Kian Ping; Zhu, Furong

2009-09-01

The power conversion efficiency (PCE) of regioregular poly(3-hexylthiophene) (P3HT) and {6,6}-phenyl C61-butyric acid methylester (PCBM)-based polymer solar cells was increased using an ionic liquid-functionalized carbon nanoparticles (ILCNs) thin film-modified cathode. The PCE of P3HT:PCBM based-polymer solar cells with a conventional aluminum (Al)-only cathode was increased by 20%-30% when the identical devices were made with an ILCNs-modified Al cathode, but its PCE was 10% lower than that of devices with LiF/Al cathode, measured under AM1.5G illumination of 100 mW/cm2. The ILCN interlayer approach, however, offers practical advantages to LiF in terms of its solution-processability, which is compatible with low cost, large area, and flexible solar cell fabrication.

User Privacy in RFID Networks

NASA Astrophysics Data System (ADS)

Singelée, Dave; Seys, Stefaan

Wireless RFID networks are getting deployed at a rapid pace and have already entered the public space on a massive scale: public transport cards, the biometric passport, office ID tokens, customer loyalty cards, etc. Although RFID technology offers interesting services to customers and retailers, it could also endanger the privacy of the end-users. The lack of protection mechanisms being deployed could potentially result in a privacy leakage of personal data. Furthermore, there is the emerging threat of location privacy. In this paper, we will show some practical attack scenarios and illustrates some of them with cases that have received press coverage. We will present the main challenges of enhancing privacy in RFID networks and evaluate some solutions proposed in literature. The main advantages and shortcomings will be briefly discussed. Finally, we will give an overview of some academic and industrial research initiatives on RFID privacy.

A synthetic polymer system with repeatable chemical recyclability

NASA Astrophysics Data System (ADS)

Zhu, Jian-Bo; Watson, Eli M.; Tang, Jing; Chen, Eugene Y.-X.

2018-04-01

The development of chemically recyclable polymers offers a solution to the end-of-use issue of polymeric materials and provides a closed-loop approach toward a circular materials economy. However, polymers that can be easily and selectively depolymerized back to monomers typically require low-temperature polymerization methods and also lack physical properties and mechanical strengths required for practical uses. We introduce a polymer system based on γ-butyrolactone (GBL) with a trans-ring fusion at the α and β positions. Such trans-ring fusion renders the commonly considered as nonpolymerizable GBL ring readily polymerizable at room temperature under solvent-free conditions to yield a high–molecular weight polymer. The polymer has enhanced thermostability and can be repeatedly and quantitatively recycled back to its monomer by thermolysis or chemolysis. Mixing of the two enantiomers of the polymer generates a highly crystalline supramolecular stereocomplex.

Privacy enhancing techniques - the key to secure communication and management of clinical and genomic data.

PubMed

De Moor, G J E; Claerhout, B; De Meyer, F

2003-01-01

To introduce some of the privacy protection problems related to genomics based medicine and to highlight the relevance of Trusted Third Parties (TTPs) and of Privacy Enhancing Techniques (PETs) in the restricted context of clinical research and statistics. Practical approaches based on two different pseudonymisation models, both for batch and interactive data collection and exchange, are described and analysed. The growing need of managing both clinical and genetic data raises important legal and ethical challenges. Protecting human rights in the realm of privacy, while optimising research potential and other statistical activities is a challenge that can easily be overcome with the assistance of a trust service provider offering advanced privacy enabling/enhancing solutions. As such, the use of pseudonymisation and other innovative Privacy Enhancing Techniques can unlock valuable data sources.

Communication Matters: Exploring the Intersection of Family and Practitioner End of Life Communication

PubMed Central

Omilion-Hodges, Leah M.; Swords, Nathan M.

2017-01-01

After establishing a baseline understanding of some of the factors that influence and shape family end of life communication, empirical research centered on the communication tendencies of nationally-recognized palliative care clinicians is presented. Because death is no longer confined to the bedroom and individuals are increasingly turning to hospitals and health care institutes to assist with end of life, the role of palliative care practitioners is vital. To that end, common communication-rooted issues that may transpire among various medical personnel are explored. Focus on a shared underlying tension—care vs. cure—links the findings between family and palliative care clinician communication regarding end of life. Practical communication solutions and suggestions are offered to facilitate productive and mindful end of life communication between and among family members and health care practitioners. PMID:28335501

Communication Matters: Exploring the Intersection of Family and Practitioner End of Life Communication.

PubMed

Omilion-Hodges, Leah M; Swords, Nathan M

2017-03-19

After establishing a baseline understanding of some of the factors that influence and shape family end of life communication, empirical research centered on the communication tendencies of nationally-recognized palliative care clinicians is presented. Because death is no longer confined to the bedroom and individuals are increasingly turning to hospitals and health care institutes to assist with end of life, the role of palliative care practitioners is vital. To that end, common communication-rooted issues that may transpire among various medical personnel are explored. Focus on a shared underlying tension-care vs. cure-links the findings between family and palliative care clinician communication regarding end of life. Practical communication solutions and suggestions are offered to facilitate productive and mindful end of life communication between and among family members and health care practitioners.

Post-event debriefings during neonatal care: why are we not doing them, and how can we start?

PubMed

Sawyer, T; Loren, D; Halamek, L P

2016-06-01

Post-event debriefings are a foundational behavior of high performing teams. Despite the inherent value of post-event debriefings, the frequency with which they are used in neonatal care is extremely low. If post-event debriefings are so beneficial, why aren't they conducted more frequently? The reasons are many, but solutions are available. In this report, we provide practical advice on conducting post-event debriefing in neonatal care. In addition, we examine the perceived barriers to conducting post-event debriefings, and offer strategies to overcome them. Finally, we consider opportunities to foster a culture change within neonatal care which integrates debriefing as standard daily work. By establishing a safety culture in neonatal care that encourages and facilitates effective post-event debriefings, patient safety can be enhanced and clinical outcomes can be improved.

Development of integrated radioactive waste packaging and conditioning solutions in the UK

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

Sibley, Peter; Butter, Kevin; Zimmerman, Ian

2013-07-01

In order to offer a more cost effective, safer and efficient Intermediate Level Waste (ILW) management service, EnergySolutions EU Ltd. and Gesellschaft fur Nuklear-Service mbH (GNS) have been engaged in the development of integrated radioactive waste retrieval, packaging and conditioning solutions in the UK. Recognising the challenges surrounding regulatory endorsement and on-site implementation in particular, this has resulted in an alternative approach to meeting customer, safety regulator and disposability requirements. By working closely with waste producers and the organisation(s) responsible for endorsing radioactive waste management operations in the UK, our proposed solutions are now being implemented. By combining GNS' off-the-shelf,more » proven Ductile Cast Iron Containers (DCICs) and water removal technologies, with EnergySolutions EU Ltd.'s experience and expertise in waste retrieval, safety case development and disposability submissions, a fully integrated service offering has been developed. This has involved significant effort to overcome technical challenges such as onsite equipment deployment, active commissioning, conditioning success criteria and disposability acceptance. Our experience in developing such integrated solutions has highlighted the importance of working in collaboration with all parties to achieve a successful and viable outcome. Ultimately, the goal is to ensure reliable, safe and effective delivery of waste management solutions. (authors)« less

Interfaith Leaders as Social Entrepreneurs

ERIC Educational Resources Information Center

Patel, Eboo; Meyer, Cassie

2012-01-01

Social entrepreneurs work to find concrete solutions to large-scale problems that are scalable and sustainable. In this article, the authors explore what the framework of social entrepreneurship might offer those seeking to positively engage religious diversity on college campuses, and highlight two programs that offer examples of what such…

Anodizing And Sealing Aluminum In Nonchromated Solutions

NASA Technical Reports Server (NTRS)

Emmons, John R.; Kallenborn, Kelli J.

1995-01-01

Improved process for anodizing and sealing aluminum involves use of 5 volume percent sulfuric acid in water as anodizing solution, and 1.5 to 2.0 volume percent nickel acetate in water as sealing solution. Replaces process in which sulfuric acid used at concentrations of 10 to 20 percent. Improved process yields thinner coats offering resistance to corrosion, fatigue life, and alloy-to-alloy consistency equal to or superior to those of anodized coats produced with chromated solutions.

Privacy-preserving genome-wide association studies on cloud environment using fully homomorphic encryption

PubMed Central

2015-01-01

Objective Developed sequencing techniques are yielding large-scale genomic data at low cost. A genome-wide association study (GWAS) targeting genetic variations that are significantly associated with a particular disease offers great potential for medical improvement. However, subjects who volunteer their genomic data expose themselves to the risk of privacy invasion; these privacy concerns prevent efficient genomic data sharing. Our goal is to presents a cryptographic solution to this problem. Methods To maintain the privacy of subjects, we propose encryption of all genotype and phenotype data. To allow the cloud to perform meaningful computation in relation to the encrypted data, we use a fully homomorphic encryption scheme. Noting that we can evaluate typical statistics for GWAS from a frequency table, our solution evaluates frequency tables with encrypted genomic and clinical data as input. We propose to use a packing technique for efficient evaluation of these frequency tables. Results Our solution supports evaluation of the D′ measure of linkage disequilibrium, the Hardy-Weinberg Equilibrium, the χ2 test, etc. In this paper, we take χ2 test and linkage disequilibrium as examples and demonstrate how we can conduct these algorithms securely and efficiently in an outsourcing setting. We demonstrate with experimentation that secure outsourcing computation of one χ2 test with 10, 000 subjects requires about 35 ms and evaluation of one linkage disequilibrium with 10, 000 subjects requires about 80 ms. Conclusions With appropriate encoding and packing technique, cryptographic solutions based on fully homomorphic encryption for secure computations of GWAS can be practical. PMID:26732892

Circuit-based versus full-wave modelling of active microwave circuits

NASA Astrophysics Data System (ADS)

Bukvić, Branko; Ilić, Andjelija Ž.; Ilić, Milan M.

2018-03-01

Modern full-wave computational tools enable rigorous simulations of linear parts of complex microwave circuits within minutes, taking into account all physical electromagnetic (EM) phenomena. Non-linear components and other discrete elements of the hybrid microwave circuit are then easily added within the circuit simulator. This combined full-wave and circuit-based analysis is a must in the final stages of the circuit design, although initial designs and optimisations are still faster and more comfortably done completely in the circuit-based environment, which offers real-time solutions at the expense of accuracy. However, due to insufficient information and general lack of specific case studies, practitioners still struggle when choosing an appropriate analysis method, or a component model, because different choices lead to different solutions, often with uncertain accuracy and unexplained discrepancies arising between the simulations and measurements. We here design a reconfigurable power amplifier, as a case study, using both circuit-based solver and a full-wave EM solver. We compare numerical simulations with measurements on the manufactured prototypes, discussing the obtained differences, pointing out the importance of measured parameters de-embedding, appropriate modelling of discrete components and giving specific recipes for good modelling practices.

USM3D Simulations of Saturn V Plume Induced Flow Separation

NASA Technical Reports Server (NTRS)

Deere, Karen; Elmlilgui, Alaa; Abdol-Hamid, K. S.

2011-01-01

The NASA Constellation Program included the Ares V heavy lift cargo vehicle. During the design stage, engineers questioned if the Plume Induced Flow Separation (PIFS) that occurred along Saturn V rocket during moon missions at some flight conditions, would also plague the newly proposed rocket. Computational fluid dynamics (CFD) was offered as a tool for initiating the investigation of PIFS along the Ares V rocket. However, CFD best practice guidelines were not available for such an investigation. In an effort to establish a CFD process and define guidelines for Ares V powered simulations, the Saturn V vehicle was used because PIFS flight data existed. The ideal gas, computational flow solver USM3D was evaluated for its viability in computing PIFS along the Saturn V vehicle with F-1 engines firing. Solutions were computed at supersonic freestream conditions, zero degree angle of attack, zero degree sideslip, and at flight Reynolds numbers. The effects of solution sensitivity to grid refinement, turbulence models, and the engine boundary conditions on the predicted PIFS distance along the Saturn V were discussed and compared to flight data from the Apollo 11 mission AS-506.

A flexible approach to distributed data anonymization.

PubMed

Kohlmayer, Florian; Prasser, Fabian; Eckert, Claudia; Kuhn, Klaus A

2014-08-01

Sensitive biomedical data is often collected from distributed sources, involving different information systems and different organizational units. Local autonomy and legal reasons lead to the need of privacy preserving integration concepts. In this article, we focus on anonymization, which plays an important role for the re-use of clinical data and for the sharing of research data. We present a flexible solution for anonymizing distributed data in the semi-honest model. Prior to the anonymization procedure, an encrypted global view of the dataset is constructed by means of a secure multi-party computing (SMC) protocol. This global representation can then be anonymized. Our approach is not limited to specific anonymization algorithms but provides pre- and postprocessing for a broad spectrum of algorithms and many privacy criteria. We present an extensive analytical and experimental evaluation and discuss which types of methods and criteria are supported. Our prototype demonstrates the approach by implementing k-anonymity, ℓ-diversity, t-closeness and δ-presence with a globally optimal de-identification method in horizontally and vertically distributed setups. The experiments show that our method provides highly competitive performance and offers a practical and flexible solution for anonymizing distributed biomedical datasets. Copyright © 2013 Elsevier Inc. All rights reserved.

The military health system: a community of solutions for medical education, health care delivery, and public health.

PubMed

Lennon, Robert P; Saguil, Aaron; Seehusen, Dean A; Reamy, Brian V; Stephens, Mark B

2013-01-01

Multiple strategies have been proposed to improve health care in the United States. These include the development of communities of solution (COSs), implementation of patient-centered medical homes (PCMHs), and lengthening family medicine residency training. There is scant literature on how to build and integrate these ideal models of care, and no literature about how to build a model of care integrating all 3 strategies is available. The Military Health System has adopted the PCMH model and will offer some 4-year family medicine residency positions starting in 2013. Lengthening residency training to 4 years represents an unprecedented opportunity to weave experiential COS instruction throughout a family physician's graduate medical education, providing future family physicians the skills needed to foster a COS in their future practice. This article describes our COS effort to synergize 3 aspects of modern military medicine: self-defined community populations, the transition to the PCMH model, and the initiation of the 4-year length of training pilot program in family medicine residency training. In this way we provide a starting point and general how-to guide that can be used to create a COS integrated with other current concepts in medicine.

A Hybrid Readout Solution for GaN-Based Detectors Using CMOS Technology.

PubMed

Padmanabhan, Preethi; Hancock, Bruce; Nikzad, Shouleh; Bell, L Douglas; Kroep, Kees; Charbon, Edoardo

2018-02-03

Gallium nitride (GaN) and its alloys are becoming preferred materials for ultraviolet (UV) detectors due to their wide bandgap and tailorable out-of-band cutoff from 3.4 eV to 6.2 eV. GaN based avalanche photodiodes (APDs) are particularly suitable for their high photon sensitivity and quantum efficiency in the UV region and for their inherent insensitivity to visible wavelengths. Challenges exist however for practical utilization. With growing interests in such photodetectors, hybrid readout solutions are becoming prevalent with CMOS technology being adopted for its maturity, scalability, and reliability. In this paper, we describe our approach to combine GaN APDs with a CMOS readout circuit, comprising of a linear array of 1 × 8 capacitive transimpedance amplifiers (CTIAs), implemented in a 0.35 µm high voltage CMOS technology. Further, we present a simple, yet sustainable circuit technique to allow operation of APDs under high reverse biases, up to ≈80 V with verified measurement results. The readout offers a conversion gain of 0.43 µV/e - , obtaining avalanche gains up to 10³. Several parameters of the CTIA are discussed followed by a perspective on possible hybridization, exploiting the advantages of a 3D-stacked technology.

Diameter Versus Mass in the Development of the Orion Life Support Umbilical: A Case Study in Systems Engineering

NASA Technical Reports Server (NTRS)

Jordan, Nicole; Falconi, Eric; Barido, Richard; Lewis, John

2009-01-01

Systems engineering could also be called the art of compromise. At its heart, systems engineering seeks to find that solution which maximizes the utility of the system, usually compromising the performance of each individual subsystem. While seemingly straightforward, systems engineering methodology is complicated when the utility to be maximized is unclear and the costs to each individual subsystem are not - or not easily - quantifiable. In this paper, we explore one such systems engineering problem within the Constellation Program as a case study in applied systems engineering. During suited operations, astronauts within Orion will be connected to an umbilical to receive and return breathing gas. The pressure drop associated with this umbilical must be overcome by the Orion vehicle. A smaller umbilical, which is desirable for crew operations, means a higher pressure drop, resulting in additional mass and power for the vehicle. We outline the technical considerations in the development of this integrated system and discuss the method by which we reached the ultimate solution. This paper, while just one example of the kind of problem solving that happens every day, offers insight into what happens when the theories of systems engineering are put into practice.

Social Return On Investment (SROI): Problems, solutions … and is SROI a good investment?

PubMed

Yates, Brian T; Marra, Mita

2017-10-01

The conclusion of this special issue on Social Return On Investment (SROI) begins with a summary of both advantages and problems of SROI, many of which were identified in preceding articles. We also offer potential solutions for some of these problems that can be derived from standard evaluation practices and that are becoming expected in SROIs that follow guidances from international SROI networks. A remaining concern about SROI is that we do not yet know if SROI itself adds sufficient benefit to programs to justify its cost. Two frameworks for this proposed metaevaluation of SROI are suggested, the first comparing benefits to costs summatively (the resource→outcome model). The second framework evaluates costs and benefits according to how much they contribute to or are caused by the different activities of SROI. This resource→activity→outcome model could enable outcomes of SROI to be maximized within resource constraints (such as budget and time limits) on SROI. Alternatively, information from this model could help minimize the costs of achieving a specific level of return on investment from conducting SROI. Possible problems with this metaevaluation of SROI are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

How to handle part-time, flex-time, and job-sharing employees.

PubMed

Sachs, L

2001-01-01

Offering employment structures other than traditional full-time positions in your practice can help you draw excellent job applicants and also can enable you to increase morale, job satisfaction, and productivity. However, there are many decisions you must make when offering a part-time, flex-time, or job-sharing position. This article explores the pros and cons of offering alternative job structures. It suggests ways to make part-time, flex-time, or job-sharing positions work most effectively, both for the employee and for your practice. In addition, this article suggests which positions are best suited to alternative structures.

The case for workforce development in social marketing.

PubMed

Pounds, Lea

2016-01-01

The Centers for Disease Control and Prevention, Association of Schools and Programs of Public Health, and the Council on Linkages Between Academia and Public Health Practice have emphasized the increasing need to train the public health workforce in social marketing. With only 21 U.S. academic institutions offering course work in social marketing and only four institutions offering degrees in social marketing there is a gap between what academic institutions are offering and these recommendations (Kelly, 2013 ). The successful application of social marketing in public health practice relies on academic institutions creating and promoting social marketing-related programs.

Maximizing the Range of a Projectile.

ERIC Educational Resources Information Center

Brown, Ronald A.

1992-01-01

Discusses solutions to the problem of maximizing the range of a projectile. Presents three references that solve the problem with and without the use of calculus. Offers a fourth solution suitable for introductory physics courses that relies more on trigonometry and the geometry of the problem. (MDH)

Classroom Acoustics: The Problem, Impact, and Solution.

ERIC Educational Resources Information Center

Berg, Frederick S.; And Others

1996-01-01

This article describes aspects of classroom acoustics that interfere with the ability of listeners to understand speech. It considers impacts on students and teachers and offers four possible solutions: noise control, signal control without amplification, individual amplification systems, and sound field amplification systems. (Author/DB)

Library Systems: Current Developments and Future Directions.

ERIC Educational Resources Information Center

Healy, Leigh Watson

This report was commissioned in response to concerns expressed about the gap between institutional digital library initiatives and the products offered by library systems vendors. The study analyzes from the perspective of libraries the strategies, visions, and products that vendors of integrated library systems are offering as solutions. Case…

Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System

PubMed Central

2015-01-01

The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations, continuing education providers, and app developers. PMID:26543907

What do we think we are doing? How might a clinical information network be promoting implementation of recommended paediatric care practices in Kenyan hospitals?

PubMed

English, Mike; Ayieko, Philip; Nyamai, Rachel; Were, Fred; Githanga, David; Irimu, Grace

2017-02-02

The creation of a clinical network was proposed as a means to promote implementation of a set of recommended clinical practices targeting inpatient paediatric care in Kenya. The rationale for selecting a network as a strategy has been previously described. Here, we aim to describe network activities actually conducted over its first 2.5 years, deconstruct its implementation into specific components and provide our 'insider' interpretation of how the network is functioning as an intervention. We articulate key activities that together have constituted network processes over 2.5 years and then utilise a recently published typology of implementation components to give greater granularity to this description from the perspective of those delivering the intervention. Using the Behaviour Change Wheel we then suggest how the network may operate to achieve change and offer examples of change before making an effort to synthesise our understanding in the form of a realist context-mechanism-outcome configuration. We suggest our network is likely to comprise 22 from a total of 73 identifiable intervention components, of which 12 and 10 we consider major and minor components, respectively. At the policy level, we employed clinical guidelines, marketing and communication strategies with intervention characteristics operating through incentivisation, persuasion, education, enablement, modelling and environmental restructuring. These might influence behaviours by enhancing psychological capability, creating social opportunity and increasing motivation largely through a reflective pathway. We previously proposed a clinical network as a solution to challenges implementing recommended practices in Kenyan hospitals based on our understanding of theory and context. Here, we report how we have enacted what was proposed and use a recent typology to deconstruct the intervention into its elements and articulate how we think the network may produce change. We offer a more generalised statement of our theory of change in a context-mechanism-outcome configuration. We hope this will complement a planned independent evaluation of 'how things work', will help others interpret results of change reported more formally in the future and encourage others to consider further examination of networks as means to scale up improvement practices in health in lower income countries.

Optical wireless applications: a solution to ease the wireless airwaves spectrum crunch

NASA Astrophysics Data System (ADS)

Kavehrad, M.

2013-01-01

Demands by the communications industry for greater and greater bandwidth push the capability of conventional wireless technology. Part of the Radio Spectrum that is suitable for mobility is very limited. Higher frequency waves above 30 GHz tend to travel only a few miles or less and generally do not penetrate solid materials very well. This offers a sustainable solution for the current Spectrum Crunch in the lower microwave bands. One mission of this paper is to demonstrate practical and usable networks that can select a self-limiting link distance, allowing spectrum reuse. The motivation for operators of such bands to actually choose to self-limit is that by doing so, they improve the signal-tonoise against competing users at a lower cost than trying to overcome interference. These characteristics of wave propagation are not necessarily disadvantageous as they enable more densely packed communications links. Thus, high frequencies can provide very efficient spectrum utilization through "selective spectrum reuse", and naturally increase the security of transmissions. Optical systems and networks offer a far greater bandwidth. This means new devices and systems have to be developed. Semiconductor Light Emitting Diode (LED) is considered to be the future primary lighting source for buildings, automobiles and aircrafts. LED provides higher energy efficiency compared to incandescent and fluorescent light sources and it will play a major role in the global reduction of carbon dioxide emissions, as a consequence of the significant energy savings. Lasers are also under investigation for similar applications. These core devices have the potential to revolutionize how we use light, including not only for illumination, but as well; for communications, sensing, navigation, positioning, surveillance, and imaging.

FireFly: reconfigurable optical wireless networking data centers

NASA Astrophysics Data System (ADS)

Kavehrad, Mohsen; Deng, Peng; Gupta, H.; Longtin, J.; Das, S. R.; Sekar, V.

2017-01-01

We explore a novel, free-space optics based approach for building data center interconnects. Data centers (DCs) are a critical piece of today's networked applications in both private and public sectors. The key factors that have driven this trend are economies of scale, reduced management costs, better utilization of hardware via statistical multiplexing, and the ability to elastically scale applications in response to changing workload patterns. A robust DC network fabric is fundamental to the success of DCs and to ensure that the network does not become a bottleneck for high-performance applications. In this context, DC network design must satisfy several goals: high performance (e.g., high throughput and low latency), low equipment and management cost, robustness to dynamic traffic patterns, incremental expandability to add new servers or racks, and other practical concerns such as cabling complexity, and power and cooling costs. Current DC network architectures do not seem to provide a satisfactory solution, with respect to the above requirements. In particular, traditional static (wired) networks are either overprovisioned or oversubscribed. Recent works have tried to overcome the above limitations by augmenting a static (wired) "core" with some flexible links (RF-wireless or optical). These augmented architectures show promise, but offer only incremental improvement in performance. Specifically, RFwireless based augmented solutions also offer only limited performance improvement, due to inherent interference and range constraints of RF links. This paper explores an alternative design point—a fully flexible and all-wireless DC interrack network based on free-space optical (FSO) links. We call this FireFly as in; Free-space optical Inter-Rack nEtwork with high FLexibilitY. We will present our designs and tests using various configurations that can help the performance and reliability of the FSO links.

MARSOL: Demonstrating Managed Aquifer Recharge as a Solution to Water Scarcity and Drought

NASA Astrophysics Data System (ADS)

Schueth, Christoph

2014-05-01

Southern Europe and the Mediterranean region are facing the challenge of managing its water resources under conditions of increasing scarcity and concerns about water quality. Already, the availability of fresh water in sufficient quality and quantity is one of the major factors limiting socio economic development. Innovative water management strategies such as the storage of reclaimed water or excess water from different sources in Managed Aquifer Recharge (MAR) schemes can greatly increase water availability and therefore improve water security. Main objective of the proposed project MARSOL is to demonstrate that MAR is a sound, safe and sustainable strategy that can be applied with great confidence and therefore offering a key approach for tackling water scarcity in Southern Europe. For this, eight field sites were selected that will demonstrate the applicability of MAR using various water sources, ranging from treated wastewater to desalinated seawater, and a variety of technical solutions. Targets are the alleviation of the effect of climate change on water resources, the mitigation of droughts, to countermeasure temporal and spatial misfit of water availability, to sustain agricultural water supply and rural socio-economic development, to combat agricultural related pollutants, to sustain future urban and industrial water supply and to limit seawater intrusion in coastal aquifers. Results of the demonstration sites will be used to develop guidelines for MAR site selection, technical realization, monitoring strategies, and modeling approaches, to offer stakeholders a comprehensive, state of the art and proven toolbox for MAR implementation. Further, the economic and legal aspects of MAR will be analyzed to enable and accelerate market penetration. The MARSOL consortium combines the expertise of consultancies, water suppliers, research institutions, and public authorities, ensuring high practical relevance and market intimacy.

MARSOL: Demonstrating Managed Aquifer Recharge as a Solution to Water Scarcity and Drought

NASA Astrophysics Data System (ADS)

Kurtzman, D.; Schüth, C.; Kallioras, A.; Rossetto, R.; Lobo-Ferreira, J.; Escalante, E.; Sanchez-Vila, X.; Foglia, L.

2013-12-01

Southern Europe and the Mediterranean region are facing the challenge of managing its water resources under conditions of increasing scarcity and concerns about water quality. Already, the availability of fresh water in sufficient quality and quantity is one of the major factors limiting socio-economic development. Innovative water management strategies such as the storage of reclaimed water or excess water from different sources in Managed Aquifer Recharge (MAR) schemes can greatly increase water availability and therefore improve water security. Main objective of the proposed project MARSOL is to demonstrate that MAR is a sound, safe and sustainable strategy that can be applied with great confidence and therefore offering a key approach for tackling water scarcity in Southern Europe. For this, eight field sites were selected that will demonstrate the applicability of MAR using various water sources, ranging from treated wastewater to desalinated seawater, and a variety of technical solutions. Targets are the alleviation of the effect of climate change on water resources, the mitigation of droughts, to countermeasure temporal and spatial misfit of water availability, to sustain agricultural water supply and rural socio-economic development, to combat agricultural related pollutants, to sustain future urban and industrial water supply and to limit seawater intrusion in coastal aquifers. Results of the demonstration sites will be used to develop guidelines for MAR site selection, technical realization, monitoring strategies, and modeling approaches, to offer stakeholders a comprehensive, state of the art and proven toolbox for MAR implementation. Further, the economic and legal aspects of MAR will be analyzed to enable and accelerate market penetration. The MARSOL consortium combines the expertise of consultancies, water suppliers, research institutions, and public authorities, ensuring high practical relevance and market intimacy.

Practical solution concepts for planning and designing roadways in Kentucky.

DOT National Transportation Integrated Search

2008-10-01

Kentucky's highway agency has embarked upon an initiative tagged "Practical Solutions" which sets its goal toward reducing costs throughout the project development process extended into operations and maintenance of all highway facilities. This study...

Workplace etiquette for the medical practice employee.

PubMed

Hills, Laura

2010-01-01

Medical practice workplace etiquette is slowly being modified and fine-tuned. New workplace etiquette rules have become necessary because of advances in communications technology, shifting norms, and expectations of what constitutes good manners. Today's medical practice employees must concern themselves with traditional workplace manners but also the manners that come into play when they make or receive cell phone calls, text messages, and e-mails, and when they use social networking media outside of work. This article offers 25 rules for good manners in the medical practice that relate to the ways employees interact with people today, whether face-to-face or when using electronic communications technologies. It offers practical guidelines for making introductions both inside and outside the medical practice. This article also provides a self-quiz to help medical practice employees assess their workplace etiquette intelligence and 12 tips for good workplace table manners.

Smart energy management system

NASA Astrophysics Data System (ADS)

Desai, Aniruddha; Singh, Jugdutt

2010-04-01

Peak and average energy usage in domestic and industrial environments is growing rapidly and absence of detailed energy consumption metrics is making systematic reduction of energy usage very difficult. Smart energy management system aims at providing a cost-effective solution for managing soaring energy consumption and its impact on green house gas emissions and climate change. The solution is based on seamless integration of existing wired and wireless communication technologies combined with smart context-aware software which offers a complete solution for automation of energy measurement and device control. The persuasive software presents users with easy-to-assimilate visual cues identifying problem areas and time periods and encourages a behavioural change to conserve energy. The system allows analysis of real-time/statistical consumption data with the ability to drill down into detailed analysis of power consumption, CO2 emissions and cost. The system generates intelligent projections and suggests potential methods (e.g. reducing standby, tuning heating/cooling temperature, etc.) of reducing energy consumption. The user interface is accessible using web enabled devices such as PDAs, PCs, etc. or using SMS, email, and instant messaging. Successful real-world trial of the system has demonstrated the potential to save 20 to 30% energy consumption on an average. Low cost of deployment and the ability to easily manage consumption from various web enabled devices offers gives this system a high penetration and impact capability offering a sustainable solution to act on climate change today.

CERN’s AFS replacement project

NASA Astrophysics Data System (ADS)

Iven, J.; Lamanna, M.; Pace, A.

2017-10-01

OpenAFS is the legacy solution for a variety of use cases at CERN, most notably home-directory services. OpenAFS has been used as the primary shared file-system for Linux (and other) clients for more than 20 years, but despite an excellent track record, the project’s age and architectural limitations are becoming more evident. We are now working to offer an alternative solution based on existing CERN storage services. The new solution will offer evolved functionality, and is expected to eventually benefit from operational synergies. In this paper we will present CERN’s usage and an analysis of our technical choices: we will focus on the alternatives chosen for the various use cases (among them EOS, CERNBox and CASTOR); on implementing the migration process over the coming years; and the challenges and opportunities of the migration.

Physical activity practices in elementary schools and associations with physical education staffing and training.

PubMed

Turner, Lindsey; Johnson, Tyler G; Slater, Sandy J; Chaloupka, Frank J

2014-12-01

Authorities recommend that schools provide a variety of opportunities for students to obtain physical activity (PA) before, during, and after school. This study assessed the prevalence of several school PA practices-including measures of quantity and quality of physical education (PE)-in elementary schools and examined the associations of PA practices with school resources (PE staffing, training, and facilities). Surveys were obtained from respondents in nationally representative samples of elementary schools from 2009-2010 to 2011-2012 (1,831 schools). Few schools (20.8%) provided students with PE class every day, but most (76.3%) had an appropriate PE student-to-teacher ratio ( ≤ 25:1). Many schools (74.0%) offered 20 min of recess daily, but fewer than half offered organized opportunities for PA before or after school (e.g., sports). After controlling for demographics and school size, having a full-time PE teacher and requiring PE teachers to obtain PE-related continuing education (CE) were associated with PE practices such as offering ≥ 150 min of PE per week (for 3rd-grade students) and testing PE knowledge, skills, and fitness. Required CE was also associated with a higher likelihood of offering PA during the school day (i.e., activity breaks and PA outside of PE class) and before or after the school day (i.e., afterschool PA programs). Few schools offer a broad array of PA programming. However, PE staffing and CE are positively associated with many PA practices including those outside of PE, possibly indicating that PE staff serve a crucial role in promoting a whole-school PA-supportive environment.

RETHINKING ACTIVE LEARNING AS A PARADIGM OF OUR TIMES: TOWARDS POETICIZING AND HUMANIZING NATURAL SCIENCES IN THE AGE OF STEM

PubMed Central

Uskoković, Vuk

2018-01-01

Though practiced since ancient times, active learning has emerged as the dominant educational paradigm in the 1990s. Methodologically, it is more suitable to teach critical thinking skills compared to the classical lecturing approach. On the other hand, most university settings, including those focusing heavily on STEM (Science-Engineering-Technology-Mathematics), have embraced it unreservedly, offering no forums to analyze its pros and cons and thus provide conditions for its progress. This constitutes a fundamental paradox. In this essay, specific drawbacks associated with the practical applications of this educational paradigm are discussed. They include the promotion of mediocrity through classroom “democratization”; the suppression of solitary reflections and introspectiveness, along with the creative potentials associated therewith; the inhibition of extraordinariness through excessive teamwork; and the incompatibility with the dominant learning assessment strategies. It is argued that the absorption of ideas stemming from domains distant from pedagogy and one’s field of research are needed to revitalize the current state of active learning practice. Proposed solutions include the revival of the magic of live lecturing through training teachers in spoken poetry and performance arts; integrating research projects into teaching time; and restructuring the concept of the classroom toward a space and context more reflective of life and more conducive to the learning experience. Continued discussion over the weaknesses of active learning practices are needed to ensure the unhindered progress of this teaching methodology that is currently unrivaled in its popularity and prospect. PMID:29899595

The Community Preceptor Crisis: Recruiting and Retaining Community-Based Faculty to Teach Medical Students-A Shared Perspective From the Alliance for Clinical Education.

PubMed

Christner, Jennifer G; Dallaghan, Gary Beck; Briscoe, Gregory; Casey, Petra; Fincher, Ruth Marie E; Manfred, Lynn M; Margo, Katherine I; Muscarella, Peter; Richardson, Joshua E; Safdieh, Joseph; Steiner, Beat D

2016-01-01

Community-based instruction is invaluable to medical students, as it provides "real-world" opportunities for observing and following patients over time while refining history taking, physical examination, differential diagnosis, and patient management skills. Community-based ambulatory settings can be more conducive to practicing these skills than highly specialized, academically based practice sites. The Association of American Medical Colleges and other national medical education organizations have expressed concern about recruitment and retention of preceptors to provide high-quality educational experiences in community-based practice sites. These concerns stem from constraints imposed by documentation in electronic health records; perceptions that student mentoring is burdensome resulting in decreased clinical productivity; and competition between allopathic, osteopathic, and international medical schools for finite resources for medical student experiences. In this Alliance for Clinical Education position statement, we provide a consensus summary of representatives from national medical education organizations in 8 specialties that offer clinical clerkships. We describe the current challenges in providing medical students with adequate community-based instruction and propose potential solutions. Our recommendations are designed to assist clerkship directors and medical school leaders overcome current challenges and ensure high-quality, community-based clinical learning opportunities for all students. They include suggesting ways to orient community clinic sites for students, explaining how students can add value to the preceptor's practice, focusing on educator skills development, recognizing preceptors who excel in their role as educators, and suggesting forms of compensation.

The Coastal Resilience Index: High School Students Planning for Their Community's Future

NASA Astrophysics Data System (ADS)

Kastler, J. A.; Dorcik, S.; Sempier, T.; Kimbrell, C.

2017-12-01

Communities in Jackson County, Mississippi sustained heavy damages during Hurricane Katrina in 2005 and are expected to experience early effects as sea level rise and increasing episodes of nuisance flooding. Many high school students still remember months-long evacuations and other disruptions to home and family in 2005. Others do not remember or moved here recently. None anticipate their communities are likely to face similar challenges in the future, nor do they have a strong understanding that preparing for such an event is a practical, local career choice for a science major. Through a series of classroom and field lessons, students in two coastal communities learned how and why coastal habitats are changing, and how modeling predicts future impacts. During a culminating experience students learn how to use the Coastal Resilience Index developed by Mississippi Alabama Sea Grant Consortium. Working in teams or three to four students, the students addressed one of twelve scenarios based on real experiences observed by Gulf Coast communities during their post-hurricane assessments. Each team explored its topic using internet resources and conversations with family members, then worked together to brainstorm possible approaches to address the situation described in their scenario. They selected one potential solution for their focus and developed it, ultimately producing a poster of the scenario and their idea of its solution. The teams gathered at the University of Southern Mississippi at the end of the term to present their work, science fair style, to a selection of community leaders from the Climate Community of Practice. Posters were judged and best poster presentations were awarded. This talk will focus on the evaluation results. Existing qualitative observations show differences in awareness and self-efficacy to work productively in this field. Community leaders expressed interest in the solutions offered. Ongoing quantitative evaluations will also be introduced. This is one focus of a multi-dimensional Meaningful Watershed Educational Experience sponsored by NOAA's B-WET Program.

Dentists' self-perceived role in offering tobacco cessation services: results from a nationally representative survey, United States, 2010-2011.

PubMed

Jannat-Khah, Deanna P; McNeely, Jennifer; Pereyra, Margaret R; Parish, Carrigan; Pollack, Harold A; Ostroff, Jamie; Metsch, Lisa; Shelley, Donna R

2014-11-06

Dental visits represent an opportunity to identify and help patients quit smoking, yet dental settings remain an untapped venue for treatment of tobacco dependence. The purpose of this analysis was to assess factors that may influence patterns of tobacco-use-related practice among a national sample of dental providers. We surveyed a representative sample of general dentists practicing in the United States (N = 1,802). Multivariable analysis was used to assess correlates of adherence to tobacco use treatment guidelines and to analyze factors that influence providers' willingness to offer tobacco cessation assistance if reimbursed for this service. More than 90% of dental providers reported that they routinely ask patients about tobacco use, 76% counsel patients, and 45% routinely offer cessation assistance, defined as referring patients for cessation counseling, providing a cessation prescription, or both. Results from multivariable analysis indicated that cessation assistance was associated with having a practice with 1 or more hygienists, having a chart system that includes a tobacco use question, having received training on treating tobacco dependence, and having positive attitudes toward treating tobacco use. Providers who did not offer assistance but who reported that they would change their practice patterns if sufficiently reimbursed were more likely to be in a group practice, treat patients insured through Medicaid, and have positive attitudes toward treating tobacco dependence. Findings indicate the potential benefit of increasing training opportunities and promoting system changes to increase involvement of dental providers in conducting tobacco use treatment. Reimbursement models should be tested to assess the effect on dental provider practice patterns.

On one solution of Volterra integral equations of second kind

NASA Astrophysics Data System (ADS)

Myrhorod, V.; Hvozdeva, I.

2016-10-01

A solution of Volterra integral equations of the second kind with separable and difference kernels based on solutions of corresponding equations linking the kernel and resolvent is suggested. On the basis of a discrete functions class, the equations linking the kernel and resolvent are obtained and the methods of their analytical solutions are proposed. A mathematical model of the gas-turbine engine state modification processes in the form of Volterra integral equation of the second kind with separable kernel is offered.

A theoretical approach to dual practice regulations in the health sector.

PubMed

González, Paula; Macho-Stadler, Inés

2013-01-01

Internationally, there is wide cross-country heterogeneity in government responses to dual practice in the health sector. This paper provides a uniform theoretical framework to analyze and compare some of the most common regulations. We focus on three interventions: banning dual practice, offering rewarding contracts to public physicians, and limiting dual practice (including both limits to private earnings of dual providers and limits to involvement in private activities). An ancillary objective of the paper is to investigate whether regulations that are optimal for developed countries are adequate for developing countries as well. Our results offer theoretical support for the desirability of different regulations in different economic environments. Copyright © 2012 Elsevier B.V. All rights reserved.

Preferred Tone of Nutrition Text Messages for Young Adults: Focus Group Testing

PubMed Central

2016-01-01

Background Young adults are a particularly hard to reach group using conventional health promotion practices as they do not see nutrition messages as personally relevant to them. Text messaging (short message service, SMS) offers an innovative approach to reaching young adults to support and promote dietary behavior change. Objective The aim of this study was to develop and test tonal preferences for nutrition text messages among young adults using focus groups. Methods A total of 39 young adults aged 18-30 years residing in Perth, Western Australia participated in four focus groups. Participants briefly discussed their perception of healthy eating and their responses to messages about increasing fruit and vegetables, and reducing “junk food” and alcohol intake. They ranked their preference for 15 nutrition messages across 3 dietary behaviors (fruit and vegetables, junk food, and alcohol) with 5 different message tones (authoritative, empathetic, generation Y, solutions, and substitutions) and identified the messages most likely to persuade young adults to change their diet. A 5-point ranking of the nutrition messages was from the most likely to least likely to persuade (1-5). The focus groups were conducted by a trained facilitator and observer and were recorded. Data driven content analysis was used to explore themes. Tonal preferences and potential motivators were collated and frequencies presented. Results Participants ranked offering substitutes (29%, 11/39) and using empathy (22%, 9/39) as the most persuasive message techniques in improving diets of young adults, with low responses for Generation Y (17%, 7/39), solutions (17%, 7/39), and authoritative (15%, 6/39) tones. Females were more likely to consider substitution messages persuasive (35%, 7/20) compared with males (22%, 4/19). A greater proportion of males compared with females considered authoritative messages persuasive: (22%, 4/19) compared with (7%, 1/20). There is a strong preference for a substitution tone for fruit and vegetable messages (52%, 20/39), and no overall message tone preference for junk food and alcohol messages. Substitutions were viewed as helpful and practical. Empathy was liked as it acknowledged previous efforts. Responses to authoritative tone were mixed with some feeling guilt while others found them informative. Acceptability of the solutions depended on the behavioral change and acceptability of the solution proposed. Generation Y tone had some support for junk food and alcohol messages, and if favored, was considered casual, humorous, catchy, and motivational. Conclusions Substitutions and tone of empathy were favored as the most likely execution styles to motivate nutrition behavior change across all participants. There is no “one size fits all” with different tones preferred by individuals for different dietary behaviors. Although text messaging provides instant message delivery direct to the individual, these results demonstrate the complexity of developing motivational nutrition message for young adults. These findings reveal the importance of considering the tone and content and pretesting messages for health promotion text message interventions. PMID:26787115

21 CFR 1316.60 - Objections; offer of proof.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Objections; offer of proof. 1316.60 Section 1316.60 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES Administrative Hearings § 1316.60 Objections; offer of proof. If any party in the...

ATLAS computing on Swiss Cloud SWITCHengines

NASA Astrophysics Data System (ADS)

Haug, S.; Sciacca, F. G.; ATLAS Collaboration

2017-10-01

Consolidation towards more computing at flat budgets beyond what pure chip technology can offer, is a requirement for the full scientific exploitation of the future data from the Large Hadron Collider at CERN in Geneva. One consolidation measure is to exploit cloud infrastructures whenever they are financially competitive. We report on the technical solutions and the performances used and achieved running simulation tasks for the ATLAS experiment on SWITCHengines. SWITCHengines is a new infrastructure as a service offered to Swiss academia by the National Research and Education Network SWITCH. While solutions and performances are general, financial considerations and policies, on which we also report, are country specific.